Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.04.035
{"title":"When should assisted reproductive technology workups be performed: following a tiered approach or all on day 1?","authors":"","doi":"10.1016/j.fertnstert.2024.04.035","DOIUrl":"10.1016/j.fertnstert.2024.04.035","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.07.016
Qiaosong Han M.D. , Jinwei Hou M.D. , Zhengao Sun M.D., Ph.D.
{"title":"Seminal plasma exposure in in vitro fertilization cycles: “Dripping water hollows out stone, not through force but through persistence”","authors":"Qiaosong Han M.D. , Jinwei Hou M.D. , Zhengao Sun M.D., Ph.D.","doi":"10.1016/j.fertnstert.2024.07.016","DOIUrl":"10.1016/j.fertnstert.2024.07.016","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.06.016
<div><h3>Importance</h3><div>Menstruation serves as an indicator of women’s reproductive well-being and plays a pivotal role in their fertility; nevertheless, there remains an ongoing debate regarding the epidemiological evidence linking menstrual characteristics as well as fertility.</div></div><div><h3>Objective</h3><div>To explore the correlation between menstrual characteristics and fertility in women of reproductive age.</div></div><div><h3>Data Sources</h3><div>A comprehensive literature search was conducted using PubMed, Embase, Web of Science, and Cochrane libraries to identify research articles published up until February 9, 2024.</div></div><div><h3>Study Selection and Synthesis</h3><div><span>We included all studies in which the relationship between menstrual characteristics and pregnancy rates among women of reproductive age was investigated. We excluded studies involving the administration of </span>oral contraceptives<span>, the application of assisted reproductive technologies, and individuals with a documented history of infertility or partners with a known history of infertility.</span></div></div><div><h3>Main Outcome Measure(s)</h3><div>Clinical pregnancy and miscarriage.</div></div><div><h3>Result(s)</h3><div><span>This meta-analysis was composed of nine studies involving a total of 399,966 women, and the evidential quality derived from these studies was deemed to be high with a low risk of bias. Compared with a normal menstrual cycle<span> length (25–32 days), the impact of a short (<25 days) or long (>32 days) menstrual cycle on a woman’s pregnancy was relatively insignificant ([odds ratio {OR}, 0.81; 95% confidence interval {CI}, 0.65–1.01; I</span></span><sup>2</sup>, 68%]; [OR, 0.89; 95% CI, 0.75–1.06; I<sup>2</sup>, 60%], respectively); however, a change in cycle length may increase the risk of miscarriage ([relative risk, 1.87; 95% CI, 1.11–3.15; I<sup>2</sup>, 0]; [relative risk, 1.66; 95% CI, 1.07, 2.57; I<sup>2</sup><span>, 43%], respectively). In comparison to women experiencing menarche<span> at a typical age (12–14 years), those with a late age at menarche (>14 years) exhibited a decreased likelihood of pregnancy (OR, 0.92; 95% CI, 0.91–0.93; I</span></span><sup>2</sup><span>, 0%); and compared with women experiencing a normal duration of menstrual bleeding<span> (4–7 days), those with a short duration of menstrual bleeding (<4 days) exhibited reduced fertility potential (OR, 0.86; 95% CI, 0.84–0.88; I</span></span><sup>2</sup>, 29%).</div></div><div><h3>Conclusion(s)</h3><div>Short and long menstrual cycle lengths may elevate women’s susceptibility to spontaneous abortion, whereas late age at menarche as well as short duration of menstrual bleeding appear to be linked to diminished fertility among women of reproductive age.</div></div><div><h3>Clinical Trial Registration</h3><div>PROSPERO CRD42023487458 (9 December 2023).</div></div><div><div>La correlación entre las características menstruales y la f
