Archives of Gynecology and Obstetrics最新文献

{"title":"Association of serum AMH levels with the number of oocytes retrieved in adolescent and young adult women undergoing controlled ovarian stimulation for fertility preservation","authors":"Sung Woo Kim,&nbsp;Hee Jin Son,&nbsp;Ji Yeon Han,&nbsp;Hoon Kim,&nbsp;Seung-Yup Ku","doi":"10.1007/s00404-025-07976-x","DOIUrl":"10.1007/s00404-025-07976-x","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate whether the number of oocytes retrieved after controlled ovarian stimulation (COS) for fertility preservation (FP) can be predicted using serum anti-Müllerian hormone (AMH) levels in adolescent and young adult (AYA) women.</p><h3>Methods</h3><p>This is a retrospective cohort study in a large university-affiliated fertility center. AYA women aged 11 to 25 years received COS using gonadotropin-releasing hormone (GnRH) antagonist protocols for FP were enrolled. Those with canceled cycles or incomplete data were excluded. The primary outcome is to determine whether the number of oocytes retrieved can be predicted through serum AMH levels using multiple linear regression analysis.</p><h3>Results</h3><p>The mean numbers of oocytes retrieved, mature oocytes retrieved, and oocytes cryopreserved were 10.3 ± 7.6, 6.9 ± 6.2, and 8.5 ± 6.8, respectively. Multiple stepwise linear regression analysis revealed that serum AMH level independently predicts COS outcomes, including the total number of oocytes retrieved (adjusted <i>R</i>² = 0.222, <i>P</i> &lt; 0.001), the number of mature oocytes retrieved (adjusted <i>R</i>² = 0.102, <i>P</i> = 0.013), and the number of oocytes cryopreserved (adjusted <i>R</i>² = 0.153, <i>P</i> = 0.003).</p><h3>Conclusion</h3><p>Serum AMH level was a significant predictor of the number of oocytes retrieved after COS for FP in AYA women, while antral follicle count and age were not significantly related.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"811 - 818"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07976-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors, pregnancy outcomes, and management associated with non-reportable results in prenatal cell-free DNA testing.","authors":"Hailing Yin, Jue Wang, Xin Wu, Mingzhu Miao, Ya Wang, Jiale Shi, Xi Wang, Xiang Ma","doi":"10.1007/s00404-025-07977-w","DOIUrl":"https://doi.org/10.1007/s00404-025-07977-w","url":null,"abstract":"<p><strong>Purpose: </strong>To offer more effective strategies by classification of non-reportable results for physicians to manage those pregnancies.</p><p><strong>Methods: </strong>From July 2022 to May 2024, a total of 14,073 prenatal cell-free DNA (cfDNA) tests were performed by massively parallel sequencing (MPS) in our genetic laboratory and 52 cases received non-reportable results caused by different reasons. Chi-square analysis and logistic regression analysis were used to analyze the risk factors contributing to non-reportable results. The redraw test results and the pregnancy outcomes were collected and analyzed.</p><p><strong>Results: </strong>Overall, 52 (0.37%) of 14,073 pregnant women had non-reportable cfDNA testing results after the first draw. Multivariate logistic regression analysis revealed that pregnancies conceived by in vitro fertilization (IVF) (OR = 2.42, 95% CI 1.08-5.42, P = 0.03) and heparin use (OR = 7.04, 95% CI 2.40-20.62, P < 0.001) were independent factors for non-reportable cfDNA test results. In 52 cases with non-reportable results, 27 (51.92%) cases had borderline Z scores, 15 (28.85%) cases had a low fetal fraction (< 4.0%), 5 (9.62%) cases indicated multiple chromosomal aberrations (MCA, ≥ 4), and 5 (9.62%) cases had data fluctuation in sex chromosomes. All 52 (100%) cases chose to have a redraw test. The overall success rate of redraw test was 65.38%; however, cases with MCA mainly caused by cfDNA from uterine fibroids or maternal malignancies had relatively low success rate of redraw testing. Compared to pregnant women without risk factors, those with caution indications and with low fetal fraction (LFF) had a lower chance to obtain valid redraw testing results (100.00% vs 16.67%, P = 0.002). The abnormal conditions of perinatal women and infants were more frequent in the cases with non-reportable results after redraw tests (2.94% vs 14.71%, P = 0.027; 7.41% vs 14.81%, P = 0.038).