Pub Date : 2026-02-01DOI: 10.1016/j.fertnstert.2025.12.018
Philippe R. Koninckx MD, PhD
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Pub Date : 2026-02-01DOI: 10.1016/j.fertnstert.2025.12.001
Patients preparing to undergo therapies that pose a risk to their fertility or who are at risk of premature ovarian insufficiency should be provided prompt counseling regarding available options for fertility preservation. Fertility preservation can best be provided by comprehensive programs designed and equipped to confront the unique challenges facing these patients. This document replaces the document entitled “Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion,” last published in 2019.
Preservación de Fertilidad en pacientes con indicaciones médicas: opinión del comité.
Preservación de la fertilidad en pacientes con indicaciones médicas: opinión del comité Comité de Práctica de la Sociedad Americana de Medicina Reproductiva, Sociedad Americana de Medicina Reproductiva, Washington, D.C., EE. UU. Los pacientes que van a someterse a terapias que implican un riesgo para su fertilidad o que presentan riesgo de insuficiencia ovárica prematura deben recibir asesoramiento oportuno sobre las opciones disponibles para la preservación de la fertilidad. La preservación de la fertilidad puede ofrecerse mejor mediante programas integrales diseñados y dotados específicamente para afrontar los desafíos únicos que afrontan estos pacientes. Este documento reemplaza al titulado «Preservación de la fertilidad en pacientes sometidos a tratamiento gonadotóxico o gonadectomía: opinión del comité», publicado por última vez en 2019.
{"title":"Fertility preservation in patients with medical indications: a committee opinion","authors":"","doi":"10.1016/j.fertnstert.2025.12.001","DOIUrl":"10.1016/j.fertnstert.2025.12.001","url":null,"abstract":"<div><div>Patients preparing to undergo therapies that pose a risk to their fertility or who are at risk of premature ovarian insufficiency should be provided prompt counseling regarding available options for fertility preservation. Fertility preservation can best be provided by comprehensive programs designed and equipped to confront the unique challenges facing these patients. This document replaces the document entitled “Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion,” last published in 2019.</div></div><div><div>Preservación de Fertilidad en pacientes con indicaciones médicas: opinión del comité.</div><div>Preservación de la fertilidad en pacientes con indicaciones médicas: opinión del comité Comité de Práctica de la Sociedad Americana de Medicina Reproductiva, Sociedad Americana de Medicina Reproductiva, Washington, D.C., EE. UU. Los pacientes que van a someterse a terapias que implican un riesgo para su fertilidad o que presentan riesgo de insuficiencia ovárica prematura deben recibir asesoramiento oportuno sobre las opciones disponibles para la preservación de la fertilidad. La preservación de la fertilidad puede ofrecerse mejor mediante programas integrales diseñados y dotados específicamente para afrontar los desafíos únicos que afrontan estos pacientes. Este documento reemplaza al titulado «Preservación de la fertilidad en pacientes sometidos a tratamiento gonadotóxico o gonadectomía: opinión del comité», publicado por última vez en 2019.</div></div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 247-259"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902563","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.2025.09.012
Dominique de Ziegler M.D., Ph.D. , Natascha Braumann M.D. , Sokteang Sean M.D. , James P. Toner M.D., Ph.D.
Decreasing birth rates are a worldwide phenomenon with potentially alarming consequences. This decline results either from women choosing not to have children or from couples ending up with a smaller family size than initially intended, a phenomenon called the fertility gap. In the latter case, delaying parenthood plays a key role in not achieving the desired reproductive objective. This review will examine age-related fertility decline, couple awareness, and factors contributing to the postponement of parenthood. We will also review potential strategies to prevent fertility gaps in couples wishing to conceive and how family values can be revived.
Efforts to assess current levels of fertility awareness and identify ways to improve this knowledge will be highlighted. We will critically evaluate measures implemented worldwide for enhancing fertility and explore their relative effectiveness on the basis of reported experience. Finally, we will analyze potential signs of fertility rebounds, some of which may already be emerging, and critically assess possible means to amplify these effects.
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Pub Date : 2026-02-01DOI: 10.1016/j.fertnstert.2025.11.025
Luce A. Kassi M.D., May-Tal Sauerbrun-Cutler M.D.
