Reproductive biomedicine online最新文献

英文中文

Do directed and non-directed oocyte donors differ regarding their motives, ambivalence, satisfaction and openness about donating? 定向和非定向卵细胞捐献者在捐献动机、矛盾心理、满意度和开放性方面是否存在差异？

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104455

Emilia Thorup , Gunilla Sydsjö , Agneta Skoog Svanberg , Claudia Lampic

Research question

Do directed oocyte donors differ from non-directed identity-release oocyte donors regarding pre-donation motives and ambivalence, and post-donation satisfaction and openness?

Design

The study is part of the longitudinal Swedish Study on Gamete Donation where consecutive samples of identity-release gamete donors at seven Swedish University Hospitals were approached during a 3-year period (2005–2008). The participants of the current study were 16 women who donated oocytes to family members or friends (directed donation) and 123 women who donated to unknown recipients (non-directed donation). Survey data on motivation, ambivalence, post-donation satisfaction and openness were collected at five time points between acceptance as a donor and 14–17 years post-donation. Statistical group comparisons and longitudinal analyses were conducted.

Results

In contrast to non-directed donors, who reported general altruism as their main motivation, directed donors were primarily motivated by empathy with the recipients. Pre-donation ambivalence was present in a quarter of donors and did not differ between groups (P = 0.601). Post-donation satisfaction was similar between groups (P = 0.17) and stable over time (P = 0.37). One directed donor reported regretting her donation, and this was attributed to negative relations with the recipients. Donors from both groups were generally open about having donated, but some directed donors felt restricted by the recipients’ wishes.

Conclusions

Despite being differently motivated, the current findings suggest that directed oocyte donors are comparable to non-directed oocyte donors in terms of pre-donation ambivalence and post-donation satisfaction and openness. The findings also highlight how directed donation may be associated with specific challenges, which emphasizes the need for pre- and post-donation counselling.

研究问题：定向卵母细胞捐献者与非定向身份释放卵母细胞捐献者在捐赠前动机和矛盾心理、捐赠后满意度和开放性方面有什么不同吗？设计：该研究是瑞典配子捐赠纵向研究的一部分，该研究在3年期间（2005-2008年）接触了七所瑞典大学医院的连续样本。目前研究的参与者是16名将卵母细胞捐赠给家人或朋友的女性（直接捐赠）和123名捐赠给未知接受者的女性（非直接捐赠）。在接受捐赠到捐赠后14-17年之间的五个时间点收集动机、矛盾心理、捐赠后满意度和开放性的调查数据。进行统计学组间比较和纵向分析。结果：与非定向捐赠相比，定向捐赠的主要动机是利他主义，而定向捐赠的主要动机是与接受者的共情。捐献前的矛盾心理存在于四分之一的捐献者中，各组之间没有差异（P = 0.601）。捐赠后满意度各组间相似（P = 0.17），且随时间稳定（P = 0.37）。一位直接捐赠者报告说，她后悔自己的捐赠，这是由于与接受者的负面关系。两组捐赠者都对自己的捐赠行为持开放态度，但一些直接捐赠者觉得自己受到了接受者意愿的限制。结论：尽管动机不同，但目前的研究结果表明，定向卵母细胞供者在捐赠前的矛盾心理和捐赠后的满意度和开放性方面与非定向卵母细胞供者相当。研究结果还强调了直接捐赠如何与特定挑战相关联，这强调了捐赠前和捐赠后咨询的必要性。

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引用次数: 0

Inside Front Cover - Affiliations and First page of TOC

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/S1472-6483(25)00017-3

引用次数: 0

Decision-making in women who considered planned oocyte cryopreservation: decision satisfaction or regret? 考虑计划性卵母细胞冷冻保存的妇女的决策：决策满意还是遗憾？

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.103944

A. Korkidakis , S. Martinez , R. Sabbagh , Q. Heyward , D. Sakkas , A. Domar , T.L. Toth

Research question

Among women who considered planned oocyte cryopreservation, does decision regret differ between those who pursued planned oocyte cryopreservation and those who did not?