</p><p><strong>Conclusion: </strong>Repeated testing was not suitable for all cases with non-reportable results. Invasive prenatal diagnosis should be recommended for cases with MCA, cases with caution indications and with low fetal fraction for the first non-reportable results, cases with consecutive non-reportable cfDNA results. More attention should be paid to the cases with non-reportable cfDNA results, especially to the cases with non-reportable redraw testing results.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial pregnancy outcomes in correlation with history of ipsilateral tubal surgery: a retrospective study","authors":"Miaomiao Jing,&nbsp;Runju Zhang,&nbsp;Wei Zhao","doi":"10.1007/s00404-025-07972-1","DOIUrl":"10.1007/s00404-025-07972-1","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of the study is to review the clinical characteristics and risk factors that influence the timing of diagnosis and rupture of interstitial pregnancy, and to evaluate the outcomes of interstitial heterotopic pregnancies after ipsilateral tubal surgery.</p><h3>Methods</h3><p>A retrospective statistical analysis was performed on the case data of patients with interstitial pregnancy who met the inclusion criteria and were treated in a single institution.</p><h3>Results</h3><p>A total of 885 patients with interstitial pregnancy were included in the study, including 55 patients with heterotopic interstitial pregnancies. The gestational age of patients with interstitial rupture was less than those that were diagnosed prior to rupture (<i>P</i> &lt; 0.01). The risk of interstitial pregnancy rupture was higher in women with a history of ipsilateral fallopian tube surgery <i>P</i> &lt; 0.01). In the &gt; 42-day rupture group, the gestation age was less in those with a history of ipsilateral surgery than those without, and the difference was statistically significant (<i>P</i> = 0.005). The shorter the interval, the higher the risk of interstitial pregnancy rupture (<i>P</i> = 0.001).</p><h3>Conclusion</h3><p>Patients with a history of ipsilateral tubal surgery have a higher risk of interstitial pregnancy rupture. The shorter the interval between ipsilateral tubal surgery and interstitial pregnancy, the higher the risk of rupture. For patients with a combined intrauterine and interstitial pregnancy, timely treatment may improve the chances of achieving term live birth.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"775 - 780"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07972-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy outcomes in women with mitral valve stenosis: 10-year experience of a tertiary care center","authors":"Amirreza Sajjadieh Khajouei,&nbsp;Azar Tavana,&nbsp;Parvin Bahrami,&nbsp;Minoo Movahedi,&nbsp;Shayan Mirshafiee,&nbsp;Mohaddeseh Behjati","doi":"10.1007/s00404-024-07900-9","DOIUrl":"10.1007/s00404-024-07900-9","url":null,"abstract":"<div><h3>Introduction</h3><p>Mitral stenosis (MS) is recognized as one of the most common cardiovascular diseases during pregnancy and can result in adverse outcomes including maternal and fetal mortality if not diagnosed and treated in a timely manner. This study aimed to investigate the pregnancy outcomes of women with MS who were treated at the cardio-obstetric clinic in Alzahra Hospital, Isfahan, from 2011 to 2020.</p><h3>Methods</h3><p>A total of 81 pregnant women diagnosed with MS were selected for the study. Their demographic and clinical data, along with echocardiography information—including systolic pulmonary artery pressure (SPAP), severity of MS, and NYHA class—were monitored throughout pregnancy. Additionally, the maternal and fetal outcomes were examined.