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Immature oocyte proportion may or may not compromise ICSI outcomes, but methods do: a critical appraisal. 未成熟卵母细胞比例可能影响ICSI结果,也可能不影响,但方法会影响:一个关键的评估。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-07 DOI: 10.1093/humrep/deag012
Fatih Aktoz, Yucel Sahin
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引用次数: 0
Reply: immature oocyte proportion may or may not compromise ICSI outcomes, but methods do: a critical appraisal. 回答:未成熟卵母细胞比例可能影响ICSI结果,也可能不影响,但方法会影响:一个关键的评估。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-07 DOI: 10.1093/humrep/deag013
Veda Sripada, Denny Sakkas, Denis Vaughan, Brittany Morse, Yuval Fouks
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引用次数: 0
The impact of endometrial fluid on single euploid frozen embryo transfers, to cancel or not? 子宫内膜液对单整倍体冷冻胚胎移植的影响,是否取消?
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-04 DOI: 10.1093/humrep/deag010
Karishma Patel, Denny Sakkas, Brittany Morse, Daniel W Duvall, Alan Penzias, Denis A Vaughan
<p><strong>Study question: </strong>What is the impact of endometrial fluid (EF) on single, euploid frozen embryo transfer (FET) cycles on live birth rate (LBR) and is cycle cancellation for EF a worthwhile intervention?</p><p><strong>Summary answer: </strong>The LBR of single euploid FETs was significantly lower by 20.2 percentage points when EF was persistent on the day of decision for progesterone start/trigger, but despite the lower LBR, cycle cancellation may not confer an improved chance at live birth.</p><p><strong>What is known already: </strong>The incidence of EF in cycles ranges from 3% to 8%, thus, only a few small studies have been performed to evaluate its impact. Existing literature generally concludes that the presence of EF leading up to an embryo transfer is detrimental to successful implantation, however, these studies examined untested embryos.</p><p><strong>Study design, size, duration: </strong>A retrospective cohort study was performed at a single, academically affiliated infertility center in the USA from January 2014 to December 2022. Inclusion criteria comprised patients who underwent their first IVF cycle, had pre-implantation genetic testing for aneuploidy performed by trophectoderm biopsy, had at least one euploid embryo, and were undergoing their first FET. Cycles were subdivided into three groups: no EF present in the cycle (no EF group), EF present but resolved prior to the day of decision for progesterone start/trigger (EF resolved group), and lastly, EF persistent on the day of decision for progesterone start/trigger (EF persistent group). Clinical outcomes were compared between the groups. In a secondary analysis, all single, euploid FET cycles that were cancelled due to EF were identified. The first subsequent completed single, euploid FET during the same study period was identified and analyzed.</p><p><strong>Participants/materials, setting, methods: </strong>Four thousand three hundred eight FET cycles met inclusion criteria. Four thousand one hundred forty documented no EF, 108 documented EF that resolved, and 60 documented EF that persisted. The primary outcome was LBR per ET. A logistic regression analysis was performed adjusting for baseline characteristics (age, BMI, gravidity, parity, reason for infertility) and cycle characteristics (method of fertilization, protocol, endometrial thickness achieved during FET, embryo grade/day cryopreserved). In our secondary analysis, 90 single, euploid FET cycles were identified as cancelled specifically due to the presence of EF. Following these 90 cancelled cycles, there were 58 cycles that were identified as the first subsequent completed FET after cancellation. For the first subsequent completed single, euploid FET after index cycle cancellation, the presence of EF and overall LBR were recorded.