Reproductive biomedicine online最新文献

{"title":"Excessive KLF2 impairs mesenchymal–epithelial transition efficiency and adhesion in endometrial stromal cells via AKT phosphorylation","authors":"S. Yin ,&nbsp;X. Liu ,&nbsp;H. Zhao ,&nbsp;X. Zhang ,&nbsp;H. Bao","doi":"10.1016/j.rbmo.2025.105123","DOIUrl":"10.1016/j.rbmo.2025.105123","url":null,"abstract":"<div><h3>Research question</h3><div>What is the dynamic expression profile of Krüppel-like factor 2 (KLF2) during the progression of mesenchymal–epithelial transition (MET), and through which molecular mechanisms does KLF2 regulate transformation?</div></div><div><h3>Design</h3><div>This study examined changes in KLF2 expression during the in-vivo menstrual cycle using immunohistochemistry and an in-vitro decidualization cell model. KLF2 negative control (KLF2-NC) and KLF2 overexpression (KLF2-OE) models were constructed in primary and immortalized human endometrial stromal cells via lentiviral transfection. Mesenchymal and epithelial protein changes were detected in the KLF2-NC and KLF2-OE groups on different days of MET using immunofluorescent staining. Potential <em>KLF2</em> binding sites were predicted through motif enrichment analysis, and the interaction between KLF2 expression and AKT phosphorylation during MET was analysed using co-immunoprecipitation (co-IP) and western blotting. Finally, the effects of excessive KLF2 expression on the expression of adhesion factor and the efficiency of adhesion of BeWo-spheroids were determined.</div></div><div><h3>Results</h3><div>The results showed that KLF2 demonstrated significantly higher expression during the proliferative phase compared with the decidual phase in normal human endometrial tissue (<em>P</em> = 0.0095). Furthermore, KLF2 expression showed a progressive decline during MET. KLF2 overexpression decreased epithelial gene expression. Further, co-IP and western blotting demonstrated that KLF2 affects the MET process by regulating AKT phosphorylation, affecting the expression of adhesion factor and the efficiency of adhesion.</div></div><div><h3>Conclusions</h3><div>This study found that KLF2 expression changes during the menstrual cycle, and excessive KLF2 is not conducive to AKT phosphorylation during MET in the decidual phase.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105123"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452795","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}

{"title":"Oestradiol and reproductive outcomes in ART: when too much of a good thing hurts","authors":"Mathilde Bourdon ,&nbsp;Chloé Maignien ,&nbsp;Marion Ouazana ,&nbsp;Fleur Kefelian ,&nbsp;Louis Marcellin ,&nbsp;Catherine Patrat ,&nbsp;Khaled Pocate-Cheriet ,&nbsp;Charles Chapron ,&nbsp;Pietro Santulli","doi":"10.1016/j.rbmo.2025.105131","DOIUrl":"10.1016/j.rbmo.2025.105131","url":null,"abstract":"<div><div>Oestradiol plays a crucial role in reproduction, particularly in assisted reproductive technology (ART), where it can reach supraphysiological concentrations. These fluctuations occur during ovarian stimulation in fresh embryo transfer cycles and during endometrial preparation for frozen embryo transfer, potentially impacting implantation and perinatal outcomes. Oestradiol influences endometrial proliferation, receptivity, implantation and placentation, with the sensitivity of the endometrium to systemic oestrogen emerging as a key determinant of reproductive success. In fresh embryo transfer cycles, ovarian stimulation induces histological, immunological and genetic changes in the endometrium, correlating with elevated oestradiol concentrations and possibly disrupting implantation. However, this adverse effect appears time-limited, as endometrial receptivity is restored in subsequent cycles. In FET cycles, both the duration and intensity of oestradiol exposure are critical, as excessive or prolonged exposure to exogenous oestradiol may impair reproductive outcomes. Despite these potential effects, strategies to regulate oestradiol concentrations in ART remain underexplored. This review examines the physiological and pathological roles of oestradiol in natural and ART cycles, emphasizing its impact on endometrial function, implantation and pregnancy outcomes. It highlights the need for further research to define optimal oestradiol thresholds and develop personalized ART protocols that consider both oestradiol concentrations and endometrial sensitivity to improve reproductive success and obstetric outcomes. Finally, it highlights strategies aimed at modulating oestradiol exposure to optimize reproductive success.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105131"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496302","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}