</p><h3>Results</h3><p>Among the participants, 38.3% were diagnosed with progressive MS, 56.8% exhibited severe stenosis, and 4.9% presented with very severe stenosis. Prior to pregnancy, no cases were classified as NYHA class 3 or 4. However, during the first trimester, six patients (7.4%) were classified as NYHA class 3. In the second trimester, 23 patients (28.4%) were in class 3, and 1 patient (1.2%) was classified as class 4. In the third trimester, 24 cases (29.6%) were in class 3, and 14 cases (17.3%) were in class 4. Notably, significant changes in NYHA class were observed throughout pregnancy (<i>P</i> &lt; 0.001). Furthermore, 16% of participants required percutaneous balloon mitral commissurotomy, highlighting the severity of their condition. Additionally, 2.5% experienced decompensated heart failure and another 2.5% developed arrhythmia after delivery. Unfortunately, there was one case (1.2%) of mortality due to complications from MS. The study also documented one stillbirth (1.2%), 11 cases (13.6%) of spontaneous abortion, 17 cases (21%) of induced abortion, six cases (7.4%) of birth anomalies, three cases (3.7%) of prematurity, and four cases (4.9%) of intrauterine growth restriction, underscoring the critical need for careful management.</p><h3>Conclusion</h3><p>The results of the study suggest that cardiac function in women diagnosed with MS typically declines during pregnancy. Furthermore, even with optimal treatments, certain complications may still arise.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 2","pages":"229 - 236"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07900-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of sperm DNA fragmentation on embryo morphokinetic parameters and laboratory outcomes in women of different ages during intracytoplasmic sperm treatment cycles.","authors":"Danna Ye, Zhujun Ye, Huan Zhang","doi":"10.1007/s00404-025-07949-0","DOIUrl":"https://doi.org/10.1007/s00404-025-07949-0","url":null,"abstract":"<p><strong>Background: </strong>Whether SDF (sperm DNA fragmentation) influences embryo development and the clinical outcomes of assisted reproductive technology (ART) cycles remains controversial. Oocytes derived from women of different ages have varying abilities to repair SDF.</p><p><strong>Objective: </strong>This study aimed to explore the correlation between SDF and the morphokinetic parameters of embryos during intracytoplasmic sperm injection (ICSI) treatment cycles with consideration of the different ages of female patients.</p><p><strong>Materials and methods: </strong>A total of 301 ICSI cycles between April 2022 and December 2023 were analyzed in this retrospective study. Cycles were categorized into two groups according to female age: the older group (females aged ≥ 35 years) and the younger group (females aged < 35 years). Moreover, each age group was further divided into low- and high- sperm DNA fragmentation index (DFI) subgroups. The morphokinetic parameters of embryo development and the laboratory outcomes were compared between the two DFI subgroups within each age category.</p><p><strong>Results: </strong>In the younger group, there were no differences between the two DFI groups in terms of the rate of usable blastocyst formation on Day 5; time to 2, 3, 4, 5, 6, 7, and 8 cells; or timing of blastulation. However, in the older group, the rate of usable blastocyst formation on Day 5 was significantly greater in the low DFI group than in the high DFI group (35.6% vs. 23.4%, p = 0.030). Although the times to reach 2, 3, 4, 5, 6, 7, and 8 cells were similar across the two DFI groups, the time to blastulation (tB) was significantly shorter in the low DFI group than in the high DFI group (106.5 ± 9.0 h vs. 111.1 ± 10.3 h, p = 0.013).</p><p><strong>Conclusion: </strong>SDF could adversely affect the rate of usable blastocyst formation on Day 5 and delay the formation of usable blastocysts only when oocytes were derived from women of advanced maternal age. These results may indicate that oocytes derived from younger females have a greater capacity to repair SDF than those from women of advanced maternal age.