{"title":"Pelvic organ transposition: fertility preservation promise or premise?","authors":"Luce A. Kassi M.D., May-Tal Sauerbrun-Cutler M.D.","doi":"10.1016/j.fertnstert.2025.11.025","DOIUrl":"10.1016/j.fertnstert.2025.11.025","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 273-274"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145689001","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 present an optimized fixation method for levonorgestrel-releasing intrauterine device (LNG-IUD) in adenomyosis patients, addressing high expulsion rates and improving clinical feasibility.</div></div><div><h3>Design</h3><div>Case series with a technical surgical video demonstrating the continuously improved hysteroscopic sutureless fixation of LNG-IUD.</div></div><div><h3>Subjects</h3><div>A representative case: a 43-year-old G4P2 woman with recurrent heavy menstrual bleeding and two prior LNG-IUD expulsions, with pretreatment uterine dimensions 91×82×81 mm. The patients included in this video gave consent for the publication of the video and posting of the video online, including social media, the journal website, scientific literature websites (e.g., PubMed, ScienceDirect, and Scopus), and other applicable sites.</div></div><div><h3>Exposure</h3><div>The optimized fixation technique involves three key surgical steps: Step 1. Form Knot A: A sliding knot using the preattached polyethylene tail thread of LNG-IUD, allowing easy removal and reinsertion. Step 2. Form Knot B: A “loop knot” embedded into a 1- to 2-mm gap in the uterine fundus (depth 8 mm), designed to expand in narrow spaces for enhanced stability. Step 3. Procedure: Performed via an integrated continuous flow hysteroscope (outer diameter 5.0 mm) by a single operator.</div></div><div><h3>Main Outcome Measures</h3><div>Expulsion rate, operative time, intraoperative bleeding, ease of removal/reinsertion, and technical feasibility.</div></div><div><h3>Results</h3><div>The fixation procedure was successfully performed by a single gynecologist in 5 minutes, with the patient discharged home 30 minutes later. A total of 212 patients underwent this treatment between May 2022 and July 2024, with an expulsion rate of 1.4% (3/212). Among these cases, 159 patients had a uterine depth ≥9 cm (2 expulsions) and 45 patients had a history of expulsion (no expulsions).</div><div>Although using the hysteroscopic cold-knife surgical system yields reliable results, our surgical method offers 10 advantages, including learning curve, instrument/consumable needs, preoperative cervical preparation, delivery method, removal/reinsertion difficulty, operative time, intraoperative bleeding, physician requirements, and expulsion rate.</div></div><div><h3>Conclusions</h3><div>The optimized fixation method for LNG-IUD is effective in reducing expulsion rates in adenomyosis patients, with advantages of simplicity, ease of mastery, low instrument needs, ultralow expulsion rate, and high universality.</div></div><div><div>Método de fijación con optimización progresiva para el dispositivo intrauterino liberador de levonorgestrel</div></div><div><h3>Objetivo</h3><div>Describir un método optimizado de fijación del dispositivo intrauterino liberador de levonorgestrel (DIU-LNG) en pacientes con adenomiosis, orientado a reducir la tasa de expulsión y mejorar su viabilidad clínica.</div></div><di
