Digital twins – the term for virtual representations of biological systems – are emerging as promising tools in reproductive medicine. They offer personalized simulations for optimizing fertility, assisted reproductive technology (ART) and pregnancy outcomes. However, their use remains limited and fragmented across diverse applications. A systematic search was conducted in PubMed, EMBASE, Scopus and IEEE Xplore up to July 2025 for this review of the current evidence on digital twins in fertility, ART and pregnancy, identifying applications, outcomes, challenges and future prospects. Original studies that applied digital twins to fertility, ART or pregnancy in human or in-silico models were included in this review. Eight original studies were included, complemented by nine mechanistic or conceptual works. Applications encompassed embryo selection, IVF procedure modelling, placental physiology, pregnancy pharmacokinetics, and intrapartum monitoring. Most studies were predictive or descriptive in nature, static or batch-coupled, and at early stages of validation. Risk of bias ranged from moderate to high due to study design and external validity concerns. Only two studies fulfilled strict digital twin criteria, and the exclusion of borderline studies did not change the overall conclusions. Digital twins hold substantial promise for personalized reproductive care. However, their clinical utility remains largely theoretical. Future work must improve modelling accuracy, data integration and ethical implementation to unlock their full potential.
{"title":"Digital twins in fertility, assisted reproductive technology and pregnancy: a systematic review","authors":"Alexandre Vallée , Gaby Moawad , Anis Feki , Jean-Marc Ayoubi","doi":"10.1016/j.rbmo.2025.105281","DOIUrl":"10.1016/j.rbmo.2025.105281","url":null,"abstract":"<div><div>Digital twins – the term for virtual representations of biological systems – are emerging as promising tools in reproductive medicine. They offer personalized simulations for optimizing fertility, assisted reproductive technology (ART) and pregnancy outcomes. However, their use remains limited and fragmented across diverse applications. A systematic search was conducted in PubMed, EMBASE, Scopus and IEEE Xplore up to July 2025 for this review of the current evidence on digital twins in fertility, ART and pregnancy, identifying applications, outcomes, challenges and future prospects. Original studies that applied digital twins to fertility, ART or pregnancy in human or in-silico models were included in this review. Eight original studies were included, complemented by nine mechanistic or conceptual works. Applications encompassed embryo selection, IVF procedure modelling, placental physiology, pregnancy pharmacokinetics, and intrapartum monitoring. Most studies were predictive or descriptive in nature, static or batch-coupled, and at early stages of validation. Risk of bias ranged from moderate to high due to study design and external validity concerns. Only two studies fulfilled strict digital twin criteria, and the exclusion of borderline studies did not change the overall conclusions. Digital twins hold substantial promise for personalized reproductive care. However, their clinical utility remains largely theoretical. Future work must improve modelling accuracy, data integration and ethical implementation to unlock their full potential.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105281"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182029","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 : 2026-03-01Epub Date: 2025-10-08DOI: 10.1016/j.rbmo.2025.105339
Ana Cobo , Aila Coello , Lucía Murria , Yolanda Garijo , María José de los Santos , Juan A García-Velasco , Fernando Bronet
Research question
Are there differences in survival, embryo development and clinical outcomes between sibling oocytes warmed using one-step and conventional protocols?
Design
A prospective, randomized, proof-of-concept trial using sibling donor oocytes to evaluate a one-step warming procedure. A total of 352 metaphase II oocytes (n = 30 donors) that had been previously vitrified using the conventional procedure were included. Just before warming, the oocytes were randomized into two groups: one-step warming (n = 179) and conventional warming (n = 173). The conventional warming protocol takes 10 min and involves three steps, using decreasing concentrations of trehalose. One-step warming only requires 1 min in 1.0 M trehalose solution. The main outcome was the survival rate. Fertilization rates, embryo quality, clinical results and oocyte developmental competence were also analysed.
Results
The survival rate was 96.1% in the one-step warming group and 94.2% in the conventional-warming group, with no statistically significant difference. No differences were found when comparing the usable blastocyst rate (55.3% versus 52.1%) or good-quality blastocyst rate (46.1% versus 43.6%) of the one-step and conventional warming protocols, respectively. Similarly, no significant differences were found between implantation rates (69.2% versus 58.8%, respectively) and ongoing pregnancy rate per embryo transfer (53.8% versus 41.2%). The logistic regression analysis showed that the warming protocol did not correlate with ongoing pregnancy rate.
Conclusion
One-step warming can be safely applied to donor metaphase II oocytes, providing similar survival rates and clinical outcomes compared with conventional warming.