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of endometrial PRP on fertility outcomes in women with implantation failure or thin endometrium","authors":"Naziye Gurkan,&nbsp;Tayfun Alper","doi":"10.1007/s00404-025-07948-1","DOIUrl":"10.1007/s00404-025-07948-1","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the effect of intrauterine platelet-rich plasma (PRP) treatment on frozen–thawed embryo transfer (FET) cycles in patients with recurrent implantation failure.</p><h3>Materials and methods</h3><p>The study group consisted of 150 patients. The patients were grouped only as those with thin endometria, those with recurrent implantation failure (RIF), and those with both thin endometria and RIF. All participants underwent frozen embryo transfer. The control group consisted of a total of 150 patients who had normal endometrial thickness and did not have a history of RIF and who presented to the clinic due to unexplained infertility. The rates of biochemical pregnancy, clinical pregnancy, miscarriage and live birth were compared among the groups in terms of fertility outcomes.</p><h3>Results</h3><p>In 150 patients with a thin endometrium or a history of RIF who underwent PRP, the endometrial thickness was significantly greater than the pre-PRP endometrial thickness, and this value was found to be statistically significant (7.38 mm vs. 7.96 mm, <i>p</i> &lt; 0.001). In the thin endometrium group, there was also a statistically significant difference between the endometrial thickness measured before and after PRP (5.85 mm vs 6.65 mm, <i>p</i> &lt; 0.001). The rate of not achieving pregnancy in the RIF group without PRP was found to be significantly greater than that in the control group (53.1% vs 28.7%, <i>p</i> &lt; 0.05). There was no significant difference in pregnancy rates between the PRP groups. Morever, no statistically significant relationship was found between pregnancy status and whether or not PRP was performed in RIF patients (<i>p</i> value &gt; 0.05). Overall, although there was an increase in clinical pregnancy and live birth rates in the PRP group compared with the control group, this difference did not reach statistical significance.</p><h3>Conclusion</h3><p>In patients suffering from a thin endometrium or RIF, although endometrial PRP increases endometrial thickness, it does not significantly improve fertility outcomes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1195 - 1204"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07948-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted vesicovaginal fistula repair with “Rainbow-shaped” peritoneal flap: a single-center experience","authors":"Yang Yang,&nbsp;Huang Chenchen,&nbsp;Wu Shiliang,&nbsp;Chen Yuke,&nbsp;Shen Cheng","doi":"10.1007/s00404-024-07919-y","DOIUrl":"10.1007/s00404-024-07919-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Vesicovaginal fistula (VVF) refers to an abnormal communication between the bladder and vagina, leading to uncontrolled leakage of urine from the vagina. This study aimed to assess the efficacy and safety of robot-assisted laparoscopic VVF repair with a “rainbow-shaped” peritoneal flap.</p><h3>Methods</h3><p>A retrospective analysis was conducted on 15 patients who underwent robot-assisted VVF repair from July 2021 to March 2023 in Peking University First Hospital. The patient cohort included 1 patient who had undergone abdominal total hysterectomy, 11 patients who had laparoscopic total hysterectomy, 1 patient who had cervical conization, and 2 adolescents with residual intravaginal foreign bodies.</p><h3>Results</h3><p>Seven had a history of failed VVF repair, while 8 underwent primary repair. The mean operative time was 137 (range 92–182) min, and the mean hospital stay was 4.9 (range 4.3–5.5) days. Surgical blood loss was minimal, averaging 14 (range 6–22) ml. The fistula was located supratrigonal in 14 patients and in the triangle area in one patient. In the vagina, the fistulas were located at the stump in 12 patients, at the anterior vaginal wall in one patient, and at the vaginal wall with partial involvement of the cervix in two patients. All procedures were successfully completed without the need for open conversion. All 15 patients achieved successful repair, with no complications reported during the mean follow-up period of 7.8 months.