Human reproduction最新文献

{"title":"Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15–49 years) from 1990 to 2021, with projections to 2040","authors":"Yuanhao Liang, Jing Huang, Qiang Zhao, Haixin Mo, Zhaohong Su, Suihua Feng, Shuzhen Li, Xiaohong Ruan","doi":"10.1093/humrep/deae292","DOIUrl":"https://doi.org/10.1093/humrep/deae292","url":null,"abstract":"STUDY QUESTION What is the prevalence and trend of infertility among individuals of childbearing age at global, regional, and national levels by sex and socio-demographic index (SDI) across 21 regions and 204 countries and territories? SUMMARY ANSWER Our findings reveal a growing prevalence of infertility among individuals aged 15–49 years worldwide from 1990 to 2021, with an expected continued increase through 2040. WHAT IS KNOWN ALREADY Infertility is a persistent global reproductive health issue, leading to significant societal and health consequences. No study has specifically described the current prevalence of infertility, its secular trend, or the variations between regions or countries with different SDI levels. STUDY DESIGN, SIZE, DURATION A sex- and SDI-stratified systematic analysis of the prevalence of infertility across 21 regions and 204 countries and territories from 1990 to 2021 has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS We retrieved data from the Global Burden of Disease Study (GBD) 2021 on the count and crude rate of infertility prevalence for individuals aged 15–49 years across 204 countries and territories from 1990 to 2021. In the GBD 2021 framework, infertility is defined as the absence of a live birth in a couple who have been in a union for at least 5 years and are actively trying to conceive, or in a couple who have been in a union for at least 5 years since their last live birth, with no use of contraceptives during this period. Estimated annual percent change was calculated to quantify the temporal trend in age-standardized prevalence rates (ASPRs) for infertility by sex, age, and SDI. The Bayesian age-period-cohort model was used to project the ASPRs from 2022 to 2040. MAIN RESULTS AND ROLE OF CHANCE In 2021, an estimated 55 000 818 men and 110 089 459 women were living with infertility worldwide, corresponding to approximately 1820.6 cases per 100 000 population (1.8%) for males and 3713.2 cases per 100 000 population (3.7%) for females. Regionally, the highest infertility prevalence was observed in middle SDI regions, such as East and South Asia and Eastern Europe. Infertility primarily affected the age group of 35–39 years and females in most regions, with some notable exceptions. Between 1990 and 2021, the global ASPRs of infertility increased by an average of 0.49% (95% CI 0.34–0.63) for males and 0.68% (0.51–0.86) for females. Additionally, the fastest increase in female infertility occurred in high SDI regions, while the most significant rise in male infertility was seen in low-middle SDI areas. Furthermore, the global ASPR of male infertility is projected to rise more rapidly than that of female infertility from 2022 to 2040. LIMITATIONS, REASONS FOR CAUTION The primary data sources for the infertility burden in the GBD 2021 are population-based surveys; however, less-developed regions often lack complete population-based statistics, leading to potential reporting bias of the infertility burde","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"82 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142925009","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}

{"title":"Human ovarian tissue xenotransplantation: advancements, challenges, and future perspectives.","authors":"Paweena Thuwanut, Ellen C R Leonel, Thalles Fernando Rocha Ruiz, Porntip Sirayapiwat, Stine Gry Kristensen, Christiani A Amorim","doi":"10.1093/humrep/deae291","DOIUrl":"https://doi.org/10.1093/humrep/deae291","url":null,"abstract":"<p><p>Ovarian tissue cryopreservation and transplantation has emerged as a promising fertility preservation technique for individuals facing premature ovarian insufficiency due to various medical conditions or treatments. Xenotransplantation, involving the transplantation of ovarian tissue into animal hosts, has played a pivotal role in refining ovarian tissue cryopreservation and transplantation techniques and addressing key challenges. This review provides a comprehensive overview of the current landscape of ovarian tissue xenotransplantation research, focusing on its applications in investigating ovarian biology, optimizing ovarian tissue cryopreservation and transplantation protocols, and assessing safety concerns. It also explores the utilization of xenografting of human ovarian tissue in mouse models in the last 10 years. Key findings from preclinical studies investigating grafting site optimization, cryopreservation protocol refinement, the development of strategies to mitigate chemotherapy-induced damage, follicle development, tissue revascularization, and the risk of malignant cell reintroduction are summarized. Moreover, the review examines the ethical considerations surrounding the use of animals in ovarian tissue xenotransplantation research and suggests emerging alternative models that aim to minimize animal use while maximizing clinical relevance.</p>","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921368","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}

