Human reproduction openPub Date : 2023-10-09eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad038
C De Geyter, L Matt, I De Geyter, R Moffat, C Meier
{"title":"In infertile women with subclinical hypothyroidism, with or without thyroid peroxidase antibodies, serum TSH during pregnancy follows preconception values and thyroid hormones remain stable.","authors":"C De Geyter, L Matt, I De Geyter, R Moffat, C Meier","doi":"10.1093/hropen/hoad038","DOIUrl":"10.1093/hropen/hoad038","url":null,"abstract":"<p><strong>Study question: </strong>How does subclinical hypothyroidism, defined in infertile women during preconception by thyroid-stimulating hormone (TSH) >2.5 or >4.5 mIU/l, with or without thyroid peroxidase antibodies (anti-TPO) >100 IU/ml, impact thyroid hormone levels during pregnancy and after birth?</p><p><strong>Summary answer: </strong>During pregnancy, TSH levels remain similar to those in preconception, even with supplementary thyroxine, whereas the serum levels of anti-TPO progressively decline.</p><p><strong>What is known already: </strong>Overt hypothyroidism impacts both pregnancy and offspring but randomized clinical trials and cohort studies failed to detect the benefit of treatment with thyroxine in cases with low-threshold TSH or with anti-TPO during pregnancy.</p><p><strong>Study design size duration: </strong>First, the prevalence and reproducibility of two candidate cut-off levels of subclinical hypothyroidism in a cohort of 177 infertile women was compared with 171 women not aiming for pregnancy. Second, the impact of distinct setpoints of TSH in preconception (with or without anti-TPO) was monitored during pregnancy in 87 previously infertile women by high-frequency monitoring of thyroid function. Both studies were carried out from 2007 to 2019.</p><p><strong>Participants/materials setting methods: </strong>Reproducibility and prevalence of subclinical hypothyroidism were examined in infertile women presenting in the fertility care unit of an academic institution. Women not aiming for pregnancy participated as controls. In both groups, TSH and anti-TPO were measured two times on different occasions. In addition, a group of previously infertile women with known preconception setpoints of TSH (with or without anti-TPO) were followed up prospectively throughout pregnancy and after birth. During pregnancy, serum was sampled weekly until Week 12, then monthly until delivery, and once after birth. Only cases with preconception TSH >4.5 mIU/l were supplemented with thyroxine. After collection of all samples, the serum levels of anti-TPO and the major thyroid hormones were measured. Prolactin with known fluctuations during pregnancy was used as reference.</p><p><strong>Main results and the role of chance: </strong>Measures of both TSH and anti-TPO at two different time points were accurate and reproducible. The odds of subclinical hypothyroidism in infertile women and controls were similar. During pregnancy, TSH closely followed preconception TSH levels, whereas serum levels of the thyroid hormones predominantly remained within or above (not below) the reference. Treatment of infertile women with preconception TSH >4.5 mIU/l with thyroxine resulted in higher free thyroxine (fT4) serum levels. The serum levels of anti-TPO declined as pregnancies evolved.</p><p><strong>Limitations reasons for caution: </strong>The numbers of participants both in the prevalence study and in pregnancy did not reach the <i>a priori</i> estimated num","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad038"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-09-22eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad037
S Makieva, M K Sachs, M Xie, A Velasco, S El-Hadad, D R Kalaitzopoulos, I Dedes, R Stiller, B Leeners
{"title":"Double vitrification and warming does not compromise the chance of live birth after single unbiopsied blastocyst transfer.","authors":"S Makieva, M K Sachs, M Xie, A Velasco, S El-Hadad, D R Kalaitzopoulos, I Dedes, R Stiller, B Leeners","doi":"10.1093/hropen/hoad037","DOIUrl":"10.1093/hropen/hoad037","url":null,"abstract":"<p><strong>Study question: </strong>Does double vitrification and thawing of an embryo compromise the chance of live birth after a single blastocyst transfer?</p><p><strong>Summary answer: </strong>The live birth rate (LBR) obtained after double vitrification was comparable to that obtained after single vitrification.