Pub Date : 2025-12-01Epub Date: 2025-06-23DOI: 10.1016/j.rbmo.2025.105083
Farnoosh Saraee , Faezeh Shekari , Ashraf Moini , Mehdi Mirzaei , Pooneh Ghaznavi , Shabnam Khodabakhshi , Anna Meyfour , Sara Fayazzadeh , Azadeh Ghaheri , Najmeh Salehi , Mohammad Reza Ghaffari , Ghasem Hosseini Salekdeh , Poopak Eftekhari Yazdi , Mehdi Totonchi
Research question
Can proteomic analysis of uterine fluid identify a panel of proteins that could potentially improve targeted embryo transfer strategies in IVF?
Design
Uterine fluid samples were collected from 18 patients who had undergone in vitro fertilization (IVF) with frozen embryo transfer 2 days before embryo transfer (11 patients in the main cohort and 7 patients in the independent cohort). Seven weeks later, patients were categorized into receptive and non-receptive groups based on ultrasonography results confirming clinical pregnancy. The proteins in these samples were analysed using tandem mass tag labelling and mass spectrometry. Differentially abundant proteins between the two groups were identified, and the candidate protein panel was selected based on the variable of importance in projection score and protein database analysis. The accuracy of the candidate panel was assessed using logistic regression, and findings were confirmed through western blot analysis.
Results
Bioinformatics analysis revealed that proteins related to protein synthesis, cell adhesion, keratinization, peroxisome proliferator-activated receptors, arachidonic acid metabolism and vascular endothelial growth factor were enriched in the receptive group. Biological processes, such as receptor internalization, negative regulation of cell junctions, the innate immune response, inflammatory response, and actin cytoskeleton organization were enriched in the non-receptive group. The key proteins, including desmoplakin, keratin type II cytoskeletal 1, the neuroblast differentiation-associated proteins AHNAK, moesin, and fibulin-1 were confirmed as potential biomarkers for assessing endometrial receptivity via western blot analysis.
Conclusion
The candidate panel may provide an approach for evaluating endometrial receptivity in the embryo transfer cycle, potentially improving personalized embryo transfer timing in clinical settings.
{"title":"Comparative proteomic analysis of receptive and non-receptive endometria-derived uterine fluid suggests a panel for endometrial receptivity assessment","authors":"Farnoosh Saraee , Faezeh Shekari , Ashraf Moini , Mehdi Mirzaei , Pooneh Ghaznavi , Shabnam Khodabakhshi , Anna Meyfour , Sara Fayazzadeh , Azadeh Ghaheri , Najmeh Salehi , Mohammad Reza Ghaffari , Ghasem Hosseini Salekdeh , Poopak Eftekhari Yazdi , Mehdi Totonchi","doi":"10.1016/j.rbmo.2025.105083","DOIUrl":"10.1016/j.rbmo.2025.105083","url":null,"abstract":"<div><h3>Research question</h3><div>Can proteomic analysis of uterine fluid identify a panel of proteins that could potentially improve targeted embryo transfer strategies in IVF?</div></div><div><h3>Design</h3><div>Uterine fluid samples were collected from 18 patients who had undergone in vitro fertilization (IVF) with frozen embryo transfer 2 days before embryo transfer (11 patients in the main cohort and 7 patients in the independent cohort). Seven weeks later, patients were categorized into receptive and non-receptive groups based on ultrasonography results confirming clinical pregnancy. The proteins in these samples were analysed using tandem mass tag labelling and mass spectrometry. Differentially abundant proteins between the two groups were identified, and the candidate protein panel was selected based on the variable of importance in projection score and protein database analysis. The accuracy of the candidate panel was assessed using logistic regression, and findings were confirmed through western blot analysis.