Archives of Gynecology and Obstetrics最新文献

{"title":"Impact of intrapartum ultrasound on mode of delivery guidance and adverse pregnancy outcomes in primigravidae undergoing vaginal trial labor.","authors":"Xu Chen, Wei Li, Hualin Li, Haibo Song, Mengting Liu, Jianfeng Fan, Zhen Chen, Ling Cao, Ge Zhang","doi":"10.1007/s00404-026-08459-3","DOIUrl":"https://doi.org/10.1007/s00404-026-08459-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the impact of intrapartum ultrasound on mode of delivery guidance and the occurrence of adverse pregnancy outcomes in primigravidae undergoing a vaginal trial of labor.</p><p><strong>Methods: </strong>A total of 200 primigravidae admitted to our hospital from January 2021 to December 2022 were included as the subjects of this study. They were randomly divided into a control group and a study group, with 100 cases in each group. The control group underwent the vaginal finger test, while the study group underwent a combination of the vaginal finger test and intrapartum ultrasound. The consistency between the vaginal finger test and intrapartum ultrasound in determining fetal position was evaluated in the study group, and the mode of delivery and pregnancy outcomes were compared between the two groups.</p><p><strong>Results: </strong>The consistency of fetal occiput position between ultrasound and vaginal finger examination in the study group was 54.5% for occiput anterior position, 46.1% for occiput posterior position, and 31.4% for occiput transverse position, with an overall consistency of 46.5%. There was no significant difference in the cesarean section rate between the two groups. The rate of vaginal delivery in the control group was significantly lower than that in the study group, while the rate of perineal laceration was significantly higher in the control group. There were no significant differences in adverse outcomes for mothers and newborns between the two groups. The Angle of Progression (AOP) during natural vaginal delivery was significantly higher than that in other delivery modes, while AOP in cesarean section was significantly lower than that in other delivery modes. The head-perineum distance (HPD) during natural vaginal delivery was significantly lower than that in other delivery modes, while HPD in cesarean section was significantly higher than that in other delivery modes.</p><p><strong>Conclusion: </strong>Intrapartum ultrasound serves as an important adjunct in a vaginal trial of labor for primigravidae, aiding healthcare providers in accurately determining fetal head position, reducing the rate of perineal laceration, and increasing the rate of vaginal delivery. Notably, there are significant differences in ultrasound findings between women undergoing natural vaginal delivery and those with other delivery modes.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223326","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 impact of obesity and overweight on maternal and fetal health with conservative preconception interventions: a structured narrative review.","authors":"Szczerba Mateusz, Hejnosz Aleksandra, Falecka Katarzyna, Urban Aleksandra, Kacperczyk-Bartnik Joanna, Romejko-Wolniewicz Ewa","doi":"10.1007/s00404-026-08527-8","DOIUrl":"10.1007/s00404-026-08527-8","url":null,"abstract":"<p><strong>Purpose: </strong>Overweight and obesity before pregnancy are associated with adverse maternal, pregnancy-related, and longer-term health outcomes. This review aimed to summarize recent evidence on preconception overweight and obesity and to synthesize findings on conservative preconception or interpregnancy interventions, including lifestyle, dietary, behavioral, weight-management, and supplementation-based strategies.</p><p><strong>Methods: </strong>A structured narrative review with a predefined database search was conducted. PubMed and Embase were searched for studies published between January 2019 and December 2023 using the search string ((\"obesity\" OR \"overweight\") AND \"preconception\"). Due to heterogeneity in study design, populations, interventions, comparators, outcomes, and follow-up durations, findings were synthesized narratively rather than quantitatively. Thirteen studies were included: 11 intervention studies and 2 observational cohort studies retained as contextual evidence.