</p><p><strong>Main results and the role of chance: </strong>When EF was present, but resolved prior to decision for progesterone start/trigger, the LBR was 9.4 percentage
研究问题:子宫内膜液(EF)对单、整倍体冷冻胚胎移植(FET)周期对活产率(LBR)的影响是什么? EF的周期取消是否值得干预?总结回答:单倍体fet的LBR在决定启动/触发孕酮的当天持续EF显著降低20.2个百分点,但尽管LBR较低,周期取消可能不会提高活产的机会。已知情况:EF在周期内的发生率在3%至8%之间,因此,仅进行了几项小型研究来评估其影响。现有文献普遍认为,胚胎移植前EF的存在不利于成功植入,然而,这些研究检查了未经测试的胚胎。研究设计、规模、持续时间:2014年1月至2022年12月,在美国一家学术附属不孕不育中心进行了一项回顾性队列研究。纳入标准包括接受第一次体外受精周期,通过滋养外胚层活检进行非整倍体植入前基因检测,至少有一个整倍体胚胎,并且正在接受第一次FET的患者。将周期细分为三组:周期内无EF(无EF组),EF在孕激素启动/触发决定当天出现但消退(EF消退组),最后,EF在孕激素启动/触发决定当天持续(EF持续组)。比较两组临床结果。在二次分析中,发现了所有因EF而取消的单倍体、整倍体FET周期。在同一研究期间,鉴定并分析了第一个随后完成的单个整倍体FET。参与者/材料、环境、方法:43,308个FET周期符合纳入标准。4140份文件没有记录EF, 108份文件解决了EF, 60份文件持续记录EF。主要结局是每胎率。对基线特征(年龄、BMI、妊娠、胎次、不孕原因)和周期特征(受精方法、方案、FET期间达到的子宫内膜厚度、胚胎等级/天冷冻保存)进行logistic回归分析。在我们的二次分析中,由于EF的存在,90个单一的整倍体FET周期被确定为取消。在这90个被取消的周期之后,有58个周期被确定为取消后第一个后续完成的FET。对于指数周期取消后的第一个完整的单倍体FET,记录了EF和总体LBR的存在。主要结果和机会的作用:当EF存在,但在决定开始/触发黄体酮之前解决时,LBR比无EF组低9.4个百分点,但这没有达到统计学意义(49.1%对58.5%,aOR 0.71 (95% CI 0.47, 1.05))。在决定黄体酮启动/触发的当天,超声持续EF组的LBR比不EF组显著降低20.2个百分点(38.3% vs 58.5%, aOR 0.50 (95% CI 0.28, 0.88))。在初始FET取消后确定的58个后续FET周期中,23个显示EF复发(但未取消)。所有58个后续周期的总LBR为39.7%,与EF持续性组无显著差异(aOR 0.99 (95% CI 0.38, 2.64))。局限性,谨慎的原因:回顾性、单中心设计可能限制通用性。只分析整倍体胚胎会引入选择偏差。研究EF的挑战包括EF的病因不确定和未知,以及EF的数量/测量文件不统一。考虑到EF的低发病率,EF组的样本量很小,但与以前的研究规模相似。进行了功率分析,为了达到80%的机会发现10%的LBR差异,每组需要385名患者。鉴于实际LBR差异为20.2个百分点(58.5% vs 38.3%),我们EF组60例患者的样本量提供了88%的机会发现统计学上显著的差异。研究结果的更广泛含义:EF消退时,LBR降低9.4个百分点,EF持续时,LBR降低20.2个百分点。我们确定了一个小队列,在初始周期取消后的后续周期中,这些周期中获得的LBR与指数转移周期中的LBR相似,如果在黄体酮开始/触发时持续EF的情况下进行转移;也许如果EF持续,周期取消可能不会带来LBR的改善。总的来说,许多EF病例可能是由潜在的子宫内膜病理引起的。患者应得到相应的指导。研究资金/竞争利益:本研究未使用任何资金。 作者没有利益冲突。试验注册号:无。
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引用次数: 0
Public attitudes towards consent for the donation of surplus frozen eggs to research. 公众对捐赠多余冷冻卵子作研究的态度。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-03 DOI: 10.1093/humrep/deag007
J Langford, J Demaree-Cotton, M Johnston
<p><strong>Study question: </strong>In the context of donating surplus frozen eggs (SFE) to research, what level of information disclosure, and associated consent model, do the public believe most effectively allows donors to make an informed decision, exercise autonomy, and be treated morally?</p><p><strong>Summary answer: </strong>The public supports the information disclosure requirements of both a specific and broad consent model in this context, with the latter considered to better enhance autonomy and facilitate the moral treatment of SFE donors.</p><p><strong>What is known already: </strong>Despite research indicating that many individuals' first preference is to donate their SFEs to research, donation rates remain low. One possible reason for this is the way consent processes for the donation of SFEs to research are currently regulated, specifically that their high information requirements limit opportunities to donate. There is a notable lack of research on how consent processes should operate, and more specifically, how much information a person should be provided before providing consent, in the context of donating SFEs to research.