</p><p><strong>What is known already: </strong>Double vitrification-warming (DVW) is commonly practiced to accommodate surplus viable embryos suitable for transfer, to allow retesting of inconclusively diagnosed blastocysts in preimplantation genetic testing (PGT), and to circumvent limitations associated with national policies on embryo culture in certain countries. Despite its popularity, the evidence concerning the impact of DVW practice on ART outcomes is limited and lacking credibility. This is the first thorough investigation of clinical pregnancy and LBR following DVW in the case where the first round of vitrification occurred at the zygote stage and the second round occurred at the blastocyst stage in the absence of biopsy.</p><p><strong>Study design size duration: </strong>This is a retrospective observational analysis of n = 407 single blastocyst transfers whereby embryos created by IVF/ICSI were vitrified-warmed once (single vitrification-warming (SVW) n = 310) or twice (DVW, n = 97) between January 2017 and December 2021.</p><p><strong>Participants/materials setting methods: </strong>In the SVW group, blastocysts were vitrified on Day 5/6 and warmed on the day of embryo transfer (ET). In the DVW group, two pronuclear (2PN) zygotes were first vitrified-warmed and then re-vitrified on Day 5/6 and warmed on the day of ET. Exclusion criteria were ETs from PGT and vitrified-warmed oocyte cycles. All of the ETs were single blastocyst transfers performed at the University Hospital Zurich in Switzerland following natural or artificial endometrial preparation.</p><p><strong>Main results and the role of chance: </strong>The biochemical pregnancy rate, clinical pregnancy rate (CPR), and LBR were all comparable between the DVW and SVW groups. The CPR for DVW was 44.3% and for SVW it was 42.3% (<i>P</i> = 0.719). The LBR for DVW was 30.9% and for SVW it was 28.7% (<i>P</i> = 0.675). The miscarriage rate was additionally similar between the groups: 27.9% for DVW and 32.1% for SVW groups (<i>P</i> = 0.765).</p><p><strong>Limitations reasons for caution: </strong>The study is limited by its retrospective nature. Caution should be taken concerning interpretation of these findings in cases where DVW occurs at different stages of embryo development.</p><p><strong>Wider implications of the findings: </strong>The result of the present study on DVW procedure provides a framework for counselling couples on their chance of clinical pregnancy per warming cycle. It additionally provides confidence and reassurance to laboratory professionals in certain countries where national policies limit embryo culture strategies making DVW inevitable.</p><p><s","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad037"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-09-14eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad035
Na Chen, Jingyu Li, Yexing Li, Yiyuan Zhang, Jiarong Li, Jie Gao, Jingmei Hu, Linlin Cui, Zi-Jiang Chen
{"title":"Risk factors associated with monozygotic twinning in offspring conceived by assisted reproductive technology.","authors":"Na Chen, Jingyu Li, Yexing Li, Yiyuan Zhang, Jiarong Li, Jie Gao, Jingmei Hu, Linlin Cui, Zi-Jiang Chen","doi":"10.1093/hropen/hoad035","DOIUrl":"10.1093/hropen/hoad035","url":null,"abstract":"<p><strong>Study question: </strong>What are the factors influencing the occurrence of monozygotic (MZ) twins in offspring conceived by assisted reproductive technology (ART)?</p><p><strong>Summary answer: </strong>Parental ages, the transfer of fresh versus frozen embryos, and the grade of blastocysts are all related to MZ twinning in ART offspring.</p><p><strong>What is known already: </strong>Offspring conceived by ART have significantly increased risk of MZ twins, which may be due to the characteristics of the infertile population. The objective of this study was to explore the incidence of monozygotic (MZ) twins after ART and to clarify the risk factors for MZ twinning.</p><p><strong>Study design size duration: </strong>A total of 255 monozygotic twins were enrolled in this cohort study, and then matched with singletons at a ratio of 1:4 randomly (with 1020 in the control group). All offspring were conceived by single embryo transfer.</p><p><strong>Participants/materials setting methods: </strong>The collected data were divided into the following three aspects for analysis: characteristics of the infertile population, gamete or embryo manipulations, and factors related to embryo development.