目的探讨一种优化的左炔诺孕酮释放型宫内节育器（LNG-IUD）固定方法，解决子宫腺肌症患者排出率高的问题，提高临床可行性。设计案例系列与技术手术视频展示了不断改进的宫腔镜无缝线固定LNG-IUD。代表性病例：43岁G4P2女性，反复月经大出血，既往有2次LNG-IUD排出，子宫预处理尺寸91×82×81 mm。本视频中包含的患者同意发布视频并将视频发布到网络上，包括社交媒体、期刊网站、科学文献网站（如PubMed、ScienceDirect、Scopus）和其他适用的网站。优化的固定技术包括三个关键的手术步骤：形式结A：使用LNG-IUD预附聚乙烯尾线的滑动结，便于拆卸和重新插入。步骤2。形式结B：一个“环结”嵌入子宫底1- 2毫米的间隙（深度8毫米），旨在在狭窄的空间中扩展以增强稳定性。步骤3。操作步骤：由一名操作人员通过一个集成的连续流宫腔镜（外径5.0 mm）执行。主要观察指标：拔除率、手术时间、术中出血、取出/再插入的难易程度和技术可行性。结果由一名妇科医生在5分钟内完成固定手术，30分钟后出院。在2022年5月至2024年7月期间，共有212名患者接受了这种治疗，驱逐率为1.4%（3/212）。159例患者子宫深度≥9cm（2例），45例患者有子宫排物史（无排物）。虽然使用宫腔镜冷刀手术系统可以获得可靠的结果，但我们的手术方法有10个优点，包括学习曲线、器械/耗材需求、术前宫颈准备、分娩方式、取出/再插入难度、手术时间、术中出血、医生要求和排出率。结论优化后的LNG-IUD固定方法具有操作简单、易于掌握、器械需求少、排出率极低、通用性强等优点，可有效降低子宫腺肌症患者的排出率。在子宫内膜异位症患者的子宫内释放左炔诺孕酮（DIU-LNG），定向和减少子宫内膜异位症患者的子宫内释放左炔诺孕酮（DIU-LNG）通过子宫内膜异位症的生存能力expulsión通过子宫内生存能力clínica。DiseñoSerie de casos con vídeo de la tacimnica quirúrgica mostrando la mejora continua de la fijación histeroscópica in sutura del DIU-LNG。患者：caso代表性子宫内膜炎43 años (G4P2)，月经丰产复发，子宫内膜炎（DIU- lng），子宫内膜炎(DIU- lng)≥91 × 82 × 81 mm。这些文献包括：文献网vídeo、文献网、文献网、文献网、文献网、文献网、文献网、文献网、文献网、文献网、文献网等。， PubMed, ScienceDirect (Scopus)， así等。ExposiciónLa tsamicnica de fijación optimizizada requireres pasos quirúrgicos claves: Paso 1: confección del Nudo A: unnudo corredizo preinsertado利用率：unundo corredizo preinsertado利用率：unundo corredizo preinsertado利用率：unundo corredizo preinsertado利用率：unundo corredizo preinsertado利用率：unundo corediu - lng permitendo el retiy reinserción de manera fácil；Paso 2: confección del Nudo B: unnudo en lazo anclado en unespacio de 1-2 mm en el fondo uterino（深度为8 mm）， diseñado para expandirse en espacios estrechos para una mayor estabidad。第3部分：程序：实现连续flujo的组织学检查（diámetro外部5.0 mm）和único操作器。结果变量：estasa de expulsión，时间操作，sangrado操作内，设施管理reinserción，设施管理。结果：处理过程中，fijación se completó在5分钟内完成对único ginecólogo的处理，con la pacente siendo完成对único ginecólogo的处理，con la pacente siendo完成对único ginecólogo的处理，30分钟后完成对糖类的处理。共有212例患者在2022年5月至2024年7月间接受了este治疗，其中expulsión患者占1.4%（3/212）。宫内妊娠，159例tenían宫内妊娠深度≥9 cm（2例排出），45例tenían宫内妊娠expulsión前置（sin expulsión）。 虽然使用外科手术histeroscópico同该系统提供冷可靠的结果,我们的方法可以提供10优势,包括学习曲线,需要工具和编写涂片多方面撤回的程序本身,很难/重返社会,时间是手术,出血intraoperatorio经营者的需求率和驱逐。结论：优化的DIU-LNG固定方法有效地降低了腺瘤患者的排出率，其优点包括简单、易于掌握该技术、低仪器要求、非常低的排出率和普遍可用性。
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Pub Date : 2026-02-01DOI: 10.1016/j.fertnstert.2025.08.032
Barbara Lawrenz M.D., Ph.D. , Sara Peralta M.D., Ph.D. , Erkan Kalafat M.D., Ph.D. , Laura Marqueta Marques M.D. , Laura Melado M.D., Ph.D. , Ibrahim ElKhatib M.Sc. , Raquel Del Gallego M.Sc., Ph.D. , Baris Ata M.D., M.Sc. , Human Fatemi M.D., Ph.D.