</p><p><strong>Study design, size, duration: </strong>An online experimental survey of 225 participants was conducted. The survey assessed the impact of two variables-Information Disclosure and Preference Fulfilment-on participants' views towards whether a consent process allowed for informed, autonomous consent and the moral treatment of donors.</p><p><strong>Participants/materials, setting, methods: </strong>A nationally representative sample of the UK public was recruited using the online platform Prolific. The survey consisted of a vignette-based experimental design, one free-text question, and demographic data collection. Quantitative data were summarized using descriptive statistics and the relationship between variables was tested using ANOVAs and t-tests, where appropriate. Inductive content analysis through manual coding was performed on the free-text question.</p><p><strong>Main results and the role of chance: </strong>Participants considered both specific and broad information disclosure as sufficient for informed consent (mean Consent Judgements M = 6.49/7 and M = 5.79/7, respectively). The ability to fulfil disposition preferences was critical to the public's assessment of whether a consent process enabled donors to act autonomously and be treated morally. Participants agreed that a potential donor was able to make an autonomous decision if their preference to donate their SFEs to research was fulfilled (mean Autonomy Judgement M = 5.46/7, mean Moral Judgement M = 5.63/7), but not when it was not (mean Autonomy Judgement M = 3.96/7, mean Moral Judgement: M = 4.76/7).</p><p><strong>Limitations, reasons for caution: </strong>Ecological validity of online surveys is limited, and data may be subject to response biases. Additionally, the sample size was relatively small. Finally, since the sample pop
研究问题:在捐赠多余的冷冻卵子(SFE)进行研究的背景下,公众认为什么样的信息披露水平和相关的同意模型最有效地允许捐赠者做出明智的决定,行使自主权,并得到道德对待?概要回答:在这种情况下,公众支持具体同意模式和广泛同意模式的信息披露要求,后者被认为可以更好地增强自主权,并促进对SFE捐赠者的道德对待。已知情况:尽管研究表明,许多人的第一偏好是将他们的sfe捐赠给研究,但捐赠率仍然很低。造成这种情况的一个可能原因是,目前对sfe捐赠研究的同意过程进行了监管,特别是它们对信息的高要求限制了捐赠的机会。在将sfe捐赠给研究的背景下,关于同意过程应该如何运作,更具体地说,在提供同意之前应该向个人提供多少信息,这方面的研究明显缺乏。研究设计、规模、持续时间:对225名参与者进行了在线实验调查。该调查评估了两个变量——信息披露和偏好履行——对参与者对同意过程是否允许知情、自主同意和对捐赠者的道德待遇的看法的影响。参与者/材料,环境,方法:通过在线平台多产招募了具有全国代表性的英国公众样本。该调查包括一个基于小插图的实验设计,一个自由文本问题和人口统计数据收集。定量数据采用描述性统计汇总,变量之间的关系在适当情况下使用方差分析和t检验进行检验。通过人工编码对自由文本题进行归纳性内容分析。主要结果和偶然性的作用:参与者认为具体和广泛的信息披露对于知情同意都是足够的(平均同意判断M = 6.49/7和M = 5.79/7)。履行处置偏好的能力对于公众评估同意程序是否能使捐赠者自主行动并得到道德对待至关重要。参与者一致认为,如果一个潜在的捐赠者愿意将他们的sfe捐赠给研究,那么他就能够做出自主的决定(平均自主性判断M = 5.46/7,平均道德判断M = 5.63/7),但如果不是这样,就不能(平均自主性判断M = 3.96/7,平均道德判断M = 4.76/7)。局限性,谨慎的原因:在线调查的生态有效性是有限的,数据可能受到反应偏差的影响。此外,样本量相对较小。最后,由于样本人口是基于英国,调查结果的普遍性到其他国家可能是有限的。研究结果的更广泛含义:我们的研究结果强调需要审查并可能更新sfe捐赠给研究的同意程序。我们鼓励根据我们的研究结果进行政策讨论,特别是考虑向广泛同意模式转变。这样做可能会让更多的捐赠者满足他们的处置偏好,促进sfe从储存中移出,并对目前可用于研究的卵子短缺做出反应。研究经费/竞争利益:本研究由英国科学院资助(资助号KF8230096)。这项研究的调查部分是由上广牛津研究所资助的。M.J.获得了莫纳什试管婴儿和Ferring制药公司的研究资助。她报告了吉迪恩·里希特给她的酬金和旅费。试验注册号:无。
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引用次数: 0
Refined trajectory smoothing and deep learning classification of human sperm motility. 精细化的轨迹平滑和人类精子运动的深度学习分类。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-03 DOI: 10.1093/humrep/deag005
Sahar Shahali, Sharon T Mortimer, Robert McLachlan, Moira K O'Bryan, Deirdre Zander-Fox, David Mortimer, Klaus Ackermann, Adrian Neild, Reza Nosrati