</p><p><strong>Main results and the role of chance: </strong>The incidence of MZ twins was 1.638% (255 out of 15 567 pregnancies after single embryo transfers). Compared to singleton births, a significantly lower rate of frozen embryo transfers (FET; 78.0% vs 86.1% <i>P</i> = 0.002) was seen amongst the MZ twins. Amongst fresh ETs, the rate of blastocyst transfers in the MZ twins group was higher compared to that in the control group (92.9% vs 75.4%, <i>P</i> = 0.005). We also found that certain grades of blastocysts in terms of trophectoderm (TE) development, inner cell mass + TE development and the classification of 'top-quality' embryos were associated with the incidence of MZ twinning (<i>P</i> = 0.025, <i>P</i> = 0.012, <i>P</i> = 0.020, respectively). Logistic regression analysis revealed that higher paternal age (odds ratio (OR) = 0.94, 95% CI = 0.89-1.00, <i>P</i> = 0.029) and FET (OR = 0.48, 95% CI = 0.33-0.68, <i>P</i> = 0.001) may be protective factors against MZ twinning. However, higher maternal age (OR = 1.07, 95% CI = 1.01-1.13, <i>P</i> = 0.027) and the transfer of blastocysts (OR = 4.31, 95% CI = 1.46-12.73, <i>P</i> = 0.008) appeared to be associated with an increased risk of MZ twinning. Amongst blastocyst transfers, a C grade TE may be protective factor against MZ twinning (B: OR = 1.90, 95% CI = 1.18-3.07, <i>P</i> = 0.009; A: OR = 1.58, 95% CI = 0.93-2.67, <i>P</i> = 0.089).</p><p><strong>Limitations reasons for caution: </strong>First, our definition of MZ twins was based on twins' birth after single embryo transfers (SET), rather than ultrasound examination during early pregnancy. Second, the parental characteristics of the two groups were homogenous, so it was difficult to find any associations between infertility factors and the ","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad035"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10570986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-08-15eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad031
M Salih, C Austin, R R Warty, C Tiktin, D L Rolnik, M Momeni, H Rezatofighi, S Reddy, V Smith, B Vollenhoven, F Horta
{"title":"Embryo selection through artificial intelligence versus embryologists: a systematic review.","authors":"M Salih, C Austin, R R Warty, C Tiktin, D L Rolnik, M Momeni, H Rezatofighi, S Reddy, V Smith, B Vollenhoven, F Horta","doi":"10.1093/hropen/hoad031","DOIUrl":"10.1093/hropen/hoad031","url":null,"abstract":"<p><strong>Study question: </strong>What is the present performance of artificial intelligence (AI) decision support during embryo selection compared to the standard embryo selection by embryologists?</p><p><strong>Summary answer: </strong>AI consistently outperformed the clinical teams in all the studies focused on embryo morphology and clinical outcome prediction during embryo selection assessment.</p><p><strong>What is known already: </strong>The ART success rate is ∼30%, with a worrying trend of increasing female age correlating with considerably worse results. As such, there have been ongoing efforts to address this low success rate through the development of new technologies. With the advent of AI, there is potential for machine learning to be applied in such a manner that areas limited by human subjectivity, such as embryo selection, can be enhanced through increased objectivity. Given the potential of AI to improve IVF success rates, it remains crucial to review the performance between AI and embryologists during embryo selection.</p><p><strong>Study design size duration: </strong>The search was done across PubMed, EMBASE, Ovid Medline, and IEEE Xplore from 1 June 2005 up to and including 7 January 2022. Included articles were also restricted to those written in English. Search terms utilized across all databases for the study were: ('Artificial intelligence' OR 'Machine Learning' OR 'Deep learning' OR 'Neural network') AND ('IVF' OR '<i>in vitro</i> fertili*' OR 'assisted reproductive techn*' OR 'embryo'), where the character '*' refers the search engine to include any auto completion of the search term.</p><p><strong>Participants/materials setting methods: </strong>A literature search was conducted for literature relating to AI applications to IVF. Primary outcomes of interest were accuracy, sensitivity, and specificity of the embryo morphology grade assessments and the likelihood of clinical outcomes, such as clinical pregnancy after IVF treatments. Risk of bias was assessed using the Modified Down and Black Checklist.