Reproductive biomedicine online最新文献_第3页

A biomimetic sperm selection device for routine sperm selection 一种用于常规精子选择的仿生精子选择装置。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104433

Steven A. Vasilescu , Dale M. Goss , Kathryn H. Gurner , Rebecca L. Kelley , Maria Mazi , Fabrice K. De Bond , Jennifer Lorimer , Fabrizzio Horta , Farin Y. Parast , David K. Gardner , Reza Nosrati , Majid E. Warkiani

Research question

Can a biomimetic microfluidic sperm sorter isolate motile sperm while minimizing DNA damage in comparison with density gradient centrifugation (DGC)?

Design

This was a two-phase study of 61 men, consisting of a proof-of-concept study with 21 donated semen samples in a university research laboratory, followed by a diagnostic andrology study with 40 consenting patients who presented at a fertility clinic for semen diagnostics. Each sample was split to perform DGC and microfluidic sperm selection (one-step sperm selection with 15 min of incubation) side-by-side. Outcomes evaluated included concentration, progressive motility, and DNA fragmentation index (DFI) of raw semen, and sperm isolated using DGC and the microfluidic device. Results were analysed using Friedman's test for non-parametric data (significant when P < 0.05). DFI values were assessed by sperm chromatin dispersion assay.

Results

Sperm isolated using DGC and the microfluidic device showed improved DFI values and motility compared with the raw semen sample in both cohorts. However, the microfluidic device was significantly better than DGC at reducing DFI values in both the proof-of-concept study (P = 0.012) and the diagnostic andrology study (P < 0.001). Progressive motility was significantly higher for sperm isolated using the microfluidic device in the proof-of-concept study (P = 0.0061) but not the diagnostic andrology study. Sperm concentration was significantly lower for samples isolated using the microfluidic device compared with DGC for both cohorts (P < 0.001).

Conclusions

Channel-based biomimetic sperm selection can passively select motile sperm with low DNA fragmentation. When compared with DGC, this method isolates fewer sperm but with a higher proportion of progressively motile cells and greater DNA integrity.

研究问题：与密度梯度离心（DGC）相比，仿生微流控精子分选器能否在分离运动精子的同时最大限度地减少DNA损伤？设计：这是一项涉及61名男性的两阶段研究，包括在大学研究实验室中使用21份捐赠精液样本的概念验证研究，以及在生育诊所接受精液诊断的40名同意患者的诊断男科研究。每个样本被分开，同时进行DGC和微流体精子选择（一步精子选择，孵育15分钟）。评估的结果包括浓度、进行性和原始精液的DNA碎片指数（DFI），以及使用DGC和微流控装置分离的精子。结果采用非参数数据的Friedman检验进行分析（P < 0.05显著）。采用精子染色质分散试验评估DFI值。结果：使用DGC和微流控装置分离的精子与原始精液样本相比，在两个队列中均显示出更高的DFI值和运动性。然而，在概念验证研究（P = 0.012）和诊断性男科研究（P < 0.001）中，微流控装置在降低DFI值方面都明显优于DGC。在概念验证研究中，使用微流控装置分离的精子的进行性运动能力显著提高（P = 0.0061），但在诊断性男科研究中则不然。在两个队列中，使用微流体装置分离的样本的精子浓度显著低于使用DGC分离的样本（P < 0.001）。结论：基于通道的仿生精子选择可以被动选择DNA碎片化程度低的活动精子。与DGC相比，该方法分离的精子较少，但逐渐运动的细胞比例更高，DNA完整性更高。

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引用次数: 0

Transrectal oocyte retrieval for fertility preservation in virginal women 经直肠提取卵母细胞保存处女的生育能力。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104475

Michael Fakih , Ahmad Fakih , Mouna Fawaz , Yasmin Sajjad , Muhammad Ahsan Akhtar , Fady Sharara

Research question

How safe and effective is transrectal oocyte retrieval (TROR) for fertility preservation in nulliparous virginal women?

Design

This was a retrospective single-centre study of 105 nulliparous women from five satellite centres of Fakih IVF, UAE, who underwent TROR for oocyte cryopreservation. Extensive bowel preparation and rectal cleansing was performed prior to oocyte retrieval. Patient characteristics, stimulation protocol, and procedure outcome and safety data were collected. Correlation analyses of the number of follicles and oocyte yield in relation to age and anti-Müllerian hormone (AMH) concentration, and the number of follicles in relation to oocyte yield were performed.

