Pub Date : 2026-02-04DOI: 10.1016/j.fertnstert.2026.01.034
Aileen Portugal, Mitra Sharifi, Kenan Omurtag
{"title":"Banking sperm from home: A meaningful access win, with gaps still to solve.","authors":"Aileen Portugal, Mitra Sharifi, Kenan Omurtag","doi":"10.1016/j.fertnstert.2026.01.034","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.01.034","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131725","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 : 2026-02-04DOI: 10.1016/j.fertnstert.2026.01.031
Alice Abernathy, Miatta Goba, Markolline Forkpa, Jesse Chittams, Sindhu K. Srinivas, Sunni L. Mumford, Courtney A. Schreiber
{"title":"Unplanned pregnancy and severe maternal morbidity","authors":"Alice Abernathy, Miatta Goba, Markolline Forkpa, Jesse Chittams, Sindhu K. Srinivas, Sunni L. Mumford, Courtney A. Schreiber","doi":"10.1016/j.fertnstert.2026.01.031","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.01.031","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"31 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109989","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 : 2026-02-03DOI: 10.1016/j.fertnstert.2026.01.030
Sophia H. Yin, Jeremy Applebaum
{"title":"Between signal and noise: ejaculatory abstinence and embryo mosaicism","authors":"Sophia H. Yin, Jeremy Applebaum","doi":"10.1016/j.fertnstert.2026.01.030","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.01.030","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"253 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109994","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 : 2026-02-01DOI: 10.1016/j.fertnstert.2025.07.384
Nicholas Eberstadt Ph.D.
This article addresses the prospect of global depopulation and its far-reaching implications. It argues that the advent of global population decline may come sooner than commonly anticipated, because of remarkable drops in birth rates underway in low-income regions as well as more developed locales. Notwithstanding uncertainties about the precise level of planetary fertility (due mainly to limited statistical capabilities in Africa), it is clear that overall childbearing patterns for our species are at most only slightly above the replacement level today—and might already actually have fallen below that significant threshold. Prolonged sub-replacement fertility will have far-reaching social, economic, and political ramifications. This study attempts to describe some of them and offers an introductory exploration of the new questions that could face problem solvers in the future.
{"title":"Depopulation globally and in the Asia-Pacific: the shape of things to come","authors":"Nicholas Eberstadt Ph.D.","doi":"10.1016/j.fertnstert.2025.07.384","DOIUrl":"10.1016/j.fertnstert.2025.07.384","url":null,"abstract":"<div><div>This article addresses the prospect of global depopulation and its far-reaching implications. It argues that the advent of global population decline may come sooner than commonly anticipated, because of remarkable drops in birth rates underway in low-income regions as well as more developed locales. Notwithstanding uncertainties about the precise level of planetary fertility (due mainly to limited statistical capabilities in Africa), it is clear that overall childbearing patterns for our species are at most only slightly above the replacement level today—and might already actually have fallen below that significant threshold. Prolonged sub-replacement fertility will have far-reaching social, economic, and political ramifications. This study attempts to describe some of them and offers an introductory exploration of the new questions that could face problem solvers in the future.</div></div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 203-207"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756205","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 : 2026-02-01DOI: 10.1016/j.fertnstert.2025.08.027
Matthew R. Reeder Ph.D. , Joseph B. Stanford M.D. , Christina A. Porucznik Ph.D. , Karen C. Schliep Ph.D. , Erica Johnstone M.D. , Lorenzo D. Botto M.D. , James Hotaling M.D.