{"title":"The correlation between menstrual characteristics and fertility in women of reproductive age: a systematic review and meta-analysis","authors":"","doi":"10.1016/j.fertnstert.2024.06.016","DOIUrl":"10.1016/j.fertnstert.2024.06.016","url":null,"abstract":"<div><h3>Importance</h3><div>Menstruation serves as an indicator of women’s reproductive well-being and plays a pivotal role in their fertility; nevertheless, there remains an ongoing debate regarding the epidemiological evidence linking menstrual characteristics as well as fertility.</div></div><div><h3>Objective</h3><div>To explore the correlation between menstrual characteristics and fertility in women of reproductive age.</div></div><div><h3>Data Sources</h3><div>A comprehensive literature search was conducted using PubMed, Embase, Web of Science, and Cochrane libraries to identify research articles published up until February 9, 2024.</div></div><div><h3>Study Selection and Synthesis</h3><div><span>We included all studies in which the relationship between menstrual characteristics and pregnancy rates among women of reproductive age was investigated. We excluded studies involving the administration of </span>oral contraceptives<span>, the application of assisted reproductive technologies, and individuals with a documented history of infertility or partners with a known history of infertility.</span></div></div><div><h3>Main Outcome Measure(s)</h3><div>Clinical pregnancy and miscarriage.</div></div><div><h3>Result(s)</h3><div><span>This meta-analysis was composed of nine studies involving a total of 399,966 women, and the evidential quality derived from these studies was deemed to be high with a low risk of bias. Compared with a normal menstrual cycle<span> length (25–32 days), the impact of a short (<25 days) or long (>32 days) menstrual cycle on a woman’s pregnancy was relatively insignificant ([odds ratio {OR}, 0.81; 95% confidence interval {CI}, 0.65–1.01; I</span></span><sup>2</sup>, 68%]; [OR, 0.89; 95% CI, 0.75–1.06; I<sup>2</sup>, 60%], respectively); however, a change in cycle length may increase the risk of miscarriage ([relative risk, 1.87; 95% CI, 1.11–3.15; I<sup>2</sup>, 0]; [relative risk, 1.66; 95% CI, 1.07, 2.57; I<sup>2</sup><span>, 43%], respectively). In comparison to women experiencing menarche<span> at a typical age (12–14 years), those with a late age at menarche (>14 years) exhibited a decreased likelihood of pregnancy (OR, 0.92; 95% CI, 0.91–0.93; I</span></span><sup>2</sup><span>, 0%); and compared with women experiencing a normal duration of menstrual bleeding<span> (4–7 days), those with a short duration of menstrual bleeding (<4 days) exhibited reduced fertility potential (OR, 0.86; 95% CI, 0.84–0.88; I</span></span><sup>2</sup>, 29%).</div></div><div><h3>Conclusion(s)</h3><div>Short and long menstrual cycle lengths may elevate women’s susceptibility to spontaneous abortion, whereas late age at menarche as well as short duration of menstrual bleeding appear to be linked to diminished fertility among women of reproductive age.</div></div><div><h3>Clinical Trial Registration</h3><div>PROSPERO CRD42023487458 (9 December 2023).</div></div><div><div>La correlación entre las características menstruales y la f","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply of the authors: Seminal plasma exposure in IVF cycles: “dripping water hollows out stone, not through force but through persistence”","authors":"Susanne Liffner M.D., Ph.D., Gunilla Sydsjö Ph.D., Elizabeth Nedstrand M.D., Ph.D.","doi":"10.1016/j.fertnstert.2024.08.344","DOIUrl":"10.1016/j.fertnstert.2024.08.344","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.08.347
Liam Kali B.A., C.M
Importance
Lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) families deserve evidence-based care within environments designed for their unique needs; however, care provided in fertility clinics has been reported to fall short, most notably for assigned female at birth recipients of therapeutic donor insemination (TDI).
Objective
To identify the aspects of routine infertility care that are clinically appropriate for this unique patient population, specifically those seeking pregnancy with donor sperm. The research question was posed, “What screening and treatment protocols are supported by the evidence regarding TDI care for LGBTQ+ families?”
Evidence Review
High quality, prospective studies specific to and/or inclusive of this patient population in assisted reproductive care contexts is limited, however evidence regarding age-informed prognosis, screening guidelines, treatment outcomes, insemination timing, number of inseminations per cycle, when to refer, and safety of the procedure were found.
