Reproductive biomedicine online最新文献

{"title":"Accuracy of Non-Invasive Preimplantation Genetic Testing For Aneuploidy (NiPGT-A) In Confirmed Aneuploid Embryos","authors":"Engin Turkgeldi ,&nbsp;Gozde Akcaoglu ,&nbsp;Arife Kunt ,&nbsp;Hasan Gursoy ,&nbsp;Aylin Mutlu ,&nbsp;Ali Osman Koyuncuoglu","doi":"10.1016/j.rbmo.2025.105293","DOIUrl":"10.1016/j.rbmo.2025.105293","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To assess the diagnostic concordance between non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) and standard PGT-A with trophectoderm biopsy in embryos previously diagnosed as aneuploid.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Nineteen embryos from four patients previously diagnosed as aneuploid via PGT-A were re-evaluated using niPGT-A upon patient request. Embryos were thawed using the Ultrafast-Kitazato method and incubated in an Esco MIRI incubator. Laboratory preparation included particle reduction, disinfection, and use of DNA/RNA-free single-use materials. Embryologists wore sterile attire. Embryos were washed in four 30 μL drops and transferred to 12 μL culture dishes. Each dish contained three embryo-specific drops and one negative control drop. Incubation was 24 hours for D5 and 8 hours for D6/D7 embryos. Post-incubation, embryos were re-cryopreserved. Eight microliters of medium were collected per embryo into separate PCR tubes. Negative controls were similarly processed. Samples were stored at −20°C and sent to Igenomix TR via cold chain for analysis. Statistical analysis was conducted with a 2 × 2 contingency table.</div></div><div><h3>RESULTS</h3><div>Of the 19 embryos diagnosed as aneuploid by PGT-A, 18 were also found aneuploid by niPGT-A, 13 with perfect chromosomal match and 5 with minor differences. One embryo was classified as euploid by niPGT-A. This yielded an accuracy of 94.7% (95% CI: 73.9%–99.8%), specificity of 94.7% (95% CI: 73.9%–99.8%), and NPV of 100% (95% CI: 81.5%–100%) for euploidy. Sensitivity, PPV, Cohen’s Kappa, and McNemar’s test could not be calculated due to the absence of PGT-confirmed euploid embryos.</div></div><div><h3>CONCLUSIONS</h3><div>Our results show that NiPGT-A has very high NPV and specificity compared to the gold standard, PGT-A in aneuploid embryos. However, the small sample size and lack of euploid embryos by PGT limit the generalizability of findings. The euploid outcome may be associated of cumulus cell (CC) contamination, as morphological evaluation of the embryo revealed a greater abundance of CC compared to the others. Notably, 68.4% of embryos showed perfect qualitative agreement between methods. Although minor discrepancies were observed in 26.3% of embryos, all were still reported as aneuploid, suggesting limited clinical impact. Still, further validation with a larger, balanced dataset is necessary to establish the clinical reliability of the NiPGT-A.</div></div><div><h3>IMPACT STATEMENT</h3><div>niPGT-A offers high specificity and NPV relative to PGT-A in aneuploid embryos, supporting its potential as a non-invasive alternative.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105293"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532857","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":"Single-Cell RNA-Seq Profiling Reveals PCOS-Associated Alterations in Oocytes from Small Antral Follicles for IVM Optimization","authors":"Nazli Akin ,&nbsp;Laura Saucedo Cuevas ,&nbsp;Antonio Galvao ,&nbsp;Berta Cava Cami ,&nbsp;Heidi Van Ranst ,&nbsp;Michel De Vos ,&nbsp;Gavin Kelsey ,&nbsp;Ellen Anckaert","doi":"10.1016/j.rbmo.2025.105305","DOIUrl":"10.1016/j.rbmo.2025.105305","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Recommended by international guidelines, in vitro maturation (IVM) is a low treatment burden alternative for subfertile patients with polycystic ovary syndrome (PCOS) due to abolished risk of ovarian hyperstimulation syndrome. While IVM systems have been greatly optimized, lower cumulative live birth rates compared to IVF warrants further optimization. IVM targets maturation of GV oocytes collected from 2-9 mm antral follicles (AF) collected with minimal stimulation. Yet, previous studies that characterized PCOS oocyte molecular alterations focused on MII oocytes collected after conventional ovarian stimulation. Here, we provide a comprehensive molecular comparison of GV oocytes from PCOS and non-PCOS women to uncover targets for future IVM optimization.