</div></div><div><h3>Results</h3><div>Bioinformatics analysis revealed that proteins related to protein synthesis, cell adhesion, keratinization, peroxisome proliferator-activated receptors, arachidonic acid metabolism and vascular endothelial growth factor were enriched in the receptive group. Biological processes, such as receptor internalization, negative regulation of cell junctions, the innate immune response, inflammatory response, and actin cytoskeleton organization were enriched in the non-receptive group. The key proteins, including desmoplakin, keratin type II cytoskeletal 1, the neuroblast differentiation-associated proteins AHNAK, moesin, and fibulin-1 were confirmed as potential biomarkers for assessing endometrial receptivity via western blot analysis.</div></div><div><h3>Conclusion</h3><div>The candidate panel may provide an approach for evaluating endometrial receptivity in the embryo transfer cycle, potentially improving personalized embryo transfer timing in clinical settings.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105083"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-04DOI: 10.1016/j.rbmo.2025.105338
Juan A. Garcia-Velasco, Michael Alper, Antonio Capalbo, Robert Casper, Human Fatemi, Thomas Molinaro, Filipo Ubaldi, Antonio Pellicer
{"title":"Response to: Representation of study in recent RBMO Commentary","authors":"Juan A. Garcia-Velasco, Michael Alper, Antonio Capalbo, Robert Casper, Human Fatemi, Thomas Molinaro, Filipo Ubaldi, Antonio Pellicer","doi":"10.1016/j.rbmo.2025.105338","DOIUrl":"10.1016/j.rbmo.2025.105338","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105338"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-06-22DOI: 10.1016/j.rbmo.2025.105120
Huishan Zhao , Xinrong Wang , Juan Liu , Mingwei Yu , Hongchu Bao
Research question
What is the effect and underlying molecular mechanism of plasminogen activator inhibitor 1 (PAI-1) on the progress of endometrial fibrosis in intrauterine adhesions (IUA)?
Design
The expression of PAI-1 was investigated in endometrial tissues from 20 healthy women and 31 individuals with IUA. Quantitative real-time PCR, haematoxylin and eosin staining and immunofluorescence staining were applied to examine the endometrial morphology as well as the expression of mRNA and proteins. An in-vitro model of endometrial fibrosis was constructed by inducing primary human endometrial stromal cells to differentiate into myofibroblasts using transforming growth factor β1 (TGF-β1). The study also examined the alterations in the FAK/Src/ERK and AKT signalling pathways in primary hESC following the knockdown of PAI-1, both before and after TGF-β1 treatment.
Results
There was a dramatically higher expression of PAI-1 mRNA in adhesive endometrial tissues than in normal endometrium from IUA patients (P = 0.0439). A significant difference in PAI-1 concentration was also observed between normal endometrium from healthy women and fibrotic tissues from IUA patients (P = 0.0087). Furthermore, PAI-1 expression was up-regulated following treatment with TGF-β1 in vitro. Moreover, the silencing of PAI-1 inhibited the expression of fibrosis markers (FN1, COL1A1 and α-SMA), revealing that PAI-1 deletion exerted an anti-fibrotic effect. PAI-1 down-regulation also suppressed the activation of the FAK/Src/ERK and AKT signalling pathways as well as the proliferation and migration of TGF-β1-treated primary hESC.
Conclusions
PAI-1 acts as a regulator of endometrial fibrosis progression via modulation of the FAK/Src/ERK and AKT signalling pathways, offering new insights into the clinical treatment of IUA.