</p><p><strong>Main results and the role of chance: </strong>Twenty articles were included in this review. There was no specific embryo assessment day across the studies-Day 1 until Day 5/6 of embryo development was investigated. The types of input for training AI algorithms were images and time-lapse (10/20), clinical information (6/20), and both images and clinical information (4/20). Each AI model demonstrated promise when compared to an embryologist's visual assessment. On average, the models predicted the likelihood of successful clinical pregnancy with greater accuracy than clinical embryologists, signifying greater reliability when compared to human prediction. The AI models performed at a median accuracy of 75.5% (range 59-94%) on predicting embryo morphology grade. The correct prediction (Ground Truth) was defined through the use of embryo images according to post embryologists' assessment following local respect","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad031"},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10076934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-06-01eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad027
Mandy Spaan, Martina Pontesilli, Alexandra W van den Belt-Dusebout, Curt W Burger, Marry M van den Heuvel-Eibrink, Anita C J Ravelli, Mariëtte Goddijn, Cornelis B Lambalk, Tessa J Roseboom, Flora E van Leeuwen
{"title":"Cancer risk in children, adolescents, and young adults conceived by ART in 1983-2011.","authors":"Mandy Spaan, Martina Pontesilli, Alexandra W van den Belt-Dusebout, Curt W Burger, Marry M van den Heuvel-Eibrink, Anita C J Ravelli, Mariëtte Goddijn, Cornelis B Lambalk, Tessa J Roseboom, Flora E van Leeuwen","doi":"10.1093/hropen/hoad027","DOIUrl":"10.1093/hropen/hoad027","url":null,"abstract":"<p><strong>Study question: </strong>Do children, adolescents, and young adults born after ART, including IVF, ICSI and frozen-thawed embryo transfer (FET), have an increased risk of cancer compared with children born to subfertile couples not conceived by ART and children from the general population?</p><p><strong>Summary answer: </strong>After a median follow-up of 18 years, the overall cancer risk was not increased in children conceived by ART, but a slight risk increase was observed in children conceived after ICSI.</p><p><strong>What is known already: </strong>There is growing evidence that ART procedures could perturb epigenetic processes during the pre-implantation period and influence long-term health. Recent studies showed (non-)significantly increased cancer risks after ICSI and FET, but not after IVF.</p><p><strong>Study design size duration: </strong>A nationwide historical cohort study with prospective follow-up was carried out, including all live-born offspring from women treated with ART between 1983 and 2011 and subfertile women not treated with ART in one of the 13 Dutch IVF clinics and two fertility centers.</p><p><strong>Participants/materials setting methods: </strong>Children were identified through the mothers' records in the Personal Records Database. Information on the conception method of each child was collected through the mother's medical record. In total, the cohort comprises 89 249 live-born children of subfertile couples, of whom 51 417 were conceived using ART and 37 832 were not (i.e. conceived naturally, through ovulation induction, or after IUI). Cancer incidence was ascertained through linkage with the Netherlands Cancer Registry for the period 1989-2019. Cancer risk in children conceived using ART was compared with risk in children born to subfertile couples but not conceived by ART (hazard ratio (HR)) and children from the general population (standardized incidence ratios (SIRs)).</p><p><strong>Main results and the role of chance: </strong>In total, 358 cancers were observed after a median follow-up of 18 years. Overall cancer risk was not increased in children conceived using ART, when compared with the general population (SIR = 0.96, 95% CI = 0.81-1.12) or with children from subfertile couples not conceived by ART (HR = 1.06, 95% CI = 0.84-1.33). Compared with children from subfertile couples not conceived by ART, the use of IVF or FET was not associated with increased cancer risk, but ICSI was associated with a slight risk increase (HR = 1.58, 95% CI = 1.08-2.31). Risk of cancer after ART did not increase at older ages (≥18 years, HR = 1.26, 95% CI = 0.88-1.81) compared to cancer risk in children not conceived by ART.</p><p><strong>Limitations reasons for caution: </strong>The observed increased risk among children conceived using ICSI must be interpreted with caution owing to the small number of cases.</p><p><strong>Wider implications of the findings: </strong>After a median follow-up of 18 years, children","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad027"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/36/hoad027.PMC10279651.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-05-22eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad021