</div></div><div><h3>MATERIALS AND METHODS</h3><div>11 PCOS (phenotype A) and 7 non-PCOS (normo-ovulatory) donors were recruited for this study. Single-cell libraries were prepared with 81 GV oocytes (52 PCOS, 29 non-PCOS), aspirated from small-AF &lt;10 mm, following minimal HP-hMG priming (PCOS 600 IU, non-PCOS 450 IU). RNA-seq reads were aligned to GRCh38 with HISAT2 (v2.0.5) and quantified via SeqMonk. Differential gene expression was analyzed in R using DESeq2 (FDR &lt;0.05, |log2FC|&gt;0.58), followed by gene ontology term enrichment.</div></div><div><h3>RESULTS</h3><div>267 differentially expressed genes (114 down-, 153 up-regulated) were identified between PCOS vs non-PCOS oocytes. Three main biological processes being affected included (i) energy metabolism (e.g. respiration, lipid metabolism), (ii) cytoskeletal dynamics (e.g. microtubules) and (iii) intracellular signalling pathways. These alterations occur in key cellular compartments such as mitochondria, cytoskeleton, and ribosomes and affect molecular functions like structural support, enzyme regulation, and ion transport.</div></div><div><h3>CONCLUSIONS</h3><div>This is the first study analyzing transcriptomic differences between PCOS and non-PCOS oocytes collected from small AF after minimal hormonal stimulation and to be cultured using IVM. Our data indicate that PCOS leads to distinct changes in processes essential for cellular energy balance, structural dynamics, and intracellular communication. Utilizing mitochondrial and cytoskeletal modulators, or targeted growth factor supplementation may boost IVM outcomes to potentially match the clinical efficacy observed in conventional IVF.</div></div><div><h3>IMPACT STATEMENT</h3><div>This pioneer study identifies the alterations associated with PCOS pathology in the GV oocytes from small antral follicles and provides insights for future IVM optimization studies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105305"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532951","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":"Sibling Monozygotic Couples with Divergent Female Fertility: A Case Report Highlighting the Impact of BPA Exposure on OR","authors":"Hande Nalan Tore ,&nbsp;Hasan Bulut ,&nbsp;Rovshan Jabbarov ,&nbsp;Murat Berkkanoglu ,&nbsp;Kevin Coetzee ,&nbsp;Kemal Ozgur ,&nbsp;Muhittin Serdar","doi":"10.1016/j.rbmo.2025.105311","DOIUrl":"10.1016/j.rbmo.2025.105311","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To present a rare case of monozygotic twin sisters with discordant ovarian reserve and fertility outcomes, highlighting the significant role of environmental exposure—particularly to bisphenol A (BPA)—and lifestyle factors in influencing reproductive health, despite identical genetic backgrounds. This case aims to underscore the necessity of incorporating environmental and epigenetic assessments in fertility evaluations.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Sister B demonstrated normal ovarian reserve (AFC: 18; AMH: 2.4 ng/mL) and a reproductive history of two term pregnancies with live births. In contrast, Sister A had a seven-year history of infertility, with diminished ovarian reserve (AFC: 8; AMH: 0.8 ng/mL). Further evaluation revealed that Sister A had poor dietary habits—frequent fast-food consumption and minimal water intake, replaced by carbonated beverages. Occupational exposure to epoxy resins in a marble processing plant and pesticides in an agricultural setting was also noted. Semen analyses of both sisters' husbands were within normal parameters.</div></div><div><h3>RESULTS</h3><div>Toxicological screening revealed Sister A had a significantly elevated urinary BPA level (629.1 µg/L), over 50 times higher than her sister and their husbands (normal: 0–15.9 µg/L). After a diagnosis of diminished ovarian reserve, she adopted a healthier lifestyle to reduce environmental risks. Controlled ovarian stimulation yielded eight oocytes (three mature), resulting in three blastocysts. Two were transferred via ICSI and FET, leading to the term birth of a healthy 2750 g male infant. BPA levels normalized by 33 weeks of gestation.</div></div><div><h3>CONCLUSIONS</h3><div>This rare case demonstrates how even genetically identical individuals, living in the same environment, may exhibit striking differences in ovarian function, driven by differential exposure to environmental toxins such as BPA. This case report underscores the importance of investigating genetic (including epigenetics) as well as modifiable factors such as lifestyle habits, diet, and occupation in fertility workups and when encountering DOR and infertility.