{"title":"Comparison of one-step and conventional warming in sibling donor oocytes: a proof-of-concept study","authors":"Ana Cobo , Aila Coello , Lucía Murria , Yolanda Garijo , María José de los Santos , Juan A García-Velasco , Fernando Bronet","doi":"10.1016/j.rbmo.2025.105339","DOIUrl":"10.1016/j.rbmo.2025.105339","url":null,"abstract":"<div><h3>Research question</h3><div>Are there differences in survival, embryo development and clinical outcomes between sibling oocytes warmed using one-step and conventional protocols?</div></div><div><h3>Design</h3><div>A prospective, randomized, proof-of-concept trial using sibling donor oocytes to evaluate a one-step warming procedure. A total of 352 metaphase II oocytes (<em>n</em> = 30 donors) that had been previously vitrified using the conventional procedure were included. Just before warming, the oocytes were randomized into two groups: one-step warming (<em>n</em> = 179) and conventional warming (<em>n</em> = 173). The conventional warming protocol takes 10 min and involves three steps, using decreasing concentrations of trehalose. One-step warming only requires 1 min in 1.0 M trehalose solution. The main outcome was the survival rate. Fertilization rates, embryo quality, clinical results and oocyte developmental competence were also analysed.</div></div><div><h3>Results</h3><div>The survival rate was 96.1% in the one-step warming group and 94.2% in the conventional-warming group, with no statistically significant difference. No differences were found when comparing the usable blastocyst rate (55.3% versus 52.1%) or good-quality blastocyst rate (46.1% versus 43.6%) of the one-step and conventional warming protocols, respectively. Similarly, no significant differences were found between implantation rates (69.2% versus 58.8%, respectively) and ongoing pregnancy rate per embryo transfer (53.8% versus 41.2%). The logistic regression analysis showed that the warming protocol did not correlate with ongoing pregnancy rate.</div></div><div><h3>Conclusion</h3><div>One-step warming can be safely applied to donor metaphase II oocytes, providing similar survival rates and clinical outcomes compared with conventional warming.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105339"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258972","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 : 2026-03-01Epub Date: 2025-10-16DOI: 10.1016/j.rbmo.2025.105354
En-Qi Yan , Hong-Xia Chen , Yuan-Li Li , Lei Jin , Bing-Xin Ma
Research question
How does diminished ovarian reserve (DOR) affect euploid blastocyst rates, and how many embryos need to be biopsied for women with or without DOR to achieve one euploid embryo?
Design
A retrospective study was conducted at a single reproductive centre, involving 694 women (126 with and 568 without DOR) undergoing 803 preimplantation genetic testing for aneuploidies (PGT-A) cycles from 2016 to 2024. DOR was defined as a concentration of anti-Müllerian hormone below 1.1 ng/ml and/or an antral follicle count of less than 7. Participants were stratified by age into three groups: <35, 35–39 and >39 years. Euploidy rates and pregnancy outcomes were compared between the DOR and non-DOR groups. Cumulative euploid embryo acquisition was analysed.
Results
DOR patients showed comparable euploidy rates to their non-DOR counterparts. The number of embryos required to obtain a euploid embryo was a: for age <35 years, a mean of 1.6 embryos for the DOR group and 1.7 for the non-DOR group; for age 35–39 years, a mean of 1.9 and 2.3 embryos, respectively; and for age >39 years, a mean of 7.2 and 4.2 embryos, respectively. In women over aged 39 years, the mean number of euploid embryos obtained remained low even after two retrievals for both groups. Pregnancy outcomes after euploid embryo transfer were similar between the two groups.
Conclusions
Participants with DOR had similar euploidy rates and pregnancy outcomes to non-DOR patients. Limited embryo quantity, rather than inferior oocyte quality, thus remains the predominant challenge for individuals with DOR.