Findings
Findings indicate that compared with routine infertility care protocols, a low-tech, low-intervention model of care for ovulatory LGBTQ+ individuals renders equal or higher success rates without increasing risk.
Conclusion
Given the current evidence, TDI for LGBTQ+ families can, with support and training, be provided appropriately in a variety of contexts, including community-based and primary care settings as well as in fertility clinics.
Relevance
This review establishes the current state of the evidence supporting TDI for LGBTQ+ families, expanding access to care for recipients as well as their care providers and outlining areas for further study.
{"title":"Therapeutic donor insemination for LGBTQ+ families: a systematic review","authors":"Liam Kali B.A., C.M","doi":"10.1016/j.fertnstert.2024.08.347","DOIUrl":"10.1016/j.fertnstert.2024.08.347","url":null,"abstract":"<div><h3>Importance</h3><div>Lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) families deserve evidence-based care within environments designed for their unique needs; however, care provided in fertility clinics has been reported to fall short, most notably for assigned female at birth recipients of therapeutic donor insemination (TDI).</div></div><div><h3>Objective</h3><div>To identify the aspects of routine infertility care that are clinically appropriate for this unique patient population, specifically those seeking pregnancy with donor sperm. The research question was posed, “What screening and treatment protocols are supported by the evidence regarding TDI care for LGBTQ+ families?”</div></div><div><h3>Evidence Review</h3><div>High quality, prospective studies specific to and/or inclusive of this patient population in assisted reproductive care contexts is limited, however evidence regarding age-informed prognosis, screening guidelines, treatment outcomes, insemination timing, number of inseminations per cycle, when to refer, and safety of the procedure were found.</div></div><div><h3>Findings</h3><div>Findings indicate that compared with routine infertility care protocols, a low-tech, low-intervention model of care for ovulatory LGBTQ+ individuals renders equal or higher success rates without increasing risk.</div></div><div><h3>Conclusion</h3><div>Given the current evidence, TDI for LGBTQ+ families can, with support and training, be provided appropriately in a variety of contexts, including community-based and primary care settings as well as in fertility clinics.</div></div><div><h3>Relevance</h3><div>This review establishes the current state of the evidence supporting TDI for LGBTQ+ families, expanding access to care for recipients as well as their care providers and outlining areas for further study.</div></div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.08.338
Luce A. Kassi M.D., Jennifer L. Eaton M.D., M.S.C.I.
{"title":"Fresh or frozen oocyte donation: is there a bad egg?","authors":"Luce A. Kassi M.D., Jennifer L. Eaton M.D., M.S.C.I.","doi":"10.1016/j.fertnstert.2024.08.338","DOIUrl":"10.1016/j.fertnstert.2024.08.338","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.06.014
<div><h3>Objective</h3><div>To assess whether the provision of fertility treatment for patients with polycystic ovary syndrome (PCOS) varies by patient and physician-level demographic characteristics.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>University health system.</div></div><div><h3>Patient(s)</h3><div>Patients seeking care for PCOS and infertility from 2007–2021.</div></div><div><h3>Intervention(s)</h3><div>Patient age, body mass index, race, ethnicity, estimated household income, primary insurance payor, provider sex, and provider medical specialty.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Prescriptions for fertility treatment, including clomiphene citrate (CC), letrozole, and injectable gonadotropins. Differences in patient and physician demographics between patients who did as well as did not receive a prescription were identified with univariable analysis. Multilevel mixed-effects logistic regression was performed to determine associations between patient and physician demographics and prescription receipt.