</p><h3>Conclusion</h3><p>Robot-assisted laparoscopic repair with a “rainbow-shaped” peritoneal flap for VVF is an effective, safe, and highly successful technique.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 6","pages":"1697 - 1703"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07919-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of breast cancer on life satisfaction in the elderly patient","authors":"M. Burgmann,&nbsp;K. Hermelink,&nbsp;A. Lotz,&nbsp;V. Schlager,&nbsp;T. Kolben,&nbsp;Ch. Seifert,&nbsp;S. Schrodi,&nbsp;F. Ganster,&nbsp;Alexander Koenig,&nbsp;S. Beyer,&nbsp;S. Mahner,&nbsp;N. Harbeck,&nbsp;R. Wuerstlein","doi":"10.1007/s00404-025-07956-1","DOIUrl":"10.1007/s00404-025-07956-1","url":null,"abstract":"<div><h3>Purpose</h3><p>Due to increasing life expectancy and demographic trends in recent years, the specific needs of elderly patients have gained more and more attendance. The aim of this study is to determine the impact of adjuvant chemotherapy on health-related life satisfaction of elderly breast cancer patients while considering the conditions of comorbidities and global health status.</p><h3>Methods</h3><p>All breast cancer patients over 60 years who had been treated at the Breast Center of the University Hospital of Munich, Germany between 2010 and 2013 were eligible for participation. Life satisfaction was assessed on the basis of validated questionnaires, with a self-developed questionnaire we assessed issues of the patients general health status and for the geriatric assessment.</p><h3>Results</h3><p>Our research included data of 276 patients. Compared to a normal German population, our cohort reported significantly higher life satisfaction regardless of treatment with chemotherapy. Regardless of the type of therapy, the following factors are associated with a lower life health-related satisfaction: <i>low educational level, obesity</i>, <i>high Charlson Comorbidity Index (CI)</i> and <i>low Barthel Index (BI)</i> as well as <i>polymedication</i>. <i>Obesity</i> and the presence of <i>comorbidities</i> were significantly associated with reduced health-related life satisfaction.</p><h3>Conclusion</h3><p>This cross-sectional, retrospective analysis indicates, that chemotherapy does not impact the patients´ life satisfaction. <i>BI</i> and <i>CCI</i> as well as <i>obesity</i>, <i>polymedication</i> and <i>level of education</i> are significantly associated with a lower satisfaction. These data should be taken into account in the decision-making process to improve the medical care and support of elderly breast cancer patients.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1163 - 1171"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07956-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to gonadotropin-releasing hormone agonist in early pregnancy leads to adverse pregnancy outcomes: a retrospective analysis","authors":"Mimi Xiong,&nbsp;Jinyu Lu,&nbsp;Nan Dong,&nbsp;Ruochun Wu,&nbsp;Dingyun Zhang,&nbsp;Bife Li,&nbsp;Wenjun Wang","doi":"10.1007/s00404-024-07914-3","DOIUrl":"10.1007/s00404-024-07914-3","url":null,"abstract":"<div><h3>Background</h3><p>GnRH-a is commonly used in the luteal phase for pituitary down-regulation during in-vitro fertilization (IVF). There is an ineluctable risk of spontaneous pregnancy for infertile couples who lack the use of contraception during the luteal phase down-regulation before IVF treatment. However, it is unclear whether exposure to GnRH-a affects clinical pregnancy outcomes.</p><h3>Methods</h3><p>A single-center retrospective cohort study based on propensity score matching was used to analyze the clinical data of a total of 6602 infertile women who were about to undergo assisted reproduction with IVF or intracytoplasmic microsperm injection with spermatozoa (ICSI) and with confirmed clinical pregnancies outcomes in the Reproductive Center of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China, from January 2011 to December 2022. Participants were divided into the NP group (Natural pregnancy with the use of GnRH-a) and the CT group (Conceived through IVF/ICSI-ET). Baseline characteristics and pregnancy outcomes of the groups were compared by correlation analysis, analysis of variance, and generalized estimating equations. The correlation between pregnancy outcomes and GnRH-a exposure was analyzed based on logistic regression modeling. The primary outcome of the study is the ectopic pregnancy rate. The secondary outcomes included spontaneous abortion rate, clinical pregnancy rate, live birth rate and adverse neonatal outcomes rate.