Results

This study evaluated 105 patients who underwent 152 cycles of ovarian stimulation and TROR. The most common indication was social fertility preservation. A significant positive correlation was found between the AMH concentration and number of oocytes (r = 0.83, P < 0.003). No intra-operative or postoperative complications were observed.

Conclusion

This study demonstrated that TROR is an alternative and clinically effective oocyte harvesting procedure in assisted reproductive technology, producing good results in terms of oocyte yield, with no complications and a good safety profile. Although transvaginal oocyte retrieval remains the gold-standard treatment, TROR is safe and effective for virginal women in whom transvaginal oocyte retrieval is not an option.

研究问题：经直肠卵母细胞回收（TROR）对未生育女性的生育能力保存安全有效吗？设计：这是一项回顾性的单中心研究，来自阿联酋Fakih IVF的五个卫星中心的105名未生育妇女接受了TROR卵母细胞冷冻保存。在取卵之前进行了广泛的肠道准备和直肠清洁。收集患者特征、刺激方案、手术结果和安全性数据。对卵泡数和卵母细胞产率与年龄、抗勒氏激素（AMH）浓度的关系以及卵泡数与卵母细胞产率的关系进行相关性分析。结果：本研究评估了105例接受152周期卵巢刺激和TROR治疗的患者。最常见的迹象是社会生育保护。AMH浓度与卵母细胞数呈显著正相关（r = 0.83,P < 0.003）。术中及术后无并发症。结论：本研究表明，在辅助生殖技术中，TROR是一种可替代的临床有效的卵母细胞采集方法，在卵母细胞产量方面效果良好，无并发症，安全性好。虽然经阴道卵母细胞回收仍然是金标准治疗，但对于不能经阴道卵母细胞回收的处女女性来说，TROR是安全有效的。

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引用次数: 0

Assisted reproductive technologies in Latin America: the Latin American Registry, 2021 拉丁美洲的辅助生殖技术：拉丁美洲登记处，2021 年。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-02-01 DOI: 10.1016/j.rbmo.2024.104413

Fernando Zegers-Hochschild , Javier A. Crosby , Carolina Musri , Fanny Petermann-Rocha , Gustavo Martinez , Hitomi Nakagawa , Carlos Morente , Armando Roque , Ana Palma-Govea , Latin American Network of Assisted Reproduction

Research question

What are the trends and impact of new technologies on the effectiveness and safety of assisted reproductive technology (ART) performed in Latin America during 2021?

Design

This was a retrospective collection of cycle-based multinational data obtained from ART procedures performed by 204 accredited institutions in 16 countries.

Results

In total 127,351initiated cycles resulted in 20,032 deliveries and 22,708 births. ART utilization showed great variability, from 623.5 cycles/million inhabitants in Uruguay to fewer than 35 in Guatemala and El Salvador. The proportion of women aged ≥40 years increased to 35.8%, while that of women ≤34 years dropped to 23.9%. Nonetheless, the proportion of single-embryo transfers (SET) increased from 11.9% in the previous decade to 42.4% in 2021. Of 22,708 babies born, 76.8% were singletons, 22.3% twins and 1.0% triplets or more. Intracytoplasmic sperm injection represented 84.5% of fertilization techniques, and blastocyst transfer increased from 49.6% in 2016 to 79.3% in 2021. The delivery rate after fresh blastocyst elective SET was significantly higher than after the transfer of one frozen embryo from a freeze-all cycle (P < 0.0001). The number of aspirations leading to preimplantation genetic testing has increased 2.8 times in 5 years and significantly increased delivery rates/transfer at all ages, including in oocyte donation (P ≤ 0.002), and reduced miscarriage in women ≥35 years old. In oocyte donation, delivery rates after the fresh transfer of embryos from vitrified-warmed oocyte cycles generated similar outcomes to frozen embryo transfer. Perinatal mortality increased from 7.7‰ in singletons to 21.3‰ in twins.

Conclusion

The systematic collection of cycle-based multinational data contributes to cooperative sustained development and helps implement evidence-based reproductive decisions.