<div><h3>Objective</h3><div>To examine birth outcomes between children conceived with in vitro fertilization (IVF) or intrauterine insemination (IUI) and sibling births from unassisted conceptions.</div></div><div><h3>Design</h3><div>Retrospective sibling cohort.</div></div><div><h3>Subjects</h3><div>Live born children conceived via IVF, with or without intracytoplasmic sperm injection, or IUI at the Utah Center for Reproductive Medicine, 1999–2018, and sibling births from unassisted conceptions (born 1985–2018). The main analysis included singleton births (460 IVF, 666 IUI, and 1,579 unassisted siblings).</div></div><div><h3>Exposure</h3><div>In vitro fertilization, with or without intracytoplasmic sperm injection, or IUI.</div></div><div><h3>Main Outcome Measures</h3><div>Preterm birth, low birth weight, small for gestational age, large for gestational age (LGA), and major congenital anomalies.</div></div><div><h3>Results</h3><div>Compared with unassisted siblings, singleton children conceived via IVF had gestational ages shorter by nearly half a week (95% confidence interval [CI], −0.6 to −0.3), birth weights of 72.1 g lower (95% CI, −118.8 to −25.4), and higher proportions of preterm birth (IVF, 11.1%; IUI, 8.7%; unassisted siblings, 6.8%), LGA (IVF, 9.1%; IUI, 4.5%; unassisted siblings, 5.9%), and major congenital anomalies (IVF, 3.7%; IUI, 2.0%; unassisted siblings, 1.4%). Models adjusted for maternal age, infant sex, infant birth year, previous pregnancy, and birth order showed that children conceived via IVF were more likely to be preterm (adjusted risk ratio [aRR], 1.6; 95% CI, 1.2–2.2; absolute difference, 4.3%) and LGA (aRR, 1.8; 95% CI, 1.2–2.5; absolute difference, 3.2%). Children conceived via IVF had a higher risk of major congenital anomalies than unassisted siblings adjusted for maternal age, infant sex, and birth order (aRR, 1.9; 95% CI, 1.0–3.8; absolute difference, 2.3%). Children conceived via IUI had birth weights 55.8 g lower (95% CI, −95.6 to −15.9) than unassisted siblings.</div></div><div><h3>Conclusion</h3><div>We observed an increased risk of preterm birth, low birth weight, LGA, and major congenital anomalies among singleton children conceived with IVF compared with that among unassisted siblings; however, absolute differences remain small. For children conceived via IUI, lower birth weights were observed. These results suggest that treatment-related factors in addition to underlying subfertility may contribute to adverse birth outcomes.</div></div><div><div>Características neonatales de niños concebidos mediante fertilización in vitro o inseminación intrauterina comparadas con hermanos nacidos por concepciones naturales.</div></div><div><h3>Objetivo</h3><div>Examinar los resultados de nacimientos entre niños concebidos mediante fertilización in vitro (IVF) o inseminación intrauterina (IUI) y nacimiento de hermanos por concepciones naturales.</div></div><div><h3>Diseño</h3><div>Cohorte retrospectiva de hermanos.</div>
{"title":"Neonatal characteristics of children conceived with in vitro fertilization or intrauterine insemination compared with sibling births from unassisted conceptions","authors":"Matthew R. Reeder Ph.D. , Joseph B. Stanford M.D. , Christina A. Porucznik Ph.D. , Karen C. Schliep Ph.D. , Erica Johnstone M.D. , Lorenzo D. Botto M.D. , James Hotaling M.D.","doi":"10.1016/j.fertnstert.2025.08.027","DOIUrl":"10.1016/j.fertnstert.2025.08.027","url":null,"abstract":"<div><h3>Objective</h3><div>To examine birth outcomes between children conceived with in vitro fertilization (IVF) or intrauterine insemination (IUI) and sibling births from unassisted conceptions.</div></div><div><h3>Design</h3><div>Retrospective sibling cohort.</div></div><div><h3>Subjects</h3><div>Live born children conceived via IVF, with or without intracytoplasmic sperm injection, or IUI at the Utah Center for Reproductive Medicine, 1999–2018, and sibling births from unassisted conceptions (born 1985–2018). The main analysis included singleton births (460 IVF, 666 IUI, and 1,579 unassisted siblings).</div></div><div><h3>Exposure</h3><div>In vitro fertilization, with or without intracytoplasmic sperm injection, or IUI.</div></div><div><h3>Main Outcome Measures</h3><div>Preterm birth, low birth weight, small for gestational age, large for gestational age (LGA), and major congenital anomalies.</div></div><div><h3>Results</h3><div>Compared with unassisted siblings, singleton children conceived via IVF had gestational ages shorter by nearly half a week (95% confidence interval [CI], −0.6 to −0.3), birth weights of 72.1 g lower (95% CI, −118.8 to −25.4), and higher proportions of preterm birth (IVF, 11.1%; IUI, 8.7%; unassisted siblings, 6.8%), LGA (IVF, 9.1%; IUI, 4.5%; unassisted siblings, 5.9%), and major congenital anomalies (IVF, 3.7%; IUI, 2.0%; unassisted siblings, 1.4%). Models adjusted for maternal age, infant sex, infant birth year, previous pregnancy, and birth order showed that children conceived via IVF were more likely to be preterm (adjusted risk ratio [aRR], 1.6; 95% CI, 1.2–2.2; absolute difference, 4.3%) and LGA (aRR, 1.8; 95% CI, 1.2–2.5; absolute difference, 3.2%). Children conceived via IVF had a higher risk of major congenital anomalies than unassisted siblings adjusted for maternal age, infant sex, and birth order (aRR, 1.9; 95% CI, 1.0–3.8; absolute difference, 2.3%). Children conceived via IUI had birth weights 55.8 g lower (95% CI, −95.6 to −15.9) than unassisted siblings.</div></div><div><h3>Conclusion</h3><div>We observed an increased risk of preterm birth, low birth weight, LGA, and major congenital anomalies among singleton children conceived with IVF compared with that among unassisted siblings; however, absolute differences remain small. For children conceived via IUI, lower birth weights were observed. These results suggest that treatment-related factors in addition to underlying subfertility may contribute to adverse birth outcomes.</div></div><div><div>Características neonatales de niños concebidos mediante fertilización in vitro o inseminación intrauterina comparadas con hermanos nacidos por concepciones naturales.</div></div><div><h3>Objetivo</h3><div>Examinar los resultados de nacimientos entre niños concebidos mediante fertilización in vitro (IVF) o inseminación intrauterina (IUI) y nacimiento de hermanos por concepciones naturales.</div></div><div><h3>Diseño</h3><div>Cohorte retrospectiva de hermanos.</div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 326-337"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948236","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 : 2026-02-01DOI: 10.1016/j.fertnstert.2025.09.026
Dominique de Ziegler M.D., Ph.D. , Sokteang Sean M.D. , James P. Toner M.D., Ph.D.
