Reproductive biomedicine online最新文献

{"title":"Imatinib Inhibits Proliferation and Migration While Inducing Apoptosis in Endometriotic Cells via c-Abl Pathway Modulation","authors":"Isil Yenigun ,&nbsp;Nazlı Ece Huner ,&nbsp;Erkut Attar ,&nbsp;Basak Aru ,&nbsp;Beyza Gaye Edepli ,&nbsp;Elif Kilic ,&nbsp;Aylin Yaba","doi":"10.1016/j.rbmo.2025.105316","DOIUrl":"10.1016/j.rbmo.2025.105316","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Endometriosis is characterized by the ectopic growth of endometrial tissue, linked to disrupted proliferation and apoptosis. c-Abl (Abelson tyrosine kinase), implicated in these processes, is inhibited by imatinib. However, its role in endometriosis remains unclear. We hypothesized that imatinib may be used as a therapeutic target for endometriosis.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Endometriotic tissues were collected from patients (n=6, aged 23-45) at Yeditepe University Hospital. Stromal cells were cultured in DMEM/F12 (10% FBS), then treated with 0 (control), 12.5, 25, and 50 µM imatinib for 48 and 72 hours. Proliferation was measured with an automatic cell counter. Apoptosis/viability was assessed via Annexin V/PI staining, and the cell cycle by DNA content analysis. Migration was evaluated by a wound-healing assay. c-Abl and phospho-c-Abl (p-c-Abl) levels were assessed by immunofluorescence.</div></div><div><h3>RESULTS</h3><div>Proliferation of endometriotic cells significantly decreased at 48 hours with 25 µM and 50 µM imatinib, and at 72 hours in all treatment groups (p&lt;0.01). Early apoptosis was increased in all treatment groups (p&lt;0.05), while late apoptosis was elevated in the 25 µM and 50 µM (p&lt;0.05). Necrotic population was increased in the 12.5 µM and 25 µM groups at 48 hours (p&lt;0.05), and in the 50 µM group at 72 hours (p&lt;0.05). Cell cycle analysis at 48 hours showed G0/G1 arrest with 12.5 μM imatinib (p&lt;0.001), while 50 μM caused cell cycle arrest in S (p&lt;0.05) and G2/M phases (p&lt;0.0001) and promoted aneuploidy. In 72 hours, 12.5 μM imatinib led to G0/G1 arrest (p&lt;0.05), and aneuploidy was observed at 25 and 50 µM imatinib, but cell cycle arrest occurred only at 50 µM, with G2/M arrest (p&lt;0.0001). Cell migration is decreased in all treatment groups(p&lt;0.001). Immunofluorescence in 72 hours showed increased c-Abl at 50µM (p&lt;0.05). In contrast, p-c-Abl levels decreased in all treatment groups (p&lt;0.05).</div></div><div><h3>CONCLUSIONS</h3><div>Imatinib inhibited proliferation and migration while promoting apoptosis and necrosis in a dose- and time-dependent manner. It alters the cell cycle by causing arrest and may induce aneuploidy. These findings suggest that inhibition of c-Abl activity may play a significant role in endometriotic cell behavior.</div></div><div><h3>IMPACT STATEMENT</h3><div>The expanding understanding of c-Abl inhibition in endometriosis could provide valuable insights into the underlying mechanisms of endometriosis. We believe that our results may guide future studies on endometriosis and contribute to the development of new therapeutic approaches.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105316"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532782","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 Piezo-Icsi or Calcium Ionofor Superior for Oocyte Activation Compared to Standard Icsi","authors":"Gokalp Oner ,&nbsp;Enes Karaman ,&nbsp;Ferhan Elmali ,&nbsp;Suat Altmisyedioglu ,&nbsp;Fatma Ozdemir","doi":"10.1016/j.rbmo.2025.105295","DOIUrl":"10.1016/j.rbmo.2025.105295","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Oocyte activation failure is a major cause of embryo arrest, cleavage anomalies, and impaired blastocyst development in assisted reproductive techniques. In intracytoplasmic sperm injection (ICSI) cycles, oocyte activation can be induced using chemical, mechanical, or physical stimuli. Calcium ionophore is the most commonly used chemical agent for artificial activation. PIEZO-ICSI is a mechanical technique that uses a piezoelectric actuator to facilitate precise penetration of the zona pellucida with a microinjection pipette. However, prospective studies directly comparing PIEZO-ICSI and calcium ionophore in patients with prior embryo cleavage arrest are lacking.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This prospective study included 240 patients with a history of embryo transfer cancellation due to embryo cleavage arrest. Patients with severe male factor infertility, endometriosis, or absolute tubal factor were excluded. Ethical approval was obtained from the Ethics Committee of Nigde Omer Halisdemir University (Approval No: 2025/04-39). Patients were allocated into three groups according to the oocyte activation method used: PIEZO-ICSI, calcium ionophore, or conventional ICSI. The primary outcomes were number of blastocysts, embryo quality, and clinical pregnancy rates.