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Perinatal complications of frozen vs. fresh embryo transfer among ongoing pregnancies: a cohort study conducted within the framework of a hypothetical trial 在持续妊娠中冷冻胚胎移植与新鲜胚胎移植的围产期并发症:一项假设试验框架内进行的队列研究
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.08.020
Ruohua Yan Ph.D. , Xiaohang Liu B.S. , Shen Gao Ph.D. , Ruixia Liu Ph.D. , Chenghong Yin Ph.D. , Xiaoxia Peng Ph.D.
<div><h3>Objective</h3><div>To compare the perinatal outcomes between fresh and frozen embryo transfer strategies among ongoing pregnancies conceived by in vitro fertilization/intracytoplasmic sperm injection.</div></div><div><h3>Design</h3><div>A prospective cohort study. The study was conducted within the framework of a hypothetical randomized controlled trial to enhance the validity of the evidence obtained from observational data.</div></div><div><h3>Subjects</h3><div>From November 2017 to August 2021, 5,118 pregnant women who conceived by in vitro fertilization/intracytoplasmic sperm injection were recruited from 50 study sites in 17 provinces of China during their first trimester.</div></div><div><h3>Exposure</h3><div>Frozen vs. fresh embryo transfer.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was perinatal complications, defined as any occurrence of perinatal death or birth defects. The secondary outcomes included preterm birth, small for gestational age, large for gestational age, low birth weight, and macrosomia. The safety outcomes were abortion, pregnancy-induced hypertension, gestational diabetes mellitus, and gestational thyroid dysfunction.</div></div><div><h3>Results</h3><div>A total of 2,856 pregnant women were included in the analysis, with the allocation ratio of 1:1. The perinatal complication rate of the frozen embryo transfer group (5.0%, 72/1,428) was similar to that of the fresh embryo transfer group (4.6%, 66/1,428), with the risk ratio of 1.09 (95% confidence interval, 0.79 to 1.51). Moreover, there was no significant difference in the risks of preterm birth, small for gestational age, large for gestational age, low birth weight, and macrosomia between the two groups. However, compared with fresh embryo transfer, frozen embryo transfer was associated with an increased risk of pregnancy-induced hypertension (risk ratio, 2.18; 95% confidence interval, 1.10 to 4.62).</div></div><div><h3>Conclusion</h3><div>The risk of perinatal complications was similar between fresh and frozen embryo transfer strategies, whereas the risk of pregnancy-induced hypertension seemed to be higher for the frozen embryo transfer strategy among ongoing pregnancies. Therefore, the decision regarding fresh or frozen embryo transfer should be made with more caution, with careful consideration of the benefits and potential risks.</div></div><div><div>Complicaciones perinatales de la transferencia de embriones congelados frente a embriones frescos en embarazos en curso: Un estudio de cohortes realizado en el marco de un ensayo hipotético</div></div><div><h3>Objetivo</h3><div>Comparar los resultados perinatales entre las estrategias de transferencia de embriones frescos y congelados en embarazos en curso, concebidos mediante fecundación in vitro/inyección intracitoplasmática de espermatozoides.</div></div><div><h3>Diseño</h3><div>Estudio de cohorte prospectivo. El estudio se llevó a cabo dentro del marco de un ensayo clínico al
比较IVF/ICSI妊娠中新鲜和冷冻胚胎移植策略的围产儿结局。
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引用次数: 0
Should you do ultrasound monitoring and trigger for intrauterine insemination cycles? 你应该做超声监测和触发宫内人工授精周期吗?
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.11.023
Lindsay A. Hartup M.D. , Cassie L. Hobbs M.D. , Clarisa R. Gracia M.D., M.S.C.E. , Elizabeth S. Ginsburg M.D.
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引用次数: 0
Epidemiology of falling fertility: the contribution of social, environmental, and genetic forces 生育率下降的流行病学:社会、环境和遗传力量的贡献。
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.04.048
Robert John Aitken Ph.D. , Robert John Norman M.D.