{"title":"PAI-1 deficiency inhibits endometrial fibrosis via modulation of the FAK/Src/ERK and AKT signalling pathways","authors":"Huishan Zhao , Xinrong Wang , Juan Liu , Mingwei Yu , Hongchu Bao","doi":"10.1016/j.rbmo.2025.105120","DOIUrl":"10.1016/j.rbmo.2025.105120","url":null,"abstract":"<div><h3>Research question</h3><div>What is the effect and underlying molecular mechanism of plasminogen activator inhibitor 1 (PAI-1) on the progress of endometrial fibrosis in intrauterine adhesions (IUA)?</div></div><div><h3>Design</h3><div>The expression of <em>PAI-1</em> was investigated in endometrial tissues from 20 healthy women and 31 individuals with IUA. Quantitative real-time PCR, haematoxylin and eosin staining and immunofluorescence staining were applied to examine the endometrial morphology as well as the expression of mRNA and proteins. An in-vitro model of endometrial fibrosis was constructed by inducing primary human endometrial stromal cells to differentiate into myofibroblasts using transforming growth factor β1 (TGF-β1). The study also examined the alterations in the FAK/Src/ERK and AKT signalling pathways in primary hESC following the knockdown of PAI-1, both before and after TGF-β1 treatment.</div></div><div><h3>Results</h3><div>There was a dramatically higher expression of <em>PAI-1</em> mRNA in adhesive endometrial tissues than in normal endometrium from IUA patients (<em>P</em> = 0.0439). A significant difference in PAI-1 concentration was also observed between normal endometrium from healthy women and fibrotic tissues from IUA patients (<em>P</em> = 0.0087). Furthermore, PAI-1 expression was up-regulated following treatment with TGF-β1 <em>in vitro</em>. Moreover, the silencing of <em>PAI-1</em> inhibited the expression of fibrosis markers (FN1, COL1A1 and α-SMA), revealing that <em>PAI-1</em> deletion exerted an anti-fibrotic effect. <em>PAI-1</em> down-regulation also suppressed the activation of the FAK/Src/ERK and AKT signalling pathways as well as the proliferation and migration of TGF-β1-treated primary hESC.</div></div><div><h3>Conclusions</h3><div>PAI-1 acts as a regulator of endometrial fibrosis progression via modulation of the FAK/Src/ERK and AKT signalling pathways, offering new insights into the clinical treatment of IUA.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105120"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-07-08DOI: 10.1016/j.rbmo.2025.105133
Lucy Caughey , Katherine M White , Sarah Lensen , Alex Polyakov , Iolonda S. Rodino , Franca Agresta , Michelle Peate
Research question
What are the significant decision-making pathways for oocyte disposition outcomes for elective egg freezers?
Design
Observational cross-sectional study undertaken between May and November 2023. Questions were derived from the Prototype Willingness Model with six additional theoretical constructs informed from qualitative research and analysed using structured equation modelling. Patients (n = 175, aged ≥18 years, living in Australia) had electively frozen their eggs with at least one currently in storage. Primary outcomes were willingness to donate to friends or family members; a couple advertising online for an egg donor; an egg bank/fertility clinic; research; or discard or reclaim the eggs.
Results
Each outcome had a distinct decision pathway. All variables were significant for at least one outcome. The models accounted for a substantial variance in willingness to donate (from 45% [research] to 75% [egg bank/fertility clinic]. Across all outcomes, a positive attitude was the strongest enabling factor. Attitude was informed by factors such as concern about other people raising their donor child; desire to meet recipient; empathy; and concern for wellbeing of donor child, depending on the outcome choice. When donating to research, what others thought of their choice was a significant enabler. Feeling favourably towards the typical woman who chooses to discard their eggs was an enabling factor for discarding eggs.
Conclusions
As disposition decisions are individual and personal, the study highlights the importance of counselling for elective egg freezers when considering disposition options. The development of support tools is recommended to help patients navigate this complex decision.