</p><p><strong>Results: </strong>Observational evidence associated higher preconception BMI with adverse pregnancy-related outcomes, including labor induction, cesarean delivery, preterm birth, neonatal care admission, stillbirth, and post-delivery dysglycemia. Conservative interventions showed heterogeneous effects. Preconception weight loss was associated with selected fertility-related and glucose-related benefits in some studies, including shorter time to pregnancy after a very-low-energy diet intervention and lower odds of recurrent gestational diabetes mellitus when meaningful weight loss was achieved. Supplementation-based interventions showed inconsistent findings across BMI subgroups. Safety-related outcomes varied between studies, and long-term follow-up suggested that sustained benefits may depend on successful weight loss and maintenance of behavioral change.</p><p><strong>Conclusions: </strong>Conservative preconception interventions may provide selected benefits for women with overweight or obesity, particularly when clinically meaningful weight loss is achieved. However, current evidence remains heterogeneous and does not define a single optimal intervention model, timing, or universal weight-loss target.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219721","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":"Gestational age-specific nomograms for fetal eyeball depth and intraocular measurements using 3-D ultrasound.","authors":"Marwan Odeh, Rasha Nasra, Zvi Leibovitz, Hasan Bakry, Lior Lowenstein, Inshirah Sgayer","doi":"10.1007/s00404-026-08541-w","DOIUrl":"10.1007/s00404-026-08541-w","url":null,"abstract":"<p><strong>Purpose: </strong>To establish gestational age-specific nomograms for fetal eyeball anteroposterior (AP) diameter and intraocular measurements (lens AP diameter, vitreous body AP diameter).</p><p><strong>Methods: </strong>A retrospective study was conducted and included singleton pregnancies without prenatal or postnatal structural abnormalities. Three-dimensional ultrasound volumes of the fetal face acquired between 12 and 41 weeks' gestation were analyzed using multiplanar reformatting to obtain a standardized axial orbital plane. Right and left eyeball, lens, and vitreous body AP diameters were measured. Gestational age-specific reference ranges were generated using percentile distributions. Quadratic regression was used to assess associations with gestational age and biparietal diameter.</p><p><strong>Results: </strong>Of 608 volumes screened, 588 were included. Complete assessment of all parameters was available in 577 (98.1%). All ocular and intraocular measurements increased with gestational age (all p < 0.001). Quadratic regression demonstrated associations between gestational age and eyeball AP diameter (right R² = 0.80; left R² = 0.79), lens AP diameter (right R² = 0.44; left R² = 0.42), and vitreous body AP diameter (right R² = 0.80; left R² = 0.81). Similar associations were observed with biparietal diameter (all p < 0.001). Gestational age-specific nomograms and percentile tables are presented.</p><p><strong>Conclusions: </strong>Gestational age-specific nomograms for fetal eyeball depth and intraocular measurements are provided and may support objective prenatal assessment of fetal ocular growth.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219652","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":"Short-term obstetrical and neonatal complications in women with endometriosis.","authors":"Noa Leybovitz-Haleluya, Gil Gutvirtz, Anastasia Bendet, Eyal Sheiner","doi":"10.1007/s00404-026-08519-8","DOIUrl":"10.1007/s00404-026-08519-8","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis is a chronic gynecological condition that affects women in their reproductive age and could potentially lead to reproductive difficulties. Despite extensive research into the impact of endometriosis on fertility and reproductive health, its association with obstetric complications and short-term neonatal outcomes is still an area of limited understanding with conflicting evidence in published studies. We conducted this study to explore a potential effect of endometriosis on obstetric and neonatal outcomes.</p><p><strong>Methods: </strong>A retrospective population-based cohort study was conducted comparing obstetric and perinatal complications in women with and without endometriosis. We evaluated all singleton deliveries that occurred between 1991 and 2021 at a tertiary medical center. Fetuses with chromosomal abnormalities or congenital malformations were excluded. Generalized estimation equation (GEE) models were used to control for maternal recurrence in the cohort and for confounding variables.