</div></div><div><h3>RESULTS</h3><div>The groups were similar in age, BMI, antral follicle count, AMH, and baseline hormone levels (FSH, LH, Estradiol). The mean number of retrieved oocytes was comparable across all groups (p = 0.911). PIEZO-ICSI achieved significantly higher fertilization rates (1.69±0.22) compared to conventional ICSI (0.93±0.22; p = 0.045), and also higher pregnancy rates (47% vs. 15%; p &lt; 0.001). Calcium ionophore showed similar fertilization to control (1.51±0.21 vs. 0.93±0.22; p = 0.051), but significantly higher pregnancy rates (40% vs. 15%; p &lt; 0.001). No significant differences were observed between PIEZO-ICSI and calcium ionophore groups.</div></div><div><h3>CONCLUSIONS</h3><div>Both PIEZO-ICSI and calcium ionophore significantly improved fertilization and pregnancy outcomes in patients with a history of cleavage arrest. This is the first prospective study comparing these two methods. PIEZO-ICSI may serve as a viable mechanical alternative for oocyte activation in selected IVF patients.</div></div><div><h3>IMPACT STATEMENT</h3><div>PIEZO-ICSI or calcium ionophore may be preferred for oocyte activation in patients with a history of cleavage arrest.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105295"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532862","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":"Comparison of Clinical and Artificial Intelligence (AI)-Based Interpretation: Agreement and Diagnostic Consistency","authors":"Simge Berrak Beyoglu Oruc ,&nbsp;Rozerin Balci ,&nbsp;Berfin Baybas ,&nbsp;Busra Toper","doi":"10.1016/j.rbmo.2025.105302","DOIUrl":"10.1016/j.rbmo.2025.105302","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Artificial intelligence (AI)-based models trained on large datasets and advanced algorithms employ signal processing and pattern recognition techniques to reduce subjectivity and human error in the evaluation of Non-Stress Tests (NST). This study examined the agreement between clinician and AI-based NST evaluations, highlighting AI’s potential in clinical decision support.</div></div><div><h3>MATERIALS AND METHODS</h3><div>In a cohort of 100 patients, NST parameters were assessed by both clinical interpretation and ChatGPT, categorized into seven subcomponents, and Inter-rater agreement was assessed using Cohen’s Kappa coefficient.</div></div><div><h3>RESULTS</h3><div>Good agreement was observed between clinician and ChatGPT evaluations (Kappa 0.655, accuracy 77%). Subgroup analyses showed moderate agreement in cases undergoing cesarean section due to fetal distress (Kappa 0.47, accuracy 76%), with ChatGPT classifying 87% of these cases as Category 3. Notably, no patients in this subgroup were classified as Category 1 by ChatGPT, suggesting a conservative approach in high-risk scenarios. In the non-reactive NST subgroup, moderate agreement (0.42) was also observed. In all 9 cases of fetal tachycardia, ChatGPT correctly identified the condition (100% accuracy) and classified 8 of them as Category 2.</div><div>When evaluating individual NST parameters, a very strong agreement was observed for the presence of accelerations (0.84). Good agreement was found in NST categorization (0.64), presence of decelerations (0.79),and variability presence (0.67). In contrast, only moderate agreement was observed in the classification of deceleration types (0.53) and grading of variability (0.47) (Table 1). Detailed comparison of deceleration type revealed weak-to-moderate agreement (0.29). “Deep prolonged” decelerations were consistently recognized by both evaluators, whereas significant discrepancies were noted in identifying “recurrent late,” “deep late,” and “variable” patterns. These results indicate that while AI shows acceptable performance in general pattern recognition, its ability to distinguish specific and complex patterns remains limited.</div></div><div><h3>CONCLUSIONS</h3><div>This study demonstrated moderate agreement between AI and clinical evaluations. The agreement was lower for nuanced parameters, such as deceleration type and variability; yet AI could still support early diagnosis and evidence-based decision-making.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study introduces an AI-based approach for clinical interpreting, such as NST categorization, aiming to enhance diagnostic clarity and support clinical education.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105302"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532940","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":"Management of Tuba-ovarian Abscess After Incomplete Surgery and Drainage in an Endometrioma: A Case Report","authors":"Simge Berrak Beyoglu Oruc","doi":"10.1016/j.rbmo.2025.105332","DOIUrl":"10.1016/j.rbmo.2025.105332","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The weak cyst wall and the creation of a culture medium for hemorrhagic content may theoretically facilitate bacterial implantation and infection. We aimed to discuss the importance of preoperative evaluation in preventing incomplete surgeries in deep infiltrative endometriosis, the management of abscess after ovarian drilling.