</p><h3>Results</h3><p>Our study demonstrates statistically significant differences in spontaneous abortion rate (29.5% vs. 13.6%, <i>P</i> &lt; 0.05), ectopic pregnancy rate (14.3% vs. 3.1%, <i>P</i> &lt; 0.05), live birth rate ((56.2% vs. 83.3%, <i>P</i> &lt; 0.05)) between NP group and CT group. Logistic analysis showed that exposure to GnRH-a was a risk factor for adverse pregnancy outcomes and was associated with spontaneous abortion(odds ratio[ OR], 95% confidence interval [95% CI] {2.66,1.61–4.40}, <i>P</i> &lt; 0.05) and ectopic pregnancy(odds ratio [OR], 95%confidence interval [95% CI] {5.21,2.39–11.32}, <i>P</i> &lt; 0.05).</p><h3>Conclusion</h3><p>Exposure to GnRH-a during the luteal phase of down-regulation can adversely affect pregnancy outcomes. Therefore, we recommend contraception during the IVF/ICSI down-regulation. A higher dose of progesterone during early pregnancy is needed for infertile women who conceive spontaneously after exposure to GnRH-a.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"801 - 809"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07914-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of progesterone level on day of trigger on embryo ploidy in egg donor’s cycles","authors":"Priscilla Lopes Caldeira,&nbsp;Aline Rodrigues Lorenzon,&nbsp;Peter Chedraui,&nbsp;Ana Paula Aquino,&nbsp;Bruna Barros,&nbsp;Eduardo Alves Leme da Motta,&nbsp;Thais Sanches Domingues,&nbsp;Pedro Augusto Araujo Monteleone,&nbsp;Edmund Chada Baracat,&nbsp;José Maria Soares Junior","doi":"10.1007/s00404-025-07942-7","DOIUrl":"10.1007/s00404-025-07942-7","url":null,"abstract":"<div><h3>Purpose</h3><p>Elevated progesterone (P4) has emerged as a cofounder for embryo quality and recently been investigated in blastocyst aneuploidy rates. In this context, we explored the prevalence of aneuploidy in blastocysts generated from donated eggs according to P4 levels on trigger’s day.</p><h3>Methods</h3><p>This retrospective cohort study analyzed data from intracytoplasmic sperm injection (ICSI) cycles using frozen donated oocytes that underwent embryo biopsy (PGT-A) at blastocyst stage. Patients were divided into two groups according to serum P4 on trigger day: &lt; 1.5 ng/mL (group A) and ≥ 1.5 ng/mL (group B). Only euploid embryos were transferred to recipients. Primary outcome was embryo euploidy and aneuploidy rate. Secondary outcomes were number of blastocysts, number of top-quality embryos, number of euploid/aneuploid embryos and clinical pregnancy rate.</p><h3>Results</h3><p>259 ICSI PGT-A cycles with frozen donated oocytes were analyzed. Group A included 75 cycles (57 donors; 69 recipients) and group B 184 cycles (115 donors; 163 recipients). The number of blastocysts (3.60 ± 1.52 vs 3.68 ± 1.52, <i>P</i> = 0.667), top-quality embryos (2.27 ± 1.59 vs 2.28 ± 1.43, <i>P</i> = 0.802), euploid embryos (1.92 ± 1.25 vs 1.92 ± 1.13, <i>P</i> = 0.954) and aneuploid embryos (1.23 ± 1.01 vs 1.14 ± 0.94, <i>P</i> = 0.593) were not significantly different between groups A and B, respectively. Euploid embryo rate (A: 0.31 ± 0.20 vs B: 0.30 ± 0.18, <i>P</i> = 0.626), aneuploidy embryo rate (A: 0.21 ± 0.19 vs B: 0.18 ± 0.15, <i>P</i> = 0.436) and clinical pregnancy rate (A: 73% vs B: 82%, <i>P</i> = 0.476) were comparable between the two groups.</p><h3>Conclusions</h3><p>Elevated P4 values on trigger day did not affect embryo ploidy or embryo quality parameters in donated eggs cycles.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"765 - 774"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07942-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}