The past half century has witnessed a dramatic decline in human fertility as reflected in the total fertility rate. This decline in total fertility rate is thought to have been triggered by an increase in resources and knowledge that precipitated a significant decline in infant mortality. This, in turn, led to a reduction in the desire of couples to have large families, supported in recent times by a series of factors including a delay in childbearing as women acquired the education and autonomy to enter the paid workforce, the progressive urbanization of advanced societies, and, for many, a seismic shift in life’s purpose away from procreation and toward self-fulfillment. Notwithstanding the power of such short-acting socioeconomic drivers, they are all potentially reversible given appropriate revisions in governmental policies and societal aspirations. However, we argue that if human societies experience subreplacement levels of fertility for a prolonged period, then there is a danger that our fundamental fecundity (ability to reproduce) will become compromised. A lack of evolutionary selection pressure on fertility, the excessive use of assisted reproductive technology, and the pervasive presence of environmental pollutants in the environment, are all relevant in this context. Addressing the causes of human fertility decline is critical if we are to manage our population rather than become its hapless victim.
从总生育率(TFR)可以看出,过去半个世纪人类生育率急剧下降。总生育率的下降被认为是由于资源和知识的增加导致了婴儿死亡率的显著下降。这反过来又导致了夫妇对大家庭的渴望减少,这在最近受到一系列因素的支持,包括:(1)随着女性获得教育和进入有偿劳动力市场的自主权,生育推迟;(2)发达社会的逐步城市化;(3)对许多人来说,生活目的从生育转向自我实现的巨大转变。尽管这些短期的社会经济驱动因素具有强大的力量,但只要政府政策和社会愿望得到适当修正,它们都有可能逆转。然而,我们认为,如果人类社会在很长一段时间内经历生育率低于更替水平,那么我们的基本繁殖力(繁殖能力)就有可能受到损害。生育能力缺乏进化选择压力,抗逆转录病毒药物的过度使用以及环境中普遍存在的环境污染物都与此有关。如果我们要管理人口而不是成为不幸的受害者,解决人类生育率下降的原因是至关重要的。
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引用次数: 0
To ultrasound and trigger or not in intrauterine insemination cycles, that is the question 在宫内人工授精周期中,超声是否触发,这是一个问题。
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.11.022
Elizabeth S. Ginsburg M.D.
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引用次数: 0
Clinical implications of expanded carrier screening for pregnancy-related care and individual health 扩大携带者筛查(ECS)对妊娠相关护理和个人健康的临床意义
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.08.024
Laura C. Gemmell M.D. , Anjali Jotwani M.D. , Jessica L. Giordano M.S., C.G.C. , Stephanie Galloway M.S., C.G.C. , Diamond Lewis B.A. , Sinem Karipcin M.D. , Eric J. Forman M.D. , Paula C. Brady M.D.