{"title":"Oocyte quality in women with diminished ovarian reserve: not as poor as assumed","authors":"En-Qi Yan , Hong-Xia Chen , Yuan-Li Li , Lei Jin , Bing-Xin Ma","doi":"10.1016/j.rbmo.2025.105354","DOIUrl":"10.1016/j.rbmo.2025.105354","url":null,"abstract":"<div><h3>Research question</h3><div>How does diminished ovarian reserve (DOR) affect euploid blastocyst rates, and how many embryos need to be biopsied for women with or without DOR to achieve one euploid embryo?</div></div><div><h3>Design</h3><div>A retrospective study was conducted at a single reproductive centre, involving 694 women (126 with and 568 without DOR) undergoing 803 preimplantation genetic testing for aneuploidies (PGT-A) cycles from 2016 to 2024. DOR was defined as a concentration of anti-Müllerian hormone below 1.1 ng/ml and/or an antral follicle count of less than 7. Participants were stratified by age into three groups: <35, 35–39 and >39 years. Euploidy rates and pregnancy outcomes were compared between the DOR and non-DOR groups. Cumulative euploid embryo acquisition was analysed.</div></div><div><h3>Results</h3><div>DOR patients showed comparable euploidy rates to their non-DOR counterparts. The number of embryos required to obtain a euploid embryo was a: for age <35 years, a mean of 1.6 embryos for the DOR group and 1.7 for the non-DOR group; for age 35–39 years, a mean of 1.9 and 2.3 embryos, respectively; and for age >39 years, a mean of 7.2 and 4.2 embryos, respectively. In women over aged 39 years, the mean number of euploid embryos obtained remained low even after two retrievals for both groups. Pregnancy outcomes after euploid embryo transfer were similar between the two groups.</div></div><div><h3>Conclusions</h3><div>Participants with DOR had similar euploidy rates and pregnancy outcomes to non-DOR patients. Limited embryo quantity, rather than inferior oocyte quality, thus remains the predominant challenge for individuals with DOR.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105354"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213651","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 : 2026-03-01Epub Date: 2025-10-22DOI: 10.1016/j.rbmo.2025.105358
Amelia G. Kelly , Zoey McFarland , Andria Besser , James A. Grifo , Jennifer K. Blakemore
Research question
What are the overall, singleton and twin live birth rates (LBR) after a double embryo transfer (DET) involving mosaic embryos?
Design
This was a retrospective cohort study of DET with at least one mosaic embryo between 1 December 2016 and 1 December 2024. Each DET was assigned a prognostic score (A–F) based on the ploidy of both embryos. The primary outcome was the overall, singleton and twin LBR of good-prognosis (A and B), moderate-prognosis (C and D) and poor-prognosis (E and F) DET. Secondary outcomes were the LBR for mosaic/mosaic compared with euploid/mosaic transfers. Comparisons were also made with previously published data on euploid/euploid transfers.
Results
In total, there were 38 DET: 22 mosaic/mosaic and 16 euploid/mosaic. Twenty-nine (76.3%) patients had prior failed euploid transfers, and 19 (86.4%) mosaic/mosaic patients did not have any euploid embryos. The differences in overall LBR between the prognostic groups did not reach significance [65.0% (13/20) good-prognosis group versus 71.4% (5/7) moderate-prognosis group versus 45.5% (5/11) poor-prognosis group; P = 0.5]. The twin LBR was higher in the good-prognosis group (46.2%) compared with the moderate- and poor-prognosis groups (0% for both; P = 0.04).
Overall [72.7% (16/22) versus 43.8% (7/16); P = 0.07], singleton [54.5% (12/22) versus 31.3% (5/11); P = 0.20] and twin [18.2% (4/22) versus 12.5% (2/16); P = 0.6] LBR were similar between mosaic/mosaic and euploid/mosaic DET. While the multiple LBR was high in both groups, it was lower for mosaic/mosaic and euploid/mosaic DET compared with euploid/euploid DET [26.1% (6/23) versus 49.8% (113/227, previously published data); P = 0.04].
Conclusions
Caution must be exercised with mosaic embryos as they can behave like euploid embryos, and DET can result in twins. DET with moderate- or poor-prognosis mosaic embryos had lower twin rates and may be reasonably considered. Larger studies are needed.