</div></div><div><h3>IMPACT STATEMENT</h3><div>This is the first reported case of significantly discordant ovarian reserve in monozygotic twins linked to differential BPA exposure. It underscores the critical impact of modifiable environmental and lifestyle factors on fertility and highlights the need to incorporate environmental and epigenetic assessments into routine reproductive evaluations. These findings offer novel insights with clinical and public health relevance.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105311"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532382","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 Effect of Antagonist Initiation Day on IVF Outcomes in Patients with Unexplained Infertility: A Retrospective Analysis","authors":"Dogukan Halis Ozkan ,&nbsp;Merve Ayas Ozkan ,&nbsp;Yaprak Engin Ustun","doi":"10.1016/j.rbmo.2025.105331","DOIUrl":"10.1016/j.rbmo.2025.105331","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study aimed to investigate the effect of antagonist treatment initiation day on IVF outcomes in women with unexplained infertility undergoing controlled ovarian stimulation.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This retrospective observational study included a total of 14 patients who were diagnosed with unexplained infertility and underwent antagonist protocol at our clinic between July 2024 and July 2025. Patients were divided into two groups based on the day antagonist treatment was initiated: fixed protocol group (Day 5, n=7) and flexible initiation group (≥Day 6, n=7).The groups were comparable in terms of age, body mass index (BMI), gravida, parity, and duration of infertility. The primary outcomes were the total number of oocytes retrieved, the number of mature oocytes, endometrial thickness on embryo transfer (ET) day, β-hCG positivity, and clinical pregnancy rate. Numerical data were analyzed using the Mann-Whitney U test, and categorical data were analyzed using Fisher's exact test.</div></div><div><h3>RESULTS</h3><div>The total number of oocytes was 11.57±2.37 in the fixed group and 8.71±3.64 in the flexible group (p=0.140). The number of mature oocytes was 8.71±2.56 and 7.29±3.77, respectively (p=0.561). Endometrial thickness on ET day was similar (10.53±3.15 vs. 10.74±2.97, p=0.798). β-hCG positivity was 57.1% in both groups (4/7 patients, p=1.000). The clinical pregnancy rate was 42.9% (3/7) in group 1 and 57.1% (4/7) in group 2 (p=1.000).</div></div><div><h3>CONCLUSIONS</h3><div>Starting the antagonist protocol later may allow for longer support of follicular development, thereby affecting oocyte response. Although clinical pregnancy rates were numerically higher in the later-starting group, statistical significance was not achieved. This may be related to the small sample size.Initiating the antagonist protocol on or after day 6 in patients with unexplained infertility may result in a clinically significant increase in oocyte response. This parameter, which influences IVF success, should be considered in individualized treatment planning. Further prospective studies with larger sample sizes are needed to validate these findings.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study suggests that delaying antagonist initiation in IVF cycles for women with unexplained infertility may improve oocyte response and clinical pregnancy trends. These findings support individualized stimulation timing and warrant further validation in larger, prospective studies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105331"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Live Birth by ART with a History of Tubal Ectopic Pregnancy, Uterus Didelphys with Double Cervical Os on a Single Cervix","authors":"Mustafa Kemal Ozel ,&nbsp;Firat Sahi̇n","doi":"10.1016/j.rbmo.2025.105334","DOIUrl":"10.1016/j.rbmo.2025.105334","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Uterus didelphys is rare congenital anomaly arising from fusion defects of the Müllerian ducts. This anomaly may be associated with infertility, obstetric complications and urinary tract anomalies. Here, we present an infertile patient diagnosed with uterus didelphys, single cervix with double os, and right renal agenesis, with a history of tubal ectopic pregnancy, achieved a live birth through IVF.