{"title":"Impact of native language on the pursuit of fertility care","authors":"R. Garland Almquist,&nbsp;Marisa R. Young,&nbsp;Maranatha Genet,&nbsp;Heather Hipp","doi":"10.1016/j.rbmo.2025.105055","DOIUrl":"10.1016/j.rbmo.2025.105055","url":null,"abstract":"<div><h3>Research question</h3><div>Are there any differences in the demographics, diagnostic work-up, fertility treatments attempted, and clinical pregnancy rate between patients whose native language is English compared with those whose native language is not English at a reproductive endocrinology and infertility (REI) clinic within an urban safety-net hospital in the USA?</div></div><div><h3>Design</h3><div>This retrospective cohort study included 321 patients who presented at the REI clinic between 2016 and 2022 with concern of infertility. The exposure of interest was native language spoken: English versus non-English. The primary outcome measure was attempt at any type of fertility treatment. Secondary outcome measures included completion of infertility diagnostic work-up, clinical pregnancy, and discontinuation of care.</div></div><div><h3>Results</h3><div>Among patients evaluated for infertility, 106 (33%) reported a native language other than English. Of 266 patients who underwent fertility testing, 218 (82%) completed sufficient diagnostic work-up to determine the type of infertility. Types of infertility were similar between the two groups, except for tubal factor infertility which was more common in native-English-speaking patients [62 (29%) versus 15 (14%); <em>P</em> = 0.003]. Fifty-six percent (149/266) of patients who underwent diagnostic testing for infertility attempted fertility treatment. Patients whose native language is not English were significantly more likely to attempt fertility treatment (adjusted risk ratio 1.44, 95% CI 1.09–1.91; <em>P</em> = 0.011) and to achieve clinical pregnancy (adjusted risk ratio 1.72, 95% CI 1.07–2.76; <em>P</em> = 0.025) compared with native-English-speaking patients. In total, 141 (44%) patients discontinued care.</div></div><div><h3>Conclusions</h3><div>Patients whose native language is not English were more likely to attempt fertility treatment and achieve clinical pregnancy compared with native-English-speaking patients. This suggests that, in a setting in the USA which aimed to reduce disparities and improve access to care, patients can overcome language barriers to pursue fertility care and undergo treatment.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105055"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459356","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}

{"title":"Towards a universal rapid warming protocol for cryopreserved human ovarian tissue","authors":"Cara Maria Färber ,&nbsp;Rebekka Einenkel ,&nbsp;Norah LA Emrich ,&nbsp;Emily Zia Kestermann ,&nbsp;Lodovico Parmegiani ,&nbsp;Andreas Schallmoser ,&nbsp;Nicole Sänger","doi":"10.1016/j.rbmo.2025.105151","DOIUrl":"10.1016/j.rbmo.2025.105151","url":null,"abstract":"<div><h3>Research question</h3><div>Is it feasible to apply a universal warming protocol to slow-frozen human ovarian tissue, using the rapid-warming protocols already established for vitrified tissue, so that a single protocol could be used for both methods?</div></div><div><h3>Design</h3><div>Slow-frozen ovarian tissue samples from 25 patients were thawed by conventional protocol (slow freezing–thawing) or by a rapid-warming protocol produced ‘in-house’ or by commercially available media. Anti-Müllerian hormone values and follicular viability were determined before cryopreservation. Twenty-four hours after thawing, follicular viability was determined. Hypoxic tissue culture was conducted for 48 h to determine VEGF-A levels to estimate the angiogenic potential. Tissue sections were analysed with TUNEL staining for apoptosis and with haematoxylin and eosin staining for primordial follicles.</div></div><div><h3>Results</h3><div>Follicular survival did not statistically differ: based on fresh tissue (67.5), viable follicle numbers after conventional thawing (44.5), rapid warming with ‘in-house’ produced (54.5) and commercially available media (58.5) revealed no statistically significant differences between the groups, but were the highest using the rapid warming protocols. After 48 h in culture, preservation of primordial follicles was highest in the rapid warming groups (52% and 57%) compared with the regular thawing group (33%). No significant differences in vascular endothelial growth factor-A were observed comparing conventional thawing protocol with the rapid warming protocol using ‘in-house’-produced media. Although VEGF-A secretion was significantly lower in tissues after using commercially available rapid-warming media (<em>P</em> ≤ 0.0001) compared with conventional thawing, apoptosis level was significantly lower (<em>P</em> = 0.014) indicating improved tissue preservation.</div></div><div><h3>Conclusions</h3><div>Rapid-warming protocols provide similar to superior results compared with the conventional thawing approach. A universal protocol would increase the efficiency of ovarian tissue thawing–warming, potentially optimizing costs and improving outcome.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105151"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459582","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}