</p><p><strong>Results: </strong>During the study period, 232,476 deliveries met our inclusion criteria, 0.1% (n = 224) of whom had documented endometriosis. In the univariate analysis, women with endometriosis were significantly older, had higher rates of infertility and diabetes mellitus, and were more likely to undergo cesarean delivery. They also had higher rates of preterm birth and low birthweight infants, whereas perinatal mortality rates were comparable between the groups. In the GEE models, after controlling for maternal age, gravidity, and fertility treatments, the association for most of the aforementioned variables was no longer statistically significant. However, women with endometriosis were found to have a significant independent higher risk for cesarean delivery (adjusted OR 2.14 (1.62-2.83, p < 0.001).</p><p><strong>Conclusion: </strong>Among the obstetrical and perinatal complications investigated in this study, endometriosis was found to be an independent risk factor for cesarean delivery, while all other pregnancy outcomes were comparable to women without endometriosis.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219699","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":"Impaired fasting glucose and elevated 180-minute OGTT values predict metformin failure in gestational diabetes mellitus: a retrospective cohort study","authors":"Sivan Farladansky-Gershnabel,&nbsp;May Weinberg,&nbsp;Reut Baram,&nbsp;Shani Saffer,&nbsp;Ilil Mishani-Sagi,&nbsp;Or Eliner,&nbsp;Tal Biron-Shental,&nbsp;Dorit Ravid","doi":"10.1007/s00404-026-08528-7","DOIUrl":"10.1007/s00404-026-08528-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether oral glucose tolerance test (OGTT)-derived metabolic abnormalities and maternal characteristics predict metformin failure in women with gestational diabetes mellitus (GDM).</p><h3>Methods</h3><p>This retrospective cohort study included women with singleton pregnancies and gestational diabetes mellitus treated with metformin at a tertiary center (2018–2023). Gestational diabetes mellitus was diagnosed using the American Diabetes Association (ADA) two-step approach, consisting of an initial 50-g glucose challenge screening test followed, when abnormal, by a diagnostic 100-g, 3-h oral glucose tolerance test performed under fasting conditions and interpreted according to Carpenter-Coustan criteria (fasting ≥ 95 mg/dL, 1-h ≥ 180 mg/dL, 2-h ≥ 155 mg/dL, and 3-h ≥ 140 mg/dL). Routine screening was generally performed between 24 and 28 weeks’ gestation, with earlier testing in high-risk women when clinically indicated. Of 431 women who initiated metformin, 6 discontinued due to adverse effects, leaving 425 for analysis. Impaired fasting glucose (IFG) was defined as fasting OGTT ≥ 95 mg/dL. The primary outcome was metformin failure, defined as subsequent insulin initiation. Multivariable logistic regression included prespecified OGTT-derived phenotypes rather than simultaneous inclusion of all continuous OGTT variables in order to reduce multicollinearity.</p><h3>Results</h3><p>Among 425 women, 114 (26.8%) required insulin. These women had higher glucose values at all OGTT time points and a higher prevalence of IFG (41.2% vs 26.4%, p = 0.005). An abnormal 180-min value was also more frequent (21.1% vs 5.1%, p &lt; 0.001). The number of abnormal OGTT values did not differ significantly between groups and was not independently associated with metformin failure. In multivariable analysis, IFG (aOR 1.96, 95% CI 1.25–3.07) and an abnormal 180-min OGTT value (aOR 4.92, 95% CI 2.50–9.66) remained independently associated with metformin failure.</p><h3>Conclusion</h3><p>IFG and an elevated 180-min OGTT value may identify women with GDM at higher risk for treatment escalation. These findings should not be interpreted as direct indications for insulin initiation but rather as potential markers of increased risk for metformin failure requiring closer glycemic surveillance.