Pub Date : 2026-03-01Epub Date: 2025-09-09DOI: 10.1016/j.fertnstert.2025.09.004
Diana Marti-Garcia Ph.D. , Patricia Sebastian-Leon Ph.D. , Pilar Alamá M.D., Ph.D. , Laura Caracena M.Sc. , Antonio Parraga-Leo Ph.D. , Elena Perez-Rico M.Sc. , Antonio Pellicer M.D., Ph.D. , Patricia Diaz-Gimeno Ph.D.
<div><h3>Objective</h3><div>To evaluate the feasibility of using hyperspectral imaging for endometrial evaluation as a potential minimally invasive method to identify the window of implantation within the same embryo transfer cycle.</div></div><div><h3>Design</h3><div>Prospective study.</div></div><div><h3>Subjects</h3><div>Healthy and normo-ovulatory volunteers aged ≤35 years with proven fertility who voluntarily agreed to participate in the study between September 2021 and February 2023 at a private fertility clinic in Spain.</div></div><div><h3>Interventions</h3><div>Hyperspectral samples were captured throughout a modified natural menstrual cycle in which ovulation was induced and controlled with human chorionic gonadotropin. A microfiberscope inside an embryo transfer catheter coupled with a hyperspectral camera was introduced into the uterine cavity to capture the endometrial spectra at the fundus level.</div></div><div><h3>Main outcome measures</h3><div>The endometrial hyperspectral visible light wavelength signature (in the 400–1,000 nm spectral range) was evaluated as a potential technique to identify the endometrial secretory-phase stages.</div></div><div><h3>Results</h3><div>Comparison of the early and midsecretory stages identified 290 significantly different wavelengths (97.3% of the total number measured), 66 with differences of more than 50% intensity (intensity ratio >1.5); in turn, the late- and mid-secretory comparison resulted in 286 significantly different wavelengths (96%), nine of them with an intensity ratio of >1.5 between them; finally, the comparison of the early- and late-secretory stages found in 287 significantly different wavelengths (96.3%), 69 with and intensity ratio of >1.5 between them. A total of 26 wavelengths were identified as a signature that could distinguish the three different secretory stages. Using this signature, the prediction model performance discriminated the three secretory stages with a mean accuracy of 87.60% (95% confidence interval: [87.08%–88.11%]) and a mean area under the curve of 79.41% (95% confidence interval: [78.32%–80.50%]).</div></div><div><h3>Conclusion</h3><div>This present study has shown, for the first time, the feasibility of using hyperspectral endometrial analysis specifically to evaluate the molecular changes that occur in the endometrium during the secretory phase. Thus, given the minimally invasive nature of this technology, the window of implantation could be discriminated in this way. Further prospective studies with infertile patients will be required to evaluate the clinical utility of this technique in patient stratification.</div></div><div><div>Evaluación de la factibilidad del análisis endometrial hiperespectral como una técnica menos invasiva para la evaluación endometrial: estudio piloto</div></div><div><h3>Objetivo</h3><div>Evaluar la factibilidad del uso de imágenes hiperespectrales para la evaluación endometrial como un método potencial mínimamente in
{"title":"Evaluating the feasibility of hyperspectral endometrial analysis as a less invasive technique for endometrial evaluation: a pilot study","authors":"Diana Marti-Garcia Ph.D. , Patricia Sebastian-Leon Ph.D. , Pilar Alamá M.D., Ph.D. , Laura Caracena M.Sc. , Antonio Parraga-Leo Ph.D. , Elena Perez-Rico M.Sc. , Antonio Pellicer M.D., Ph.D. , Patricia Diaz-Gimeno Ph.D.","doi":"10.1016/j.fertnstert.2025.09.004","DOIUrl":"10.1016/j.fertnstert.2025.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility of using hyperspectral imaging for endometrial evaluation as a potential minimally invasive method to identify the window of implantation within the same embryo transfer cycle.</div></div><div><h3>Design</h3><div>Prospective study.</div></div><div><h3>Subjects</h3><div>Healthy and normo-ovulatory volunteers aged ≤35 years with proven fertility who voluntarily agreed to participate in the study between September 2021 and February 2023 at a private fertility clinic in Spain.