{"title":"Serum progesterone monitoring after embryo transfer","authors":"Jan Tesarik","doi":"10.1016/j.rbmo.2025.105412","DOIUrl":"10.1016/j.rbmo.2025.105412","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 1","pages":"Article 105412"},"PeriodicalIF":3.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757520","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}

{"title":"Live Birth After Assisted Reproductive Techniques in a Patient with Unicornuate Uterus and Diminished Ovarian Reserve: A Case Report","authors":"Esra Oncu ,&nbsp;Shamama Behzad ,&nbsp;Sinziana Petruta Mihai ,&nbsp;Zeynep Ece Utkan Korun ,&nbsp;Erkut Attar","doi":"10.1016/j.rbmo.2025.105336","DOIUrl":"10.1016/j.rbmo.2025.105336","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Unicornuate uterus is a rare Müllerian anomaly associated with infertility and adverse obstetric outcomes. The coexistence of advanced maternal age and diminished ovarian reserve further complicates reproductive management. Herein, we present the case of a 41-year-old woman with diminished ovarian reserve and unicornuate uterus who achieved a live birth following modified induction protocols and assisted reproductive techniques.</div></div><div><h3>CASE PRESENTATION</h3><div>A 41-year-old woman presented to our clinic in 2023 with primary infertility. Baseline ovarian reserve parameters were as follows: AMH 0.66 ng/mL, FSH 7.9 IU/L, and LH 5.6 IU/L. Semen analysis was within normal limits. The first stimulation cycle was cancelled due to lack of follicular response. In subsequent cycles, the induction protocol was modified, and different medication combinations were used.</div><div>During a stimulation in February 2024, an endometrial polyp was identified. In March 2024, hysteroscopic polypectomy was performed. At that time, hysterosalpingography suggested a unilateral fallopian tube, whereas hysteroscopic evaluation confirmed bilateral tubal patency. In May 2024, stimulation resulted in embryo cryopreservation. In January 2025, a single blastocyst transfer led to clinical pregnancy. During follow-up, gestational diabetes was diagnosed and successfully managed with dietary modification. At 36+6 weeks of gestation, an elective cesarean section was performed, delivering a healthy male infant weighing 2120 g.</div></div><div><h3>CONCLUSION</h3><div>This case demonstrates that in patients with diminished ovarian reserve and uterine anomalies such as unicornuate uterus, modified induction protocols combined with assisted reproductive techniques may lead to successful pregnancy outcomes. Moreover, the discrepancy between hysterosalpingography and hysteroscopic findings highlights the importance of a multidisciplinary approach in infertility evaluation.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105336"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532397","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}

{"title":"Is the Presence of Sexual Dysfunction Associated with IUI Success in Patients with Unexplained Infertility?","authors":"Emine Acar ,&nbsp;Abdullah Acar ,&nbsp;Serap Mutlu Ozcelik Otcu ,&nbsp;Cigdem Kilinc","doi":"10.1016/j.rbmo.2025.105330","DOIUrl":"10.1016/j.rbmo.2025.105330","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To assess the association of sexual dysfunction and IUI success in unexplained infertile women</div></div><div><h3>MATERIALS AND METHODS</h3><div>The sexual functions of 265 patients presenting to our clinic with unexplained infertility were evaluated using Female Sexual Functioning Index (FSFI), and the association of the results and IUI success was assessed. 15 patients declined to complete the test. 13 patients were excluded from the evaluation because they partially answered the questions. FSFI scores were divided into two groups: &lt;26.5 and &gt;26.5, and IUI success in these groups was evaluated.</div></div><div><h3>RESULTS</h3><div>Of the 237 patients who completed the FSFI test, 143 (0.60) had a FSFI score &lt;26.5. Of these patients, 23 (16%) were BHCG positive and 20 (13%) had a live birth. The remaining 94 patients had a FSFI score &gt;26.5. Of these patients, 15 (15.9%) were BHCG positive and 13 (13.8%) had a live birth.</div></div><div><h3>CONCLUSIONS</h3><div>As a result, no difference was found in terms of IUI results (BHCG positivity, live birth, etc.) between patients with sexual dysfunction (FSFI &lt;26.5) and patients with normal sexual function (FSFI&gt;26.5).</div></div><div><h3>IMPACT STATEMENT</h3><div>The fact that recent studies have generally focused on how the IUI process affects the sexual functions of patients or what changes occur during the IUI process, and the lack of clear information in the literature about the association of sexual function on IUI success, makes our study effective.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105330"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532551","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}