K Yin, L Whitaker, E Hojo, S McLenachan, J Walker, G McKillop, C Stubbs, L Priest, M Cruz, N Roberts, H Critchley
{"title":"Measurement of changes in uterine and fibroid volume during treatment of heavy menstrual bleeding (HMB).","authors":"K Yin, L Whitaker, E Hojo, S McLenachan, J Walker, G McKillop, C Stubbs, L Priest, M Cruz, N Roberts, H Critchley","doi":"10.1093/hropen/hoad021","DOIUrl":"10.1093/hropen/hoad021","url":null,"abstract":"<p><strong>Study question: </strong>Does application of an unbiased method for analysis of magnetic resonance (MR) images reveal any effect on uterine or fibroid volume from treatment of heavy menstrual bleeding (HMB) with three 12-week courses of the selective progesterone receptor modulator ulipristal acetate (SPRM-UPA)?</p><p><strong>Summary answer: </strong>Application of an unbiased method for analysis of MR images showed that treatment of HMB with SPRM-UPA was not associated with a significant reduction in the volume of the uterus or in the volume of uterine fibroids.</p><p><strong>What is known already: </strong>SPRM-UPA shows therapeutic efficacy for treating HMB. However, the mechanism of action (MoA) is not well understood and there have been mixed reports, using potentially biased methodology, regarding whether SPRM-UPA has an effect on the volume of the uterus and fibroids.</p><p><strong>Study design size duration: </strong>In a prospective clinical study (with no comparator), 19 women with HMB were treated over a period of 12 months with SPRM-UPA and uterine and fibroid size were assessed with high resolution structural MRI and stereology.</p><p><strong>Participants/materials setting methods: </strong>A cohort of 19 women aged 38-52 years (8 with and 11 without fibroids) were treated with three 12-week courses of 5 mg SPRM-UPA given daily, with four weeks off medication in-between treatment courses. Unbiased estimates of the volume of uterus and total volume of fibroids were obtained at baseline, and after 6 and 12 months of treatment, by using the Cavalieri method of modern design-based stereology in combination with magnetic resonance imaging (MRI).</p><p><strong>Main results and the role of chance: </strong>Bland-Altman plots showed good intra-rater repeatability and good inter-rater reproducibility for measurement of the volume of both fibroids and the uterus. For the total patient cohort, two-way ANOVA did not show a significant reduction in the volume of the uterus after two or three treatment courses of SPRM-UPA (<i>P</i> = 0.51), which was also the case when the groups of women with and without fibroids were considered separately (<i>P</i> = 0.63). One-way ANOVA did not show a significant reduction in total fibroid volume in the eight patients with fibroids (<i>P</i> = 0.17).</p><p><strong>Limitations reasons for caution: </strong>The study has been performed in a relatively small cohort of women and simulations that have subsequently been performed using the acquired data have shown that for three time points and a group size of up to 50, with alpha (Type I Error) and beta (Type II Error) set to 95% significance and 80% power, respectively, at least 35 patients would need to be recruited in order for the null hypothesis (that there is no significant reduction in total fibroid volume) to be potentially rejected.</p><p><strong>Wider implications of the findings: </strong>The imaging protocol that we have developed represents a","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad021"},"PeriodicalIF":8.3,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9619544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-05-17eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad020
Wiep R de Ligny, Kathrin Fleischer, Hilde Grens, Didi D M Braat, Jan Peter de Bruin