{"title":"Elective egg freezers’ disposition decisions pathways","authors":"Lucy Caughey , Katherine M White , Sarah Lensen , Alex Polyakov , Iolonda S. Rodino , Franca Agresta , Michelle Peate","doi":"10.1016/j.rbmo.2025.105133","DOIUrl":"10.1016/j.rbmo.2025.105133","url":null,"abstract":"<div><h3>Research question</h3><div>What are the significant decision-making pathways for oocyte disposition outcomes for elective egg freezers?</div></div><div><h3>Design</h3><div>Observational cross-sectional study undertaken between May and November 2023. Questions were derived from the Prototype Willingness Model with six additional theoretical constructs informed from qualitative research and analysed using structured equation modelling. Patients (<em>n</em> = 175, aged ≥18 years, living in Australia) had electively frozen their eggs with at least one currently in storage. Primary outcomes were willingness to donate to friends or family members; a couple advertising online for an egg donor; an egg bank/fertility clinic; research; or discard or reclaim the eggs.</div></div><div><h3>Results</h3><div>Each outcome had a distinct decision pathway. All variables were significant for at least one outcome. The models accounted for a substantial variance in willingness to donate (from 45% [research] to 75% [egg bank/fertility clinic]. Across all outcomes, a positive attitude was the strongest enabling factor. Attitude was informed by factors such as concern about other people raising their donor child; desire to meet recipient; empathy; and concern for wellbeing of donor child, depending on the outcome choice. When donating to research, what others thought of their choice was a significant enabler. Feeling favourably towards the typical woman who chooses to discard their eggs was an enabling factor for discarding eggs.</div></div><div><h3>Conclusions</h3><div>As disposition decisions are individual and personal, the study highlights the importance of counselling for elective egg freezers when considering disposition options. The development of support tools is recommended to help patients navigate this complex decision.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105133"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-27DOI: 10.1016/S1472-6483(25)00589-9
{"title":"Inside Front Cover - Affiliations and First page of TOC","authors":"","doi":"10.1016/S1472-6483(25)00589-9","DOIUrl":"10.1016/S1472-6483(25)00589-9","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105382"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-06-20DOI: 10.1016/j.rbmo.2025.105118
Shuxin Ma , Xuan Gao , Mengchun Hu , Nan Xie , Runxin Yao , Yaxuan Zhang , Junhao Yan , Yingying Qin , Peihao Liu
Research question
What factors influence the rate of decline in anti-Müllerian hormone (AMH) concentrations among infertile women?
Design
In this retrospective cohort, women who underwent repeated AMH measurements between January 2012 and December 2021 were enrolled. Participants were stratified into tertiles based on their annual AMH decline rate. Multivariable linear regression model was used to identify statistically significant predictors of AMH decline rates, adjusting for several potential confounders.
Results
In infertile women, key factors associated with an accelerated decline in AMH concentrations included more than three ovarian stimulation cycles (P = 0.030), tubal lesions (P < 0.001) and advanced baseline age (P < 0.001). Polycystic ovary syndrome (PCOS) was inversely associated with the rate of AMH decline (P < 0.001). No statistically significant associations were observed between AMH decline rates and ovulation induction, gynaecological surgery (ovarian or tubal), age at menarche, baseline AMH concentrations, baseline body mass index, education concentration or employment status in infertile women.
Conclusions
In infertile women, treatment for more than three ovarian stimulation cycles in assisted reproductive technology, tubal lesions and advanced age were factors associated with an accelerated rate of AMH decline, whereas PCOS was associated with a reduced rate of AMH decline. Medical intervention targeting these influencing factors may mitigate the rate of ovarian reserve loss and delay ovarian aging. The results specifically highlight the need for caution regarding the potential impairment of ovarian reserve due to repeated cycles of ovarian stimulation.