{"title":"Psychosocial and physical wellbeing in women and male partners undergoing immediate versus postponed modified natural cycle frozen embryo transfer after ovarian stimulation and oocyte pick-up: a sub-study of a randomized controlled trial.","authors":"Sara Bergenheim, Marte Saupstad, Clara Colombo, Julie Elkjær Møller, Jeanette Wulff Bogstad, Nina la Cour Freiesleben, Ida Behrendt-Møller, Lisbeth Prætorius, Birgitte Oxlund, Bugge Nøhr, Merete Husth, Ellen Løkkegaard, Negjyp Sopa, Anja Pinborg, Kristine Løssl, Lone Schmidt","doi":"10.1093/humrep/deae260","DOIUrl":"10.1093/humrep/deae260","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Are there differences in psychosocial and physical wellbeing among women and male partners undergoing modified natural cycle (mNC) frozen embryo transfer (FET) in immediate compared to postponed cycles after ovarian stimulation (OS) and oocyte pick-up (OPU)?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Significantly more women in the immediate group reported physical symptoms than women in the postponed group whilst fewer were emotionally affected by waiting time, although the latter difference lost statistical significance after adjustment for multiple testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Infertility and fertility treatment are known to cause psychosocial distress in women and couples longing for a child. The treatment may be long-term and delayed for various reasons, such as the elective postponement of FET after a fresh transfer without pregnancy or an elective freeze-all cycle, possibly further increasing the level of distress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;Sub-study of an ongoing multicentre randomized controlled, non-inferiority trial assessing the optimal timing for mNC-FET treatment after OS and OPU. Participants were randomized 1:1 to mNC-FET in the cycle immediately following OS or mNC-FET in a subsequent cycle. The study is based on data from the first women (N = 300) and male partners (N = 228) invited to answer a self-reported questionnaire assessing psychosocial and physical wellbeing. Data were collected from April 2021 to March 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Questionnaires were distributed to all randomized women and their male partners on cycle day 2-5 of mNC-FET cycles and returned before the administration of ovulation trigger. The questionnaire consisted of validated items originating from the Copenhagen Multicentre Psychosocial Infertility-Fertility Problem Stress Scale (COMPI-FPSS) and Marital Benefit Measure (COMPI-MBM). Emotional reactions to waiting time in fertility treatment, mental health, general quality-of-life, and physical symptoms were also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Questionnaire response rates were 90.3% for women and 80.0% for male partners in the immediate group, and 82.3% for women and 57.3% for male partners in the postponed group. Approximately 90% of all women worried to some or a great extent about whether the treatment would be successful. More women in the postponed group reported that they were emotionally affected by the waiting time from OPU to blastocyst transfer to some or to a great extent (57.4% versus 73.9% in the immediate versus postponed group, P = 0.014), but the results were not significant after adjustment for multiple testing (P = 0.125). For male partners, no difference in emotional reactions to waiting time between groups was found. There was no significant difference in total infertility-related stress or symptoms of severe depression","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"96-109"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824291","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}

{"title":"Endometrioma patients are under-treated with endocrine endometriosis therapy.","authors":"C Cirkel, H Göbel, C Göbel, I Alkatout, A Khalil, N Brüggemann, A Rody, A Cirkel","doi":"10.1093/humrep/deae257","DOIUrl":"10.1093/humrep/deae257","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Is there a difference in the use of endocrine endometriosis therapy in endometriosis patients with and without endometrioma?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Patients with endometriomas received significantly less endocrine endometriosis treatment (present intake in 42.5%) compared to patients with other forms of endometriosis and without endometriomas (present intake in 52.1%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Endocrine endometriosis therapy in patients with endometriomas reduces the risk of recurrence and therefore the risk of further surgery and subsequent irreversible damage to ovaries which results into reduced antral follicle counts (AFC), anti-Mullerian hormone levels (AMH), and early menopause. However, there is evidence of increasing rejection of endocrine endometriosis treatment in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;A total of 838 premenopausal woman with dysmenorrhea and/or endometriosis (mean age 30.7 ± 6.9 years, range 15-54 years) were included in this observational cross-sectional multicenter study. Data including the extent of dysmenorrhea, prevalence of other comorbidities like migraine with aura and migraine never with aura, diagnosis of endometriosis, history of endometriosis surgery, and hormone therapy, were collected in a retrospective online survey from May to November 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Patients visiting two university hospital endometriosis centers between January 2017 and March 2023, and with available email address, were invited for study participation by email in May 2023. Further recruitment of participants was achieved through the website and social medial channels of the German Endometriosis Association. Participation in the online survey was open between May and November 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;In the subgroup of women (with dysmenorrhea) without surgically confirmed endometriosis (SCE) (n = 277), 95 (34.3%) were currently undergoing endocrine treatment for dysmenorrhea and contraceptional purposes. On the contrary, in the subgroup of patients with SCE (n = 561), 275 (49.0%) were currently undergoing hormonal treatment. Subjects with SCE therefore significantly more commonly took endocrine treatment (F = 16.587, P &lt; 0.001) compared to those without SCE. Endometriomas were present in 254 patients (45.2% of all SCE patients), and these patients were significantly less likely to have used hormonal treatment (i) in the present and (ii) in the past (i. n = 113 42.5%, ii. n = 187, 73.9%) compared to patients with other forms of endometriosis (n = 261) (i. n = 139, 52.1%, ii. n = 220, 84.3%) (i. F = 3.976, P = 0.047, ii. F = 8.297, P = 0.004). Various reasons for rejection of endocrine endometriosis treatment were analyzed, when comparing endometrioma subjects to patients with other types of endometriosis, but no statistical differences were","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"69-76"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695477","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}