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Case Report</div><div>A 31-year-old G0P0A0 nulliparous was admitted with high fever and pelvic pain. In the patient's history, it was learned that laparoscopic 4-centimeter(cm) right ovary endometrioma cyst excision, left ovary drilling and endometriotic noduls cauterization were performed at an external center 20 days ago. In her preoperative application, she reported pelvic pain and dysmenorrhea, and a gynecological evaluation revealed an 8-cm endometrioma cyst on a pelvic MRI. The patient had laparoscopic excision of a right ovarian endometrioma, left ovarian drilling, and cauterization of nodules, followed by a single dose of GnRH agonist for suppression therapy. The patient was hospitalized with the diagnosis of tubo-ovarian abscess with CRP: 223 mg/L and observation of a 5-cm heterogeneous collection area in the left adnexal area on the pelvic MRI.</div><div>After clinical and laboratory improvement with antibiotherapy, pelvic MRI showed a persistent 5-cm left adnexal mass (Figure 1). Preoperative AMH was 5.6 ng/mL and postoperative AMH 1.98 ng/mL, indicating a postoperative loss of ovarian reserve. Hysterosalpingography (HSG) showed normal right tubal passage and significant hydrosalpinx with no passage in the left tube.</div></div><div><h3>RESULTS</h3><div>Discussion</div><div>We believe that the use of ovarian drilling is an outdated approach, and that the abscess complication observed following incomplete surgery was attributable to this procedure. Considering the relatively lower negative impact of sterile hydrosalpinx, associated with endometrioma, on implantation success compared to septic hydrosalpinx secondary to pelvic inflammatory disease, the patient was offered an opportunity for spontaneous conception before planning secondary surgical intervention.</div></div><div><h3>CONCLUSIONS</h3><div>New treatment options, such as sclerotherapy, are also reported to have positive results in symptomatic improvement and pregnancy outcomes. Medical management was chosen, with follow-up for spontaneous conception due to the risk of diminished ovarian reserve from a second surgery.</div></div><div><h3>IMPACT STATEMENT</h3><div>Treatment options and complication management in surgical or medical treatments for deep infiltrative endometriosis need to be individualized.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105332"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532479","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":"Does Oocyte Morphology Differ in Polycystic Ovary Syndrome Patients During IVF Cycles?: A Preliminary Study","authors":"Sebnem Alanya Tosun ,&nbsp;Sedanur Yilmaz Dogan ,&nbsp;Ayse Firuze Biyik ,&nbsp;Emine Aksoy ,&nbsp;Tugba Zengin ,&nbsp;Recep Erin ,&nbsp;Omur Erden ,&nbsp;Kubra Baki Erin","doi":"10.1016/j.rbmo.2025.105310","DOIUrl":"10.1016/j.rbmo.2025.105310","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The purpose of this study was to determine the impact of polycystic ovary syndrome on oocyte morphology and fertility outcome in invitro fertilisation (IVF) cycles undergoing ovarian stimulation with a gonadotropin antagonist protocol.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This retrospective study was conducted between June-2024 and June-2025 in a tertiary university hospital's IVF clinic with totally 67 IVF cycles of infertile women aged between 20 and 38 years who were applied antagonist gonadotropin stimulation procedure due to the unexplained infertility or polycystic ovary syndrome. All oocytes were individually classified and checked blindly by two different experienced senior embryologists. The oocyte morphology were recorded with the use of inverted microscope at 3200 magnification (Nikon Tokyo, Japan) and oocytes classified for morphological features as follows: empty zona, elliptical shape, vacuole, flat polar body, fragmented polar body, perivitelline septa, perivitelline debris, central granulation, dense central granulation, inclusion body, thick zona pellucida, smooth endoplasmic reticulum, resistance by oolemma. Fertilization was defined in oocytes when two pronuclei and two polar bodies were observed. The ratio of oocytes with specific morphological abnormalities was calculated and compared between groups.</div></div><div><h3>RESULTS</h3><div>Groups with and without polycystic ovary syndrome had similar baseline demographic and clinical characteristics including age, number of previous cycles, thyroid stimulating hormone, prolactin and follicle stimulating hormone tests (p &gt;.05, Table 1). Although, average duration of ovarian stimulation day was slightly higher in PCOS group, mean total gonadotropin dose used was similar between groups (Table 1). Peak estradiol level on the day of trigger, mean numbers of total and mature oocytes (MII) were significantly higher in the PCOS group (p &lt;.05, Table 1). Majority of specific oocyte morphological abnormalities were significantly higher in PCOS group (Table 1).