{"title":"The lack of evidence behind over-the-counter antioxidant supplements for male fertility patients: a scoping review.","authors":"Wiep R de Ligny, Kathrin Fleischer, Hilde Grens, Didi D M Braat, Jan Peter de Bruin","doi":"10.1093/hropen/hoad020","DOIUrl":"10.1093/hropen/hoad020","url":null,"abstract":"<p><strong>Study question: </strong>What is the evidence for over-the-counter antioxidant supplements for male infertility?</p><p><strong>Summary answer: </strong>Less than half of over-the-counter antioxidant supplements for male fertility patients have been tested in a clinical trial, and the available clinical trials are generally of poor quality.</p><p><strong>What is known already: </strong>The prevalence of male infertility is rising and, with this, the market for supplements claiming to improve male fertility is expanding. Up to now, there is limited data on the evidence for these over-the-counter supplements.</p><p><strong>Study design size duration: </strong>Amazon, Google Shopping and other relevant shopping websites were searched on 24 June 2022 with the following terms: 'supplements', 'antioxidants', 'vitamins', AND 'male fertility', 'male infertility', 'male subfertility', 'fertility men', 'fertility man'. All supplements with a description of ingredients in English, Dutch, French, Spanish, or German were included. Subsequently, Pubmed and Google Scholar were searched for studies that included the supplements.</p><p><strong>Participants/materials setting methods: </strong>Inclusion criteria were supplements with antioxidant properties, of which the main purpose was to improve male fertility. Included supplements must be available without a doctor's prescription. Supplements containing plant extracts were excluded, as well as supplements of which the content or dosage was not clear. The ingredients, dosage, price and health claims of the supplements were recorded. We assessed whether substances in the supplements exceeded the recommended dietary allowance (RDA) or tolerable upper intake level (UL). All clinical trials and animal studies investigating included supplements were selected for this review. Clinical trials were assessed for risk of bias with a risk of bias tool appropriate for the study design.</p><p><strong>Main results and the role of chance: </strong>There were 34 eligible antioxidant supplements found, containing 48 different active substances. The average price per 30 days was 53.10 US dollars. Most of the supplements (27/34, 79%) contained substances in a dosage exceeding the recommended daily allowance (RDA). All manufacturers of the supplements made health claims related to the improvement of sperm quality or male fertility. For 13 of the 34 supplements (38%), published clinical trials were available, and for one supplement, only an animal study was found. The overall quality of the included studies was poor. Only two supplements were tested in a good quality clinical trial.</p><p><strong>Limitations reasons for caution: </strong>As a consequence of searching shopping websites, a comprehensive search strategy could not be formulated. Most supplements were excluded because they contained plant extracts or because supplement information was not available (in an appropriate language).</p><p><strong>Wider implications o","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad020"},"PeriodicalIF":8.3,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9601415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-05-15eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad017
Pedro Melo, Simon Wood, Georgios Petsas, Yealin Chung, Julija Gorodeckaja, Malcolm J Price, Arri Coomarasamy
{"title":"Reply to: 'Hiding in plain sight' and 'Caution is needed when communicating analyses based on an apple to orange comparison'.","authors":"Pedro Melo, Simon Wood, Georgios Petsas, Yealin Chung, Julija Gorodeckaja, Malcolm J Price, Arri Coomarasamy","doi":"10.1093/hropen/hoad017","DOIUrl":"10.1093/hropen/hoad017","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad017"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-04-24eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad011
Christian De Geyter, Carlos Calhaz-Jorge, Veerle Goossens, Cristina M Magli, Jesper Smeenk, Kristina Vesela, Nathalie Vermeulen, Christine Wyns
{"title":"EuMAR: a roadmap towards a prospective, cycle-by-cycle registry of medically assisted reproduction in Europe.","authors":"Christian De Geyter, Carlos Calhaz-Jorge, Veerle Goossens, Cristina M Magli, Jesper Smeenk, Kristina Vesela, Nathalie Vermeulen, Christine Wyns","doi":"10.1093/hropen/hoad011","DOIUrl":"10.1093/hropen/hoad011","url":null,"abstract":"<p><p>More than 20 years ago, the survey of activities in medically assisted reproduction (MAR) was initiated in Europe and resulted in cross-sectional annual reports, as issued by the European IVF Monitoring (EIM) consortium of ESHRE. Over time, these reports mirror the continuous development of the technologies and contribute to increased transparency and surveillance of reproductive care. Meanwhile, progressive changes of existing treatment modalities and the introduction of new technologies resulted in