研究问题：2021年期间，新技术对拉丁美洲辅助生殖技术（ART）的有效性和安全性有何趋势和影响？这是一项基于周期的多国数据回顾性收集，数据来自16个国家的204家经认证的机构所实施的ART手术：共有127,351个周期导致20,032次分娩和22,708次出生。抗逆转录病毒疗法的使用情况差异很大，从乌拉圭的 623.5 个周期/百万居民到危地马拉和萨尔瓦多的不到 35 个周期/百万居民。年龄≥40 岁的妇女比例增至 35.8%，而年龄≤34 岁的妇女比例降至 23.9%。然而，单胚胎移植（SET）的比例从上一个十年的 11.9%上升到 2021 年的 42.4%。在 22 708 名新生儿中，76.8% 为单胎，22.3% 为双胞胎，1.0% 为三胞胎或三胞胎以上。卵胞浆内单精子注射占受精技术的84.5%，囊胚移植从2016年的49.6%增至2021年的79.3%。新鲜囊胚选择性 SET 后的分娩率明显高于冷冻全周期移植一个冷冻胚胎后的分娩率（P < 0.0001）。导致植入前基因检测的抽取数量在 5 年内增加了 2.8 倍，显著提高了所有年龄段的分娩率/移植率，包括卵母细胞捐献（P ≤ 0.002），并减少了≥35 岁女性的流产。在卵母细胞捐献中，玻璃化温育卵母细胞周期的胚胎新鲜移植后的分娩率与冷冻胚胎移植结果相似。围产期死亡率从单胎的 7.7‰上升到双胞胎的 21.3‰：系统收集基于周期的多国数据有助于持续合作发展，并有助于实施循证生殖决策。

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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 : 2025-01-01 DOI: 10.1016/S1472-6483(24)00961-1

引用次数: 0

Preconception carrier screening in couples seeking IVF: exploring the patient perspective 寻求体外受精的夫妇的孕前携带者筛查：探索患者的观点。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104452

Celine Frank , Claire H.C. Laeven , Deidre Meulenbroeks , Edith Coonen , Christine E.M. de Die-Smulders , Ronald J.T. van Golde , Lonne M. Mallens , Aimée D.C. Paulussen , Juliette Schuurmans , Liesbeth A.D.M. van Osch

Research question

What is the level of understanding, and what are the attitudes and considerations regarding preconception carrier screening (PCS) among couples seeking IVF or intracytoplasmic sperm injection (ICSI)?

Design

A mixed-methods design was used. Nine interviews were conducted with couples or individual partners (n = 16) who had an initial consultation for IVF/ICSI in the 2 years preceding this study. A questionnaire was completed by 115 participants. No actual PCS was offered.

Results

All interviewed couples expressed a positive attitude towards PCS, and over half of the respondents stated that they would pursue or seriously consider pursuing PCS if possible. Some couples falsely believed that PCS could identify a cause for their fertility problems and increase their chance of conceiving. The desire to make an informed reproductive decision was the most important argument in favour of PCS. The primary argument against PCS was the apprehension of being confronted with reproductive dilemmas. The longer the delay to IVF/ICSI treatment required to perform PCS, the more couples would be inclined to decline screening. Participants indicated that they would prefer to receive information about PCS from a medical specialist at an early stage in their IVF/ICSI treatment.

Conclusion

Although attitudes towards PCS were generally positive, some concerns were raised about treatment delays and potential reproductive dilemmas, and some couples had misconceptions about the purpose of screening within the context of their IVF/ICSI treatment. These findings highlight the importance of tailoring information and counselling to the specific needs of couples seeking IVF/ICSI.

研究问题：寻求体外受精或卵胞浆内单精子显微注射（ICSI）的夫妇对受孕前携带者筛查（PCS）的了解程度、态度和考虑因素是什么？采用混合方法设计。对在本研究之前两年内接受过试管婴儿/卵胞浆内单精子显微注射初次咨询的夫妇或个人伴侣（n = 16）进行了九次访谈。115 名参与者填写了调查问卷。没有提供实际的 PCS：所有受访夫妇都对 PCS 持积极态度，半数以上的受访者表示，如果可能，他们会采取或认真考虑采取 PCS。一些夫妇错误地认为 PCS 可以找出导致其生育问题的原因，从而增加受孕机会。希望做出知情的生育决定是支持 PCS 的最重要理由。反对 PCS 的主要理由是担心面临生育困境。进行 PCS 所需的 IVF/ICSI 治疗延迟时间越长，越多的夫妇倾向于拒绝筛查。参与者表示，他们更希望在试管婴儿/卵胞浆内单精子显微注射治疗的早期阶段从医学专家那里获得有关 PCS 的信息：尽管人们对 PCS 的态度总体上是积极的，但也有一些人对治疗延误和潜在的生殖困境表示担忧，而且一些夫妇对在 IVF/ICSI 治疗过程中进行筛查的目的存在误解。这些发现凸显了根据寻求体外受精/卵胞浆内单精子显微注射的夫妇的具体需求提供信息和咨询的重要性。