</div></div><div><h3>Result(s)</h3><div>A total of 3,435 patients with PCOS and infertility were identified, with a mean age of 31.1 ± 5.7 years. Of the 68.8% of patients who received a prescription, 47.8% of prescriptions were CC, 38.6% were letrozole, and 13.7% were injectable gonadotropins. There were lower odds of prescription receipt for Black patients compared with White patients (adjusted odds ratio [aOR], 0.75; 95% confidence interval [CI], 0.61–0.93), those with estimated household income below the federal poverty level compared with those above the national median (aOR, 0.71; 95% CI, 0.46–0.97), and those with public compared with commercial insurance (aOR, 0.53; 95% CI, 0.40–0.71). These disparities persisted in a subanalysis of patients prescribed oral medications only with lower odds of prescription receipt for Black compared with White patients (aOR, 0.74; 95% CI, 0.57–0.95), those with estimated household income below the federal poverty level compared with above the national median (aOR, 0.93; 95% CI, 0.87–0.98), and those with public compared with commercial insurance (aOR, 0.57; 95% CI, 0.42–0.76). Black patients waited, on average, 153.3 days longer than White patients, from the initial visit to the prescription receipt. Patients had lower odds of receiving any prescription from family medicine physicians (aOR, 0.36; 95% CI, 0.24–0.52) and general internal medicine physicians (aOR, 0.55; 95% CI, 0.42–0.73) compared with reproductive endocrinologists.</div></div><div><h3>Conclusion(s)</h3><div>Racial and socioeconomic disparities exist in the provision of infertility treatments for patients with PCOS. Fewer primary care physicians engaged in first-line fertility treatment, indicating an opportunity for physician education to improve access to fertility care.</div></div><div><div>Diferencias raciales y socioeconómicas en la prestación de tratamient
目的评估为多囊卵巢综合征（PCOS）患者提供的生育治疗是否因患者和医生的人口统计学特征而异：设计：回顾性队列研究：2007-2021年间在某大学医疗系统就诊的多囊卵巢综合征和不孕症患者：主要结果测量指标：生育治疗处方，包括枸橼酸氯米芬、来曲唑和注射用促性腺激素。通过单变量分析确定了开具处方与未开具处方的患者和医生在人口统计学方面的差异。为了确定患者和医生的人口统计学特征与接受处方之间的关系，进行了多层次混合效应逻辑回归：共发现 3435 名多囊卵巢综合征和不孕症患者，平均年龄为 31.1 +/- 5.7 岁。在68.8%收到处方的患者中，47.8%的处方为枸橼酸克罗米芬，38.6%为来曲唑，13.7%为注射用促性腺激素。黑人患者与白人患者相比（aOR 0.75，95% CI 0.61-0.93），估计家庭收入低于联邦贫困线（FPL）与高于全国中位数相比（aOR 0.71，95% CI 0.46-0.97），以及公共保险与商业保险相比（aOR 0.53，95% CI 0.40-0.71），接受处方的几率都较低。在一项仅针对口服药物处方患者的子分析中，这些差异依然存在：黑人患者获得处方的几率低于白人患者（aOR 0.74，95% CI 0.57-0.95）；估计家庭收入低于 FPL 而高于全国中位数（aOR 0.93，95% CI 0.87-0.98）；以及公共保险患者低于商业保险患者（aOR 0.57，95% CI 0.42-0.76）。黑人患者从初次就诊到拿到处方的平均时间比白人患者长 153.3 天。与生殖内分泌科医生相比，患者从家庭医生（aOR 0.36，95% CI 0.24-0.52）和普通内科医生（aOR 0.55，95% CI 0.42-0.73）处获得处方的几率较低：结论：在为多囊卵巢综合征患者提供不孕不育治疗方面存在种族和社会经济差异。参与一线不孕不育治疗的初级保健医生较少，这表明医生有机会通过教育来改善不孕不育治疗的可及性。
{"title":"Racial and socioeconomic disparities in fertility treatment provision for patients with polycystic ovary syndrome","authors":"","doi":"10.1016/j.fertnstert.2024.06.014","DOIUrl":"10.1016/j.fertnstert.2024.06.014","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether the provision of fertility treatment for patients with polycystic ovary syndrome (PCOS) varies by patient and physician-level demographic characteristics.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>University health system.</div></div><div><h3>Patient(s)</h3><div>Patients seeking care for PCOS and infertility from 2007–2021.</div></div><div><h3>Intervention(s)</h3><div>Patient age, body mass index, race, ethnicity, estimated household income, primary insurance payor, provider sex, and provider medical specialty.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Prescriptions for fertility treatment, including clomiphene citrate (CC), letrozole, and injectable gonadotropins. Differences in patient and physician demographics between patients who did as well as did not receive a prescription were identified with univariable analysis. Multilevel mixed-effects logistic regression was performed to determine associations between patient and physician demographics and prescription receipt.