<div><h3>Objective</h3><div>To evaluate the incidence of expanded carrier screening (ECS) results with possible clinical implications on patient health and/or pregnancy-related treatment planning.</div></div><div><h3>Design</h3><div>Single academic center, retrospective, cohort study.</div></div><div><h3>Subjects</h3><div>A total of 3,136 patients underwent ECS between January 2018 and December 2020.</div></div><div><h3>Exposure</h3><div>All patients were screened using the same ECS, comprising 283 genes.</div></div><div><h3>Main Outcome Measures</h3><div>Rates of positive ECS results and carrier-carrier couples were reported, excluding carrier-carrier couples without a reproductive risk for a serious clinical outcome (i.e., alpha thalassemia single-gene deletions). Results with possible ramifications for an individual patient’s health were recorded. This included individuals identified through ECS to be potentially affected with a genetic condition due to homozygous or compound heterozygous findings, and those with heterozygous findings associated with a personal health risk, such as elevated risk for premature ovarian insufficiency, metabolic crisis, neurological disease, cardiovascular disease, or malignancy.</div></div><div><h3>Results</h3><div>Expanded carrier screening was performed and resulted in 3,136 patients; 2,280 (72.7%) carried at least one condition. Fifty-four patients (1.7%) were homozygous or compound heterozygous for a recessive genetic condition. Another 68 patients (2.2%) were high-risk heterozygote carriers of a recessive disease: Gaucher (n = 34), familial hypercholesterolemia (n = 14), fumarase deficiency (n = 9), ataxia-telangiectasia (n = 7), and fragile X premutation (n = 4). Ten female carriers of X-linked conditions were identified (0.4%). When restricting analysis to couples who both completed ECS (n = 905 couples), 58 couples (6.4%) carried the same genetic condition, although only 21 (2.3%) were considered clinically significant disease-causing combinations and recommended for preimplantation genetic testing for monogenic conditions.</div></div><div><h3>Conclusion</h3><div>A small proportion (1.7%) of total ECS results impact clinical fertility care by triggering recommendations for in vitro fertilization with preimplantation genetic testing for monogenic conditions. A larger proportion of results (3.9%) had implications for patients’ personal health, which may not be sufficiently addressed in the consent process and can affect eligibility for benefits such as life and disability insurance.</div></div><div><div>Implicaciones clínicas del tamizaje ampliado de portadores para la atención relacionada con el embarazo y la salud individual</div></div><div><h3>Objetivo</h3><div>Evaluar la incidencia de resultados del tamizaje ampliado de portadores (expanded carrier screening, ECS) con posibles implicaciones clínicas sobre la salud de los pacientes y/o la planificación del tratamiento reproductivo.</div></div><div><h3>Di
目的:评价扩大携带者筛查(ECS)结果的发生率与患者健康和/或妊娠相关治疗计划可能的临床意义。设计:单一学术中心、回顾性、队列研究。研究对象:2018年1月至2020年12月期间,3136例患者接受了体外循环治疗。暴露:所有患者使用相同的ECS进行筛选,包括283个基因。主要结局指标:报告了ECS阳性结果和携带者-携带者夫妇的比率,不包括无严重临床结局(α地中海贫血单基因缺失)生殖风险的携带者-携带者夫妇。记录了可能对个体患者健康产生影响的结果。这包括通过ECS确定的由于纯合子或复合杂合子发现而可能受到遗传状况影响的个体,以及那些杂合子发现与个人健康风险相关的个体,如卵巢早衰、代谢危象、神经系统疾病、心血管疾病或恶性肿瘤的风险升高。结果:行ECS治疗3136例;2280例(72.7%)至少携带一种疾病。54例患者(1.7%)为隐性遗传纯合子或复合杂合子。另有68例(2.2%)是隐性疾病的高风险杂合子携带者:戈谢病(n=34)、家族性高胆固醇血症(n=14)、富马尔酸酶缺乏症(n=9)、共济失调-毛细血管扩张(n=7)和脆性X基因突变(n=4)。发现10名女性x连锁携带者(0.4%)。当对完成ECS的夫妇(n=905对夫妇)进行限制分析时,58对夫妇(6.4%)携带相同的遗传状况,尽管只有21对夫妇(2.3%)被认为是临床显著的致病组合,并建议进行单基因性状(PGT-M)植入前基因检测。结论:ECS总结果中有一小部分(1.7%)影响临床生育护理,引发推荐IVF与PGT-M。更大比例的结果(3.9%)对患者的个人健康有影响,这在同意过程中可能没有得到充分解决,并可能影响获得人寿和残疾保险等福利的资格。