<div><h3>Objective</h3><div>To compare the impact of luteal-phase ovarian stimulation on embryo count, embryo ploidy, and embryo quality with that of follicular-phase stimulation.</div></div><div><h3>Design</h3><div>Retrospective cohort study between March 2017 and November 2024.</div></div><div><h3>Subjects</h3><div>Women who underwent ovarian stimulation, commenced either in the follicular or the luteal phase of the menstrual cycle.</div></div><div><h3>Exposure</h3><div>Luteal-phase ovarian stimulation</div></div><div><h3>Main Outcome Measures</h3><div>Counts of euploid embryos and embryo quality.</div></div><div><h3>Results</h3><div>The initial cohort included 3,524 follicular-phase cycles and 552 luteal-phase cycles. After 2:1 propensity score matching on age, body mass index, antimüllerian hormone, antral follicle count, origin of semen, stimulation medication used, 1,058 follicular-phase cycles were matched to 550 luteal-phase cycles. Luteal-phase stimulations required a significantly longer duration (median 11.0 vs. 10 days) and higher total gonadotropin dose (median 4,050 IU vs. 3,300 IU). Median counts of cumulus-oocyte-complexes (COCs), mature (MII) and fertilized oocytes, total-, biopsied-, and euploid blastocysts did not differ significantly between groups before regression adjustment. Multivariable regression analyses on the matched cohort showed adjusted incidence rate ratios (IRRs) for MII count (luteal-phase vs. follicular-phase) of 1.04 (95% confidence interval [CI]: 1.00–1.09), for blastocyst count 1.05 (95% CI: 0.99–1.11), and for euploid blastocyst count 1.04 (95% CI: 0.94–1.14). Embryo quality distribution did not differ significantly between follicular-phase (N = 3,831: 8.4% top, 49.5% good, 22.1% fair, and 20.0% poor) and luteal-phase (N = 2,110: 9.4% top, 51.1% good, 20.9% fair, and 18.6% poor) groups.</div><div>A total of 147 women with a luteal-phase and follicular-phase cycle within one year underwent a paired analysis. Again, luteal-phase cycles required significantly longer stimulation (median 11 vs. 10 days) and higher gonadotropin doses (median 4,050 IU vs. 3,600 IU). No statistically significant differences were found in the median number of COCs, MIIs, fertilized oocytes, total-, biopsied-, or euploid blastocysts between the paired luteal-phase and follicular-phase cycles for these women.</div></div><div><h3>Conclusion</h3><div>Ovarian stimulation initiated in the luteal phase has no detrimental impact on ploidy number or embryo quality. The key advantage of luteal-phase stimulation is an extended duration for initiating ovarian stimulation, which can be useful for couples with time constraints.</div></div><div><div>Resultados similares con distintos inicios: estimulación en fase lútea frente a fase folicular en la fecundación in vitro</div></div><div><h3>Objetivo</h3><div>Comparar el impacto de la estimulación ovárica en fase lútea frente a la estimulación en fase folicular, sobre el número de embriones, la ploid
目的比较黄体期卵巢刺激与卵泡期卵巢刺激对胚胎数量、胚胎倍性和胚胎质量的影响。2017年3月至2024年11月的回顾性队列研究。受试者：接受卵巢刺激的女性，在月经周期的卵泡期或黄体期开始。主要观察指标：整倍体胚胎计数和胚胎质量。结果初始队列包括3524个卵泡期周期和552个黄体期周期。根据年龄、BMI、AMH、AFC、精液来源、使用的刺激药物进行2:1的倾向评分匹配，1058个卵泡期周期与550个黄体期周期相匹配。黄体期刺激所需的持续时间明显更长（中位11.0 vs 10天，均p0.05）。结论黄体期卵巢刺激对倍性数和胚胎质量无不良影响。黄体期刺激的主要优点是可以延长卵巢刺激的起始时间，这对于时间限制的夫妇是有用的。