</div></div><div><h3>Result(s)</h3><div>A total of 3,435 patients with PCOS and infertility were identified, with a mean age of 31.1 ± 5.7 years. Of the 68.8% of patients who received a prescription, 47.8% of prescriptions were CC, 38.6% were letrozole, and 13.7% were injectable gonadotropins. There were lower odds of prescription receipt for Black patients compared with White patients (adjusted odds ratio [aOR], 0.75; 95% confidence interval [CI], 0.61–0.93), those with estimated household income below the federal poverty level compared with those above the national median (aOR, 0.71; 95% CI, 0.46–0.97), and those with public compared with commercial insurance (aOR, 0.53; 95% CI, 0.40–0.71). These disparities persisted in a subanalysis of patients prescribed oral medications only with lower odds of prescription receipt for Black compared with White patients (aOR, 0.74; 95% CI, 0.57–0.95), those with estimated household income below the federal poverty level compared with above the national median (aOR, 0.93; 95% CI, 0.87–0.98), and those with public compared with commercial insurance (aOR, 0.57; 95% CI, 0.42–0.76). Black patients waited, on average, 153.3 days longer than White patients, from the initial visit to the prescription receipt. Patients had lower odds of receiving any prescription from family medicine physicians (aOR, 0.36; 95% CI, 0.24–0.52) and general internal medicine physicians (aOR, 0.55; 95% CI, 0.42–0.73) compared with reproductive endocrinologists.</div></div><div><h3>Conclusion(s)</h3><div>Racial and socioeconomic disparities exist in the provision of infertility treatments for patients with PCOS. Fewer primary care physicians engaged in first-line fertility treatment, indicating an opportunity for physician education to improve access to fertility care.</div></div><div><div>Diferencias raciales y socioeconómicas en la prestación de tratamient","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.07.009
<div><h3>Objective</h3><div>To report utilization, effectiveness, and safety of assisted reproductive technologies in 2015 and 2016.</div></div><div><h3>Design</h3><div>A retrospective, cross-sectional survey of 3,103 assisted reproductive technology clinics in 74 countries in 2015 and 3,249 clinics in 79 countries in 2016 that submitted cycle and pregnancy outcome data through national and regional registries.</div></div><div><h3>Setting</h3><div>Seventy-nine countries and >3,000 assisted reproductive technology clinics.</div></div><div><h3>Patient(s)</h3><div>Patients undergoing assisted reproductive technology procedures.</div></div><div><h3>Intervention(s)</h3><div>Assisted reproductive technology.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Outcomes on country, regional, and global levels.</div></div><div><h3>Result(s)</h3><div>Reported for 2015: 2,358,239 cycles with 548,652 infants born; for 2016: 2,807,963 cycles with 647,188 infants born. Estimated in 2015, ≥2,683,677 cycles resulted in >675,134 infants; in 2016, ≥3,100,448 cycles resulted in ≥723,026 infants. Reported cycles represent approximately 80% of global utilization. In 2015 and 2016, 27.6% and 27.8%, respectively, of women undergoing fresh autologous treatment cycles were aged ≥40 years. Frozen-thawed embryo transfer (ET) cycles accounted for 47.0% and 51.9%, respectively, of all ETs in 2015 and 2016. Oocyte donation cycles accounted for 6.7% and 7.1% of all ETs in 2015 and 2016. Intracytoplasmic sperm injection was performed in 57.7% and 56.4% of autologous aspiration cycles in 2015 and 2016, respectively. The cumulative delivery rate per aspiration cycle for fresh and frozen-thawed ET was 32.4% in 2015 and 33.1% in 2016, respectively. The average number of transferred embryos was 1.70 in 2015 and 1.69 in 2016. The proportion of single ETs in fresh autologous cycles increased from 42.1% in 2015 to 44.0% in 2016. The twin delivery rate decreased from 16.0% in 2015 to 14.7% in 2016, and the triplet rate decreased from 0.6% in 2015 to 0.4% in 2016. The proportion of single ETs in frozen-thawed ET autologous treatment cycles was 62.2% in 2015 and 64.2% in 2016, with twin and triplet rates of 10.1% and 0.3% in 2015 and 10.0% and 0.2% in 2016, respectively.