</div></div><div><h3>Interventions</h3><div>Hyperspectral samples were captured throughout a modified natural menstrual cycle in which ovulation was induced and controlled with human chorionic gonadotropin. A microfiberscope inside an embryo transfer catheter coupled with a hyperspectral camera was introduced into the uterine cavity to capture the endometrial spectra at the fundus level.</div></div><div><h3>Main outcome measures</h3><div>The endometrial hyperspectral visible light wavelength signature (in the 400–1,000 nm spectral range) was evaluated as a potential technique to identify the endometrial secretory-phase stages.</div></div><div><h3>Results</h3><div>Comparison of the early and midsecretory stages identified 290 significantly different wavelengths (97.3% of the total number measured), 66 with differences of more than 50% intensity (intensity ratio >1.5); in turn, the late- and mid-secretory comparison resulted in 286 significantly different wavelengths (96%), nine of them with an intensity ratio of >1.5 between them; finally, the comparison of the early- and late-secretory stages found in 287 significantly different wavelengths (96.3%), 69 with and intensity ratio of >1.5 between them. A total of 26 wavelengths were identified as a signature that could distinguish the three different secretory stages. Using this signature, the prediction model performance discriminated the three secretory stages with a mean accuracy of 87.60% (95% confidence interval: [87.08%–88.11%]) and a mean area under the curve of 79.41% (95% confidence interval: [78.32%–80.50%]).</div></div><div><h3>Conclusion</h3><div>This present study has shown, for the first time, the feasibility of using hyperspectral endometrial analysis specifically to evaluate the molecular changes that occur in the endometrium during the secretory phase. Thus, given the minimally invasive nature of this technology, the window of implantation could be discriminated in this way. Further prospective studies with infertile patients will be required to evaluate the clinical utility of this technique in patient stratification.</div></div><div><div>Evaluación de la factibilidad del análisis endometrial hiperespectral como una técnica menos invasiva para la evaluación endometrial: estudio piloto</div></div><div><h3>Objetivo</h3><div>Evaluar la factibilidad del uso de imágenes hiperespectrales para la evaluación endometrial como un método potencial mínimamente in","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 515-526"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035546","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 : 2026-03-01Epub Date: 2026-01-02DOI: 10.1016/j.fertnstert.2025.12.026
Alexander J. Marion M.D. , Katherine Moran Sweterlitsch M.D., M.B.A. , Mindy S. Christianson M.D., M.B.A.
{"title":"Friend or foe after menopause: tamoxifen and uterine fibroid dynamics","authors":"Alexander J. Marion M.D. , Katherine Moran Sweterlitsch M.D., M.B.A. , Mindy S. Christianson M.D., M.B.A.","doi":"10.1016/j.fertnstert.2025.12.026","DOIUrl":"10.1016/j.fertnstert.2025.12.026","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 429-430"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145894054","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 : 2026-03-01Epub Date: 2026-01-07DOI: 10.1016/j.fertnstert.2026.01.001
Matthew C.H. Rohn M.D., Steven L. Young M.D., Ph.D.
{"title":"Hyperspectral image analysis, the final frontier of endometrial receptivity testing?","authors":"Matthew C.H. Rohn M.D., Steven L. Young M.D., Ph.D.","doi":"10.1016/j.fertnstert.2026.01.001","DOIUrl":"10.1016/j.fertnstert.2026.01.001","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 425-426"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937697","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 : 2026-03-01Epub Date: 2026-01-13DOI: 10.1016/j.fertnstert.2026.01.004
Kate D. Schoyer M.D. , Catherine D. Zhang M.D.
{"title":"Exercise, stress, and infertility: have we had it wrong all these years?","authors":"Kate D. Schoyer M.D. , Catherine D. Zhang M.D.","doi":"10.1016/j.fertnstert.2026.01.004","DOIUrl":"10.1016/j.fertnstert.2026.01.004","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Page 416"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145962658","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 : 2026-03-01Epub Date: 2025-12-22DOI: 10.1016/j.fertnstert.2025.12.014
Yunlei Cao M.D., Ph.D., Jialin Tian M.D., Xishi Liu M.D., Ph.D., Jichan Nie M.D.