</div></div><div><h3>CONCLUSIONS</h3><div>In conclusion, although PCOS patients had higher numbers of MII oocytes, PCOS was associated with a higher rate of abnormal oocytes morphologies.</div></div><div><h3>IMPACT STATEMENT</h3><div>Future studies using further oocyte quality assessment methods and prospective observational studies including live-birth rate should be designed.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105310"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532855","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":"Comparative Molecular Profiling of Exosomes from First-Trimester Human Placental Organoids and Explants","authors":"Kerem Dalgic ,&nbsp;Melike Ucak ,&nbsp;Arda Inanc ,&nbsp;Gizem Melis Kargin ,&nbsp;Mert Turgal ,&nbsp;Ozgur Oktem ,&nbsp;Bora Akgun ,&nbsp;Ciler Celik-Ozenci","doi":"10.1016/j.rbmo.2025.105294","DOIUrl":"10.1016/j.rbmo.2025.105294","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Exosomes are extracellular vesicles critical for intercellular communication, particularly in maternal–fetal signaling. This study aimed to isolate and characterize exosomes from human placenta organoids (HPOs) and compare their molecular profiles to those of exosomes from first-trimester placental explants.</div></div><div><h3>MATERIALS AND METHODS</h3><div>First-trimester placenta tissues (6–9 weeks; n = 9) were collected with informed consent (Ethics No:2025.107.IRB2.052). Villous explants were cultured at 24/48h in DMEM/F12+10% exosome-free FBS+1% penicillin-streptomycin, while HPOs were formed via cytotrophoblast cells embedded in Matrigel and maintained in trophoblast organoid medium (TOM). Explants were immunostained for CK7, Ki67, β-hCG, and vimentin; HPOs were evaluated via immunofluorescence (CK7, TP63, β-hCG, Ki67, E-cadherin), and β-hCG secretion was measured by ELISA. Conditioned media from explants and HPOs (day 3/8) were collected for exosome isolation by ultracentrifugation (100,000 × g, 2h, 4°C). Exosomes were analyzed by NTA, TEM, Western blot [CD63 (general), PLAP (placenta-specific), β-actin (negative) exosome markers], and RT-qPCR (miR-517a-3p, miR-519d-3p). PLAP expression in exosomes from term explants served as a positive control. Molecular fingerprints were assessed by surface-enhanced Raman spectroscopy (SERS). Statistical analysis included Mann-Whitney U test with Bonferroni correction for SERS data (p&lt; 0.001) and Kruskal-Wallis test for non-parametric NTA results (p&lt; 0.05).</div></div><div><h3>RESULTS</h3><div>Exosomes from both groups displayed characteristic morphology, marker expression, and size range (30–150 nm). Explant-derived exosomes had significantly higher particle concentrations (9.33 × 10¹⁰±8.71 × 10⁹ at 24h; 9.04 × 10¹⁰±6.72 × 10⁹ at 48h) than HPO-derived exosomes (3.19 × 10¹⁰±1.60 × 10⁹ at day 3; 3.71 × 10¹⁰±2.64 × 10⁹ at day 8) (p&lt; 0.05). CD63 was detected in exosomes for both groups; PLAP and β-actin were absent. TEM confirmed typical exosome morphology. Placenta-specific miRNAs were expressed in both groups. SERS revealed significant spectral differences (p&lt; 0.001) at 1080, 1445, and 1508 cm⁻¹, indicating differences in lipid and protein composition.</div></div><div><h3>CONCLUSIONS</h3><div>HPO-derived exosomes share key features with exosomes from matched first-trimester placenta explants, supporting the utility of HPOs as a relevant in vitro model to study placental extracellular vesicles.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study introduces HPOs as a scalable source for placenta exosome research, enabling investigation of maternal–fetal signaling and pregnancy-related disorders.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105294"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532863","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":"The Predictive Role of AMH In Letrozole Resistance Among PCOS Patients Undergoing Ovulation Induction","authors":"Elif Aylin Taskin ,&nbsp;Batuhan Aslan ,&nbsp;Yaprak Engin-Ustun","doi":"10.1016/j.rbmo.2025.105306","DOIUrl":"10.1016/j.rbmo.2025.105306","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To investigate the predictive value of Anti-Müllerian Hormone (AMH) levels and define a threshold for the resistance to ovulation induction (OI) with Letrozole 5 mg/mL 5-day regimen in Polycystic Ovary Syndrome (PCOS) patients.