</div></div><div><h3>Conclusion(s)</h3><div>Utilization of assisted reproductive technology treatment and births per cycle increased from 2015 to 2016, although multiple births were reduced. An increasing proportion of frozen-thawed ET cycles, continuing wide variation in use of intracytoplasmic sperm injection, and an increase in single ET rates are reported.</div></div><div><div>Informe mundial del Comité Internacional para el Seguimiento de la Tecnología de Reproducción Asistida: tecnología de la reproducción asistida, 2015 y 2016</div></div><div><h3>Objetivo</h3><div>Informar sobre la utilización, eficacia y seguridad de las tecnologías de reproducción asistida en 2015 y 2016.</div></div><div><h3>Diseño</h3><div
{"title":"International Committee for Monitoring Assisted Reproductive Technology world report: assisted reproductive technology, 2015 and 2016","authors":"","doi":"10.1016/j.fertnstert.2024.07.009","DOIUrl":"10.1016/j.fertnstert.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>To report utilization, effectiveness, and safety of assisted reproductive technologies in 2015 and 2016.</div></div><div><h3>Design</h3><div>A retrospective, cross-sectional survey of 3,103 assisted reproductive technology clinics in 74 countries in 2015 and 3,249 clinics in 79 countries in 2016 that submitted cycle and pregnancy outcome data through national and regional registries.</div></div><div><h3>Setting</h3><div>Seventy-nine countries and >3,000 assisted reproductive technology clinics.</div></div><div><h3>Patient(s)</h3><div>Patients undergoing assisted reproductive technology procedures.</div></div><div><h3>Intervention(s)</h3><div>Assisted reproductive technology.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Outcomes on country, regional, and global levels.</div></div><div><h3>Result(s)</h3><div>Reported for 2015: 2,358,239 cycles with 548,652 infants born; for 2016: 2,807,963 cycles with 647,188 infants born. Estimated in 2015, ≥2,683,677 cycles resulted in >675,134 infants; in 2016, ≥3,100,448 cycles resulted in ≥723,026 infants. Reported cycles represent approximately 80% of global utilization. In 2015 and 2016, 27.6% and 27.8%, respectively, of women undergoing fresh autologous treatment cycles were aged ≥40 years. Frozen-thawed embryo transfer (ET) cycles accounted for 47.0% and 51.9%, respectively, of all ETs in 2015 and 2016. Oocyte donation cycles accounted for 6.7% and 7.1% of all ETs in 2015 and 2016. Intracytoplasmic sperm injection was performed in 57.7% and 56.4% of autologous aspiration cycles in 2015 and 2016, respectively. The cumulative delivery rate per aspiration cycle for fresh and frozen-thawed ET was 32.4% in 2015 and 33.1% in 2016, respectively. The average number of transferred embryos was 1.70 in 2015 and 1.69 in 2016. The proportion of single ETs in fresh autologous cycles increased from 42.1% in 2015 to 44.0% in 2016. The twin delivery rate decreased from 16.0% in 2015 to 14.7% in 2016, and the triplet rate decreased from 0.6% in 2015 to 0.4% in 2016. The proportion of single ETs in frozen-thawed ET autologous treatment cycles was 62.2% in 2015 and 64.2% in 2016, with twin and triplet rates of 10.1% and 0.3% in 2015 and 10.0% and 0.2% in 2016, respectively.</div></div><div><h3>Conclusion(s)</h3><div>Utilization of assisted reproductive technology treatment and births per cycle increased from 2015 to 2016, although multiple births were reduced. An increasing proportion of frozen-thawed ET cycles, continuing wide variation in use of intracytoplasmic sperm injection, and an increase in single ET rates are reported.</div></div><div><div>Informe mundial del Comité Internacional para el Seguimiento de la Tecnología de Reproducción Asistida: tecnología de la reproducción asistida, 2015 y 2016</div></div><div><h3>Objetivo</h3><div>Informar sobre la utilización, eficacia y seguridad de las tecnologías de reproducción asistida en 2015 y 2016.</div></div><div><h3>Diseño</h3><div","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.fertnstert.2024.07.494