<div><h3>Objective</h3><div>To present an innovative approach of transumbilical single-port laparoscopic adenomyomectomy using the double-flap method combined with transient bilateral uterine artery occlusion, specifically for patients desiring uterine preservation.</div></div><div><h3>Design</h3><div>A narrated video demonstrating the surgical technique in four steps.</div></div><div><h3>Subjects</h3><div>A 42-year-old female with diffuse adenomyosis, moderate anemia, and a desire to preserve the uterus.</div></div><div><h3>Exposure</h3><div>The procedure was conducted via a transumbilical single-port laparoscopic approach. A 2.5-cm umbilical incision was made for inserting a single-port device, through which both the laparoscope and surgical instruments were introduced (<span><span>Fig. 1</span></span>). Intraoperatively, bilateral uterine arteries were temporarily occluded with bulldog clamps, and adenomyomectomy was performed using the double-flap technique. Initially, methylthioninium was administered into the uterine cavity to facilitate delineation of the uterine horns, cavity, and fallopian tube openings. A midline incision was made on the anterior uterine serosa and extended sagittally to the uterine cavity, then continued along the fundus and posterior uterine wall to the lesion margin. Adenomyotic tissue was meticulously excised, with a 0.5–1-cm myometrial layer preserved beneath the serosa and above the endometrium to avoid injury to the serosa, fallopian tube openings, and endometrium. After excising the lesions, the uterine cavity was sutured closed, and the uterine myometrium was reconstructed via the double-flap technique to restore the uterus to its normal anatomical structure.</div></div><div><h3>Main Outcome Measures</h3><div>Perioperative blood loss, operative duration, anatomical restoration, symptom relief, and maintenance of normal uterine anatomy.</div></div><div><h3>Results</h3><div>Intraoperative blood loss was 50 mL, and the procedure lasted 75 minutes. Postoperatively, the patient’s symptoms improved markedly; her dysmenorrhea visual analogue scale score dropped from 7 to 2, anemia resolved within 3 months, and uterine size reduced from 8×8×7 cm to 5×5×4 cm. Postoperative 3-month magnetic resonance imaging showed restoration of the normal morphology of the uterine cavity (<span><span>Fig. 2</span></span>).</div></div><div><h3>Conclusion</h3><div>Compared with traditional laparoscopy, single-port laparoscopy is less invasive without significantly prolonging operative time. Temporary uterine artery occlusion effectively reduces intraoperative blood loss and perioperative transfusion needs, especially in anemic patients. The double-flap technique maximizes adenomyotic lesion resection while preserving normal uterine anatomy, making this integrated approach a promising uterus-preserving option for adenomyosis patients.</div></div><div><div>Cirugía conservadora del útero para adenomiosis difusa mediante laparoscopía de puer
目的探讨双瓣联合短暂性双侧子宫动脉闭塞经脐单孔腹腔镜子宫肌瘤切除术的新术式。DesignA讲解了手术技术的四个步骤。受试者：42岁女性，弥漫性血凝块，中度贫血，希望保留子宫。该手术通过经脐单孔腹腔镜入路进行。在脐部切开2.5 cm，插入单孔装置，腹腔镜和手术器械均通过该切口进入（图1）。术中，用牛头犬钳暂时阻塞双侧子宫动脉，采用双瓣技术切除子宫腺肌瘤。最初，将甲基硫离子注入子宫腔，以促进子宫角、腔和输卵管开口的划定。在子宫前浆膜上作中线切口，矢状面延伸至子宫腔，然后沿眼底和子宫后壁延伸至病变边缘。精心切除腺肌瘤组织，在浆膜下方和子宫内膜上方保留0.5 - 1 cm的肌层，以避免损伤浆膜、输卵管开口和子宫内膜。切除病变后，缝合子宫腔，采用双瓣技术重建子宫肌层，使子宫恢复正常解剖结构。主要观察指标：术中出血量、手术时间、解剖恢复、症状缓解、子宫解剖维持正常。结果术中出血量50 mL，手术时间75 min。术后患者症状明显改善；痛经视觉模拟评分由7分降至2分，贫血在3个月内消退，子宫大小由8×8×7 cm缩小至5×5×4 cm。术后3个月磁共振成像显示子宫腔形态恢复正常（图2）。结论与传统腹腔镜相比，单孔腹腔镜手术创伤小，且无明显延长手术时间。临时子宫动脉闭塞有效减少术中出血量和围术期输血需求，特别是贫血患者。双瓣技术在保留正常子宫解剖结构的同时最大限度地切除腺肌瘤病变，使这种综合方法成为子宫腺肌症患者保留子宫的一种有希望的选择。Cirugia conservadora del子宫对位adenomiosis difusa mediante laparoscopia德波整合transumbilical: Combinando reconstruccion de快colgajo y oclusion颞de血管uterinasObjetivoPresentar联合国enfoque innovador de adenomiomectomia laparoscopica德波整合transumbilical mediante la tecnica de快colgajo combinada con oclusion双边transitoria de las血管uterinas especificamente en pacientes con deseo de preservacion uterina。