the need of a cumulative approach in the assessment of treatment outcomes, which warrants a prospective cycle-by-cycle data registry on MAR activities, including fertility preservation. This change in the paradigm of data collection in Europe towards the construction of cumulative outcome results is expected to generate additional insights into cross-institutional but also cross-border movements of patients and reproductive material. This is essential to improve vigilance and surveillance. The European monitoring of Medically Assisted Reproduction (EuMAR) project, co-funded by the European Union, will establish a registry for the transnational collection of prospective cycle-by-cycle MAR and fertility preservation data on the basis of an individual reproductive care code (IRCC). The rationale for the project and the objectives are presented here.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 2","pages":"hoad011"},"PeriodicalIF":8.3,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/b4/hoad011.PMC10126319.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Human reproduction openPub Date : 2023-04-20eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad014
Tong Wu, Ke-Cheng Huang, Jin-Feng Yan, Jin-Jin Zhang, Shi-Xuan Wang
{"title":"Extracellular matrix-derived scaffolds in constructing artificial ovaries for ovarian failure: a systematic methodological review.","authors":"Tong Wu, Ke-Cheng Huang, Jin-Feng Yan, Jin-Jin Zhang, Shi-Xuan Wang","doi":"10.1093/hropen/hoad014","DOIUrl":"10.1093/hropen/hoad014","url":null,"abstract":"<p><strong>Study question: </strong>What is the current state-of-the-art methodology assessing decellularized extracellular matrix (dECM)-based artificial ovaries for treating ovarian failure?</p><p><strong>Summary answer: </strong>Preclinical studies have demonstrated that decellularized scaffolds support the growth of ovarian somatic cells and follicles both <i>in vitro</i> and <i>in vivo</i>.</p><p><strong>What is known already: </strong>Artificial ovaries are a promising approach for rescuing ovarian function. Decellularization has been applied in bioengineering female reproductive tract tissues. However, decellularization targeting the ovary lacks a comprehensive and in-depth understanding.</p><p><strong>Study design size duration: </strong>PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception until 20 October 2022 to systematically review all studies in which artificial ovaries were constructed using decellularized extracellular matrix scaffolds. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol.</p><p><strong>Participants/materials setting methods: </strong>Two authors selected studies independently based on the eligibility criteria. Studies were included if decellularized scaffolds, regardless of their species origin, were seeded with ovarian cells or follicles. Review articles and meeting papers were removed from the search results, as were articles without decellularized scaffolds or recellularization or decellularization protocols, or control groups or ovarian cells.</p><p><strong>Main results and the role of chance: </strong>The search returned a total of 754 publications, and 12 papers were eligible for final analysis. The papers were published between 2015 and 2022 and were most frequently reported as coming from Iran. Detailed information on the decellularization procedure, evaluation method, and preclinical study design was extracted. In particular, we concentrated on the type and duration of detergent reagent, DNA and extracellular matrix detection methods, and the main findings on ovarian function. Decellularized tissues derived from humans and experimental animals were reported. Scaffolds loaded with ovarian cells have produced estrogen and progesterone, though with high variability, and have supported the growth of various follicles. Serious complications have not been reported.</p><p><strong>Limitations reasons for caution: </strong>A meta-analysis could not be performed. Therefore, only data pooling was conducted. Additionally, the quality of some studies was limited mainly due to incomplete description of methods, which impeded specific data extraction and quality analysis. Several studies that used dECM scaffolds were performed or authored by the same research group with a few modifications, which might have biased our evaluation.</p><p><strong>Wider implications of the findings: </stro","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 2","pages":"hoad014"},"PeriodicalIF":8.3,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}