Human Fertility最新文献

Knowledge of ovulatory cycle (KOC) is a crucial factor for successful conception. Despite sizable number of women suffering from infertility, empirical evidence on the relation between infertility and KOC is rare in South Asia. This study assesses the association between primary infertility and KOC. The data of ever-married women aged 20-49 gathered in the recent rounds of Demographic and Health Survey (DHS) for India (2019-2021), Bangladesh (2017-2018), Pakistan (2017-2018) and Nepal (2022) were analyzed. Bivariate analysis and binary logistic regression were conducted through Stata (V.17) with a 5% significance level. Women with no KOC in India [AOR:1.71, C.I.: (1.54, 1.9)] and Bangladesh [AOR:2.6, C.I.: (1.67, 4.06)] had higher odds of primary infertility than their counterparts with correct KOC. The study concludes that correct KOC is a significant predictor of primary infertility in India and Bangladesh and is insignificant in Pakistan and Nepal. Moreover, higher age at marriage and no-visit to healthcare facility were the other significant predictors of primary infertility in all four countries. Women who are struggling to conceive would benefit from education related to the timing and identification of the fertile window, which may be provided through primary healthcare providers.

This retrospective cohort study was conducted in a single center to investigate the influence of paternal age on oocyte recipient cycles. 320 IVF/ICSI oocyte recipient cycles resulting in embryo transfers between 01/2015- 06/2022 and meeting the inclusion criteria: donors ≤35 years, endometrial thickness 6mm and normal endometrial cavity were analyzed. Donor or surgically retrieved sperm or PGT-A cycles were excluded. Paternal and recipient ages were grouped according to previous literature for comparability. Primary outcome was live birth rate, and secondary outcomes were clinical pregnancy and miscarriage rates. The median recipient, paternal and donor ages were 42 (IQR: 19-50), 43 (IQR: 38-46) and 26 years (IQR: 23-29). 55.6% [N=178] of the cycles were fresh and 44.3% [N=142] were frozen embryo transfers. Univariate and multivariate logistic regression, adjusted for semen WHO criteria, recipient age, IVF/ICSI and fresh/frozen cycles highlighted reduced odds of live birth by 79%, OR 0.21 [95%CI 0.11 to 0.38]; P<0.0001, clinical pregnancy by 58%, OR 0.42 [95%CI 0.31 to 0.89]; P<0.0001 and increased odds of miscarriage by 108%, OR 2.08 [95%CI 1.91 to 3.01]; P<0.0001 in those of paternal age 51 years compared to fathers ≤35 years. Our study identifies the negative impact of advanced paternal age.

Gender-affirming treatments, including hormone therapy and surgery, can significantly impair fertility in transgender and non-binary (TNB) individuals. Despite growing attention to transgender health, fertility preservation (FP) remains under-addressed. This systematic review synthesizes current evidence on FP strategies, exploring clinical, psychosocial, and structural factors shaping FP decision-making in TNB populations. A systematic review and thematic metasynthesis were conducted following PRISMA guidelines. Qualitative and mixed-methods studies published between 2010 and 2025 were identified via PubMed, Scopus, Web of Science, and Google Scholar. Thematic analysis included perspectives from TNB individuals, parents, and healthcare providers. FP uptake remains low despite many TNB individuals expressing a desire for biological parenthood. Major barriers include procedural dysphoria, financial constraints, limited provider expertise, and inconsistent counselling. Gamete cryopreservation remains the most common FP method, although long-term outcomes are underreported. Early, affirming fertility counselling improves informed decision-making and aligns care with patient values. Access to FP is shaped by healthcare policies, legal frameworks, and social norms. To address persistent underutilization, providers should initiate FP discussions early in the transition process and consider both medical and psychosocial needs. Enhanced training and policy reform are needed to close knowledge gaps and ensure equitable, patient-centred fertility care.

To understand whether there was an association between very young oocyte donors and adverse outcomes, this was a single centre retrospective study (Lister Fertility Clinic, London) examining data collected between 1st January 2010 and 31st December 2021. A total of 1,182 oocyte donors were included in the final analysis. Data was categorised by donor age in years; ≤22, 23-25, 26-28, 29-31, 32-34. Statistical analysis was performed using SPSS. Donors aged ≤22 years showed increased live birth rates (LBR) in fresh In Vitro Fertilisation (IVF) cycles when compared to donors aged 26-28 (p < 0.0136), 29-31 (p < 0.0044), and 32-34 (p < 0.0003) years, respectively. There was also an increased positive pregnancy rate in fresh IVF cycles for donor oocytes ≤22 years when compared to all other groups. The LBR and positive pregnancy rates decreased with increasing oocyte age with fresh IVF cycles. There was no significant difference in the LBR with frozen IVF cycles compared to fresh IVF cycles. Our data showed that very young oocyte donors are in fact associated with improved IVF outcomes, especially in fresh IVF cycles.

Despite the rise in discussions around fertility and reproductive health, recent evidence indicates that women's fertility awareness (FA) remains low, with many avoiding essential fertility-related information (FRI). Existing research has linked low awareness to demographic factors, yet psychological and behavioural determinants have received less attention. This study, therefore, explores the influence of coping strategies (avoidant and problem-focused) on FRI-seeking and avoidance behaviours and their effect on FA. A cross-sectional survey gathered data from 216 UK-based female participants aged 18-68 (M = 31.69, SD = 10.42), measuring demographics, FA, FRI-seeking and avoidance, and coping strategies. Data underwent multiple regression and moderation analyses. The average FA score was 17.87/29 (62%). FRI-seeking positively predicted FA (p < 0.001), while FRI-avoidance negatively predicted FA (p < 0.001). Avoidant coping significantly predicted increased FRI-avoidance (p < 0.001), moderating the relationship between FRI-avoidance and FA (p < 0.001). Problem-focused coping significantly predicted FRI-seeking (p < 0.001), moderating the relationship between FRI-seeking and FA (p < 0.001). Results suggest that coping strategies influence motivation to seek and avoid FRI. Future FRI and fertility education should be tailored to suit women's coping strategies to facilitate active engagement, which may enhance awareness and support more informed fertility decision-making.