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引用次数: 0

Clinical outcomes of vitrified-warmed autologous oocyte cycles with 15-year follow-up at a single UK centre: consistent and predictable results 英国一家中心对玻璃化温育自体卵母细胞周期进行 15 年随访的临床结果：一致且可预测的结果。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104376

Jemma Garratt , Trina Shah , Anna Mclaughlin, Balsam Al-Hashimi, Nick Macklon, Elena Linara-Demakakou, Kamal K. Ahuja

Research question

What were the clinical outcomes from 332 autologous vitrified- warmed oocyte cycles derived from 3182 elective autologous oocyte freeze cycles carried out between 2008 and 2022 in a single-centre series?

Design

In this retrospective observational study, outcomes in 299 patients returning to use their frozen oocytes between 2015 and 2023 were analysed.

Results

A total of 3328 elective oocyte vitrification cycles were performed in 2280 patients. The return rate to use oocytes was 14% (299/2171). Mean ages were 37.6 years at storage and 40 at warming. Ninety-three clinical pregnancies and 77 healthy live births were recorded. The live birth rate (LBR) was 24% (39/163) per fresh transfer and 17% (39/227) per embryo transferred. Stratified by age at freezing, the LBR per embryo transferred was 26% (12/47) in participants under 35 years, 20% (24/118) in those 35–39 years and 5% (3/62) in those 40+ years. Frozen embryo transfers (FET) achieved a 30% (24/80) LBR per embryo transfer and a 27% (24/90) LBR per embryo transferred. PGT-A for embryo selection doubled the LBR compared with FET from an untested embryo after one attempt (40% versus 21%). In patients aged over 40 years, the cumulative LBR reached 42% per patient in euploid FET.

Conclusion

The proportion of patients who returned to use their stored oocytes and the clinical outcomes were consistent with other recent reports and challenges the prevalent critical narrative regarding elective oocyte freezing for fertility preservation. The results are now comparable to routine IVF. Not everyone who returns to use their oocytes will conceive, but for those choosing to preserve their fertility, oocyte freezing can provide reproducible and reassuring results.

研究问题：在一项单中心系列研究中，从2008年至2022年期间实施的3182个选择性自体卵母细胞冷冻周期中得出的332个自体玻璃化-加温卵母细胞周期的临床结果如何？在这项回顾性观察研究中，分析了2015年至2023年间299名患者返回使用其冷冻卵母细胞的结果：2280名患者共进行了3328次选择性卵母细胞玻璃化周期。返回使用卵母细胞的比例为 14%（299/2171）。储存时的平均年龄为 37.6 岁，升温时的平均年龄为 40 岁。共记录了 93 例临床妊娠和 77 例健康活产。每次新鲜移植的活产率（LBR）为 24%（39/163），每次胚胎移植的活产率（LBR）为 17%（39/227）。按冷冻时的年龄分层，35 岁以下参与者每次胚胎移植的活产率为 26%（12/47），35-39 岁为 20%（24/118），40 岁以上为 5%（3/62）。冷冻胚胎移植（FET）每移植一个胚胎的长存活率为 30%（24/80），每移植一个胚胎的长存活率为 27%（24/90）。与使用未经检验的胚胎进行一次冷冻胚胎移植相比，使用 PGT-A 进行胚胎选择的 LBR 提高了一倍（40% 对 21%）。在 40 岁以上的患者中，优倍体 FET 的累积 LBR 达到 42%：返回使用其储存的卵母细胞的患者比例和临床结果与近期的其他报告一致，并对有关选择性卵母细胞冷冻用于生育力保存的普遍批评意见提出了质疑。现在的结果可与常规试管婴儿相媲美。不是每个返回使用卵母细胞的人都能受孕，但对于那些选择保留生育能力的人来说，卵母细胞冷冻可以提供可重复和令人放心的结果。