Design

A survey was e-mailed to all women who presented for an initial consultation for planned oocyte cryopreservation between January 2016 and December 2021 using a secure REDCap platform. The survey comprised questions on demographics, reproductive planning and the validated Decision Regret Scale (DRS). Univariable and multivariable models were fitted to compare decision regret in the group who had proceeded with planned oocyte cryopreservation with the group who had not. A sentiment analysis was employed to characterize the emotional tone of respondents.

Results

In total, 338 respondents met the eligibility criteria. Of these, 178 (52.7%) patients had proceeded with planned oocyte cryopreservation and 160 (47.3%) had not. The groups were similar in age, race, ethnicity and education. Respondents who had proceeded with planned oocyte cryopreservation were more likely to be single, to anticipate starting a family at ≥39 years of age, and to consider the use of donor spermatozoa to be an acceptable option. Respondents who had not proceeded with planned oocyte cryopreservation more frequently reported starting attempts at conception since their consultation. A higher proportion of respondents who had not undergone planned oocyte cryopreservation experienced moderate-to-severe regret with their decision compared with respondents who had undergone at least one cycle of planned oocyte cryopreservation (50% versus 13%; P < 0.001). There was a correlation between decreasing number of cryopreserved oocytes and increasing DRS score (R = -0.41, P < 0.001).

Conclusions

Women who consider planned oocyte cryopreservation but do not proceed with it experience substantial decision regret. The DRS score was highest among respondents who had not proceeded with planned oocyte cryopreservation, and respondents who had undergone at least one cycle of planned oocyte cryopreservation that resulted in a low number of cryopreserved oocytes.

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引用次数: 0

Fertility preservation before sterilizing treatment: cryopreservation of both ovaries to restore endocrine and reproductive functions 绝育前保存生育能力：双卵巢冷冻保存，恢复内分泌和生殖功能。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104472

Catherine Poirot , Nicolas Foureur , Claudine Esper , Marie-Madeleine Dolmans

Ovarian cortex cryopreservation is now a validated fertility preservation technique. Autotransplantation of this tissue allows restoration of ovarian hormone function in more than 90% of patients, and birth of at least one child in 30% of transplanted women. In the case of very highly gonadotoxic treatments, it is recommended that ovarian cortex be cryopreserved as first-line therapy to safeguard future fertility. However, the ovary left in place runs a very high risk of being significantly altered. This raises the question of harvesting both ovaries, looking to restore fertility as well as endocrine function. Indeed, hormone balance in these cancer survivors may be recovered naturally for their entire lifetime. Autotransplantation could also be performed to restore hormone function in women with no wish to have children, with the sole purpose of improving their quality of life. Ethical and legal challenges exist and are discussed in this paper, but they do not constitute an argument against it. Clinical trials investigating this strategy are clearly needed, but this approach truly offers women the chance of having both endocrine and reproductive functions restored and maintained throughout their entire life.

卵巢皮层冷冻保存现在是一种有效的生育保存技术。这种组织的自体移植使90%以上的患者恢复卵巢激素功能，30%的移植妇女至少生育一个孩子。在高度促性腺毒性治疗的情况下，建议卵巢皮质冷冻保存作为一线治疗，以保障未来的生育能力。然而，留在原位的卵巢发生显著改变的风险非常高。这就提出了切除两个卵巢的问题，希望恢复生育能力和内分泌功能。事实上，这些癌症幸存者的激素平衡可能会在他们的一生中自然恢复。自体移植也可以用于恢复不想要孩子的女性的激素功能，其唯一目的是提高她们的生活质量。伦理和法律挑战存在，并在本文中进行了讨论，但它们并不构成反对它的论据。研究这种策略的临床试验显然是必要的，但这种方法确实为妇女提供了恢复和维持其一生的内分泌和生殖功能的机会。

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引用次数: 0

Oocyte yield and live birth rate after follitropin delta dosing and fresh embryo transfer: an individual patient data meta-analysis 卵泡素δ剂量和新鲜胚胎移植后的卵母细胞产量和活产率：个体患者数据荟萃分析。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104451

Rita Lobo , Ali Falahati , Kelle Moley , Anja Pinborg , Samuel Santos-Ribeiro , Nick S. Macklon , Ida E. Jepsen

Research question

What number of retrieved oocytes is associated with the optimum chance of achieving a live birth for women undergoing ovarian stimulation with individualized follitropin delta?