{"title":"Similar outcomes, different timings: luteal vs. follicular stimulation in in vitro fertilization","authors":"Barbara Lawrenz M.D., Ph.D. , Sara Peralta M.D., Ph.D. , Erkan Kalafat M.D., Ph.D. , Laura Marqueta Marques M.D. , Laura Melado M.D., Ph.D. , Ibrahim ElKhatib M.Sc. , Raquel Del Gallego M.Sc., Ph.D. , Baris Ata M.D., M.Sc. , Human Fatemi M.D., Ph.D.","doi":"10.1016/j.fertnstert.2025.08.032","DOIUrl":"10.1016/j.fertnstert.2025.08.032","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the impact of luteal-phase ovarian stimulation on embryo count, embryo ploidy, and embryo quality with that of follicular-phase stimulation.</div></div><div><h3>Design</h3><div>Retrospective cohort study between March 2017 and November 2024.</div></div><div><h3>Subjects</h3><div>Women who underwent ovarian stimulation, commenced either in the follicular or the luteal phase of the menstrual cycle.</div></div><div><h3>Exposure</h3><div>Luteal-phase ovarian stimulation</div></div><div><h3>Main Outcome Measures</h3><div>Counts of euploid embryos and embryo quality.</div></div><div><h3>Results</h3><div>The initial cohort included 3,524 follicular-phase cycles and 552 luteal-phase cycles. After 2:1 propensity score matching on age, body mass index, antimüllerian hormone, antral follicle count, origin of semen, stimulation medication used, 1,058 follicular-phase cycles were matched to 550 luteal-phase cycles. Luteal-phase stimulations required a significantly longer duration (median 11.0 vs. 10 days) and higher total gonadotropin dose (median 4,050 IU vs. 3,300 IU). Median counts of cumulus-oocyte-complexes (COCs), mature (MII) and fertilized oocytes, total-, biopsied-, and euploid blastocysts did not differ significantly between groups before regression adjustment. Multivariable regression analyses on the matched cohort showed adjusted incidence rate ratios (IRRs) for MII count (luteal-phase vs. follicular-phase) of 1.04 (95% confidence interval [CI]: 1.00–1.09), for blastocyst count 1.05 (95% CI: 0.99–1.11), and for euploid blastocyst count 1.04 (95% CI: 0.94–1.14). Embryo quality distribution did not differ significantly between follicular-phase (N = 3,831: 8.4% top, 49.5% good, 22.1% fair, and 20.0% poor) and luteal-phase (N = 2,110: 9.4% top, 51.1% good, 20.9% fair, and 18.6% poor) groups.</div><div>A total of 147 women with a luteal-phase and follicular-phase cycle within one year underwent a paired analysis. Again, luteal-phase cycles required significantly longer stimulation (median 11 vs. 10 days) and higher gonadotropin doses (median 4,050 IU vs. 3,600 IU). No statistically significant differences were found in the median number of COCs, MIIs, fertilized oocytes, total-, biopsied-, or euploid blastocysts between the paired luteal-phase and follicular-phase cycles for these women.</div></div><div><h3>Conclusion</h3><div>Ovarian stimulation initiated in the luteal phase has no detrimental impact on ploidy number or embryo quality. The key advantage of luteal-phase stimulation is an extended duration for initiating ovarian stimulation, which can be useful for couples with time constraints.</div></div><div><div>Resultados similares con distintos inicios: estimulación en fase lútea frente a fase folicular en la fecundación in vitro</div></div><div><h3>Objetivo</h3><div>Comparar el impacto de la estimulación ovárica en fase lútea frente a la estimulación en fase folicular, sobre el número de embriones, la ploid","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 298-307"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995659","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.2025.08.013
Allison Eubanks M.D. , Kerry Flannagan Ph.D. , Kyle Le M.D. , Amalia Namath M.D. , Anupama Rambhatla M.D. , Jensen Reckhow M.D., M.P.H. , Atoosa Ghofranian M.D. , Jiarui Wang M.S. , Kate Devine M.D. , Matthew Connell D.O. , Phillip Romanski M.D., M.Sc. , Micah Hill D.O.