</div></div><div><h3>MATERIALS AND METHODS</h3><div>26-year-old woman G1P0, with a history of ampullary ectopic pregnancy, presented after two years of infertility. She underwent laparoscopic left partial salpingectomy for a spontaneous ectopic pregnancy last year. Her husband was 28 years old, sperm concentration 110 million/ml, 68% motility.</div><div>HSG performed with catheterization of both cervical os demonstrated two distinct uterine cavities. The left cavity appeared normal, with the left tube interrupted at the isthmus due to partial salpingectomy. The right cavity was narrow, with a patent right fallopian tube and free spillage into the peritoneal cavity. BMI 22.7 kg/m², FSH 6.2 mIU/mL, E2 52 pg/mL, LH 14 mIU/mL, prolactin 17 ng/mL, AMH 5.93 ng/mL, TSH 1.2 mIU/L.</div></div><div><h3>RESULTS</h3><div>The patient underwent antagonist IVF protocol, yielding 21 MII oocytes and 8 blastocyst embryos. A single frozen-thawed embryo was transferred into the left uterus. β-hCG measured 550 IU/L and USG evaluation confirmed a gestational sac, yolk sac, embryo, and fetal cardiac activity. First-trimester combined screening revealed low risk for trisomies. Cervical length measured 38 mm at 20 weeks. Serial antenatal visits confirmed fetal growth consistent with gestational age. At 38 weeks of gestation, the patient underwent elective C/S; delivered a healthy male infant weighing 3400 g.</div></div><div><h3>CONCLUSIONS</h3><div>Uterus didelphys is a rare congenital anomaly resulting from incomplete fusion of the Müllerian ducts. Such anatomical variations may impair conception and increase obstetric risks. Advances in ART have significantly improved the chances of achieving successful pregnancies in these patients.</div></div><div><h3>IMPACT STATEMENT</h3><div>Careful monitoring of pregnancy in women with uterus didelphys is of paramount importance. Early pregnancy USG, cervical length assessment, close obstetric follow-up, and individualized delivery planning are crucial to minimize potential complications. The mode of delivery should be determined according to the patient’s specific anatomy and pregnancy course. Multidisciplinary management in experienced centers is strongly recommended for optimal outcomes in such cases.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105334"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532335","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":"Retrospective Evaluation of Embryo Development and Pregnancy Outcomes in ICSI Cycles Using HOST (Hypo-Osmotic Swelling Test)","authors":"Gonca Yetkin Yildirim ,&nbsp;Tuba Varli Yelke ,&nbsp;Ipek Uzaldi","doi":"10.1016/j.rbmo.2025.105297","DOIUrl":"10.1016/j.rbmo.2025.105297","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate fertilization, embryo development, and pregnancy outcomes in ICSI cycles where sperm selection was based on the Hypo-Osmotic Swelling Test (HOST), a method for assessing membrane integrity and functional maturity of spermatozoa.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This retrospective study analyzed 721 ICSI cycles conducted between 2019–2024 using only HOST-positive spermatozoa for injection. A total of 281 patients underwent fresh embryo transfer. Clinical and embryological parameters including maternal age, endometrial thickness, MII oocyte count, number of fertilized embryos, transfer day, and embryo morphology were compared between groups with and without clinical pregnancy.</div></div><div><h3>RESULTS</h3><div>Out of 5,077 retrieved MII oocytes, 4,303 fertilized successfully. The clinical pregnancy rate was 44.1%. Significantly better outcomes were observed in the pregnancy group in terms of higher MII count (5.0 vs. 3.3), thicker endometrium (10.1 mm vs. 9.1 mm), and younger maternal age (31.9 vs. 35.2 years) (p&lt;0.001). Day 5 embryo transfers yielded the highest pregnancy rates (62%). Embryo quality—particularly D5GQ and D3G1 grades—was strongly associated with pregnancy. Patients with severe male factor infertility (e.g., oligoasthenoteratozoospermia) demonstrated pregnancy rates above 70%. Sperm from ejaculate sources outperformed testicular sources.</div></div><div><h3>CONCLUSIONS</h3><div>Using HOST-selected spermatozoa improves fertilization and embryo development in ICSI cycles, especially in male infertility. While HOST binding ratio alone does not predict pregnancy, it offers a reliable method to identify functionally competent sperm, supporting its integration into ART protocols.