DiseñoVideo关于薪金和薪金的说明quirúrgica关于薪金和薪金的说明。研究对象：smjer de 42 años原发性弥漫性子宫腺瘤病、中度贫血和子宫内膜炎útero。ExposiciónEl procedimiento se realizó mediante unabordaje laparoscópico de puerto único经脐。剖宫产efectuó una incisión脐部2.5 cm剖宫产inserción de un dispositivo de puerto único，剖宫产剖宫产通过腹腔镜检查quirúrgicos（图1）。术中，双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉、双侧子宫动脉。在官方网站上，我们看到administró tiltioninio en la cavidad uterina para facility la delimitación de los cuernos uterinos， la cavidad y los orificios tubáricos。Se practicó una incisión en la línea子宫前浆膜中膜y Se extendió子宫腔下垂；后侧，见continuó子宫后缘处有一个大的凹凹，子宫后缘处有一个凹凹lesión。El tejido adenomiótico fue cuidadosamente extirpado， preservando una capa子宫内膜病变0,5-1 cm子宫内膜病变病变，子宫内膜病变病变，子宫内膜病变tubáricos。Tras la resección de las lesiones， se cerró la cavidad子宫内侧缝合，el miometrio子宫内侧缝合，reconstruyó mediante la t<s:1> cnica de double colgajo para restaurar la anatomía子宫正常。手术原理媒体sanguínea围手术期，duración quirúrgica, restauración anatómica， alivio sintomático y mantenimiento de la anatomía子宫正常。还是ResultadosLa sanguinea intraoperatoria fue 50 mL y la duracion del procedimiento。《75分钟》相类似的 术后患者的症状明显改善；在模拟视觉量表上，痛经得分从7降至2，贫血在3个月内消失，子宫大小从8×8×7厘米降至5×5×4厘米。术后3个月进行的核磁共振显示子宫腔恢复正常形态（图2）。结论：与传统腹腔镜相比，单口腹腔镜侵入性较低，且手术时间显著延长。子宫动脉的临时闭塞有效地减少了术后失血和术后输血的需要，特别是对贫血患者。双挂锁技术在保留正常子宫解剖结构的同时，最大限度地切除腺肌瘤病变，使这种综合方法成为腺肌瘤患者子宫保存的一个很有前途的选择。
{"title":"Uterus-preserving surgery for diffuse adenomyosis via transumbilical single-port laparoscopy: combining dual-flap reconstruction and temporary uterine artery occlusion","authors":"Yunlei Cao M.D., Ph.D., Jialin Tian M.D., Xishi Liu M.D., Ph.D., Jichan Nie M.D.","doi":"10.1016/j.fertnstert.2025.12.014","DOIUrl":"10.1016/j.fertnstert.2025.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>To present an innovative approach of transumbilical single-port laparoscopic adenomyomectomy using the double-flap method combined with transient bilateral uterine artery occlusion, specifically for patients desiring uterine preservation.</div></div><div><h3>Design</h3><div>A narrated video demonstrating the surgical technique in four steps.</div></div><div><h3>Subjects</h3><div>A 42-year-old female with diffuse adenomyosis, moderate anemia, and a desire to preserve the uterus.</div></div><div><h3>Exposure</h3><div>The procedure was conducted via a transumbilical single-port laparoscopic approach. A 2.5-cm umbilical incision was made for inserting a single-port device, through which both the laparoscope and surgical instruments were introduced (<span><span>Fig. 1</span></span>). Intraoperatively, bilateral uterine arteries were temporarily occluded with bulldog clamps, and adenomyomectomy was performed using the double-flap technique. Initially, methylthioninium was administered into the uterine cavity to facilitate delineation of the uterine horns, cavity, and fallopian tube openings. A midline incision was made on the anterior uterine serosa and extended sagittally to the uterine cavity, then continued along the fundus and posterior uterine wall to the lesion margin. Adenomyotic tissue was meticulously excised, with a 0.5–1-cm myometrial layer preserved beneath the serosa and above the endometrium to avoid injury to the serosa, fallopian tube openings, and endometrium. After excising the lesions, the uterine cavity was sutured closed, and the uterine myometrium was reconstructed via the double-flap technique to restore the uterus to its normal anatomical structure.</div></div><div><h3>Main Outcome Measures</h3><div>Perioperative blood loss, operative duration, anatomical restoration, symptom relief, and maintenance of normal uterine anatomy.</div></div><div><h3>Results</h3><div>Intraoperative blood loss was 50 mL, and the procedure lasted 75 minutes. Postoperatively, the patient’s symptoms improved markedly; her dysmenorrhea visual analogue scale score dropped from 7 to 2, anemia resolved within 3 months, and uterine size reduced from 8×8×7 cm to 5×5×4 cm. Postoperative 3-month magnetic resonance imaging showed restoration of the normal morphology of the uterine cavity (<span><span>Fig. 2</span></span>).