{"title":"Immune system regulation of physiological and pathological aspects of the ovarian follicle pool throughout the female reproductive lifespan.","authors":"L Cacciottola, A Camboni, M M Dolmans","doi":"10.1093/humrep/deae254","DOIUrl":"10.1093/humrep/deae254","url":null,"abstract":"<p><p>The immune system plays a major role in ovarian physiology by regulating the ovarian follicle pool through complex signaling of different growth factors, cytokines, and chemokines. These may promote follicle activation and further growth but could also trigger follicle atresia and clearance of aging or damaged cells within the ovarian cortex. Moreover, extraglandular steroidogenesis potentially occurring in different immune cells like macrophages and natural killer cells might be another way of modulating follicle growth. Ovarian macrophages have recently been found to contain two different populations, namely resident macrophages and monocyte-derived cells, with potentially different roles. The immune system also plays a role in the development of pathological conditions, including premature ovarian insufficiency (POI). Indeed, autoimmune activation against various ovarian antigen targets results in lymphocytic oophoritis mainly targeting early growing follicles, but later leading to complete follicle pool depletion. Immune-mediated ovarian damage may also be caused by viral infection or be the consequence of iatrogenic damage. Certain novel cancer immunotherapies like checkpoint inhibitors have recently been shown to induce ovarian reserve damage in a murine model. Studies are needed to corroborate these findings and further investigate the potential of newly developed immunotherapies to treat POI. Technological advances such as single-cell analyses of less represented cell populations like immune cells inside the ovary are now contributing to valuable new information, which will hopefully lead to the development of new therapeutic strategies for women with fertility issues.</p>","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"12-22"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750774","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}

{"title":"Novel application of metabolic imaging of early embryos using a light-sheet on-a-chip device: a proof-of-concept study.","authors":"E Vargas-Ordaz, H Newman, C Austin, S Catt, R Nosrati, V J Cadarso, A Neild, F Horta","doi":"10.1093/humrep/deae249","DOIUrl":"10.1093/humrep/deae249","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Is it feasible to safely determine metabolic imaging signatures of nicotinamide adenine dinucleotide [NAD(P)H] associated auto-fluorescence in early embryos using a light-sheet on-a-chip approach?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;We developed an optofluidic device capable of obtaining high-resolution 3D images of the NAD(P)H autofluorescence of live mouse embryos using a light-sheet on-a-chip device as a proof-of-concept.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Selecting the most suitable embryos for implantation and subsequent healthy live birth is crucial to the success rate of assisted reproduction and offspring health. Besides morphological evaluation using optical microscopy, a promising alternative is the non-invasive imaging of live embryos to establish metabolic activity performance. Indeed, in recent years, metabolic imaging has been investigated using highly advanced microscopy technologies such as fluorescence-lifetime imaging and hyperspectral microscopy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;The potential safety of the system was investigated by assessing the development and viability of live embryos after embryo culture for 67 h post metabolic imaging at the two-cell embryo stage (n = 115), including a control for culture conditions and sham controls (system non-illuminated). Embryo quality of developed blastocysts was assessed by immunocytochemistry to quantify trophectoderm and inner mass cells (n = 75). Furthermore, inhibition of metabolic activity (FK866 inhibitor) during embryo culture was also assessed (n = 18).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;The microstructures were fabricated following a standard UV-photolithography process integrating light-sheet fluorescence microscopy into a microfluidic system, including on-chip micro-lenses to generate a light-sheet at the centre of a microchannel. Super-ovulated F1 (CBA/C57Bl6) mice were used to produce two-cell embryos and embryo culture experiments. Blastocyst formation rates and embryo quality (immunocytochemistry) were compared between the study groups. A convolutional neural network (ResNet 34) model using metabolic images was also trained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;The optofluidic device was capable of obtaining high-resolution 3D images of live mouse embryos that can be linked to their metabolic activity. The system's design allowed continuous tracking of the embryo location, including high control displacement through the light-sheet and fast imaging of the embryos (&lt;2 s), while keeping a low dose of light exposure (16 J · cm-2 and 8 J · cm-2). Optimum settings for keeping sample viability showed that a modest light dosage was capable of obtaining 30 times higher signal-noise-ratio images than images obtained with a confocal system (P &lt; 0.00001; t-test). The results showed no significant differences between the control, illuminated and non-illuminat","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"41-55"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619215","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}