<p><strong>Study question: </strong>Can precise trajectory smoothing improve extraction of sperm motility features, and can deep learning on raw trajectory data enable accurate classification of sperm motility patterns?</p><p><strong>Summary answer: </strong>We present an approach that enhances the precision of motility parameter extraction through frequency-domain smoothing and enables accurate classification of sperm motility patterns using a deep learning model trained on raw trajectory data.</p><p><strong>What is known already: </strong>Conventional computer-aided sperm analysis (CASA) systems estimate motility parameters by applying basic smoothing algorithms to derive an average path, which can result in over- or under-smoothing, leading to inaccuracies in key parameters such as beat cross frequency (BCF) and amplitude of lateral head displacement (ALH). Since the identification of hyperactivated spermatozoa relies heavily on these kinematic metrics, such inaccuracies can contribute to misclassification.</p><p><strong>Study design, size, duration: </strong>This cross-sectional study analysed 2326 sperm trajectories (1931 progressive, 395 hyperactivated) recorded at 60 frames per second, derived from five individual samples, to develop and evaluate improved motility parameter extraction methods and trajectory-based classification models.</p><p><strong>Participants/materials, setting, methods: </strong>We compared Gaussian Process Regression (GPR), moving average, and Discrete Cosine Transform (DCT) smoothing to improve average path estimation. A novel metric, path average width (PAW), was introduced to quantify lateral head displacement. An ensemble of InceptionTime models was trained on (x, y) coordinate sequences to classify spermatozoa as progressive or hyperactivated. Additional classification of motility grades was performed using trajectory endpoints.</p><p><strong>Main results and the role of chance: </strong>The DCT model retaining 12 frequency components (DCT-12) produced the most consistent and symmetric average paths, leading to improved accuracy in the calculation of BCF and ALH. Our introduced PAW metric effectively distinguished between hyperactivated spermatozoa (5.5 ± 1.5 μm) and progressive spermatozoa (2.0 ± 1.3 μm). The InceptionTime-based classification model achieved 89% accuracy in differentiating progressive and hyperactivated trajectories, and 78% accuracy for predicting motility grades.</p><p><strong>Limitations, reasons for caution: </strong>Models were trained on sperm trajectories recorded in low-viscosity media. Since sperm selection for ICSI is performed in viscous environments like low concentrations of polyvinylpyrrolidone, future training on such data is essential to improve clinical translation. Additionally, the model for classifying progressive and hyperactivated sperm was trained on a single-centre dataset (5 individuals, total of 790 trajectories) and, despite cross-validation and data augmentation, stil