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study reinforces the clinical utility of the Hypo-Osmotic Swelling Test as a non-invasive, inexpensive, and effective sperm selection tool. Its application may enhance ART outcomes in selected populations, particularly in challenging cases of male factor infertility.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105297"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532778","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":"Oocyte Retrieval Characteristics in Patients with Endometriomas: A Comprehensive Analysis","authors":"Ayse Seyhan Ata ,&nbsp;Irem Usta Korkut ,&nbsp;Ece Aksakal ,&nbsp;Sinem Ertas ,&nbsp;Bulent Urman","doi":"10.1016/j.rbmo.2025.105317","DOIUrl":"10.1016/j.rbmo.2025.105317","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate the characteristics and outcomes of oocyte retrieval in women with ovarian endometriomas between January 2020 and December 2022.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This retrospective study included women diagnosed with one or more ovarian endometriomas at the time of in vitro fertilization (IVF). We collected data on demographic characteristics, infertility duration, previous pregnancies, surgical history, endometrioma features, oocyte retrieval parameters, and any complications for analysis.</div></div><div><h3>RESULTS</h3><div>A total of 366 patients met the selection criteria. The mean age of participants was 33.4 ± 4.3 years, with a median infertility duration of 4 years. Among the participants, 64 (17%) had previous pregnancies, but only 9 resulted in live births. Surgical history indicated that only 5 (1.4%) patients had previously undergone surgery for endometriosis. The cohort included 55 patients with bilateral endometriomas and 62 with multiple endometriomas. The mean size of the endometriomas was 31 ± 10 mm. The mean number of follicles &gt; 14 mm and the number of oocytes collected were 7.5 ± 3.2 and 7 ± 3, respectively. The duration of the oocyte collection procedure averaged 13.2 ± 4.3 minutes. The median doses of propofol and fentanyl used were 150 mg (range: 50-400 mg) and 50 mg (range: 50-200 mg), respectively. Endometrioma was punctured in only one patient. Pain intensity scores were recorded, with only 5 patients reporting scores of 7 or above. Additionally, 18 patients requested extra pain medication beyond routine analgesia. The incidence of complications included one case of tubo-ovarian abscess following the oocyte collection procedure.</div></div><div><h3>CONCLUSIONS</h3><div>Women with endometriomas undergoing oocyte retrieval for IVF generally experience manageable pain levels and few complications. Despite the presence of ovarian endometriomas, oocyte retrieval procedures can be performed effectively with minimal intervention on the lesions.</div></div><div><h3>IMPACT STATEMENT</h3><div>In women with endometriomas selected for IVF, the risk of developing a pelvic abscess after oocyte retrieval is minimal, and the follicle-to-oocyte ratio is favorable. Concerns about complications and the potential inability to access all follicles during oocyte collection should not influence the decision to remove the cyst prior to initiating the treatment cycle.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105317"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532783","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":"Conservative Management of Cervical Ectopic Pregnancy: Case Report and Review of Literature","authors":"Emel Caglayan ,&nbsp;Batuhan Ustun","doi":"10.1016/j.rbmo.2025.105335","DOIUrl":"10.1016/j.rbmo.2025.105335","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Ectopic pregnancies, occurring in approximately 1-2% of cases, are typically found within the fallopian tube. Among these instances, cervical ectopic pregnancies constitute less than 1% of cases, with the majority observed within the endocervical canal. This study presents a case of cervical ectopic pregnancy following in vitro fertilization (IVF), treated with a single dose of methotrexate.