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08528-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547611","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":"Complementary and alternative therapies in the management of menopausal symptoms: a systematic review and meta-analysis of randomised controlled trials","authors":"Eda Yakit AK,&nbsp;Zeynep Ogul","doi":"10.1007/s00404-026-08517-w","DOIUrl":"10.1007/s00404-026-08517-w","url":null,"abstract":"<div><h3>Objective</h3><p>This meta-analysis evaluated the effects of complementary and alternative therapies on menopausal symptoms.</p><h3>Materials and methods</h3><p>Relevant randomized controlled trials published after 2020 were systematically searched in the ASSIA, CENTRAL, CINAHL, LILACS, PubMed, Embase, and WOS databases. A total of 24 studies were included, and analyses were conducted using RevMan and JASP software. Heterogeneity and publication bias were assessed using various statistical methods. Results Twenty-four randomized controlled trials were synthesized. Evidence from the included studies indicates that complementary and traditional interventions may contribute to improvements in menopausal symptoms; however, effect estimates varied substantially across studies. A random-effects meta-analysis identified an average effect estimate, but substantial heterogeneity (τ² = 0.362) and a wide 95% prediction interval (−0.228 to 2.340) suggest considerable uncertainty in the magnitude and direction of effects across different settings. Meta-regression analyses showed that larger sample sizes were associated with smaller observed effects (β = −0.005, p = .014), indicating potential small-study effects. Intervention duration significantly influenced outcomes, whereas intervention type, dose, and formulation were not significant moderators. Subgroup analyses suggested beneficial trends for both herbal and non-herbal interventions, although prediction intervals remained wide, reinforcing the variability of findings.</p><h3>Conclusion</h3><p>Improvements were most consistent for hot flashes, while evidence for overall symptom severity and quality of life was less consistent. Although no statistically significant publication bias was detected, this finding should be interpreted with caution given the limited number of studies and observed heterogeneity. Integrating evidence-based complementary and alternative approaches into clinical guidelines could enhance holistic women’s healthcare.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08517-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519681","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":"Exploring the potential of metaphase I oocytes unresponsive to rescue IVM: fertilization, embryo development, and pregnancy outcomes","authors":"Ayşe Altun Akpınar,&nbsp;Burçin Karamustafaoğlu Balcı,&nbsp;Cigdem Celik,&nbsp;Ömer Demir,&nbsp;Cemil Akgül","doi":"10.1007/s00404-026-08484-2","DOIUrl":"10.1007/s00404-026-08484-2","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this prospective cohort study was to evaluate the developmental potential of metaphase I (MI) oocytes that failed to mature following rescue in vitro maturation (IVM), and to investigate the roles of artificial oocyte activation (AOA) and meiotic spindle presence in fertilization and early embryo development.</p><h3>Methods</h3><p>A total of 49 patients were included in the analysis. The study population was divided into 2 groups: an AOA group (28 patients, 42 MI oocytes) undergoing intracytoplasmic sperm injection (ICSI) followed by calcium ionophore-mediated activation, and a non-AOA control group (21 patients, 40 MI oocytes) undergoing ICSI without activation. Fertilization, embryo development, and clinical outcomes were compared between the groups. In addition, meiotic spindle presence was assessed using polarized light microscopy, and patients were categorized as spindle-positive or spindle-negative.</p><h3>Results</h3><p>Fertilization occurred in 23 of 42 MI oocytes (54.7%) in the AOA group, compared with 1 of 40 (2.5%) in the non-AOA group (<i>p</i> &lt; 0.001). In the control group, fertilization was observed only in a spindle-positive patient, and the resulting embryo arrested before transfer. In contrast, embryos derived from AOA-treated oocytes were able to progress to the transfer stage. Among AOA-treated patients, fertilization rates were higher in the spindle-positive group than in the spindle-negative group (71.4% vs. 50.0%), although this difference did not reach statistical significance. A total of eight embryos reached the transfer stage, resulting in one biochemical pregnancy and one clinical pregnancy leading to a live birth.