研究问题:精确的轨迹平滑能否改善精子运动特征的提取,对原始轨迹数据的深度学习能否实现精子运动模式的准确分类?摘要回答:我们提出了一种方法,通过频域平滑提高运动参数提取的精度,并使用基于原始轨迹数据训练的深度学习模型对精子运动模式进行准确分类。已知情况:传统的计算机辅助精子分析(CASA)系统通过应用基本的平滑算法来推导平均路径来估计运动参数,这可能导致平滑过度或平滑不足,从而导致关键参数的不准确性,例如节拍交叉频率(BCF)和侧头位移幅度(ALH)。由于过度激活精子的识别在很大程度上依赖于这些运动学指标,因此这种不准确性可能导致错误分类。研究设计、大小、持续时间:本横断面研究分析了2326个精子轨迹(1931个是渐进的,395个是过度激活的),以60帧/秒的速度记录,来自5个个体样本,以开发和评估改进的运动参数提取方法和基于轨迹的分类模型。参与者/材料,设置,方法:我们比较了高斯过程回归(GPR),移动平均和离散余弦变换(DCT)平滑来改进平均路径估计。引入了一种新的度量,路径平均宽度(PAW)来量化头部侧向位移。在(x, y)坐标序列上训练一组InceptionTime模型,将精子分类为进行性或超活性。使用轨迹终点进行运动等级的额外分类。主要结果和偶然性的作用:保留12个频率分量的DCT模型(DCT-12)产生了最一致和对称的平均路径,从而提高了计算BCF和ALH的精度。我们引入的PAW指标可以有效区分过度激活的精子(5.5±1.5 μm)和进步的精子(2.0±1.3 μm)。基于inception time的分类模型在区分进行性和过度激活轨迹方面达到89%的准确率,在预测运动等级方面达到78%的准确率。局限性,谨慎的原因:模型是在低粘度介质中记录的精子轨迹上训练的。由于ICSI的精子选择是在低浓度的聚乙烯吡咯烷酮等粘性环境中进行的,因此未来对这些数据的培训对于提高临床翻译至关重要。此外,对进行性和过度活化精子进行分类的模型是在单中心数据集(5个个体,总共790个轨迹)上进行训练的,尽管进行了交叉验证和数据增强,但仍需要独立的多中心验证来确认泛化性。缺乏个人标识符和临床元数据妨碍了对每个人的分析。研究结果的更广泛意义:通过将基于精细信号的特征提取与轨迹级分类相结合,我们的方法解决了CASA系统的核心局限性,并具有实时应用于ART工作流程的潜力。对高粘度介质进行培训,可进一步提高其在ICSI精子选择中的适用性。研究经费/竞争利益:这项工作得到了澳大利亚研究委员会(ARC)发现项目资助(DP210103361给A.N.和R.N.),澳大利亚国家卫生和医学研究委员会(NHMRC)奖学金(研究者资助2017370给R.N.)和莫纳什试管婴儿小组的支持。作者声明没有利益冲突。试验注册号:无。
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引用次数: 0
Contribution of endometrial microbiome to inflammation-mediated infertility in women undergoing ART. 子宫内膜微生物组对接受抗逆转录病毒治疗的妇女炎症介导性不孕的贡献。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-03 DOI: 10.1093/humrep/deaf252
F Giangrazi, J A Sugrue, V M Sularea, A A I Brugman, M Horan, M Wingfield, D A Crosby, L E Glover, C O'Farrelly
<p><strong>Study question: </strong>Is the endometrial microbiome altered in women who fail to get pregnant after ART and do microbial-derived metabolites influence endometrial cellular mechanisms important for embryo implantation?</p><p><strong>Summary answer: </strong>The endometrial microbiome in women who fail to get pregnant after ART is more diverse and has fewer lactobacilli species than the endometrial microbiomes of women who become pregnant; the short-chain fatty acid butyrate, a common metabolite found in the presence of increased microbial diversity, diminishes endometrial epithelial barrier function and increases the expression of inflammatory markers.</p><p><strong>What is known already: </strong>Shifts in the endometrial microbial community structure have been linked to fertility and pregnancy complications although the underlying mechanisms are poorly understood. Microbial metabolites at other mucosal surfaces, such as the gut, act as important modulators of immune and barrier function, particularly in epithelial cells. Effects of changes in local bacterial microbial populations on fertility, and how their metabolites might influence endometrial cell function have not been explored.</p><p><strong>Study design, size, duration: </strong>In this prospective longitudinal study of ART outcomes, 29 nulliparous women with unexplained infertility were recruited between October 2016 and February 2018. Endometrial tissue samples were taken for microbiome analysis and endometrial transcriptomics prior to ART. For primary cell culture studies, endometrial biopsies were obtained from fertile women of reproductive age undergoing laparoscopic surgical investigation between February 2021 and September 2023. In vitro models of implantation were established using endometrial cell lines and primary endometrial stromal cells.</p><p><strong>Partcipants/materials, setting, methods: </strong>Microbiome 16S sequencing analysis was performed on bacterial DNA isolated from endometrial biopsies and correlated with receptivity markers. Endometrial RNA sequencing data from women undergoing ART were used to analyse differential gene expression of receptivity and decidualization markers in women who had a positive or negative ART cycle outcome. In vitro models, using both established endometrial cell lines and primary human endometrial epithelial cells and stromal cells, were developed to investigate the effects of microbial-derived metabolites. An in vitro model of peri-implantation was used to test the effect of butyrate on endometrial epithelial receptivity and stromal cell decidualization.