</div></div><div><h3>Conclusion</h3><div>Compared with traditional laparoscopy, single-port laparoscopy is less invasive without significantly prolonging operative time. Temporary uterine artery occlusion effectively reduces intraoperative blood loss and perioperative transfusion needs, especially in anemic patients. The double-flap technique maximizes adenomyotic lesion resection while preserving normal uterine anatomy, making this integrated approach a promising uterus-preserving option for adenomyosis patients.</div></div><div><div>Cirugía conservadora del útero para adenomiosis difusa mediante laparoscopía de puer","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 536-539"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822712","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 : 2026-03-01Epub Date: 2025-09-12DOI: 10.1016/j.fertnstert.2025.09.013
Konstantin Sharafutdinov Dr. rer. nat. , Jan Hilpert M.D. , Rolf Burghaus Dr. rer. nat. , Christian Diedrich Dr. rer. nat. , Jörg Lippert Dr. rer. nat. , Christian Scheerans Dr. rer. nat. , Steffen Schaper D.Phil.
<div><h3>Objective</h3><div>To study the relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) in a retrospective US cohort.</div></div><div><h3>Design</h3><div>Longitudinal case-control study.</div></div><div><h3>Subjects</h3><div>The study utilized data from the IBM Explorys database, a comprehensive real-world dataset containing deidentified, longitudinal patient-level electronic health records from approximately 400 hospitals across the United States. The study population consisted of women diagnosed with PCOS between 2000 and 2020, aged 25 to 55 years (n = 42,030) and control women without PCOS (n = 84,060), matched 1:2 by ethnicity, geographic region, age, and body mass index (BMI). Additionally, a secondary control group (n = 42,030) was employed, matched on all covariates except BMI.</div></div><div><h3>Exposure</h3><div>The PCOS status was identified using International Classification of Disease -coded diagnoses, whereas T2DM diagnosis was determined using International Classification of Disease-coded diagnoses as well as hemoglobin A1c levels.</div></div><div><h3>Main Outcome Measures</h3><div>The incidence of T2DM.</div></div><div><h3>Results</h3><div>The 3-year cumulative incidence rates of T2DM in the PCOS and non-PCOS cohorts were 9.2% (95% Confidence Interval: 8.9%–9.5%) and 6.0% (5.8%–6.2%), respectively. The 15-year cumulative incidence rates were 34.3% (31.4%–37.4%) and 22.6% (21.2%–24.1%), respectively. The adjusted hazard ratio (HR) of T2DM in women with PCOS was 1.47 (1.41–1.53) compared with control individuals. The HRs for PCOS were found to be consistent in different BMI strata ranging from 1.37 in the obese class III subgroup to 1.78 in the subgroup with normal weight. The median BMI in the PCOS cohort was 34.86 kg/m<sup>2</sup>, in contrast to 27.26 kg/m<sup>2</sup> in non-PCOS controls not matched for BMI. The additional HR for T2DM associated with this BMI difference of 7.6 kg/m<sup>2</sup> is estimated to be 1.87 (1.82–1.92).</div></div><div><h3>Conclusion</h3><div>In the current analysis, PCOS was independently associated with increased T2DM incidence across all BMI categories. Moreover, the elevated BMI in patients with PCOS confers additional T2DM risk mediated by excess adiposity. This BMI-mediated risk exceeds the risk associated with PCOS through other mechanisms, such as hyperandrogenism.</div></div><div><div>El síndrome de ovario poliquístico y el índice de masa corporal elevado incrementan de forma independiente el riesgo de diabetes mellitus tipo 2, con predominio del riesgo mediado por obesidad: análisis de datos de vida real en pacientes de Estados Unidos</div></div><div><h3>Objetivo</h3><div>Evaluar la relación entre el síndrome de ovario poliquístico (SOP) y la diabetes mellitus tipo 2 (DM2) en una cohorte retrospectiva de Estados Unidos.</div></div><div><h3>Diseño</h3><div>Estudio longitudinal de casos y controles.</div></div><div><h3>Sujetos</h3><div>El estudio utili