Design

An individual patient data meta-analysis was performed on 1772 patients from five randomized controlled trials using individualized follitropin delta for ovarian stimulation with fixed daily dosing based on serum anti-Müllerian hormone (AMH) level and body weight. Live birth rate (LBR) and ovarian hyperstimulation syndrome (OHSS) were evaluated in relation to the number of oocytes retrieved. Predicted LBR was obtained using a logistic regression analysis with fractional polynomials. Subgroup analyses were performed based on number of oocytes retrieved, age and AMH level.

Results

The analysis included patients treated with follitropin delta who had at least one oocyte retrieved. The mean number of oocytes retrieved was 10.4, and overall LBR was 32.1%. Predicted LBR increased with the number of oocytes retrieved, reaching >34% for patients with 8-14 oocytes retrieved, and peaking at 34.9% for patients with 11 oocytes retrieved. LBR declined gradually beyond retrieval of 14 oocytes. LBR was 27.8%, 33.6% and 30.9% for patients with 1-7, 8-14, and ≥15 oocytes retrieved, respectively. LBR decreased with increasing age: 32.7%, 30.7% and 23.4% at <35, 35–37 and 38–42 years, respectively. The incidence of OHSS (any grade) was 2.1%, 5.2% and 17.0% for patients with 1-7, 8-14, and ≥15 oocytes retrieved, respectively.

Conclusions

After ovarian stimulation with individualized follitropin delta, LBR in fresh transfer cycles was highest for patients with 8-14 oocytes retrieved, and peaked in patients with 11 oocytes retrieved. The results support the appropriateness of the follitropin delta dosing algorithm.

研究问题：对于接受个体化促卵泡素刺激卵巢的妇女，取多少卵母细胞与获得活产的最佳机会有关？设计：对来自5项随机对照试验的1772例患者进行个体患者数据荟萃分析，根据血清抗勒氏激素（AMH）水平和体重，使用个体化卵泡素δ进行卵巢刺激，每日固定剂量。评估活产率（LBR）和卵巢过度刺激综合征（OHSS）与卵母细胞数量的关系。采用分数阶多项式进行逻辑回归分析，得到预测LBR。根据获得的卵母细胞数量、年龄和AMH水平进行亚组分析。结果：该分析包括至少有一个卵母细胞被取出的患者。平均取卵数为10.4个，总LBR为32.1%。预测LBR随着取卵数的增加而增加，取卵8-14个时达到bb0 34%，取卵11个时达到34.9%的峰值。14个卵母细胞取出后LBR逐渐下降。1-7、8-14和≥15个卵母细胞患者的LBR分别为27.8%、33.6%和30.9%。结论：个体化促卵素刺激卵巢后，在新鲜移植周期中，取卵8-14个卵母细胞的患者LBR最高，取卵11个卵母细胞的患者LBR最高。结果支持卵泡素δ给药算法的适宜性。

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引用次数: 0

Front Matter - Continued TOC

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/S1472-6483(25)00018-5

引用次数: 0

Corrigendum to 'Successful live birth in women with partial 17α-hydroxylase deficiency: report of two cases' [Reproductive BioMedicine Online (2024) Volume 49, Issue 2, 103855].