</p><p><strong>Main results and the role of chance: </strong>Endometrial microbiome 16S sequencing revealed a lower abundance of Lactobacillus spp. and significantly higher abundance of pathogenic species such as Prevotella spp. and Corynebacterium spp. in women who did not become pregnant after ART. Endometrial microbiota from women who had positive ART outcomes showed si
进一步研究健康子宫内膜的微生物代谢组将有助于阐明丁酸盐和其他细菌代谢物在子宫内膜功能中的生理作用。研究经费/竞争利益:本研究由默克公司生育创新基金支持,资助号15692。作者声明,他们没有已知的竞争经济利益或个人关系,可能会影响本文所报道的工作。试验注册号:无。
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引用次数: 0
Role of extracellular vesicles in fertility preservation before gonadotoxic exposures to the ovaries and testes. 在卵巢和睾丸暴露于促性腺毒素之前,细胞外囊泡在维持生育能力中的作用。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-03 DOI: 10.1093/humrep/deag004
Esra Cetin, Leen Oyoun Alsoud, Yassine El Mahi, Hang-Soo Park, Begum Mathyk, Mervat M Omran, Sana M Salih, Ayman Al-Hendy, Farzana Begum Liakath Ali

Fertility preservation remains a significant concern for individuals undergoing gonadotoxic treatments. While traditional fertility preservation techniques are well-established, these methods can be time-consuming and limited by various medical or logistical barriers. In recent years, the potential of mesenchymal stem cell (MSC)-derived extracellular vesicles (EVs) has emerged as a promising, paradigm-shifting approach in fertility preservation. Preclinical studies have demonstrated the protective and regenerative properties of EVs in chemotherapy-induced ovarian and testicular damage in animal models. EVs provide a cell-free therapy that can potentially preserve ovarian function in females and spermatogenesis in males without the need for surgery or delay in cancer treatment. Additionally, using MSC-derived EVs offers advantages over traditional stem cell therapies, such as a reduced risk of immune rejection, targeted treatment, and avoidance of safety concerns associated with stem cell-based therapies. Future directions include enhancing the therapeutic potential of MSC-derived EVs through genetic engineering or cell priming techniques to target specific tissues and further optimize their utilization in fertility preservation. Given the potential of MSC-derived EVs to protect fertility in both females and males, this approach could revolutionize treatment in oncofertility. Further research, including clinical trials, is necessary to confirm the safety and efficacy of MSC-derived EVs, focusing on premature ovarian insufficiency. Looking ahead, MSC-derived EVs could revolutionize fertility preservation, offering hope for cancer patients and individuals exposed to various environmental risks affecting reproduction, including in space exploration, where protection from cosmic radiation is essential.

对于接受促性腺毒素治疗的个体来说,生育能力的保存仍然是一个重要的问题。虽然传统的保存生育能力的技术是行之有效的,但这些方法可能耗时,并受到各种医疗或后勤障碍的限制。近年来,间充质干细胞(MSC)衍生的细胞外囊泡(EVs)的潜力已经成为一种有前途的、范式转变的生育保存方法。临床前研究已经在动物模型中证明了ev在化疗诱导的卵巢和睾丸损伤中的保护和再生特性。EVs提供了一种无细胞治疗方法,可以在不需要手术或延迟癌症治疗的情况下,潜在地保持女性卵巢功能和男性精子发生。此外,与传统的干细胞疗法相比,使用msc衍生的ev具有优势,例如降低免疫排斥的风险、靶向治疗以及避免与干细胞疗法相关的安全问题。未来的发展方向包括通过基因工程或细胞启动技术来增强msc衍生的ev的治疗潜力,以靶向特定组织,并进一步优化其在生育保护中的应用。鉴于msc衍生的ev在保护女性和男性生育能力方面的潜力,这种方法可能会彻底改变肿瘤生育的治疗方法。需要进一步的研究,包括临床试验,以确认msc来源的ev的安全性和有效性,重点是卵巢早衰。展望未来,msc衍生的电动汽车可能会彻底改变生育能力,为癌症患者和面临各种影响生殖的环境风险的个体带来希望,包括在太空探索中,保护免受宇宙辐射是必不可少的。