{"title":"Unexpected Poor Ovarian Response in IVF: Does Systemic Inflammation Matter?","authors":"Caner Kose ,&nbsp;Busra Korpe ,&nbsp;Dicle Mutel Gurer ,&nbsp;Inci Kahyaoglu ,&nbsp;Caganay Soysal","doi":"10.1016/j.rbmo.2025.105328","DOIUrl":"10.1016/j.rbmo.2025.105328","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study aimed to investigate the association between the Systemic Immune-Inflammation Index (SII) and ovarian response parameters in women undergoing IVF who exhibit unexpected poor ovarian response (POR).</div></div><div><h3>MATERIALS AND METHODS</h3><div>A retrospective analysis was conducted on women aged 20–40 years undergoing IVF treatment at Ankara Etlik City Hospital between May 2024 and June 2025. Participants with normal ovarian reserve (AFC ≥5 and AMH ≥1.2 ng/mL) were grouped according to their ovarian response: unexpected poor responders (n=26) and normal responders (n=53). SII was calculated using peripheral blood neutrophil, lymphocyte, and platelet counts. Ovarian response was evaluated by Follicular Output Rate (FORT), Follicle-Oocyte Index (FOI), and Ovarian Sensitivity Index (OSI). Correlations between SII and ovarian response parameters were analyzed, and logistic regression was used to identify predictors of unexpected POR.</div></div><div><h3>RESULTS</h3><div>There was no significant difference in SII levels between women with low and normal AMH (624.75 ± 536.80 vs. 808.05 ± 973.28, p=0.103). However, women with unexpected poor ovarian response had significantly lower SII levels compared to normal responders (376.19 ± 180.57 vs. 1010.99 ± 1148.57, p=0.008). No significant correlations were found between SII and individual ovarian response parameters such as FORT, FOI, and OSI. Multivariate logistic regression showed that lower SII values were independently associated with a unexpected poor ovarian response, with each unit decrease in SII linked to a 52.7% increase in the odds of being a poor responder (OR = 0.473; 95% CI: 0.313–0.723; p &lt; 0.001).</div></div><div><h3>CONCLUSIONS</h3><div>Lower systemic immune-inflammation levels are linked to unexpected poor ovarian response in women with normal ovarian reserve. Assessing SII may help personalize IVF treatments by identifying patients at risk of suboptimal response. Further studies are needed to confirm these findings.</div></div><div><h3>IMPACT STATEMENT</h3><div>Contrary to the expectation that higher systemic inflammation impairs ovarian response, our findings reveal that lower SII levels are linked to suboptimal ovarian responsiveness in women with normal ovarian reserve. This may suggest that a balanced level of systemic immune activation is essential for effective folliculogenesis and optimal oocyte yield. These results underscore the importance of a finely tuned immune-inflammatory environment in ovarian function and highlight systemic inflammation as a potential contributor to unexpected poor ovarian response.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105328"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532569","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}