<div><h3>Objective</h3><div>To study the association between antimüllerian hormone (AMH) and antral follicle count (AFC) with embryo euploidy rates in patients undergoing in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A), independent of maternal age and other confounding factors.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>A total of 11,473 women who underwent 13,451 IVF cycles with PGT-A between October 2016 and August 2024 across a large national network of infertility clinics in the United States.</div></div><div><h3>Exposure</h3><div>Values of AMH and AFC recorded within 6 months of oocyte retrieval. Both AMH and AFC were categorized on the basis of Bologna criteria for diminished ovarian reserve: AMH <1.1, 1.1–4.0, and >4.0 ng/mL; AFC <7, 7–16, and >16.</div></div><div><h3>Main Outcome Measures</h3><div>Adjusted relative risk (RR) of embryo euploidy on the basis of AMH and AFC levels, with secondary outcomes including live birth, clinical pregnancy, and implantation rates.</div></div><div><h3>Results</h3><div>Euploidy rates were comparable across AMH categories (56.9%, 54.0%, and 55.8% for AMH <1.1, 1.1–4.0, and >4.0 ng/mL, respectively) and AFC categories (56.3%, 54.8%, and 54.9% for AFC <7, 7–16, and >16, respectively). After adjustment, euploidy was modestly higher in the lowest AMH category (RR: 1.08; 95% confidence interval [CI]: 1.05, 1.11) but similar in the highest AMH category (RR: 1.00; 95% CI: 0.98, 1.02). Euploidy rates were comparable among AFC <7 and 7–16 (RR: 1.00; 95% CI: 0.98, 1.03) but slightly lower in AFC >16 (RR: 0.96; 95% CI: 0.95, 0.98). Both AMH and AFC levels were not significantly associated with live birth, clinical pregnancy, or implantation rates.</div></div><div><h3>Conclusion</h3><div>Contrary to recent studies, lower AMH and AFC levels were not associated with a clinically significant decrease in embryo euploidy or live birth outcomes. These findings suggest that although AMH and AFC are useful for assessing ovarian reserve, they may have limited value in predicting embryo euploidy when considered independently of other factors, such as maternal age.</div></div><div><div>Más allá de los números: la hormona antimülleriana y el recuento de folículos antrales no son predictores independientes de la euploidía embrionaria en fecundación in vitro con pruebas genéticas preimplantacionales para aneuploidía.</div></div><div><h3>Objetivo</h3><div>Estudiar la asociación entre la hormona antimülleriana (AMH) y el recuento de folículos antrales (AFC) con las tasas de euploidía embrionaria en pacientes sometidas a fertilización in vitro (FIV) con prueba genética preimplantacional para aneuploidía (PGT-A), independientemente de la edad materna y otros factores de confusión.</div></div><div><h3>Diseño</h3><div>Estudio de cohorte retrospectivo.</div></div><div><h3>Sujetos</h3><div>Un total de 11.473 mu
{"title":"Beyond numbers: antimüllerian hormone and antral follicle count are not independent predictors of embryo euploidy in in vitro fertilization with preimplantation genetic testing for aneuploidy","authors":"Allison Eubanks M.D. , Kerry Flannagan Ph.D. , Kyle Le M.D. , Amalia Namath M.D. , Anupama Rambhatla M.D. , Jensen Reckhow M.D., M.P.H. , Atoosa Ghofranian M.D. , Jiarui Wang M.S. , Kate Devine M.D. , Matthew Connell D.O. , Phillip Romanski M.D., M.Sc. , Micah Hill D.O.","doi":"10.1016/j.fertnstert.2025.08.013","DOIUrl":"10.1016/j.fertnstert.2025.08.013","url":null,"abstract":"<div><h3>Objective</h3><div>To study the association between antimüllerian hormone (AMH) and antral follicle count (AFC) with embryo euploidy rates in patients undergoing in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A), independent of maternal age and other confounding factors.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>A total of 11,473 women who underwent 13,451 IVF cycles with PGT-A between October 2016 and August 2024 across a large national network of infertility clinics in the United States.</div></div><div><h3>Exposure</h3><div>Values of AMH and AFC recorded within 6 months of oocyte retrieval. Both AMH and AFC were categorized on the basis of Bologna criteria for diminished ovarian reserve: AMH <1.1, 1.1–4.0, and >4.0 ng/mL; AFC <7, 7–16, and >16.</div></div><div><h3>Main Outcome Measures</h3><div>Adjusted relative risk (RR) of embryo euploidy on the basis of AMH and AFC levels, with secondary outcomes including live birth, clinical pregnancy, and implantation rates.</div></div><div><h3>Results</h3><div>Euploidy rates were comparable across AMH categories (56.9%, 54.0%, and 55.8% for AMH <1.1, 1.1–4.0, and >4.0 ng/mL, respectively) and AFC categories (56.3%, 54.8%, and 54.9% for AFC <7, 7–16, and >16, respectively). After adjustment, euploidy was modestly higher in the lowest AMH category (RR: 1.08; 95% confidence interval [CI]: 1.05, 1.11) but similar in the highest AMH category (RR: 1.00; 95% CI: 0.98, 1.02). Euploidy rates were comparable among AFC <7 and 7–16 (RR: 1.00; 95% CI: 0.98, 1.03) but slightly lower in AFC >16 (RR: 0.96; 95% CI: 0.95, 0.98). Both AMH and AFC levels were not significantly associated with live birth, clinical pregnancy, or implantation rates.