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引用次数: 0
The impact of transdermal testosterone treatment on quality of life in women with diminished ovarian reserve: secondary analysis of a randomized controlled trial. 经皮睾酮治疗对卵巢储备功能减退妇女生活质量的影响:一项随机对照试验的二次分析
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1093/humrep/deaf233
Sebastian J Leathersich, Susan R Davis, Sandra García Martínez, Christophe Blockeel, Francisca Martínez, Antonio Gosálvez, Peter Humaidan, Laura de la Fuente, Francesc Fàbregues, Anja Pinborg, Dominic Stoop, Nikolaos P Polyzos
<p><strong>Study question: </strong>Does transdermal testosterone treatment improve fertility-related quality of life (QOL) in women with diminished ovarian reserve (DOR)?</p><p><strong>Summary answer: </strong>Transdermal testosterone for 9 weeks at a dose of 5.5 mg per day did not result in improved fertility-related QOL compared with placebo in women with DOR.</p><p><strong>What is known already: </strong>Reduced QOL is prevalent in women with infertility, many of whom have DOR. Several studies have shown a correlation between DOR and lower testosterone levels, and testosterone is frequently prescribed to women with DOR undergoing fertility treatment. Some studies have reported that testosterone therapy may improve wellbeing in pre- and post-menopausal women, though others have found no benefit. There are no studies evaluating the effect of testosterone on QOL in women undergoing fertility treatment.</p><p><strong>Study design, size, duration: </strong>Pre-planned secondary analysis of a double-blind placebo-controlled randomized controlled trial that included 288 participants recruited between April 2015 and August 2022. Of these, 213 completed QOL surveys both before and after treatment and were eligible for inclusion in this analysis.</p><p><strong>Participants/materials, settings, methods: </strong>Participants were women aged 18-43 years with DOR according to the Bologna criteria and planning to undergo IVF treatment at one of eight fertility clinics in Spain, Belgium, and Denmark. Participants were randomized to 5.5 mg of transdermal testosterone per day as 1% gel (n = 106) or an identical placebo (n = 107), applied for a median of 60 days prior to commencing ovarian stimulation. QOL was assessed using the FertiQoL instrument prior to commencing the intervention, and at the completion of the intervention but prior to commencing ovarian stimulation. QOL scores were compared using a one-way ANCOVA adjusted for age, BMI, parity, history of IVF treatment, and baseline FertiQoL scores.</p><p><strong>Main results and the role of chance: </strong>There were no significant differences in baseline characteristics between the testosterone (n = 106) and placebo (n = 107) groups. After adjustment, testosterone showed no benefit over placebo for the Total FertiQoL score (F(1,204)=0.07, P = 0.79), the Core and Treatment scores, nor for any of the included FertiQoL subscales. Total testosterone levels were higher in the testosterone group than the placebo group at the end of the treatment (3.2 ± 2.7 nmol/l vs 0.6 ± 0.4 nmol/l, P < 0.001).</p><p><strong>Limitation, reasons for caution: </strong>QOL was a secondary outcome in this trial, and participants were not recruited based on a low QOL.</p><p><strong>Wider implications of the findings: </strong>Considering the available evidence, including the current study, premenopausal women are unlikely to benefit from testosterone treatment with regard to wellbeing and QOL. This study provides further evidence