{"title":"Factors influencing the rate of anti-Müllerian hormone decline: a retrospective study of 4245 infertile women","authors":"Shuxin Ma , Xuan Gao , Mengchun Hu , Nan Xie , Runxin Yao , Yaxuan Zhang , Junhao Yan , Yingying Qin , Peihao Liu","doi":"10.1016/j.rbmo.2025.105118","DOIUrl":"10.1016/j.rbmo.2025.105118","url":null,"abstract":"<div><h3>Research question</h3><div>What factors influence the rate of decline in anti-Müllerian hormone (AMH) concentrations among infertile women?</div></div><div><h3>Design</h3><div>In this retrospective cohort, women who underwent repeated AMH measurements between January 2012 and December 2021 were enrolled. Participants were stratified into tertiles based on their annual AMH decline rate. Multivariable linear regression model was used to identify statistically significant predictors of AMH decline rates, adjusting for several potential confounders.</div></div><div><h3>Results</h3><div>In infertile women, key factors associated with an accelerated decline in AMH concentrations included more than three ovarian stimulation cycles (<em>P</em> = 0.030), tubal lesions (<em>P</em> < 0.001) and advanced baseline age (<em>P</em> < 0.001). Polycystic ovary syndrome (PCOS) was inversely associated with the rate of AMH decline (<em>P</em> < 0.001). No statistically significant associations were observed between AMH decline rates and ovulation induction, gynaecological surgery (ovarian or tubal), age at menarche, baseline AMH concentrations, baseline body mass index, education concentration or employment status in infertile women.</div></div><div><h3>Conclusions</h3><div>In infertile women, treatment for more than three ovarian stimulation cycles in assisted reproductive technology, tubal lesions and advanced age were factors associated with an accelerated rate of AMH decline, whereas PCOS was associated with a reduced rate of AMH decline. Medical intervention targeting these influencing factors may mitigate the rate of ovarian reserve loss and delay ovarian aging. The results specifically highlight the need for caution regarding the potential impairment of ovarian reserve due to repeated cycles of ovarian stimulation.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105118"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-06-06DOI: 10.1016/j.rbmo.2025.105076
Xinrong Zhou , Lianci Ren , Xiang Ma , Yajing Wu , Jie Wang , Chun Yuan , Chunyan Jiang , Wei Wu , Chunxiang Wu , Jin Liu , Jing Wang
Research question
Does recombinant human LH (rhLH) supplementation improve the cumulative live birth rate (CLBR) in overweight/obese women undergoing IVF?
Design
This retrospective cohort study was conducted at the Centre for Clinical Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University, China. Clinical data of patients who underwent IVF from 2013 to 2021 were analysed. In total, 791 oocyte retrieval cycles were included and categorized into recombinant human FSH (rhFSH)/rhLH and rhFSH alone groups. Propensity score matching (PSM) for potential confounders was performed in a 1:1 ratio. After matching, 130 cycles from each group were included in the final analyses. The primary outcome was CLBR.
Results
Baseline characteristics of the two groups were comparable after PSM. The gonadotrophin starting dose [200 (IQR 175–225) IU versus 175 (IQR 150–200) IU, P < 0.001] and the total gonadotrophin dose [1800 (IQR 1581.25–2200) IU versus 1600 (IQR 1350–1925) IU, P < 0.001] were significantly higher in the rhFSH/rhLH group compared with the rhFSH alone group. Patients in the rhFSH/rhLH group had a lower oestradiol concentration on trigger day [12,332.95 (IQR 7547.1–18,036.64) pmol/l versus 15,881.00 (IQR 9616.88–21,487) pmol/l, P = 0.007] and fewer oocytes retrieved [10 (IQR 7–13.75) versus 11 (IQR 9–14), P = 0.029] compared with the rhFSH alone group. There were no significant intergroup differences in the rates of biochemical pregnancy (71.65% versus 67.20%, P = 0.443), clinical pregnancy (61.42% versus 60.80%, P = 0.920), miscarriage (20.51% versus 10.53%, P = 0.088) and live birth (48.82% versus 54.40%, P = 0.375) after first embryo transfer. CLBR was also similar [85/130 (65.38%) versus 94/130 (72.31%), P = 0.228]. Results remained consistent on logistic regression after adjusting for potential confounders such as gonadotrophin starting dose, total gonadotrophin dose, oestradiol concentration on trigger day, and oocyte number retrieved. There were no significant differences in obstetric–perinatal complications.
Conclusion
In overweight/obese women undergoing IVF, rhFSH supplementation with rhLH did not significantly improve CLBR or pregnancy outcomes compared with rhFSH alone.