Fertility decline and global depopulation are on everyone’s lips. The numbers are indeed dire, particularly in Asia, where fertility decline is not mitigated by immigration. Demographic predictions are often shortsighted, and course corrections may be possible if solutions are thoughtfully designed and holistically implemented.
{"title":"Coping with fertility decline: tackling the new reproductive challenge","authors":"Dominique de Ziegler M.D., Ph.D. , Sokteang Sean M.D. , James P. Toner M.D., Ph.D.","doi":"10.1016/j.fertnstert.2025.09.026","DOIUrl":"10.1016/j.fertnstert.2025.09.026","url":null,"abstract":"<div><div>Fertility decline and global depopulation are on everyone’s lips. The numbers are indeed dire, particularly in Asia, where fertility decline is not mitigated by immigration. Demographic predictions are often shortsighted, and course corrections may be possible if solutions are thoughtfully designed and holistically implemented.</div></div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 183-186"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134134","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 : 2026-02-01DOI: 10.1016/j.fertnstert.2025.11.010
Yilian Pan M.M. , Ting Ni M.M. , Shuying Wang M.M. , Shujun Gao M.D., Ph.D.
<div><h3>Objective</h3><div>To introduce a novel hysteroscopic suture fixation technique using a “pre-fabricated knot”. This is used for levonorgestrel-releasing intrauterine system placement in adenomyosis treatment.</div></div><div><h3>Design</h3><div>Step-by-step video of “pre-fabricated knot” hysteroscopic levonorgestrel-releasing intrauterine system suture fixation. The study was approved by the Institutional Review Board of the International Peace Maternity and Child Health Hospital. Informed consent was obtained from the patients.</div></div><div><h3>Subjects</h3><div>A 48-year-old nulliparous female diagnosed with adenomyosis suffering from severe dysmenorrhea and menorrhagia for nearly 7 years. The symptoms worsened over the past 6 months. Previous treatments included high-intensity focused ultrasound ablation and ongoing dienogest therapy. Laboratory tests revealed mild anemia, and transvaginal ultrasound showed a globular uterine enlargement equivalent to a 14-week gestation. The patient declined a hysterectomy because of a strong fertility preservation desire.</div></div><div><h3>Exposure</h3><div>Transvaginal ultrasonography was used to assess the uterus volume and the position of the levonorgestrel-releasing intrauterine system before and after treatment. The patient underwent the operation after a 3-month course of mifepristone. After preparatory curettage, the levonorgestrel-releasing intrauterine system was fixed within the uterine cavity using a suture with prefabricated, bead-like knots, thereby achieving the effect of anchoring the device, preventing it from falling off.</div></div><div><h3>Main Outcome Measures</h3><div>Safety and efficiency of this novel technique.</div></div><div><h3>Results</h3><div>The levonorgestrel-releasing intrauterine system was successfully fixed on the posterior uterine wall in 10 minutes with no blood loss. The patient was discharged 2 hours after the operation without complications. At 1-month follow-up, she reported that her dysmenorrhea and menorrhagia had improved. Currently, we have completed 17 surgeries from April to August 2025. To date, no cases of expulsion or complications have been observed. Furthermore, we have observed preliminary positive outcomes in symptom relief.</div></div><div><h3>Conclusion</h3><div>The technique offers equal efficacy, reduced operative time, and enhanced safety because of its simplified procedural steps. However, its indication should currently be limited to adenomyosis patients with anemia, dysmenorrhea, and menorrhagia, particularly those with a history of intrauterine device expulsion. Future studies with extended follow-up periods and larger patient cohorts are warranted to further evaluate the long-term outcomes of this technique.</div></div><div><div>Un nuevo método de fijación de sutura para el sistema intrauterino liberador de levonorgestrel mediante nudo prefabricado por histeroscopia.</div></div><div><h3>Objetivo</h3><div>Presentar una nueva técnica