Technology continues to change how we manage our health, and recent breakthroughs in Artificial Intelligence have increased the adoption of Large Language Models (LLMs) in healthcare. Since the launch of ChatGPT, LLMs have been increasingly used for health information; this study, therefore, aimed to qualitatively assess fertility information provided by LLMs. Content generated by four LLM platforms: ChatGPT, Gemini, Copilot, Perplexity, were analysed comparatively. Thirty-seven prompts were generated, covering five topics: menstrual cycle, conception, risk factors, assisted reproductive technologies and age-related fertility decline. Prompts were analysed for concordance, comprehensibility and conciseness. Safety warnings for all platforms were recorded. LLM platforms generally provided concordant answers for menstrual cycle, conception, and risk factors. However, content on assisted reproductive technologies was the least accurate. Perplexity provided the highest number of strongly-concordant and poorly-concordant responses. Comprehensibility was similar across platforms. ChatGPT was the most concise. Not all platforms provided warning or safety messages regarding potential inaccuracies. LLMs present an opportunity to expand access to fertility and reproductive health information not only for individuals and patients, but also for clinicians, researchers, educators, charities, reproductive health organisations and policymakers. Nevertheless, attention must be paid to the quality of information generated in order to ensure that professionals have accurate guidance, and that individuals can access quality information to help achieve their desired fertility and reproductive health intentions.

Following reports of mpox infections in Europe and the Americas, the World Health Organisation has declared that mpox constitutes a public health emergency of international concern. Since the mpox virus (MPXV) has been detected in semen of MPX-infected men, this puts healthcare professionals in medically assisted reproduction clinics, such as clinical embryologists and andrologists, at risk of MPX infection by handling semen from infected men. This commentary provides information about MPXV and highlights vigilance steps with regards to processing semen, oocytes, pre-implantation embryos and pregnancies of MPXV infected persons.

The role of serum 25-OH D3 (D3) in the physiology and regulation of the female genital system has gained significant research interest. Recent data have suggested that sufficient D3 levels are associated with improved outcomes of in vitro fertilization (IVF), although other studies failed to confirm so. Screening for D3 levels before IVF is becoming common practice in many IVF centres, and D3 insufficiency is treated with supplements before treatment. However, little is known about the effect of this intervention on D3 levels during endometrial preparation for frozen-embryo transfer (FET) cycles, especially regarding clinical outcomes. To examine the effect of vitamin D supplementation and the impact of vitamin D status in women undergoing FET cycles, a prospective study of infertile women undergoing FET cycles was carried out. Initial screening of D3 levels was performed in 252 infertile women before a FET cycle, and where insufficiency was found (<30 ng/mL) [115 (45.6%)], supplements were prescribed according to a standardized protocol. Serum D3 levels were measured at three distinct time-points: at the initiation of endometrial preparation (T1), embryo transfer (T2), and beta-hCG testing (T3). We found no significant difference in ongoing pregnancy [40 (34.8%) vs. 51 (37.2%); odds ratio (OR) 0.90, 95% confidence interval (CI) 0.54-1.51; adjusted OR 1.04, 95% CI 0.58-1.83], live birth, positive β-hCG, clinical pregnancy, miscarriage, and ectopic pregnancy rates between D3-insufficient participants at T1 receiving vitamin D and D3-replete ones not receiving any supplementation (p-values >0.05). We also found no significant difference in ongoing pregnancy [21 (30.9%) vs. 66 (40.2%), and 17 (34.0%) vs. 51 (41.5%)] and the rest of the outcomes between D3-insufficient and replete participants at T2 and T3, respectively (p-values >0.05). In conclusion, this prospective cohort study of women undergoing FET cycles found no significant difference in ongoing pregnancy rates between D3-insufficient participants receiving supplementation at the beginning of endometrial preparation and replete ones receiving no supplementation. Large, high-quality trials are required to further investigate this hypothesis and compare the IVF outcomes between replete participants, insufficient participants receiving no supplementation, and insufficient participants receiving supplementation.

The trend of delayed childbearing has increased the average age of parents, with the impact of paternal age on embryo euploidy remaining controversial. Therefore, this study aimed to investigate the impact of paternal age on embryo euploidy using retrospective clinical data and interpretable machine learning. This retrospective study included 960 couples and 4,718 embryos undergoing preimplantation genetic testing for aneuploidy (PGT-A). Couples were divided into two groups based on paternal age (Group 1 ≥ 40 years and Group 2 < 40 years). Statistical methods, including generalized estimating equation (GEE) and restricted cubic spline, were used to evaluate the relationship between paternal age and embryo euploidy. Interpretable machine learning models were employed to predict the likelihood of having at least one euploid embryo, validating the impact of paternal age on embryo euploidy. 867 and 3,851 blastocysts were selected as Group 1 and control Group 2, respectively. Couples with higher paternal age showed a significantly higher rate of embryo aneuploidy (60.21% vs. 41.03%, P < 0.001). Logistic regression using GEE confirmed the association between paternal age and aneuploidy rate (OR: 1.396, 95% CI: 1.150-1.695, P < 0.01). Combining clinical data analysis and interpretable machine learning models, the study provides evidence that paternal age negatively impacts embryo euploidy, emphasizing the need to consider paternal age in reproductive planning.