{"title":"Double embryo transfer with mosaic embryos: experience from a large academic fertility centre","authors":"Amelia G. Kelly , Zoey McFarland , Andria Besser , James A. Grifo , Jennifer K. Blakemore","doi":"10.1016/j.rbmo.2025.105358","DOIUrl":"10.1016/j.rbmo.2025.105358","url":null,"abstract":"<div><h3>Research question</h3><div>What are the overall, singleton and twin live birth rates (LBR) after a double embryo transfer (DET) involving mosaic embryos?</div></div><div><h3>Design</h3><div>This was a retrospective cohort study of DET with at least one mosaic embryo between 1 December 2016 and 1 December 2024. Each DET was assigned a prognostic score (A–F) based on the ploidy of both embryos. The primary outcome was the overall, singleton and twin LBR of good-prognosis (A and B), moderate-prognosis (C and D) and poor-prognosis (E and F) DET. Secondary outcomes were the LBR for mosaic/mosaic compared with euploid/mosaic transfers. Comparisons were also made with previously published data on euploid/euploid transfers.</div></div><div><h3>Results</h3><div>In total, there were 38 DET: 22 mosaic/mosaic and 16 euploid/mosaic. Twenty-nine (76.3%) patients had prior failed euploid transfers, and 19 (86.4%) mosaic/mosaic patients did not have any euploid embryos. The differences in overall LBR between the prognostic groups did not reach significance [65.0% (13/20) good-prognosis group versus 71.4% (5/7) moderate-prognosis group versus 45.5% (5/11) poor-prognosis group; <em>P</em> = 0.5]. The twin LBR was higher in the good-prognosis group (46.2%) compared with the moderate- and poor-prognosis groups (0% for both; <em>P</em> = 0.04).</div><div>Overall [72.7% (16/22) versus 43.8% (7/16); <em>P</em> = 0.07], singleton [54.5% (12/22) versus 31.3% (5/11); <em>P</em> = 0.20] and twin [18.2% (4/22) versus 12.5% (2/16); <em>P</em> = 0.6] LBR were similar between mosaic/mosaic and euploid/mosaic DET. While the multiple LBR was high in both groups, it was lower for mosaic/mosaic and euploid/mosaic DET compared with euploid/euploid DET [26.1% (6/23) versus 49.8% (113/227, previously published data); <em>P</em> = 0.04].</div></div><div><h3>Conclusions</h3><div>Caution must be exercised with mosaic embryos as they can behave like euploid embryos, and DET can result in twins. DET with moderate- or poor-prognosis mosaic embryos had lower twin rates and may be reasonably considered. Larger studies are needed.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105358"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228227","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 : 2026-03-01Epub Date: 2025-10-24DOI: 10.1016/j.rbmo.2025.105361
Ellen Davenport-Pleasance, Mimi Arian-Schad, Rukma Bhattacharya, Mona Rahmati, Elena Linara-Demakakou, Nick Macklon, Kaj Rydman, Jemma Garratt, Kamal K Ahuja
Research question
How is assisted reproductive technology used by trans and/or non-binary (TNB) individuals and their partners at London Women's Clinic?
Design
This retrospective observational study examined treatments undertaken by TNB people at London Women's Clinic between 2011 and 2025. Demographic information on patients' age, body mass index, anti-Mullerian hormone, antral follicle count and history of gender-affirming hormone therapy/surgery was analysed. Outcomes included the types of treatment pursued, ongoing pregnancies, and live births.
Results
Sixty-four individuals who identified as TNB (n = 42) or had a TNB partner (n = 22) attended the clinic. Treatments included egg freezing (22 cycles), intrauterine insemination (IUI; 17 cycles) and IVF (25 cycles). A minority of IVF cycles involved intra-partner donation (reciprocal IVF; 2/25) or donor eggs (2/25). Three couples' journeys involved surrogacy arrangements. Most TNB individuals attended the clinic with a partner (n = 30), with the exception of those undertaking egg freezing. Of the individuals/couples attempting pregnancy (n =24), most (n =20) were using donor spermatozoa, with the exception of four couples (two involving transgender women who had frozen spermatozoa, and two involving cisgender men). Thirteen live births were achieved and four individuals were discharged from the clinic with ongoing pregnancies.
Conclusions
TNB individuals in the UK are successfully using the spectrum of assisted reproduction options, often with donor gametes and occasionally surrogacy, to build families. In this study, IVF out-performed IUI, underscoring that with inclusive, legally informed care pathways, family formation for TNB patients is both feasible and effective.