{"title":"Clinical implications of expanded carrier screening for pregnancy-related care and individual health","authors":"Laura C. Gemmell M.D. ,&nbsp;Anjali Jotwani M.D. ,&nbsp;Jessica L. Giordano M.S., C.G.C. ,&nbsp;Stephanie Galloway M.S., C.G.C. ,&nbsp;Diamond Lewis B.A. ,&nbsp;Sinem Karipcin M.D. ,&nbsp;Eric J. Forman M.D. ,&nbsp;Paula C. Brady M.D.","doi":"10.1016/j.fertnstert.2025.08.024","DOIUrl":"10.1016/j.fertnstert.2025.08.024","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the incidence of expanded carrier screening (ECS) results with possible clinical implications on patient health and/or pregnancy-related treatment planning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Single academic center, retrospective, cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;A total of 3,136 patients underwent ECS between January 2018 and December 2020.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;All patients were screened using the same ECS, comprising 283 genes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Rates of positive ECS results and carrier-carrier couples were reported, excluding carrier-carrier couples without a reproductive risk for a serious clinical outcome (i.e., alpha thalassemia single-gene deletions). Results with possible ramifications for an individual patient’s health were recorded. This included individuals identified through ECS to be potentially affected with a genetic condition due to homozygous or compound heterozygous findings, and those with heterozygous findings associated with a personal health risk, such as elevated risk for premature ovarian insufficiency, metabolic crisis, neurological disease, cardiovascular disease, or malignancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Expanded carrier screening was performed and resulted in 3,136 patients; 2,280 (72.7%) carried at least one condition. Fifty-four patients (1.7%) were homozygous or compound heterozygous for a recessive genetic condition. Another 68 patients (2.2%) were high-risk heterozygote carriers of a recessive disease: Gaucher (n = 34), familial hypercholesterolemia (n = 14), fumarase deficiency (n = 9), ataxia-telangiectasia (n = 7), and fragile X premutation (n = 4). Ten female carriers of X-linked conditions were identified (0.4%). When restricting analysis to couples who both completed ECS (n = 905 couples), 58 couples (6.4%) carried the same genetic condition, although only 21 (2.3%) were considered clinically significant disease-causing combinations and recommended for preimplantation genetic testing for monogenic conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;A small proportion (1.7%) of total ECS results impact clinical fertility care by triggering recommendations for in vitro fertilization with preimplantation genetic testing for monogenic conditions. A larger proportion of results (3.9%) had implications for patients’ personal health, which may not be sufficiently addressed in the consent process and can affect eligibility for benefits such as life and disability insurance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Implicaciones clínicas del tamizaje ampliado de portadores para la atención relacionada con el embarazo y la salud individual&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objetivo&lt;/h3&gt;&lt;div&gt;Evaluar la incidencia de resultados del tamizaje ampliado de portadores (expanded carrier screening, ECS) con posibles implicaciones clínicas sobre la salud de los pacientes y/o la planificación del tratamiento reproductivo.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Di","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 348-355"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948291","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}
引用次数: 0
Pregnancy resulting from in vitro fertilization/intracytoplasmic sperm injection does not affect the ability of immunoglobulin G transplacental transfer IVF/ICSI导致的妊娠不影响IgG的胎盘移植能力。
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.10.001
Caiyi Huang M.D., Ph.D. , Nijie Li M.D. , Jie Li M.M. , Dongli Huang B.M. , Huiyuan Liu B.S.N. , Jiaxin Wu B.S.N. , Chun Ma B.S.N. , Qiuxia Chen B.S.N. , Meiqiong Fan B.S.N. , Yu Gao M.D., Ph.D. , Xiaoyan Liang M.D., Ph.D.