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104780

Xiaofang Du, Qi Jia, Sheling Wu, Bijun Wang, Yichun Guan

引用次数: 0

Association of vitamin D receptor gene polymorphisms, metabolic features and susceptibility to polycystic ovary syndrome: a preliminary study 维生素 D 受体基因多态性（FokI、ApaI、TaqI）、代谢特征与多囊卵巢综合征易感性的关系：一项初步的单中心病例对照研究

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104447

Talida Vulcan, Mihaela Iancu, Lucia Maria Procopciuc, Tudor Sergiu Suciu, Gabriela Adriana Filip

Research question

Are the combined genotypes and haplotypes of vitamin D receptor (VDR) gene polymorphisms (FokI, ApaI and TaqI) associated with susceptibility to polycystic ovary syndrome (PCOS) and metabolic features of the disease?

Design

This case–control study included 46 women with PCOS and 48 controls. Genotypes of the VDR gene were determined using the polymerase chain reaction–restriction fragment length polymorphism method. Waist circumference, and parameters of lipid and glucose metabolism were evaluated in all women.

Results

Women in the PCOS group had a larger waist circumference (P = 0.0383) and a higher visceral adiposity index (VAI) (P < 0.0001) compared with controls. Total cholesterol (P < 0.0001), high-density lipoprotein cholesterol (P = 0.00001) and triglyceride (P < 0.0001) concentrations were higher in the PCOS group. The VDR-FokI C/C (F/F) genotype was associated with significantly higher odds of PCOS (adjusted OR 6.27, 95% CI 1.53–25.65). The VDR-ApaI genotype was associated with susceptibility to PCOS in the dominant model; the variant genotypes [A/C + A/A (A/a + a/a)] had higher odds of PCOS than the wild genotype [C/C (A/A)] (adjusted OR 3.15, 95% CI 1.07–9.32). Haplotype analysis revealed that the T-C-T (f-A-T) haplotype was significantly associated with lower odds of PCOS (adjusted OR 0.10, 95% CI 0.01–0.95). Women with PCOS carrying the VDR-FokI T/T (f/f) genotype had lower fasting glucose (P = 0.0469) and higher VAI (P = 0.0406) compared with women with the C/T (Ff) + C/C (F/F) genotype.

Conclusion

The present findings suggest an association between FokI and ApaI polymorphisms and PCOS susceptibility. Moreover, the VDR-FokI T/T (f/f) genotype could be a marker for decreased fasting glucose in women with PCOS. No association was found between the TaqI polymorphism and PCOS susceptibility in the study population.

VDR 基因多态性（）的组合基因型和单倍型是否与多囊卵巢综合征的易感性和该病的代谢特征有关？我们进行了一项病例对照研究，其中包括 46 名多囊卵巢综合征妇女和 48 名对照组妇女。采用 PCR-RFLP（限制性片段长度多态性）方法确定了 VDR 基因的基因型。对所有妇女的腰围、血脂和糖代谢参数进行了评估。与对照组相比，多囊卵巢综合征组的腰围和内脏脂肪指数（VAI）水平较高。多囊卵巢综合征妇女的总胆固醇、低密度脂蛋白胆固醇和甘油三酯的数值较高。VDR- C/C（F/F）基因型患多囊卵巢综合症的几率明显更高（调整后 OR = 6.27，95% CI：1.53-25.65）。在显性模型中，VDR- 与多囊卵巢综合征的易感性相关，变异基因型（A/C-A/A）（A/a- a/a）比野生基因型 C/C (A/A)患多囊卵巢综合征的几率更高（调整 OR = 3.15，95% CI：1.07-9.32）。单倍型分析表明，T-C- T（f-A-T）单倍型与多囊卵巢综合征的较低几率有统计学关联（调整后 OR = 0.10，95% CI：0.01-0.95）。与 C/T (Ff) 或 C/C (F/F) 基因型相比，具有 VDR-Fokl T/T (f/f) 基因型的多囊卵巢综合症女性空腹血糖较低，VAI 水平较高。本研究结果表明，和多态性与多囊卵巢综合征易感性之间存在关联。此外，在我们的研究人群中，VDR-的T/T（f/f）基因型可能是多囊卵巢综合征患者空腹血糖降低的标志物。

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引用次数: 0

Legal framework and IVF outcomes: a comparative analysis of fresh and frozen embryo transfers in Switzerland 法律框架和体外受精结果：瑞士新鲜和冷冻胚胎移植的比较分析。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104483

Janna Pape , Jérémy Levy , Sofia Makieva , Michael von Wolff

Research question

To what extent do legislative measures impact standard reproductive outcome parameters?