研究问题：补充重组人黄体生成素（rhLH）是否能改善接受体外受精的超重/肥胖妇女的累积活产率（CLBR） ？设计本回顾性队列研究在中国南京医科大学第一附属医院临床生殖医学中心进行。分析2013 - 2021年接受体外受精患者的临床资料。共纳入791个卵母细胞回收周期，并将其分为重组人卵泡刺激素(rhFSH)/rhLH和单独rhFSH组。以1:1的比例进行潜在混杂因素的倾向评分匹配（PSM）。匹配后，从每组中选取130个周期纳入最终分析。主要终点为CLBR。结果两组患者经PSM后的基线特征具有可比性。促性腺激素起始剂量[200 (IQR 175 - 225) IU vs 175 (IQR 150-200) IU, P <； 0.001]和促性腺激素总剂量[1800 (IQR 1581.25-2200) IU vs 1600 (IQR 1350-1925) IU, P <； 0.001]在rhFSH/rhLH组中显著高于单独rhFSH组。与单独使用rhFSH组相比，rhFSH/rhLH组患者在触发日雌二醇浓度较低[12,332.95 (IQR 7547.1-18,036.64) pmol/l比15,881.00 (IQR 9616.88-21,487) pmol/l, P = 0.007]，回收的卵母细胞较少[10 （IQR 7-13.75）比11 (IQR 9-14), P = 0.029]。首次胚胎移植后生化妊娠率（71.65%比67.20%,P = 0.443）、临床妊娠率（61.42%比60.80%,P = 0.920）、流产率（20.51%比10.53%,P = 0.088）、活产率（48.82%比54.40%,P = 0.375）组间差异均无统计学意义。CLBR也相似[85/130 (65.38%)vs 94/130 (72.31%), P = 0.228]。在调整了潜在混杂因素（如促性腺激素起始剂量、促性腺激素总剂量、触发日雌二醇浓度和回收的卵母细胞数量）后，逻辑回归结果保持一致。产科和围产期并发症无显著差异。结论在接受体外受精的超重/肥胖妇女中，与单独使用促卵泡刺激素相比，补充促卵泡刺激素并没有显著改善CLBR或妊娠结局。
{"title":"Recombinant LH supplementation and cumulative live birth rate in overweight/obese women: a retrospective cohort study","authors":"Xinrong Zhou , Lianci Ren , Xiang Ma , Yajing Wu , Jie Wang , Chun Yuan , Chunyan Jiang , Wei Wu , Chunxiang Wu , Jin Liu , Jing Wang","doi":"10.1016/j.rbmo.2025.105076","DOIUrl":"10.1016/j.rbmo.2025.105076","url":null,"abstract":"<div><h3>Research question</h3><div>Does recombinant human LH (rhLH) supplementation improve the cumulative live birth rate (CLBR) in overweight/obese women undergoing IVF?</div></div><div><h3>Design</h3><div>This retrospective cohort study was conducted at the Centre for Clinical Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University, China. Clinical data of patients who underwent IVF from 2013 to 2021 were analysed. In total, 791 oocyte retrieval cycles were included and categorized into recombinant human FSH (rhFSH)/rhLH and rhFSH alone groups. Propensity score matching (PSM) for potential confounders was performed in a 1:1 ratio. After matching, 130 cycles from each group were included in the final analyses. The primary outcome was CLBR.</div></div><div><h3>Results</h3><div>Baseline characteristics of the two groups were comparable after PSM. The gonadotrophin starting dose [200 (IQR 175–225) IU versus 175 (IQR 150–200) IU, <em>P</em> < 0.001] and the total gonadotrophin dose [1800 (IQR 1581.25–2200) IU versus 1600 (IQR 1350–1925) IU, <em>P</em> < 0.001] were significantly higher in the rhFSH/rhLH group compared with the rhFSH alone group. Patients in the rhFSH/rhLH group had a lower oestradiol concentration on trigger day [12,332.95 (IQR 7547.1–18,036.64) pmol/l versus 15,881.00 (IQR 9616.88–21,487) pmol/l, <em>P</em> = 0.007] and fewer oocytes retrieved [10 (IQR 7–13.75) versus 11 (IQR 9–14), <em>P</em> = 0.029] compared with the rhFSH alone group. There were no significant intergroup differences in the rates of biochemical pregnancy (71.65% versus 67.20%, <em>P</em> = 0.443), clinical pregnancy (61.42% versus 60.80%, <em>P</em> = 0.920), miscarriage (20.51% versus 10.53%, <em>P</em> = 0.088) and live birth (48.82% versus 54.40%, <em>P</em> = 0.375) after first embryo transfer. CLBR was also similar [85/130 (65.38%) versus 94/130 (72.31%), <em>P</em> = 0.228]. Results remained consistent on logistic regression after adjusting for potential confounders such as gonadotrophin starting dose, total gonadotrophin dose, oestradiol concentration on trigger day, and oocyte number retrieved. There were no significant differences in obstetric–perinatal complications.