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A total of 195 PCOS patients undergoing 365 cycles of OI with Letrozole followed by IUI were enrolled to this retrospective cohort study. Patients with AMH levels lower than predefined age specific cut-offs were also excluded to increase diagnostic accuracy for PCOS and overcome interobserver bias for PCOM. OI with Letrozole (5 mg/day for 5 days) was initiated in all cycles, with dose escalation to 7.5 mg/day in resistant cases. Resistance to Letrozole, defined as failure to develop at least one pre-ovulatory follicle is the main outcome. Secondary outcomes include potential factors for resistance, predictive performance of AMH and clinical pregnancy rate (CPR).</div></div><div><h3>RESULTS</h3><div>Out of 195 patients 172 (88.2%) developed at least 1 dominant follicle in response to 5 mg/day letrozole for 5 days in at least one cycle constituting the Letrozole responsive group and 23 patients (11.8%) did not, constituting the letrozole resistant group. BMI, AMH, basal LH and LH/FSH ratio were higher in the resistant group (P˂0.05). Resistant group was characterized with a significantly high AMH when compared to responsive group (medians 8.5 vs 6.8 ng/mL, respectively, P=0.03) and probability of response was declining with increasing percentile of AMH, especially after the 75th percentile. In uni- and multivariant regression analyses, AMH and BMI are significant and independent predictors of resistance.</div><div>The ROC curve for prediction of resistance based on the serum AMH levels indicated moderate discrimination with AUC 0.64. Age-adjusted AMH thresholds for resistance are searched and above age of 30, AMH threshold of 6.5 ng/mL had 100% sensitivity and 86,4% specificity to predict resistance. CPR per cycle was 16.1% In responsive group and 9% in resistant group.</div></div><div><h3>CONCLUSIONS</h3><div>Our study demonstrates that high AMH levels and BMI are independent risk factors for letrozole resistance in PCOS patients. We propose an AMH threshold of 6.5 ng/mL as a sensitive and specific predictor of resistance in PCOS patients over 30 years of age.</div></div><div><h3>IMPACT STATEMENT</h3><div>High number of cycles with the same stimulation protocol in a large cohort with reliable diagnosis of PCOS enabled analysis of a very uniform data. We proposed an AMH threshold level to predict resistance to Letrozole in PCOS patients above 30.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105306"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532952","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":"Fertility knowledge as a tool for informed reproductive decision-making","authors":"Shalini Singh","doi":"10.1016/j.rbmo.2025.105126","DOIUrl":"10.1016/j.rbmo.2025.105126","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 5","pages":"Article 105126"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076145","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":"Minimizing waste in medically assisted reproduction: a study on sustainability initiatives for oocyte retrieval and embryo transfer","authors":"Roos A. Sluimer,&nbsp;Theodora C. van Tilborg,&nbsp;Ralph J.A. Oude Ophuis,&nbsp;Willem M.J. Verpoest,&nbsp;Taghride Dahhan","doi":"10.1016/j.rbmo.2025.105081","DOIUrl":"10.1016/j.rbmo.2025.105081","url":null,"abstract":"<div><h3>Research question</h3><div>How can waste be reduced during medically assisted reproduction (MAR) procedures, including oocyte retrieval and embryo transfer, through sustainable interventions without compromising safety?</div></div><div><h3>Design</h3><div>A quality management initiative was conducted over 12 months (October 2023 to October 2024). Through a multidisciplinary approach, sustainability initiatives were developed aimed at reducing material and medication waste generated during oocyte retrieval and embryo transfer procedures. Sustainability interventions were implemented during a 3-month pilot phase. Waste generation was measured before and after implementation of these interventions. Infection rates were evaluated at baseline and after completing the pilot.</div></div><div><h3>Results</h3><div>During the study, 234 oocyte retrievals and 291 embryo transfers were carried out. The proposed interventions resulted in a material waste reduction of about 60% for oocyte retrieval and 8% for embryo transfer, with no clinical or laboratory infections recorded.</div></div><div><h3>Conclusions</h3><div>This study revealed the possibility for significant waste reduction in MAR procedures through targeted sustainability interventions. These findings underscore the feasibility of integrating sustainability practices in MAR procedures.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 5","pages":"Article 105081"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244894","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":"Retraction notice to .ÇÿEffect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study.ÇÖ","authors":"A. Nasr","doi":"10.1016/j.rbmo.2025.105286","DOIUrl":"10.1016/j.rbmo.2025.105286","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 5","pages":"Article 105286"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465394","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}