{"title":"Effects of Sperm Preparation Protocols Using Cumulus Cell Extracellular Matrix on Semen Parameters","authors":"Sabina Aghayeva ,&nbsp;Duygu Gok-Yurtseven ,&nbsp;Cihan Cakir ,&nbsp;Isil Kasapoglu","doi":"10.1016/j.rbmo.2025.105301","DOIUrl":"10.1016/j.rbmo.2025.105301","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>In this study, it was aimed to determine the effects of the addition of cumulus cell extracellular matrix (CCEMC) to the culture medium used during conventional sperm preparation techniques used in assisted reproductive treatment approaches on routine sperm parameters, fertilisation capacity and sperm DNA fragmentation and to perform comparative analyses of protocols used in sperm separation techniques.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Ejaculate samples from 30 normozoospermic male patients and oocytes collected on the same day from their spouses were used in the study. The semen sample from each patient was divided into 5 equal volumes, and 5 different groups were formed as control, density gradient (DG), density gradient + cumulus cell extracellular matrix (DG+K), swim-up (SU), and swim-up + cumulus cell extracellular matrix (SU+K).</div></div><div><h3>RESULTS</h3><div>According to the results obtained, sperm concentration was significantly lower in all experimental groups compared to the control group, and there was a statistically significant difference, especially in the swim-up group. Motility rate was highest in the (SU+K) group, and it was also significantly increased in the (DG+K) and SU groups. TPMSS value decreased significantly in the SU and (SU+K) groups. There was no significant difference between the groups in terms of morphology. It was observed that the viability rate was significantly increased in the groups to which CCECM was added, and this significant increase continued in all experimental groups compared to the control group. ARIC scores indicating acrosomal reaction capacity were also significantly higher in the (DG+K) and (SU+K) groups. In addition, DFI values reflecting DNA damage were significantly lower in these two groups, indicating that CCECM contribution may protect DNA integrity.</div></div><div><h3>CONCLUSIONS</h3><div>As a result, it was determined that the addition of CCECM to the culture medium used during different sperm washing techniques, especially when used in combination with the swim-up method, had an effect on sperm quality and efficiency. We think that the applied method will be an applicable technique for male infertility treatment in the assisted reproductive treatment approach.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study provides a novel sperm preparation approach using cumulus cell extracellular matrix, which may enhance fertilization potential and reduce sperm DNA damage in assisted reproductive technologies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105301"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532939","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}

{"title":"Insulin Resistance in PCOS: Impact on Follicular Microenvironment, Adipokines, Embryo Development & Clinical Outcomes","authors":"Selahattin Emiroğlu ,&nbsp;Cihan Cakir ,&nbsp;Isil Kasapoglu ,&nbsp;Kiper Aslan ,&nbsp;Gurkan Uncu","doi":"10.1016/j.rbmo.2025.105303","DOIUrl":"10.1016/j.rbmo.2025.105303","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Hyperinsulinemia as a result of IR is seen in 50-75% of patients with PCOS and is among the main etiologic mechanisms of ovulatory dysfunction and hyperandrogenism. Adipokines are polypeptide biological molecules involved in energy metabolism, fertilization, inflammatory processes and endocrine regulation. It is known that changes in adipokine secretion affect oocyte quality, ovulation, hormonal balance and general metabolic processes and are closely related to infertility. The aim of this study was to evaluate whether the presence of IR in women with PCOS is associated with adipokine imbalance and increased apoptosis in the follicular microenvironment and to investigate the possible effects of these biological changes on embryo quality and clinical outcomes.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A total of 60 female patients were included in the study and the patients were divided into 3 groups as Control group (n=20), group with PCOS and IR (PCOS+IR, n=20) and group without PCOS and IR (PCOS-IR, n=20). Adipokine (CTRP3, adiponectin, leptin, visfatin) amounts, fasting insulin, fasting glucose levels, HOMA-IR values, FSHR/LHR (follicle stimulating hormone/ luteinizing hormone) ratios in serum, follicular fluid and cumulus cell samples obtained from the patients, caspase-3, IL-6 (interleukin-6), IGF-1 (insulin-like growth factor) values were statistically analyzed by ELISA and the results were evaluated in relation to embryology parameters and clinical outcomes</div></div><div><h3>RESULTS</h3><div>In the PCOS+IR group, CTRP3, adiponectin, IGF-1, FSHR, and LHR levels decreased, while leptin, visfatin, IL-6, and Caspase-3 increased. These alterations negatively affected embryo development, leading to reduced MII oocyte, fertilization, cleavage, and blastocyst rates, and significantly impaired blastocyst quality scores.</div></div><div><h3>CONCLUSIONS</h3><div>In conclusion, in PCOS women with IR (PCOS+IR) and PCOS women without IR (PCOS-IR), significant differences were found in adipokine levels in follicular fluid, serum and cumulus cells compared to the control group. It has also been scientifically shown that increased apoptotic activation negatively affects embryologic parameters and clinical outcomes.</div></div><div><h3>IMPACT STATEMENT</h3><div>Data demonstrate that IR is a direct determinant not only of metabolic but also of reproductive outcomes, highlighting the importance of considering the presence of IR in personalized treatment approaches. It is thought that controlling IR may improve fertility outcomes in women with PCOS.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105303"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532941","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}