{"title":"Fertility preservation and family-building in transgender and non-binary patients: 14 years at a UK centre","authors":"Ellen Davenport-Pleasance, Mimi Arian-Schad, Rukma Bhattacharya, Mona Rahmati, Elena Linara-Demakakou, Nick Macklon, Kaj Rydman, Jemma Garratt, Kamal K Ahuja","doi":"10.1016/j.rbmo.2025.105361","DOIUrl":"10.1016/j.rbmo.2025.105361","url":null,"abstract":"<div><h3>Research question</h3><div>How is assisted reproductive technology used by trans and/or non-binary (TNB) individuals and their partners at London Women's Clinic?</div></div><div><h3>Design</h3><div>This retrospective observational study examined treatments undertaken by TNB people at London Women's Clinic between 2011 and 2025. Demographic information on patients' age, body mass index, anti-Mullerian hormone, antral follicle count and history of gender-affirming hormone therapy/surgery was analysed. Outcomes included the types of treatment pursued, ongoing pregnancies, and live births.</div></div><div><h3>Results</h3><div>Sixty-four individuals who identified as TNB (<em>n</em> = 42) or had a TNB partner (<em>n</em> = 22) attended the clinic. Treatments included egg freezing (22 cycles), intrauterine insemination (IUI; 17 cycles) and IVF (25 cycles). A minority of IVF cycles involved intra-partner donation (reciprocal IVF; 2/25) or donor eggs (2/25). Three couples' journeys involved surrogacy arrangements. Most TNB individuals attended the clinic with a partner (<em>n</em> = 30), with the exception of those undertaking egg freezing. Of the individuals/couples attempting pregnancy (<em>n</em> =24), most (<em>n</em> =20) were using donor spermatozoa, with the exception of four couples (two involving transgender women who had frozen spermatozoa, and two involving cisgender men). Thirteen live births were achieved and four individuals were discharged from the clinic with ongoing pregnancies.</div></div><div><h3>Conclusions</h3><div>TNB individuals in the UK are successfully using the spectrum of assisted reproduction options, often with donor gametes and occasionally surrogacy, to build families. In this study, IVF out-performed IUI, underscoring that with inclusive, legally informed care pathways, family formation for TNB patients is both feasible and effective.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105361"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166342","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 : 2026-02-24DOI: 10.1016/j.rbmo.2026.105640
Ofir Michaeli, Dan Nayot, Pascal N Tyrrell, Heather M Shapiro, Jennia Michaeli
{"title":"Physician AI literacy: A key to unlocking AI's clinical potential.","authors":"Ofir Michaeli, Dan Nayot, Pascal N Tyrrell, Heather M Shapiro, Jennia Michaeli","doi":"10.1016/j.rbmo.2026.105640","DOIUrl":"https://doi.org/10.1016/j.rbmo.2026.105640","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 5","pages":"105640"},"PeriodicalIF":3.5,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481320","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 : 2026-02-18DOI: 10.1016/j.rbmo.2026.105635
Alessandro Bartolacci, Sofia de Girolamo, Juan J Fraire-Zamora, Luca Pagliardini, Enrico Papaleo
{"title":"Response to: Is the eternal dilemma dependent on embryo number?","authors":"Alessandro Bartolacci, Sofia de Girolamo, Juan J Fraire-Zamora, Luca Pagliardini, Enrico Papaleo","doi":"10.1016/j.rbmo.2026.105635","DOIUrl":"https://doi.org/10.1016/j.rbmo.2026.105635","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":" ","pages":"105635"},"PeriodicalIF":3.5,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444879","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 : 2026-02-01Epub Date: 2025-09-05DOI: 10.1016/j.rbmo.2025.105242
Rebecca Goldstein , Alexandra Benoit , Michaël Grynberg , Louise Vrtovsnik , Sophia Rakrouki , Céleste Becquart , Ines Sellami , Claire Vinolas , Vincent Puy , Florence Eustache , Anne Mayeur , Maeliss Peigné , Charlotte Sonigo
Research question
What are the fertility outcomes in women with endometriosis who attempt to conceive at least 2 years after undergoing fertility preservation.
Design
This retrospective, observational, bicentric cohort study included women diagnosed with endometriosis confirmed by imaging (pelvic magnetic resonance imaging or ultrasonography) who underwent at least one controlled ovarian stimulation cycle for fertility preservation between 1 July 2013 and 31 December 2019.
Results
Among 200 participants, follow-up data were available for 184, of whom 76 (41.3%) had attempted to conceive by the end-point (15 February 2023). The median number of oocytes and/or embryos vitrified per patient was 14 (interquartile range [IQR] 8–20). Being in a relationship at the initial consultation was significantly associated with later conception attempts (70.7% versus 25.7%, P < 0.0001). Overall, 48 (63.2%) achieved a pregnancy: 50% naturally, 37.5% using frozen material, and 12.5% via a new IVF attempt with fresh oocytes. Live birth occurred in 31 (40.8%). Among those who had attempted conception, the 4-year cumulative pregnancy incidence following fertility preservation was estimated at 55% (95% CI 45–68%). The cryopreserved material utilization rate was estimated at 48% (95% CI 37–63%) 5 years after fertility preservation. Nulliparity (hazard ratio [HR] 1.43, 95% CI [1.00–2.06] ) and having frozen embryos (HR 2.34, 95% CI [1.65–3.33]) were significant predictors of material use over the follow-up period.