{"title":"Pregnancy resulting from in vitro fertilization/intracytoplasmic sperm injection does not affect the ability of immunoglobulin G transplacental transfer","authors":"Caiyi Huang M.D., Ph.D. ,&nbsp;Nijie Li M.D. ,&nbsp;Jie Li M.M. ,&nbsp;Dongli Huang B.M. ,&nbsp;Huiyuan Liu B.S.N. ,&nbsp;Jiaxin Wu B.S.N. ,&nbsp;Chun Ma B.S.N. ,&nbsp;Qiuxia Chen B.S.N. ,&nbsp;Meiqiong Fan B.S.N. ,&nbsp;Yu Gao M.D., Ph.D. ,&nbsp;Xiaoyan Liang M.D., Ph.D.","doi":"10.1016/j.fertnstert.2025.10.001","DOIUrl":"10.1016/j.fertnstert.2025.10.001","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"125 2","pages":"Pages 372-375"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261622","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}
引用次数: 0
Promoting the International Federation of Gynecology and Obstetrics classification on magnetic resonance imaging—a clinical and scientific imperative 在MRI上推广FIGO分类——临床和科学的需要。
IF 7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.fertnstert.2025.11.024
Christopher K. Arkfeld M.D., Stylianos Vagios M.D., Ph.D., Victoria Fitz M.D., M.S.
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引用次数: 0
Misleading messages from the web: professional medical counselling and public datasets versus online health information in IVF 来自网络的误导信息:专业医疗咨询和公共数据集与试管婴儿在线健康信息
IF 6.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-31 DOI: 10.1016/j.fertnstert.2026.01.025
Alberto Vaiarelli, Danilo Cimadomo, Christine Wyns, Diane De Neubourg, Georgina M. Chambers, Anja Pinborg, Jim P. Toner, Maurizio Guido, Laura Rienzi
{"title":"Misleading messages from the web: professional medical counselling and public datasets versus online health information in IVF","authors":"Alberto Vaiarelli, Danilo Cimadomo, Christine Wyns, Diane De Neubourg, Georgina M. Chambers, Anja Pinborg, Jim P. Toner, Maurizio Guido, Laura Rienzi","doi":"10.1016/j.fertnstert.2026.01.025","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.01.025","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"90 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095695","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}
引用次数: 0
Is Embryo Ploidy Sufficient to Explain Transfer Success in RPL? 胚胎倍性是否足以解释RPL移植成功?
IF 6.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-31 DOI: 10.1016/j.fertnstert.2026.01.022
Lea George, Jason Franasiak
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引用次数: 0
Differences in Congenital Anomalies in Unassisted Conception versus In-Vitro Fertilization in Dichorionic-Diamniotic Twin Pregnancies 双绒毛膜-双羊膜双胎妊娠无辅助受孕与体外受精先天性异常的差异
IF 6.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-31 DOI: 10.1016/j.fertnstert.2026.01.018
Hannah S. Foster, Meaghan G. McCabe, Nathaniel Koelper, Bryann Bromley, Stephen Chasen, Melissa L. Russo, Ashley S. Roman, Meghana A. Limaye, Angela C. Ranzini, Caitlin Clifford, Joseph R. Biggio, Akela Subramaniam, Avinash S. Patil, Samantha Weed, Jessica M. Page, Sara Nicholas, Jay Idler, Rashmi Rao, Amber Crowder, Raj Shree, Graham McLennan, Lorraine Dugoff
{"title":"Differences in Congenital Anomalies in Unassisted Conception versus In-Vitro Fertilization in Dichorionic-Diamniotic Twin Pregnancies","authors":"Hannah S. Foster, Meaghan G. McCabe, Nathaniel Koelper, Bryann Bromley, Stephen Chasen, Melissa L. Russo, Ashley S. Roman, Meghana A. Limaye, Angela C. Ranzini, Caitlin Clifford, Joseph R. Biggio, Akela Subramaniam, Avinash S. Patil, Samantha Weed, Jessica M. Page, Sara Nicholas, Jay Idler, Rashmi Rao, Amber Crowder, Raj Shree, Graham McLennan, Lorraine Dugoff","doi":"10.1016/j.fertnstert.2026.01.018","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.01.018","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"38 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095694","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}
引用次数: 0
期刊
Fertility and sterility
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