{"title":"A novel method of “Pre-fabricated Knot” hysteroscopic levonorgestrel-releasing intrauterine system suture fixation","authors":"Yilian Pan M.M. , Ting Ni M.M. , Shuying Wang M.M. , Shujun Gao M.D., Ph.D.","doi":"10.1016/j.fertnstert.2025.11.010","DOIUrl":"10.1016/j.fertnstert.2025.11.010","url":null,"abstract":"<div><h3>Objective</h3><div>To introduce a novel hysteroscopic suture fixation technique using a “pre-fabricated knot”. This is used for levonorgestrel-releasing intrauterine system placement in adenomyosis treatment.</div></div><div><h3>Design</h3><div>Step-by-step video of “pre-fabricated knot” hysteroscopic levonorgestrel-releasing intrauterine system suture fixation. The study was approved by the Institutional Review Board of the International Peace Maternity and Child Health Hospital. Informed consent was obtained from the patients.</div></div><div><h3>Subjects</h3><div>A 48-year-old nulliparous female diagnosed with adenomyosis suffering from severe dysmenorrhea and menorrhagia for nearly 7 years. The symptoms worsened over the past 6 months. Previous treatments included high-intensity focused ultrasound ablation and ongoing dienogest therapy. Laboratory tests revealed mild anemia, and transvaginal ultrasound showed a globular uterine enlargement equivalent to a 14-week gestation. The patient declined a hysterectomy because of a strong fertility preservation desire.</div></div><div><h3>Exposure</h3><div>Transvaginal ultrasonography was used to assess the uterus volume and the position of the levonorgestrel-releasing intrauterine system before and after treatment. The patient underwent the operation after a 3-month course of mifepristone. After preparatory curettage, the levonorgestrel-releasing intrauterine system was fixed within the uterine cavity using a suture with prefabricated, bead-like knots, thereby achieving the effect of anchoring the device, preventing it from falling off.</div></div><div><h3>Main Outcome Measures</h3><div>Safety and efficiency of this novel technique.</div></div><div><h3>Results</h3><div>The levonorgestrel-releasing intrauterine system was successfully fixed on the posterior uterine wall in 10 minutes with no blood loss. The patient was discharged 2 hours after the operation without complications. At 1-month follow-up, she reported that her dysmenorrhea and menorrhagia had improved. Currently, we have completed 17 surgeries from April to August 2025. To date, no cases of expulsion or complications have been observed. Furthermore, we have observed preliminary positive outcomes in symptom relief.</div></div><div><h3>Conclusion</h3><div>The technique offers equal efficacy, reduced operative time, and enhanced safety because of its simplified procedural steps. However, its indication should currently be limited to adenomyosis patients with anemia, dysmenorrhea, and menorrhagia, particularly those with a history of intrauterine device expulsion. Future studies with extended follow-up periods and larger patient cohorts are warranted to further evaluate the long-term outcomes of this technique.</div></div><div><div>Un nuevo método de fijación de sutura para el sistema intrauterino liberador de levonorgestrel mediante nudo prefabricado por histeroscopia.</div></div><div><h3>Objetivo</h3><div>Presentar una nueva técnica","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 376-379"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525147","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 : 2026-02-01DOI: 10.1016/j.fertnstert.2025.11.013
Kentaro Iga M.D.
{"title":"Comment on “Validity of completely omitting endocrine and ultrasound monitoring in hormone-replacement therapy protocols for frozen embryo transfer in good-prognosis patients undergoing single blastocyst transfer”","authors":"Kentaro Iga M.D.","doi":"10.1016/j.fertnstert.2025.11.013","DOIUrl":"10.1016/j.fertnstert.2025.11.013","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Page 384"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098602","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 : 2026-02-01DOI: 10.1016/j.fertnstert.2025.10.038
Magdy P. Milad M.D., M.S., Mary Ellen Pavone M.D., M.S.C.I.
{"title":"Losing our edge: how the decline of surgery is reshaping the specialty of reproductive endocrinology and infertility","authors":"Magdy P. Milad M.D., M.S., Mary Ellen Pavone M.D., M.S.C.I.","doi":"10.1016/j.fertnstert.2025.10.038","DOIUrl":"10.1016/j.fertnstert.2025.10.038","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Page 383"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098601","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}
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