研究问题:经皮睾酮治疗是否能改善卵巢储备功能减退(DOR)女性与生育相关的生活质量(QOL) ?总结回答:与安慰剂相比,经皮睾酮治疗9周,每天5.5 mg的剂量并没有改善DOR女性的生育相关生活质量。已知情况:生活质量下降在不孕妇女中很普遍,其中许多人患有DOR。几项研究表明DOR与较低的睾酮水平之间存在相关性,并且睾酮经常被用于接受生育治疗的DOR妇女。一些研究报告称,睾酮疗法可能会改善绝经前和绝经后妇女的健康状况,尽管其他研究没有发现任何好处。目前还没有研究评估睾酮对接受生育治疗的女性生活质量的影响。研究设计、规模、持续时间:对2015年4月至2022年8月期间招募的288名参与者的双盲安慰剂对照随机对照试验进行预先计划的二次分析。其中213名患者在治疗前后均完成了生活质量调查,符合纳入本分析的条件。参与者/材料、环境、方法:参与者是年龄在18-43岁的女性,根据博洛尼亚标准患有DOR,计划在西班牙、比利时和丹麦的八家生育诊所之一接受体外受精治疗。参与者被随机分配到每天5.5 mg透皮睾酮1%凝胶(n = 106)或相同的安慰剂(n = 107),在开始卵巢刺激前的中位60天应用。在干预开始前、干预结束但在卵巢刺激开始前,使用FertiQoL仪器评估QOL。使用调整年龄、BMI、胎次、IVF治疗史和基线FertiQoL评分的单向ANCOVA比较QOL评分。主要结果和偶然性的作用:睾酮组(n = 106)和安慰剂组(n = 107)在基线特征上无显著差异。调整后,睾酮在总FertiQoL评分(F(1204)=0.07, P = 0.79)、核心和治疗评分以及包括的任何FertiQoL亚量表上均未显示优于安慰剂。在治疗结束时,睾酮组的总睾酮水平高于安慰剂组(3.2±2.7 nmol/l vs 0.6±0.4 nmol/l), P限制,谨慎的原因:生活质量是本试验的次要结局,参与者不是基于低生活质量招募的。研究结果的更广泛含义:考虑到现有的证据,包括目前的研究,绝经前妇女不太可能从睾酮治疗中受益,就健康和生活质量而言。这项研究提供了进一步的证据,证明睾酮不应被视为治疗低幸福感或生活质量的方法。研究经费/竞争利益:本研究得到Besins Healthcare、Roche Diagnostics和Ferring Pharmaceuticals的无限制拨款和支持。研究药物和安慰剂由Besins Healthcare提供。资助者无法获得患者数据,也无权解释数据,也无权撰写或批准最终稿件。研究人员独立于资助者,可以完全访问研究中的所有数据。S.J.L.获得了默克、奥加农和Hologic的酬金、默克的咨询费以及默克、奥加农、Besins Healthcare和Ferring Pharmaceuticals的差旅支持。srd获得了澳大利亚NHMRC、MS Australia、MRFF Australia、Australian Heart Foundation和Lawley Pharmaceuticals的资助,Besins Healthcare、Astellas和Abbott的咨询费,Theramex、Astellas和Bayer的酬金,Astellas的差旅支持,以及Lawley Pharmaceuticals的临床试验药物/安慰剂;她是澳大利亚健康与医学科学院的执行委员会成员。C.B.获得了Ferring Pharmaceuticals、IBSA、Organon、Merck A/S和Abbott的酬金。A.G.获得了Seid实验室的酬金和默克雪兰诺公司的旅行支持。P.H.获得了默克、IBSA、Gedeon Richter和Besins Healthcare的酬金。L.D.L.F.获得了Gedeon Richter、Ferring Pharmaceuticals和Organon的咨询费,Gedeon Richter、Ferring Pharmaceuticals、IBSA、Merck、Organon和Theramex的旅行支持(个人和机构),以及Gedeon Richter和Merck的教育支持(机构)。ap获得了Gedeon Richter、Ferring Pharmaceuticals和Merck A/S的资助,Gedeon Richter和Ferring Pharmaceuticals的咨询费,Ferring Pharmaceuticals、Gedeon Richter、Merck A/S、Abbott和Organon的酬金,以及Gedeon Richter的差旅支持。科学博士 曾获得来自Organon、Ferring Pharmaceuticals、Besins Healthcare、Gedeon Richter和Vitrolife的资助,来自Organon、Ferring Pharmaceuticals、Besins Healthcare、Gedeon Richter和Merck的酬金,来自Organon、Ferring Pharmaceuticals、Besins Healthcare、Gedeon Richter和Merck的差旅支持,并且是比利时生殖医学协会主席。N.P.P.获得了默克雪兰诺、Ferring Pharmaceuticals、Theramex、Organon、Besins Healthcare和Gedeon Richter的资助,默克雪兰诺、Besins Healthcare、Organon、IBSA、FertilAI和Alife的咨询费,默克雪兰诺、Theramex、IBSA、Ferring Pharmaceuticals、Organon、罗氏诊断和Besins Healthcare的酬金。通用,f.m.和F.F.没有利益需要申报。试验注册号:NCT02418572 (ClinicalTrials.gov)。
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引用次数: 0
40th anniversary of Human Reproduction: reflecting on four decades of scientific excellence. 人类生殖40周年纪念:反思40年来卓越的科学成就。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1093/humrep/deaf241
Christopher L R Barratt, Kirstine Kirkegaard, Denny Sakkas, Lauren A Wise, Andrew C Williams
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引用次数: 0
Development of technologies for the non-invasive assessment of single embryo metabolism and viability. 单胚胎代谢和生存能力无创评估技术的发展。
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1093/humrep/deaf242
David K Gardner, Henry J Leese
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引用次数: 0
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Human reproduction
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