Reproductive biomedicine online最新文献

{"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}

{"title":"Inside Front Cover - Affiliations and First page of TOC","authors":"","doi":"10.1016/S1472-6483(25)00582-6","DOIUrl":"10.1016/S1472-6483(25)00582-6","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105375"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532570","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 The Coexistence of Diminished Ovarian Reserve and Severe Male Factor Infertility A Clinically Significant Entity?''","authors":"Fatma Tunc ,&nbsp;Recep Onur Karabacak ,&nbsp;Ismail Guler","doi":"10.1016/j.rbmo.2025.105326","DOIUrl":"10.1016/j.rbmo.2025.105326","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To evaluate the available evidence on the coexistence of severe male factor infertility and diminished ovarian reserve, as observed in infertile couples.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Between July 2022 and June 2023, data were retrospectively collected from the female partners of 79 men with severe male factor infertility and 84 men with normal semen parameters who underwent IVF. The demographic characteristics of the participants were comparable between the groups. The study group (group 1) consisted of female partners of men diagnosed with severe oligospermia (n=79), whereas the control group (group 2) comprised partners of men with normal semen parameters (n=84). There were 101 women(61,9%) with normal overian reserve tests and 62 women (38,1%) with diminished ovarian reserve. Demographic data, personal information, and second-day hormone levels were obtained through retrospective review of medical records.</div></div><div><h3>RESULTS</h3><div>The association between severe male factor infertility and diminished ovarian reserve was evaluated using the chi-square test, which demonstrated no statistically significant relationship (p=0.2). The mean follicle-stimulating hormone (FSH) level was 8.9±4.2 mIU/mL in group 1 and 10±6.2 mIU/mL in group 2, with significantly higher levels observed in group 2 (p=0.05). Luteinizing hormone (LH) levels were also significantly higher in group 2 (6.5±2.9 mIU/mL) compared to Group 1 (5.2 ± 2.1 mIU/mL) (p=0.006). The mean anti-Müllerian hormone (AMH) levels were comparable between the two groups (2.5±2.4 ng/mL in group 1 vs. 2.5±2.7 ng/mL in group 2), showing no statistically significant difference (p=0.3). Similarly, the mean basal antral follicle count was slightly higher in group 1 (10.2±6.3) compared to group 2 (9.2±6.5), but the difference did not reach statistical significance (p=0.4).</div></div><div><h3>CONCLUSIONS</h3><div>The fertility parameters of infertile male partners were within the expected normal range. Contrary to expectations, these women were found to have increased fertility potential and a higher oocyte count.</div></div><div><h3>IMPACT STATEMENT</h3><div>Although the coexistence of severe oligospermia and diminished ovarian reserve is often observed in clinical settings, our findings reveal an unexpected pattern: infertile male partners tended to exhibit normal or even enhanced fertility parameters when paired with females with low ovarian reserve. This paradoxical association offers new perspectives on couple-based infertility dynamics and may influence future diagnostic and treatment approaches in assisted reproduction.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105326"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532687","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":"Front Matter - Continued TOC","authors":"","doi":"10.1016/S1472-6483(25)00555-3","DOIUrl":"10.1016/S1472-6483(25)00555-3","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 5","pages":"Article 105348"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465396","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":"Erratum Regarding Previously Published Articles","authors":"","doi":"10.1016/j.rbmo.2025.105276","DOIUrl":"10.1016/j.rbmo.2025.105276","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 5","pages":"Article 105276"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465399","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}