{"title":"Endometrial extracellular vesicles regulate processes related to embryo development and implantation in human blastocysts.","authors":"Marina Segura-Benítez, Maria Cristina Carbajo-García, Alicia Quiñonero, María José De Los Santos, Antonio Pellicer, Irene Cervelló, Hortensia Ferrero","doi":"10.1093/humrep/deae256","DOIUrl":"10.1093/humrep/deae256","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;What is the transcriptomic response of human blastocysts following internalization of extracellular vesicles (EVs) secreted by the human endometrium?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;EVs secreted by the maternal endometrium induce a transcriptomic response in human embryos that modulates molecular mechanisms related to embryo development and implantation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;EVs mediate intercellular communication by transporting various molecules, and endometrial EVs have been postulated to be involved in the molecular regulation of embryo implantation. Our previous studies showed that endometrial EVs carry miRNAs and proteins associated with implantation events that can be taken up by human blastocysts; however, no studies have yet investigated the transcriptomic response of human embryos to this EV uptake, which is crucial to demonstrate the functional significance of this communication system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;A prospective descriptive study was performed. Primary human endometrial epithelial cells (pHEECs), derived from endometrial biopsies collected from fertile oocyte donors (n = 20), were cultured in vitro to isolate secreted EVs. Following EV characterization, Day 5 human blastocysts (n = 24) were cultured in the presence or absence of the EVs for 24 h and evaluated by RNA-sequencing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;EVs were isolated from the conditioned culture media using ultracentrifugation, and characterization was performed using western blot, nanoparticle tracking analysis, and transmission electron microscopy. Human blastocysts were devitrified, divided into two groups (n = 12/group), and cultured in vitro for 24 h with or without previously isolated EVs. RNA-sequencing analysis was performed, and DESeq2 was used to identify differentially expressed genes (DEGs) (FDR &lt; 0.05). QIAGEN Ingenuity Pathway Analysis was used to perform the functional enrichment analysis and integration with our recently published data from the pHEECs' EV-miRNA cargo.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Characterization confirmed the isolation of EVs from pHEECs' conditioned culture media. Among the DEGs in blastocysts co-cultured with EVs, we found 519 were significantly upregulated and 395 were significantly downregulated. These DEGs were significantly enriched in upregulated functions related to embryonic development, cellular invasion and migration, cell cycle, cellular organization and assembly, gene expression, and cell viability; and downregulated functions related to cell death and DNA fragmentation. Further, the intracellular signaling pathways regulated by the internalization of endometrial EVs were previously related to early embryo development and implantation potential, for their role in pluripotency, cellular homeostasis, early embryogenesis, and implantation-related processes. Final","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"56-68"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686865","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}

{"title":"Targeting and missing conceptions.","authors":"Cornelis Nils B Lambalk","doi":"10.1093/humrep/deae282","DOIUrl":"https://doi.org/10.1093/humrep/deae282","url":null,"abstract":"","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"40 1","pages":"1-2"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931629","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}

{"title":"'To keep your balance, you must keep moving'†: a new chapter for Human Reproduction.","authors":"Chris Barratt, Kirstine Kirkegaard","doi":"10.1093/humrep/deae279","DOIUrl":"https://doi.org/10.1093/humrep/deae279","url":null,"abstract":"","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"40 1","pages":"3"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931633","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}

{"title":"The 'golden fleece of embryology' eludes us once again: a recent RCT using artificial intelligence reveals again that blastocyst morphology remains the standard to beat.","authors":"Denny Sakkas","doi":"10.1093/humrep/deae263","DOIUrl":"10.1093/humrep/deae263","url":null,"abstract":"<p><p>Grading of blastocyst morphology is used routinely for embryo selection with good outcomes. A lot of effort has been placed in IVF to search for the prize of selecting the most viable embryo to transfer ('the golden fleece of embryology'). To improve on morphology alone, artificial intelligence (AI) has also become a tool of interest, with many retrospective studies being published with impressive prediction capabilities. Subsequently, AI has again raised expectations that this 'golden fleece of embryology' was once again within reach. A recent RCT however was not able to demonstrate non-inferiority using a deep learning algorithm 'iDAScore version 1' for clinical pregnancy rate when compared to standard morphology. Good blastocyst morphology has again proven itself as a high bar in predicting live birth. We should however not give up on the development of further approaches which may allow us to identify extra features of viable embryos that are not captured by morphology.</p>","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"4-8"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739481","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}