</p><h3>Conclusion</h3><p>MI oocytes that fail to mature after rescue IVM appear to retain limited developmental potential. The use of artificial oocyte activation was associated with higher fertilization rates and enabled embryo development to progress to transferable stages in this cohort. The presence of a meiotic spindle may be associated with improved developmental competence and could represent a potential non-invasive marker; however, this observation requires further validation. Given the limited sample size and exploratory nature of the study, these findings should be interpreted with caution, and larger studies are needed to confirm their clinical relevance.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08484-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497148","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":"Patient satisfaction and perioperative data after breast surgery in tumescent local anaesthesia","authors":"M. Meffert,&nbsp;B. Schoenfisch,&nbsp;S. Guergan,&nbsp;I. Gruber,&nbsp;U. Hoopmann,&nbsp;G. Helms,&nbsp;C. Roehm,&nbsp;J. Pasternak,&nbsp;C. Haupt,&nbsp;E. Oberlechner,&nbsp;S. Y. Brucker,&nbsp;M. Hahn,&nbsp;B. Boeer","doi":"10.1007/s00404-026-08524-x","DOIUrl":"10.1007/s00404-026-08524-x","url":null,"abstract":"<div><h3>Purpose</h3><p>Tumescent local anaesthesia (TLA) is an upcoming alternative to general anaesthesia. No data exists regarding patient satisfaction, necessary volume of TLA, frequency of supplementary analgosedation, and associated complication rate after different kinds of breast surgeries in TLA.</p><h3>Methods</h3><p>In this retrospective study 104 patients, who underwent breast surgery in TLA between 1/2022 and 1/2023, answered a questionnaire. Patients were categorized according to histology and surgical complexity into two groups: those with benign histology undergoing minor procedures (outpatients) and those with malignant histology undergoing more complex surgical procedures (inpatients). Perioperative data was retrieved from the patients’ files.</p><h3>Results</h3><p>96.1% of all patients were (very) satisfied with the surgery, with inpatients being significantly more satisfied (p = 0.022). No significant differences were observed between the groups regarding perception of TLA-infiltration, likelihood of recommending the procedure in TLA, or willingness to undergo the procedure again in TLA. Six patients (5.8%) had postoperative complications with no significant difference in frequency of complications. Outpatients needed significantly less TLA-volume (184.7ml ± 131.4 ml), compared to inpatients with a total TLA-volume of 473.3 ml ± 205.2 ml (p &lt; 0.001). 25 patients (24.0%) opted for an intraoperative midazolam sedation (mean 1.5 mg, SD 0.9mg), predominantly in more extensive procedures.</p><h3>Conclusion</h3><p>Patients’ high satisfaction and recommendation level and the low rate of complications are convincing reasons to offer TLA as an alternative to general anaesthesia for a large spectrum of breast surgeries.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08524-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148466485","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":"Is assisted oocyte activation an effective method in poor responders?","authors":"Ayşe Altun Akpinar,&nbsp;Burçin Karamustafaoğlu Balcı ,&nbsp;Çiğdem Çelik,&nbsp;Cemil Akgül","doi":"10.1007/s00404-026-08491-3","DOIUrl":"10.1007/s00404-026-08491-3","url":null,"abstract":"<div><h3>Objective</h3><p>Poor responders pose a significant challenge in fertility treatment, leading to decreased oocyte quality and fertilization rates. Assisted oocyte activation (AOA) has emerged as a method to improve fertilization rates. This study aims to evaluate the effect of AOA on fertilization, pregnancy, and live birth rates in patients with diminished ovarian reserve.</p><h3>Materials and methods</h3><p>This prospective non-randomized comparative study included a cohort of infertility patients with diminished ovarian reserve, divided into three groups: the control group receiving standard treatment (Group I/Conventional ICSI), the electrical activation group undergoing piezoelectric stimulation (Group II/ICSI + Piezoelectric), and the chemical activation group treated with calcium ionophore (Group III/ICSI + Calcium Ionophore). Each group consisted of 50 patients. The effects of electrical and chemical activation applied after ICSI on fertilization, pregnancy, and live birth rates were evaluated.