</div></div><div><h3>Conclusion</h3><div>Contrary to recent studies, lower AMH and AFC levels were not associated with a clinically significant decrease in embryo euploidy or live birth outcomes. These findings suggest that although AMH and AFC are useful for assessing ovarian reserve, they may have limited value in predicting embryo euploidy when considered independently of other factors, such as maternal age.</div></div><div><div>Más allá de los números: la hormona antimülleriana y el recuento de folículos antrales no son predictores independientes de la euploidía embrionaria en fecundación in vitro con pruebas genéticas preimplantacionales para aneuploidía.</div></div><div><h3>Objetivo</h3><div>Estudiar la asociación entre la hormona antimülleriana (AMH) y el recuento de folículos antrales (AFC) con las tasas de euploidía embrionaria en pacientes sometidas a fertilización in vitro (FIV) con prueba genética preimplantacional para aneuploidía (PGT-A), independientemente de la edad materna y otros factores de confusión.</div></div><div><h3>Diseño</h3><div>Estudio de cohorte retrospectivo.</div></div><div><h3>Sujetos</h3><div>Un total de 11.473 mu","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 237-246"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899439","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.2025.08.005
Hannah Milad M.D. , Marcelle I. Cedars M.D. , Eve C. Feinberg M.D.
{"title":"Reimagining the funding model for reproductive endocrinology and infertility fellowship training programs","authors":"Hannah Milad M.D. , Marcelle I. Cedars M.D. , Eve C. Feinberg M.D.","doi":"10.1016/j.fertnstert.2025.08.005","DOIUrl":"10.1016/j.fertnstert.2025.08.005","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 234-236"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857697","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.2025.12.002
Patients receiving treatment that has the potential to negatively affect their gonads, including chemotherapy, surgery, and radiation therapy, should be informed of options for fertility preservation and future reproduction before initiating treatment. Reproduction in the context of fertility-affecting treatment raises a number of ethical issues related to the welfare of both patients and offspring. This document replaces the document titled, “Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion,” last published in 2018.
Preservación de la fertilidad y reproducción en pacientes tratadas con terapias gonadotóxicas: opinión del Comité Ético
Los pacientes que reciben tratamientos con el potencial de afectar negativamente sus gónadas, incluidos la quimioterapia, la cirugía y la radioterapia, deben ser informados sobre las opciones de preservación de la fertilidad y de reproducción futura antes de iniciar el tratamiento. La reproducción, en el contexto de tratamientos que afectan la fertilidad, plantea una serie de cuestiones éticas relacionadas con el bienestar tanto de los pacientes como de la descendencia. Este documento reemplaza al documento titulado “Preservación de la fertilidad y reproducción en pacientes tratadas con terapias gonadotóxicas: opinión del Comité Ético” publicado en 2018.
{"title":"Fertility preservation and reproduction in patients facing gonadotoxic therapies or gonadectomy: an Ethics Committee opinion","authors":"","doi":"10.1016/j.fertnstert.2025.12.002","DOIUrl":"10.1016/j.fertnstert.2025.12.002","url":null,"abstract":"<div><div>Patients receiving treatment that has the potential to negatively affect their gonads, including chemotherapy, surgery, and radiation therapy, should be informed of options for fertility preservation and future reproduction before initiating treatment. Reproduction in the context of fertility-affecting treatment raises a number of ethical issues related to the welfare of both patients and offspring. This document replaces the document titled, “Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion,” last published in 2018.</div></div><div><div>Preservación de la fertilidad y reproducción en pacientes tratadas con terapias gonadotóxicas: opinión del Comité Ético</div><div>Los pacientes que reciben tratamientos con el potencial de afectar negativamente sus gónadas, incluidos la quimioterapia, la cirugía y la radioterapia, deben ser informados sobre las opciones de preservación de la fertilidad y de reproducción futura antes de iniciar el tratamiento. La reproducción, en el contexto de tratamientos que afectan la fertilidad, plantea una serie de cuestiones éticas relacionadas con el bienestar tanto de los pacientes como de la descendencia. Este documento reemplaza al documento titulado “Preservación de la fertilidad y reproducción en pacientes tratadas con terapias gonadotóxicas: opinión del Comité Ético” publicado en 2018.</div></div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 260-266"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917310","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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