Design

Retrospective cohort study using data from the Swiss national IVF registry analysing the outcomes of 13,908 women undergoing embryo transfers resulting from their first lifetime oocyte retrieval before (2014–2016) or after (2020–2022) revision of the legislation, allowing extended culture for 12 zygotes. Live birth rates (LBR) and cumulative LBR (cLBR) were compared in fresh and frozen embryo transfer strategies in both periods. Adjusted multivariable mixed model analyses were performed to determine OR and incidence rate ratios (IRR).

Results

Before revision of the legislation, LBR was higher for fresh embryo transfers compared with frozen embryo transfers (27.2% versus 22.7%; P = 0.006). After revision of the legislation, LBR was lower for fresh embryo transfers (29.3% versus 36.3%; P < 0.001), and cLBR was higher for the freeze-all embryo transfer strategy (59.0% versus 39.8%; P < 0.001). However, in a multivariable analysis, no difference in the odds of live birth was found between fresh and frozen embryo transfers (OR = 1.08, 95% CI 0.95–1.22), and the freeze-all embryo transfer strategy was not found to be more effective than the fresh embryo transfer strategy (IRR = 1.12, 95% CI 0.98–1.27). In a subgroup analysis, fresh blastocyst embryo transfers showed higher LBR than cleavage stage embryo transfers (OR = 2.01, 95% CI 1.62–2.49).

Conclusion

The change in national legislation provided the unique opportunity to evaluate the legal impact on reproductive outcomes. Besides a reduction in the number of multiple births, LBR in frozen embryo transfers improved, resulting in comparable success of fresh and frozen embryo transfer strategies. In addition to technological improvement, the legal framework influences the evolution of clinical practice, thereby contributing to enhanced reproductive outcomes.

研究问题：立法措施在多大程度上影响标准生殖结果参数？设计：回顾性队列研究，使用瑞士国家试管婴儿登记处的数据，分析13908名接受胚胎移植的女性在（2014-2016）或（2020-2022）立法修订之前（2014-2016）或之后（2020-2022）进行第一次卵母细胞提取的结果，允许延长12个受精卵的培养时间。比较两期新鲜和冷冻胚胎移植策略的活产率（LBR）和累积LBR （cLBR）。采用调整后的多变量混合模型分析确定OR和发病率比（IRR）。结果：立法修订前，新鲜胚胎移植的LBR高于冷冻胚胎移植(27.2% vs 22.7%； = 0.006页)。立法修订后，新鲜胚胎移植的LBR较低(29.3%对36.3%；P < 0.001)，全冷冻胚胎移植策略的cLBR更高(59.0% vs 39.8%；P < 0.001)。然而，在多变量分析中，发现新鲜胚胎移植和冷冻胚胎移植的活产几率没有差异（OR = 1.08,95% CI 0.95-1.22），并且发现冷冻胚胎移植策略并不比新鲜胚胎移植策略更有效（IRR = 1.12,95% CI 0.98-1.27）。在亚组分析中，新鲜囊胚移植的LBR高于卵裂期胚胎移植（OR = 2.01,95% CI 1.62-2.49）。结论：国家立法的变化为评估法律对生殖结果的影响提供了独特的机会。除了减少多胎数量外，冷冻胚胎移植中的LBR得到改善，导致新鲜和冷冻胚胎移植策略的成功相当。除了技术改进之外，法律框架还影响着临床实践的演变，从而有助于提高生殖结果。

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引用次数: 0

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IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/S1472-6483(25)00028-8

引用次数: 0

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