</div></div><div><h3>MATERIALS AND METHODS</h3><div>CASE: A 23-year-old woman who has been married for 4 years with a history of infertility presents with complaints of abdominal pain for 2 days and vaginal spotting as bleeding, following her last menstrual period, at 5 weeks and 3 days of pregnancy. In her medical history, the patient mentions having low ovarian reserve (AMH 6.73 pmol/L), which led to in vitro fertilization (IVF) transfer 22 days ago. Due to the patient's young age and it being her first pregnancy, medical treatment with methotrexate (MTX) was decided. MTX was administered at a dose of 50 mg/m² (100 mg of intravenous MTX in 100 ml of 0.9% NaCl).</div></div><div><h3>RESULTS</h3><div>At the follow-up 27 days after the return of normal beta-HCG levels, after menstrual bleeding, the cervix was naturally observed, and endometrial thickness was measured as 4 mm</div></div><div><h3>CONCLUSIONS</h3><div>Experiences in cervical ectopic pregnancies predominantly stem from case-based experiences. Thus, when planning treatment for cervical ectopic pregnancy, a conservative or minimally invasive approach may be more appropriate, tailored to the patient's characteristics whenever possible.</div><div><strong>IMPACT STATEMENT:</strong></div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105335"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532395","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":"2025 TSRM Author Index","authors":"","doi":"10.1016/j.rbmo.2025.105289","DOIUrl":"10.1016/j.rbmo.2025.105289","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105289"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sperm Preparation Protocols Using Cumulus Cell Extracellular Matrix on Semen Parameters","authors":"Sabina Aghayeva ,&nbsp;Duygu Gok Yurtseven ,&nbsp;Cihan Cakir ,&nbsp;Isil Kasapoglu","doi":"10.1016/j.rbmo.2025.105323","DOIUrl":"10.1016/j.rbmo.2025.105323","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>In this study, it was aimed to determine the effects of the addition of cumulus cell extracellular matrix (CCEMC) to the culture medium used during conventional sperm preparation techniques used in assisted reproductive treatment approaches on routine sperm parameters, fertilisation capacity and sperm DNA fragmentation and to perform comparative analyses of protocols used in sperm separation techniques.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Ejaculate samples from 30 normozoospermic male patients and oocytes collected on the same day from their spouses were used in the study. The semen sample from each patient was divided into 5 equal volumes, and 5 different groups were formed as control, density gradient (DG), density gradient + cumulus cell extracellular matrix (DG+K), swim-up (SU), and swim-up + cumulus cell extracellular matrix (SU+K).</div></div><div><h3>RESULTS</h3><div>According to the results obtained, sperm concentration was significantly lower in all experimental groups compared to the control group, and there was a statistically significant difference, especially in the swim-up group. Motility rate was highest in the (SU+K) group, and it was also significantly increased in the (DG+K) and SU groups. TPMSS value decreased significantly in the SU and (SU+K) groups. There was no significant difference between the groups in terms of morphology. It was observed that the viability rate was significantly increased in the groups to which CCECM was added, and this significant increase continued in all experimental groups compared to the control group. ARIC scores indicating acrosomal reaction capacity were also significantly higher in the (DG+K) and (SU+K) groups. In addition, DFI values reflecting DNA damage were significantly lower in these two groups, indicating that CCECM contribution may protect DNA integrity.</div></div><div><h3>CONCLUSIONS</h3><div>As a result, it was determined that the addition of CCECM to the culture medium used during different sperm washing techniques, especially when used in combination with the swim-up method, had an effect on sperm quality and efficiency. We think that the applied method will be an applicable technique for male infertility treatment in the assisted reproductive treatment approach.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study provides a novel sperm preparation approach using cumulus cell extracellular matrix, which may enhance fertilization potential and reduce sperm DNA damage in assisted reproductive technologies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105323"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532684","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}