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引用次数: 0

Polar body-based PGT-A: not dead yet? A step forward back to the roots of PGT-A 基于极地车身的 PGT-A：尚未消亡？回到 PGT-A 的根源，向前迈出一步。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104430

Anna Oberle, Michael Feichtinger

Trophectoderm-based preimplantation genetic testing for aneuploidies (PGT-A) is used worldwide as a means of selecting embryos with high potential for achieving a live birth. However, trophectoderm analysis may be impaired through embryonic mosaicism, leading to genetically healthy embryos being falsely discarded, and thus even reducing cumulative live birth rates. Polar body biopsy, a technique applied since the early days of preimplantation testing, has been abandoned by most IVF centres. In comparison to trophectoderm analysis, however, polar body biopsy might even have certain advantages over trophectoderm PGT-A. This Countercurrent contribution discusses the newest clinical evidence, as well as ethical and cost-efficiency considerations, and argue that polar body analysis should be reconsidered.

基于滋养层的胚胎植入前非整倍体基因检测（PGT-A）已在全球范围内得到广泛应用，作为一种选择极有可能实现活产的胚胎的手段。然而，滋养层分析可能会因胚胎嵌合而受到影响，导致基因健康的胚胎被错误地丢弃，从而甚至降低累积活产率。极体活检是植入前检测早期就开始应用的一项技术，目前已被大多数试管婴儿中心放弃。不过，与滋养层分析相比，极体活检甚至可能比滋养层 PGT-A 更有优势。这篇逆流投稿讨论了最新的临床证据以及伦理和成本效益方面的考虑，并认为应重新考虑极体分析。

引用次数: 0

Looking into the future: a machine learning powered prediction model for oocyte return rates after cryopreservation 展望未来：冷冻保存后卵母细胞返回率的机器学习预测模型。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104432

Yuval Fouks , Pietro Bortoletto , Jeffrey Chang , Alan Penzias , Denis Vaughan , Denny Sakkas

Research question

Could a predictive model, using data from all US fertility clinics reporting to the Society for Assisted Reproductive Technology, estimate the likelihood of patients using their stored oocytes?

Design

Multiple learner algorithms, including penalized regressions, random forests, gradient boosting machine, linear discriminant analysis and bootstrap aggregating decision trees were used. Data were split into training and test datasets. Patient demographics, medical and fertility diagnoses, partner information and geographic locations were analysed.

Results

A total of 77,631 oocyte–cryopreservation cycles (2014–2020) were analysed. Patient age averaged 34.5 years. Treatment indications varied: planned (35.6%), gender-related (0.1%), medically indicated (15.5%), oncologic (5.7%) and unknown (42.3%). Infertility diagnoses were less common: unexplained infertility (1.8%), age-related infertility (3.2%), diminished ovarian reserve (9.9%) and endometriosis (1.6%). An ensemble model combining bootstrap aggregation classification and regression trees, stochastic gradient boosting and linear discriminant analysis yielded the highest predictive accuracy on test set (balanced accuracy: 0.83, sensitivity: 0.76, specificity: 0.91), with a receiver operating characteristic curve of 0.90 and precision-recall curve and area under the curve of 0.57. Key factors influencing the likelihood of returning for oocyte use included patient age, presence of a partner, race or ethnicity, the clinic's geographic region and oocyte cryopreservation indication.

Conclusions

This model demonstrated significant predictive accuracy, and is a valuable tool for patient counselling on oocyte cryopreservation. It helps to identify patients more likely to use stored oocytes, enhancing healthcare decision-making and the efficiency of gamete storage programmes. The model can be applied to self-financed and insurance-funded cycles.