</div></div><div><h3>Conclusion</h3><div>In overweight/obese women undergoing IVF, rhFSH supplementation with rhLH did not significantly improve CLBR or pregnancy outcomes compared with rhFSH alone.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105076"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-06-18DOI: 10.1016/j.rbmo.2025.105107
Noemie Sachs-Guedj , Buenaventura Coroleu , Manuel Álvarez , Sandra García Martínez , Nikolaos P. Polyzos
Research question
Are there differences between patients with and without endometriosis in progesterone concentrations the day before artificial-cycle frozen embryo transfer (AC-FET) and in live birth rate (LBR) following subcutaneous progesterone when indicated?
Design
This retrospective cohort included 985 AC-FET cycles with vaginal progesterone (600 mg/day) from January 2019 to December 2022 at a university-affiliated fertility centre. Among them, 168 cycles (17.05%) were from patients with endometriosis (n = 128) and 817 from controls (n = 649). LBR was evaluated based on progesterone the day before transfer. Subcutaneous progesterone (25 mg/day) was given when <10.6 ng/ml. Cycles were divided into four groups: 1 (endometriosis, reference, 51 cycles) and 3 (controls, 274 cycles) with progesterone <10.6 ng/ml plus supplementation; 2 (endometriosis, 117 cycles) and 4 (controls, 543 cycles) with progesterone ≥10.6 ng/ml.
Results
The likelihood of progesterone <10.6 ng/ml before transfer was similar between groups (adjusted odds ratio [aOR] 0.98, 95% CI 0.65–1.47). After adjustment for age, BMI and embryo quality, LBR were comparable between group 1 and groups 2 (aOR 0.79, 95% CI 0.36–1.74), 3 (aOR 0.91, 95% CI 0.45–1.84) and 4 (aOR 1.39, 95% CI 0.71–2.74). Higher progesterone >90th percentile (23.31 ng/ml) on pregnancy test day was associated with higher clinical pregnancy (controls: 73% vs 50.5%, P <0.001; endometriosis: 83.3% vs 46.1%, P = 0.016) and LBR (controls: 63.5% vs 38.2%, P <0.001; endometriosis: 66.7% vs 32.8%, P = 0.027).
Conclusions
Progesterone concentrations before transfer are comparable between endometriosis and control cycles. Vaginal progesterone with subcutaneous supplementation leads to comparable LBR, regardless of endometriosis status.
研究问题：子宫内膜异位症患者和非子宫内膜异位症患者在人工周期冷冻胚胎移植（AC-FET）前一天的黄体酮浓度和皮下注射黄体酮后的活产率（LBR）是否有差异？设计：该回顾性队列包括2019年1月至2022年12月在大学附属生育中心进行的985个AC-FET周期，阴道孕酮（600 mg/天）。其中168个周期（17.05%）来自子宫内膜异位症患者（n = 128），817个周期来自对照组（n = 649）。移植前一天以孕酮水平评价LBR。结果：妊娠试验当日孕酮第90百分位（23.31 ng/ml）与较高临床妊娠相关（对照组：73% vs 50.5%， P）结论：子宫内膜异位症与对照周期移植前孕酮浓度具有可比性。不论子宫内膜异位症的状况如何，阴道孕酮皮下补充可导致相似的LBR。
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