{"title":"Polycystic ovary syndrome and elevated body mass index independently increase type 2 diabetes risk with obesity-mediated risk dominating: a real-world data analysis of US patients","authors":"Konstantin Sharafutdinov Dr. rer. nat. , Jan Hilpert M.D. , Rolf Burghaus Dr. rer. nat. , Christian Diedrich Dr. rer. nat. , Jörg Lippert Dr. rer. nat. , Christian Scheerans Dr. rer. nat. , Steffen Schaper D.Phil.","doi":"10.1016/j.fertnstert.2025.09.013","DOIUrl":"10.1016/j.fertnstert.2025.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>To study the relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) in a retrospective US cohort.</div></div><div><h3>Design</h3><div>Longitudinal case-control study.</div></div><div><h3>Subjects</h3><div>The study utilized data from the IBM Explorys database, a comprehensive real-world dataset containing deidentified, longitudinal patient-level electronic health records from approximately 400 hospitals across the United States. The study population consisted of women diagnosed with PCOS between 2000 and 2020, aged 25 to 55 years (n = 42,030) and control women without PCOS (n = 84,060), matched 1:2 by ethnicity, geographic region, age, and body mass index (BMI). Additionally, a secondary control group (n = 42,030) was employed, matched on all covariates except BMI.</div></div><div><h3>Exposure</h3><div>The PCOS status was identified using International Classification of Disease -coded diagnoses, whereas T2DM diagnosis was determined using International Classification of Disease-coded diagnoses as well as hemoglobin A1c levels.</div></div><div><h3>Main Outcome Measures</h3><div>The incidence of T2DM.</div></div><div><h3>Results</h3><div>The 3-year cumulative incidence rates of T2DM in the PCOS and non-PCOS cohorts were 9.2% (95% Confidence Interval: 8.9%–9.5%) and 6.0% (5.8%–6.2%), respectively. The 15-year cumulative incidence rates were 34.3% (31.4%–37.4%) and 22.6% (21.2%–24.1%), respectively. The adjusted hazard ratio (HR) of T2DM in women with PCOS was 1.47 (1.41–1.53) compared with control individuals. The HRs for PCOS were found to be consistent in different BMI strata ranging from 1.37 in the obese class III subgroup to 1.78 in the subgroup with normal weight. The median BMI in the PCOS cohort was 34.86 kg/m<sup>2</sup>, in contrast to 27.26 kg/m<sup>2</sup> in non-PCOS controls not matched for BMI. The additional HR for T2DM associated with this BMI difference of 7.6 kg/m<sup>2</sup> is estimated to be 1.87 (1.82–1.92).</div></div><div><h3>Conclusion</h3><div>In the current analysis, PCOS was independently associated with increased T2DM incidence across all BMI categories. Moreover, the elevated BMI in patients with PCOS confers additional T2DM risk mediated by excess adiposity. This BMI-mediated risk exceeds the risk associated with PCOS through other mechanisms, such as hyperandrogenism.</div></div><div><div>El síndrome de ovario poliquístico y el índice de masa corporal elevado incrementan de forma independiente el riesgo de diabetes mellitus tipo 2, con predominio del riesgo mediado por obesidad: análisis de datos de vida real en pacientes de Estados Unidos</div></div><div><h3>Objetivo</h3><div>Evaluar la relación entre el síndrome de ovario poliquístico (SOP) y la diabetes mellitus tipo 2 (DM2) en una cohorte retrospectiva de Estados Unidos.</div></div><div><h3>Diseño</h3><div>Estudio longitudinal de casos y controles.</div></div><div><h3>Sujetos</h3><div>El estudio utili","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 506-514"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059198","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 : 2026-03-01Epub Date: 2025-11-28DOI: 10.1016/j.fertnstert.2025.11.017
Jacqueline C. Lee M.D., Jennifer F. Kawwass M.D.