研究问题：是否可以建立一个预测模型，使用所有向辅助生殖技术协会报告的美国生育诊所的数据来估计患者使用其储存的卵母细胞的可能性？设计：多重学习算法，包括惩罚回归、随机森林、梯度增强机、线性判别分析和自举聚合决策树。数据被分成训练数据集和测试数据集。分析了患者人口统计、医疗和生育诊断、伴侣信息和地理位置。结果：共分析了77,631个卵母细胞冷冻保存周期（2014-2020）。患者平均年龄34.5岁。治疗指征各不相同：计划治疗（35.6%）、性别相关（0.1%）、医学指征（15.5%）、肿瘤（5.7%）和未知（42.3%）。不孕症诊断较少见：不明原因不孕症（1.8%）、年龄相关性不孕症（3.2%）、卵巢储备功能减退（9.9%）和子宫内膜异位症（1.6%）。结合自举聚集分类和回归树、随机梯度增强和线性判别分析的集成模型在测试集上的预测精度最高（平衡精度为0.83，灵敏度为0.76，特异性为0.91），接收者工作特征曲线为0.90，精确召回率曲线和曲线下面积为0.57。影响返回卵母细胞使用可能性的关键因素包括患者年龄、伴侣的存在、种族或民族、诊所的地理区域和卵母细胞冷冻保存适应症。结论：该模型具有显著的预测准确性，为卵母细胞冷冻保存患者咨询提供了有价值的工具。它有助于识别更有可能使用储存的卵母细胞的患者，提高医疗保健决策和配子储存计划的效率。该模型可应用于自筹资金周期和保险资金周期。

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引用次数: 0

Outside Back Cover - Editorial Board

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/S1472-6483(24)00963-5

引用次数: 0

The First Lugano Workshop on the role of adenomyosis in ART 第一届卢加诺讲习班，讨论子宫腺肌症在抗逆转录病毒治疗中的作用。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104444

Mauro Cozzolino , Serdar Bulun , Dominique De Ziegler , Caterina Exacoustos , Human Fatemi , Juan Antonio Garcia-Velasco , Andrew Horne , Felice Petraglia , Pietro Santulli , Edgardo Somigliana , Kim Soorin , Thierry Van den Bosch , Paola Viganò , Peter Humaidan

Adenomyosis is an important clinical condition with uncertain prevalence, and clinical focus on adenomyosis in patients undergoing assisted reproductive technology (ART) has increased during recent years. Recognizing the limited clinical knowledge on the impact of adenomyosis on ART outcomes, the First Lugano Adenomyosis Workshop was a symposium involving experts in the field of adenomyosis, covering basic research, imaging, surgery and infertility to highlight current advances and future research areas over a wide range of topics related to adenomyosis. Adenomyosis is characterized by altered oestrogen and progesterone signalling pathways. Although the criteria of the Morphological Uterus Sonographic Assessment (MUSA) Consortium apply to patients with infertility, the presence of direct signs and localization in the different myometrial layers, particularly the inner myometrium, need more focus. In addition to the MUSA criteria, clinical symptoms and the magnitude of uterine enlargement should also be considered. Whilst pre-treatment with gonadotrophin-releasing hormone agonist with or without an aromatase inhibitor in frozen embryo transfer cycles seems promising, many issues related to therapy remain unanswered. During the Workshop, therapeutic progress over the past decades as well as novel insights were presented and discussed. The role of this opinion paper is to stimulate discussion and spark further interest in adenomyosis and the role of adenomyosis in infertility.

子宫腺肌症是一种重要的临床疾病，发病率不确定，近年来临床对辅助生殖技术（ART）患者子宫腺肌症的关注有所增加。认识到子宫腺肌症对ART结果影响的临床知识有限，第一届卢加诺子宫腺肌症研讨会是一个涉及子宫腺肌症领域专家的研讨会，涵盖基础研究，影像学，手术和不孕症，以突出子宫腺肌症相关广泛主题的当前进展和未来研究领域。子宫腺肌症的特征是雌激素和孕激素信号通路的改变。虽然子宫形态超声评估（MUSA）联盟的标准适用于不孕症患者，但不同子宫肌层，特别是子宫内膜的直接体征和定位需要更多的关注。除MUSA标准外，还应考虑临床症状和子宫增大的大小。虽然在冷冻胚胎移植周期中使用促性腺激素释放激素激动剂（含或不含芳香酶抑制剂）进行预处理似乎很有希望，但许多与治疗相关的问题仍未得到解决。在研讨会期间，介绍和讨论了过去几十年的治疗进展以及新的见解。这篇观点论文的作用是激发人们对子宫腺肌症和子宫腺肌症在不孕症中的作用的讨论和进一步的兴趣。

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引用次数: 0