Conclusions
Despite the known detrimental effects of endometriosis on fertility, a majority of women who attempted to conceive following fertility preservation achieved pregnancy, with a substantial proportion conceiving naturally. Half of these used their cryopreserved material, supporting fertility preservation as part of comprehensive reproductive counselling in endometriosis care.
研究问题子宫内膜异位症患者在接受保存生育能力至少2年后尝试怀孕的生育结果是什么？这项回顾性、观察性、双中心队列研究纳入了2013年7月1日至2019年12月31日期间接受至少一个控制卵巢刺激周期以保持生育能力的经影像学（盆腔磁共振成像或超声检查）确诊为子宫内膜异位症的女性。结果在200名参与者中，有184人获得随访数据，其中76人（41.3%）在终点（2023年2月15日）尝试怀孕。每位患者玻璃化卵母细胞和/或胚胎的中位数为14个（四分位数范围[IQR] 8-20）。在初次咨询时处于恋爱关系中与后来的受孕尝试显著相关（70.7%对25.7%,P < 0.0001）。总体而言，48例（63.2%）成功怀孕：50%自然受孕，37.5%使用冷冻材料，12.5%通过新鲜卵母细胞进行新的IVF尝试。活产31例（40.8%）。在尝试受孕的患者中，保留生育能力后的4年累计妊娠发生率估计为55% （95% CI 45-68%）。冷冻保存后5年的材料利用率估计为48% （95% CI 37-63%）。未生育（风险比[HR] 1.43, 95% CI[1.00-2.06]）和冷冻胚胎（风险比[HR] 2.34, 95% CI[1.65-3.33]）是随访期间材料使用的重要预测因素。结论：尽管已知子宫内膜异位症对生育能力有不利影响，但大多数尝试保留生育能力的妇女都成功怀孕，其中很大一部分是自然受孕。其中一半使用了冷冻保存的材料，支持将生育能力保存作为子宫内膜异位症护理中全面生殖咨询的一部分。
{"title":"Reproductive outcomes following fertility preservation in women with endometriosis","authors":"Rebecca Goldstein , Alexandra Benoit , Michaël Grynberg , Louise Vrtovsnik , Sophia Rakrouki , Céleste Becquart , Ines Sellami , Claire Vinolas , Vincent Puy , Florence Eustache , Anne Mayeur , Maeliss Peigné , Charlotte Sonigo","doi":"10.1016/j.rbmo.2025.105242","DOIUrl":"10.1016/j.rbmo.2025.105242","url":null,"abstract":"<div><h3>Research question</h3><div>What are the fertility outcomes in women with endometriosis who attempt to conceive at least 2 years after undergoing fertility preservation.</div></div><div><h3>Design</h3><div>This retrospective, observational, bicentric cohort study included women diagnosed with endometriosis confirmed by imaging (pelvic magnetic resonance imaging or ultrasonography) who underwent at least one controlled ovarian stimulation cycle for fertility preservation between 1 July 2013 and 31 December 2019.</div></div><div><h3>Results</h3><div>Among 200 participants, follow-up data were available for 184, of whom 76 (41.3%) had attempted to conceive by the end-point (15 February 2023). The median number of oocytes and/or embryos vitrified per patient was 14 (interquartile range [IQR] 8–20). Being in a relationship at the initial consultation was significantly associated with later conception attempts (70.7% versus 25.7%, <em>P</em> < 0.0001). Overall, 48 (63.2%) achieved a pregnancy: 50% naturally, 37.5% using frozen material, and 12.5% via a new IVF attempt with fresh oocytes. Live birth occurred in 31 (40.8%). Among those who had attempted conception, the 4-year cumulative pregnancy incidence following fertility preservation was estimated at 55% (95% CI 45–68%). The cryopreserved material utilization rate was estimated at 48% (95% CI 37–63%) 5 years after fertility preservation. Nulliparity (hazard ratio [HR] 1.43, 95% CI [1.00–2.06] ) and having frozen embryos (HR 2.34, 95% CI [1.65–3.33]) were significant predictors of material use over the follow-up period.</div></div><div><h3>Conclusions</h3><div>Despite the known detrimental effects of endometriosis on fertility, a majority of women who attempted to conceive following fertility preservation achieved pregnancy, with a substantial proportion conceiving naturally. Half of these used their cryopreserved material, supporting fertility preservation as part of comprehensive reproductive counselling in endometriosis care.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105242"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927751","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}
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