{"title":"Risk is in the eye of the beholder","authors":"Jacqueline C. Lee M.D., Jennifer F. Kawwass M.D.","doi":"10.1016/j.fertnstert.2025.11.017","DOIUrl":"10.1016/j.fertnstert.2025.11.017","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Page 431"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611735","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 : 2026-03-01Epub Date: 2026-01-02DOI: 10.1016/j.fertnstert.2025.12.022
Caroline J. Violette M.D., May-Tal Sauerbrun Cutler M.D.
{"title":"Revisiting oncofertility outcomes: what the Society for Assisted Reproductive Technology can and cannot tell us about cryopreserved oocyte utilization","authors":"Caroline J. Violette M.D., May-Tal Sauerbrun Cutler M.D.","doi":"10.1016/j.fertnstert.2025.12.022","DOIUrl":"10.1016/j.fertnstert.2025.12.022","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 427-428"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145894056","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 : 2026-03-01Epub Date: 2025-09-16DOI: 10.1016/j.fertnstert.2025.09.017
Huanhuan Liang M.D. , Nan Zhou M.D., Ph.D. , Yucan Chen M.D. , Kaibo Sun M.D. , Hui Zhu M.D. , Peipei Jiang M.D., Ph.D. , Huanhuan Wang M.D., Ph.D. , Qing Hu M.D. , Kefeng Zhou M.D., Ph.D. , Yali Hu M.D., Ph.D. , Zhengyang Zhou M.D., Ph.D.
<div><h3>Objective</h3><div>To assess uterine peristalsis using cine magnetic resonance imaging (MRI) in patients with different degrees of endometrial fibrosis.</div></div><div><h3>Design</h3><div>A prospective observational cohort study.</div></div><div><h3>Subjects</h3><div>A total of 75 patients with severe endometrial fibrosis, 40 patients with mild-to-moderate endometrial fibrosis, and 45 healthy women without uterine pathologies were included in the study. All patients with severe endometrial fibrosis and mild-to-moderate endometrial fibrosis were diagnosed by hysteroscopy.</div></div><div><h3>Exposure</h3><div>Eligible women underwent MRI examination during the late proliferative phase.</div></div><div><h3>Main Outcome Measures</h3><div>Uterine static parameters including junctional zone thickness and its ratio to the total myometrial thickness and cine parameters including peristaltic condition, frequency (per 4 minutes), intensity, and direction were measured and analyzed. The study aimed to investigate the differences in uterine peristalsis across patients with different degrees of endometrial fibrosis using cine MRI.</div></div><div><h3>Results</h3><div>Junctional zone thickness and its ratio to the total myometrial thickness were significantly higher in patients with severe endometrial fibrosis (6.1 mm; 95% confidence interval [CI], 5.2–6.7 mm; 0.37 ± 0.08) and patients with mild-to-moderate endometrial fibrosis (5.2 mm; 95% CI, 4.4–6.4 mm; 0.36 ± 0.07) than in healthy women (3.9 mm; 95% CI, 3.2–4.8 mm; 0.32 ± 0.08). The percentage of detectable uterine peristalsis was significantly higher in healthy women (100%) than in patients with severe endometrial fibrosis (88.0%). Peristaltic frequency (per 4 minutes) and intensity were significantly higher in healthy women (10 times; 95% CI, 8–12 times; 3) than in patients with mild-to-moderate endometrial fibrosis (6 times; 95% CI, 4–9 times; 2) and patients with severe endometrial fibrosis (5 times; 95% CI, 4–7 times; 2). Patients with mild-to-moderate endometrial fibrosis and patients with severe endometrial fibrosis showed a higher percentage of the reverse and mixed peristaltic waves than healthy women. The degree of endometrial fibrosis was negatively correlated with peristaltic frequency and intensity but positively correlated with junctional zone thickness and its ratio to the total myometrial thickness. The concordance of uterine static and cine parameters was excellent.</div></div><div><h3>Conclusion</h3><div>Cine MRI is particularly effective for assessing abnormalities in uterine peristalsis in patients with different degrees of endometrial fibrosis.</div></div><div><div>Resonancia magnética en modo cine de la peristalsis uterina en pacientes con fibrosis endometrial</div></div><div><h3>Objetivo</h3><div>Evaluar la peristalsis uterina mediante resonancia magnética (RM) en modo cine en pacientes con distintos grados de fibrosis endometrial.</div></div><div><h3>Diseño</h3><div>Estud