Guiquan Wang M.D. , Haiyan Yang M.D. , Xintong Jiang M.D. , Weian Mao M.D. , Ping Li M.D. , Xiaojing Lin M.D. , Yan Li M.D. , Zhenhong Ye M.D. , Yurong Zhang M.D. , Wei Chen M.D. , Shuai Yuan M.Med.Sc. , Yue Zhao Ph.D. , Liangshan Mu M.D. Ph.D
{"title":"Reply of the authors: a commentary on: “Association of serum uric acid with women’s ovarian reserve: observational study and Mendelian randomization analyses”","authors":"Guiquan Wang M.D. , Haiyan Yang M.D. , Xintong Jiang M.D. , Weian Mao M.D. , Ping Li M.D. , Xiaojing Lin M.D. , Yan Li M.D. , Zhenhong Ye M.D. , Yurong Zhang M.D. , Wei Chen M.D. , Shuai Yuan M.Med.Sc. , Yue Zhao Ph.D. , Liangshan Mu M.D. Ph.D","doi":"10.1016/j.fertnstert.2024.07.494","DOIUrl":"10.1016/j.fertnstert.2024.07.494","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Objective</h3><div>To evaluate the efficacy and safety of 24-week cyclic administration of estetrol (E4) (15 mg)/drospirenone (DRSP) (3 mg) in Japanese patients with endometriosis.</div></div><div><h3>Design</h3><div>A 24-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study.</div></div><div><h3>Setting</h3><div>Twenty-five study centers in Japan.</div></div><div><h3>Patient(s)</h3><div>A total of 162 Japanese women diagnosed with endometriosis.</div></div><div><h3>Intervention(s)</h3><div>Participants were randomly allocated to the E4/DRSP group or the placebo group. In the E4/DRSP group, participants were orally administered one tablet containing E4 (15 mg) and DRSP (3 mg) daily for 24 days, followed by one placebo tablet for 4 days for a hormone-free interval, constituting a 1-cycle regimen. One placebo tablet was administered once daily for 28 days to participants in the placebo group. The treatments were continued for six cycles (24 weeks) throughout the confirmatory period.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Changes in visual analogue scale (VAS) scores for the most severe pelvic pain (lower abdominal and back pain) from baseline to six treatment cycles at the end of the confirmatory study period.</div></div><div><h3>Result(s)</h3><div>Estetrol/drospirenone showed changes in the mean VAS scores for the most severe pelvic pain (−33.2 mm) from baseline to the end of the 6-cycle treatment. The between-group difference was significant (−8.5 mm; 2-sided 95% confidence interval, −16.1 to −0.9 mm), showing superiority to placebo. The responder rates, ≥30% and ≥50% reductions in the VAS scores from baseline, were higher in the E4/DRSP group than in the placebo group: 53.2% vs. 29.6% and 36.4% vs. 12.3%. Objective gynecological findings (induration of the cul-de-sac, pelvic tenderness, and limited uterine mobility) were significantly improved by E4/DRSP treatment, and the proportions of stable and worsened participants were significantly lower than in the placebo group. Estetrol/drospirenone decreased the size of endometriomas and improved quality of life, on the basis of quality of life–related questionnaires and global impression scores. No safety concerns were observed with E4/DRSP treatment. Few differences were observed in the proportion of participants with hemostasis parameters outside the reference range between the E4/DRSP and placebo groups.</div></div><div><h3>Conclusion(s)</h3><div>Estetrol/drospirenone effectively treats endometriosis-associated pain and improves gynecological findings. Estetrol/drospirenone may be a safe, new option for endometriosis treatment with a potentially decreased risk of thromboembolic events.</div></div><div><h3>Clinical Trial Registration Number</h3><div>jRCT2011210027.</div></div><div><div>Eficacia y seguridad de la combinación de estetrol 15 mg/drospirenona 3 mg en un régimen cíclico para el tratamiento del dolor asociado a la endometriosis y halla