</p><h3>Results</h3><p>There were no statistically significant differences among the groups in hormone levels (FSH, LH, E2, PRL, and AMH), number of oocytes, or number of MII oocytes. Fertilization rates were significantly higher in the piezoelectric group compared to the control group (<i>p</i> = 0.007). Although the fertilization rate in the calcium ionophore group was higher than that in the control group, this difference did not reach statistical significance (<i>p</i> = 1.000). There was no statistically significant difference in fertilization rates between the piezoelectric and calcium ionophore groups (<i>p</i> = 0.071). Regarding pregnancy rates, the highest implantation rate was observed in the calcium ionophore group (37%), but this difference does not reach statistical significance (<i>p</i> = 0.224). No significant differences were observed among the groups in embryo quality, clinical pregnancy, ongoing pregnancy, and live birth rates.</p><h3>Conclusion</h3><p>In patients classified as diminished ovarian reserve, artificial oocyte activation (AOA) was associated with higher fertilization rates for increasing fertilization rates, potentially resulting in a greater number of fertilized oocytes and transferable embryos. However, this apparent benefit does not translate into improved biochemical pregnancy outcomes. Moreover, no significant differences were observed between groups in terms of embryo quality, clinical pregnancy, ongoing pregnancy, and live birth rates. These findings suggest that while AOA may enhance early laboratory outcomes, its impact on clinically meaningful reproductive endpoints remains limited. Therefore, further adequately powered randomized studies are required to clarify the efficacy and safety of AOA.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468633","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":"Associations between waist-to-height ratio and hormonal–metabolic profiles in midlife women: evidence from a population-based cross-sectional study","authors":"Miao Deng,&nbsp;Zhifen Zhang,&nbsp;Nan Chen","doi":"10.1007/s00404-026-08518-9","DOIUrl":"10.1007/s00404-026-08518-9","url":null,"abstract":"<div><h3>Purpose</h3><p>Central adiposity increases during the menopausal transition, yet its hormonal signatures are not well defined. This study examined whether the waist-to-height ratio (WHtR) reflects coordinated variation in sex-steroid, thyroid, and metabolic pathways in midlife women, and evaluated the discriminative value of key endocrine markers for identifying elevated WHtR.</p><h3>Methods</h3><p>We conducted a population-based cross-sectional analysis of 17,379 women aged 40–60 years who underwent standardized WHtR measurement and serum assessment of sex-steroid hormones (estradiol, testosterone, progesterone, FSH, LH), thyroid hormones (free T4, free T3, TSH), and metabolic markers (lipid profile, HbA1c). Associations were tested using univariate correlations and multivariable regressions adjusted for age and BMI. Age-adjusted WHtR percentiles were estimated using quantile regression. Hormonal–metabolic clustering was mapped using correlation matrices. Logistic regression and ROC analyses evaluated the performance of estradiol, free T4, and their combination for identifying WHtR ≥ 0.50.</p><h3>Results</h3><p>WHtR values were in the healthy range for 68.4% of women, while 29.3% exceeded the ≥ 0.50 threshold. WHtR showed weak negative correlations with estradiol (<i>r</i> = −0.024, <i>P</i> = 0.0019) and free T4 (<i>r</i> = −0.017, <i>P</i> = 0.026), with small effect sizes, and these markers remained independently associated with WHtR after adjusting for age and BMI. ROC analyses demonstrated moderate discrimination by FT4 (AUC 0.67), compared with estradiol (AUC 0.61), with improved accuracy when combined (AUC 0.76).</p><h3>Conclusion</h3><p>Lower estradiol and FT4 levels were associated with higher central adiposity in midlife women. WHtR showed weak, but significant associations with both hormones, yet the small effect sizes and low explanatory power render it clinically unsuitable for individual-level assessment.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08518-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468614","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}