{"title":"Cine magnetic resonance imaging of uterine peristalsis in patients with endometrial fibrosis","authors":"Huanhuan Liang M.D. , Nan Zhou M.D., Ph.D. , Yucan Chen M.D. , Kaibo Sun M.D. , Hui Zhu M.D. , Peipei Jiang M.D., Ph.D. , Huanhuan Wang M.D., Ph.D. , Qing Hu M.D. , Kefeng Zhou M.D., Ph.D. , Yali Hu M.D., Ph.D. , Zhengyang Zhou M.D., Ph.D.","doi":"10.1016/j.fertnstert.2025.09.017","DOIUrl":"10.1016/j.fertnstert.2025.09.017","url":null,"abstract":"<div><h3>Objective</h3><div>To assess uterine peristalsis using cine magnetic resonance imaging (MRI) in patients with different degrees of endometrial fibrosis.</div></div><div><h3>Design</h3><div>A prospective observational cohort study.</div></div><div><h3>Subjects</h3><div>A total of 75 patients with severe endometrial fibrosis, 40 patients with mild-to-moderate endometrial fibrosis, and 45 healthy women without uterine pathologies were included in the study. All patients with severe endometrial fibrosis and mild-to-moderate endometrial fibrosis were diagnosed by hysteroscopy.</div></div><div><h3>Exposure</h3><div>Eligible women underwent MRI examination during the late proliferative phase.</div></div><div><h3>Main Outcome Measures</h3><div>Uterine static parameters including junctional zone thickness and its ratio to the total myometrial thickness and cine parameters including peristaltic condition, frequency (per 4 minutes), intensity, and direction were measured and analyzed. The study aimed to investigate the differences in uterine peristalsis across patients with different degrees of endometrial fibrosis using cine MRI.</div></div><div><h3>Results</h3><div>Junctional zone thickness and its ratio to the total myometrial thickness were significantly higher in patients with severe endometrial fibrosis (6.1 mm; 95% confidence interval [CI], 5.2–6.7 mm; 0.37 ± 0.08) and patients with mild-to-moderate endometrial fibrosis (5.2 mm; 95% CI, 4.4–6.4 mm; 0.36 ± 0.07) than in healthy women (3.9 mm; 95% CI, 3.2–4.8 mm; 0.32 ± 0.08). The percentage of detectable uterine peristalsis was significantly higher in healthy women (100%) than in patients with severe endometrial fibrosis (88.0%). Peristaltic frequency (per 4 minutes) and intensity were significantly higher in healthy women (10 times; 95% CI, 8–12 times; 3) than in patients with mild-to-moderate endometrial fibrosis (6 times; 95% CI, 4–9 times; 2) and patients with severe endometrial fibrosis (5 times; 95% CI, 4–7 times; 2). Patients with mild-to-moderate endometrial fibrosis and patients with severe endometrial fibrosis showed a higher percentage of the reverse and mixed peristaltic waves than healthy women. The degree of endometrial fibrosis was negatively correlated with peristaltic frequency and intensity but positively correlated with junctional zone thickness and its ratio to the total myometrial thickness. The concordance of uterine static and cine parameters was excellent.</div></div><div><h3>Conclusion</h3><div>Cine MRI is particularly effective for assessing abnormalities in uterine peristalsis in patients with different degrees of endometrial fibrosis.</div></div><div><div>Resonancia magnética en modo cine de la peristalsis uterina en pacientes con fibrosis endometrial</div></div><div><h3>Objetivo</h3><div>Evaluar la peristalsis uterina mediante resonancia magnética (RM) en modo cine en pacientes con distintos grados de fibrosis endometrial.</div></div><div><h3>Diseño</h3><div>Estud","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 3","pages":"Pages 496-505"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083478","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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