{"title":"Efficacy and safety of the combination of estetrol 15 mg/drospirenone 3 mg in a cyclic regimen for the treatment of endometriosis-associated pain and objective gynecological findings: a multicenter, placebo-controlled, double-blind, randomized study","authors":"Tasuku Harada M.D., Ph.D. , Takao Kobayashi M.D., Ph.D. , Akihiro Hirakawa Ph.D. , Toshiaki Takayanagi B.M.L.S. , Masayoshi Nogami M.Sc. , Takayuki Mochiyama M.Pharm. , Masashi Hirayama M.Pharm. , Jean-Michel Foidart M.D., Ph.D. , Yutaka Osuga M.D., Ph.D.","doi":"10.1016/j.fertnstert.2024.07.011","DOIUrl":"10.1016/j.fertnstert.2024.07.011","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of 24-week cyclic administration of estetrol (E4) (15 mg)/drospirenone (DRSP) (3 mg) in Japanese patients with endometriosis.</div></div><div><h3>Design</h3><div>A 24-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study.</div></div><div><h3>Setting</h3><div>Twenty-five study centers in Japan.</div></div><div><h3>Patient(s)</h3><div>A total of 162 Japanese women diagnosed with endometriosis.</div></div><div><h3>Intervention(s)</h3><div>Participants were randomly allocated to the E4/DRSP group or the placebo group. In the E4/DRSP group, participants were orally administered one tablet containing E4 (15 mg) and DRSP (3 mg) daily for 24 days, followed by one placebo tablet for 4 days for a hormone-free interval, constituting a 1-cycle regimen. One placebo tablet was administered once daily for 28 days to participants in the placebo group. The treatments were continued for six cycles (24 weeks) throughout the confirmatory period.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Changes in visual analogue scale (VAS) scores for the most severe pelvic pain (lower abdominal and back pain) from baseline to six treatment cycles at the end of the confirmatory study period.</div></div><div><h3>Result(s)</h3><div>Estetrol/drospirenone showed changes in the mean VAS scores for the most severe pelvic pain (−33.2 mm) from baseline to the end of the 6-cycle treatment. The between-group difference was significant (−8.5 mm; 2-sided 95% confidence interval, −16.1 to −0.9 mm), showing superiority to placebo. The responder rates, ≥30% and ≥50% reductions in the VAS scores from baseline, were higher in the E4/DRSP group than in the placebo group: 53.2% vs. 29.6% and 36.4% vs. 12.3%. Objective gynecological findings (induration of the cul-de-sac, pelvic tenderness, and limited uterine mobility) were significantly improved by E4/DRSP treatment, and the proportions of stable and worsened participants were significantly lower than in the placebo group. Estetrol/drospirenone decreased the size of endometriomas and improved quality of life, on the basis of quality of life–related questionnaires and global impression scores. No safety concerns were observed with E4/DRSP treatment. Few differences were observed in the proportion of participants with hemostasis parameters outside the reference range between the E4/DRSP and placebo groups.</div></div><div><h3>Conclusion(s)</h3><div>Estetrol/drospirenone effectively treats endometriosis-associated pain and improves gynecological findings. Estetrol/drospirenone may be a safe, new option for endometriosis treatment with a potentially decreased risk of thromboembolic events.</div></div><div><h3>Clinical Trial Registration Number</h3><div>jRCT2011210027.</div></div><div><div>Eficacia y seguridad de la combinación de estetrol 15 mg/drospirenona 3 mg en un régimen cíclico para el tratamiento del dolor asociado a la endometriosis y halla","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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