Reproductive biomedicine online最新文献

{"title":"Progestogen Hypersensitivity Following IVF: A Case of Cutaneous and Systemic Reaction in Early Pregnancy","authors":"Elif Unal ,&nbsp;Burcin Karamustafaoglu Balci ,&nbsp;Osman Gul ,&nbsp;Tugba Atci","doi":"10.1016/j.rbmo.2025.105333","DOIUrl":"10.1016/j.rbmo.2025.105333","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Progesterone hypersensitivity is a rare condition with heterogeneous manifestations, including urticaria, angioedema, wheezing, and less common findings such as erythema multiforme and vesiculobullous lesions. It may result from endogenous or exogenous progesterone, with high-dose use in IVF increasing risk. We present a case of hypersensitivity in early pregnancy following IVF.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A 26-year-old woman with secondary infertility underwent IVF with an antagonist protocol and recombinant FSH. Sixteen oocytes were retrieved, 13 fertilized, and two embryos transferred, resulting in a single intrauterine pregnancy; two embryos were cryopreserved. Luteal support included intramuscular progesterone (50 mg twice daily). At 8 weeks, she developed widespread erythematous urticarial plaques and arthralgia. Loratadine was started, and progesterone discontinued. Worsening symptoms necessitated systemic corticosteroid therapy (prednisolone 60 mg/day), tapered and stopped by day 15, leading to gradual resolution. Punch biopsy revealed mild perivascular inflammatory infiltrate with sparse eosinophils; direct immunofluorescence was negative for IgG, IgA, IgM, and C3, excluding vasculitis and supporting non-specific hypersensitivity. The pregnancy progressed uneventfully, culminating in cesarean delivery of a healthy 4000 g male infant at term.</div></div><div><h3>RESULTS</h3><div>Progestogen hypersensitivity (PH) is rare and often underdiagnosed. In this case, the absence of allergic history, symptom onset during therapy, and clinical improvement after discontinuation of progesterone support a drug-induced reaction. Diagnosis relies on clinical suspicion, temporal correlation, and therapeutic response.</div></div><div><h3>CONCLUSIONS</h3><div>Clinicians should consider PH in IVF patients presenting with unexplained dermatologic or systemic symptoms. Early recognition and multidisciplinary management are essential for maternal comfort and optimal pregnancy outcomes.</div></div><div><h3>IMPACT STATEMENT</h3><div>This case emphasizes the importance of recognizing hypersensitivity to exogenous progesterone in assisted reproduction, enabling timely diagnosis and individualized care.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105333"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532334","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 Impact of Vaginal Microbiota on IVF Success","authors":"Goncagul Kından","doi":"10.1016/j.rbmo.2025.105329","DOIUrl":"10.1016/j.rbmo.2025.105329","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The vaginal microbiota plays a vital role in female reproductive health. Recent studies have shown that a Lactobacillus-dominant vaginal microbiota provides a more favorable reproductive environment and may enhance implantation success, especially in assisted reproductive technologies. This study aims to evaluate the relationship between the composition of the vaginal microbiota and in vitro fertilization (IVF) success, emphasizing its potential as a modifiable and predictive biomarker in infertility treatment.To investigate the effect of vaginal microbiota composition on clinical pregnancy rates and implantation success in infertile women undergoing IVF treatment.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A prospective observational study was conducted with 50 infertile women undergoing IVF treatment at a tertiary reproductive medicine center between January 2023 and December 2024. Vaginal swab samples were obtained from all participants one week prior to embryo transfer. Microbial DNA was extracted and analyzed using 16S rRNA gene sequencing to determine microbiota composition. Participants were classified into two groups based on dominant bacterial taxa: Group A (Lactobacillus-dominant microbiota, n=30) and Group B (non-Lactobacillus-dominant microbiota, n=20). Primary outcomes were clinical pregnancy rate and implantation success, confirmed by serum β-hCG and transvaginal ultrasound. Statistical analysis was performed using the Chi-square test, with significance set at p&lt;0.05.</div></div><div><h3>RESULTS</h3><div>Group A demonstrated significantly higher outcomes, with a clinical pregnancy rate of 53% and implantation success of 70%. In contrast, Group B had lower rates of 25% and 42%, respectively. These differences were statistically significant (p&lt;0.01). The findings suggest that a Lactobacillus-dominant vaginal microbiota positively influences the intrauterine environment, enhancing embryo implantation and pregnancy chances.</div></div><div><h3>CONCLUSIONS</h3><div>This study supports the growing body of evidence that vaginal microbiota is a crucial factor in IVF outcomes. A Lactobacillus-dominant microbiota appears to create a protective and receptive uterine environment, facilitating successful embryo implantation. Integrating vaginal microbiota profiling into the pre-IVF assessment protocol may provide a novel, personalized approach to fertility treatment. Further large-scale studies are needed to validate these results and explore interventions that modulate microbiota composition to improve reproductive outcomes.</div></div><div><h3>IMPACT STATEMENT</h3><div>Vaginal microbiota may improve IVF success.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105329"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532480","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":"Pregnancies Achieved by ART Are Prone to Be High-Risk Pregnancies: Is Referral to a Tertiary Center Required?","authors":"Sakine Rahimli Ocakoglu ,&nbsp;Zeliha Atak ,&nbsp;Ozlem Ozgun Uyaniklar ,&nbsp;Serenat Eris Yalcin","doi":"10.1016/j.rbmo.2025.105320","DOIUrl":"10.1016/j.rbmo.2025.105320","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Fertility specialists commonly refer patients to obstetricians after detecting a biochemical or clinical pregnancy. However, a significant number of patients do not reach the stage of live birth, which is one of the most critical indicators of IVF success. This underscores the importance of pregnancy monitoring and management in the success of fertility treatments. This study aims to evaluate whether pregnancies conceived through ART should be classified as high-risk and, if so, whether systematic referral from fertility units to tertiary perinatology centers improves maternal–fetal care.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This retrospective cohort study included 109 IVF pregnancies managed at Bursa City Hospital between August 2019 and January 2025. Data on maternal characteristics, comorbidities, and first-trimester screening were collected from electronic records. The primary outcome was referral to perinatology; secondary outcomes included live birth, preterm delivery, and neonatal status. Patients were grouped based on perinatology referral status.</div></div><div><h3>RESULTS</h3><div>The median maternal age was 31 years and median gravida was 1. Comorbidities were present in 46.8% and multiple gestations in 35.8% of cases. Cerclage was applied in 7.3%, and 42.2% had normal aneuploidy screening results, while 57.8% were not screened. Live birth occurred in 74.3%, preterm delivery in 33%, and 54.1% of patients required perinatology referral. Although maternal age did not differ between referral and non-referral groups (p = 0.292), gravida number was higher in the referral group (2 vs. 1; p = 0.047). Comorbidities (64.4% vs. 26%; p &lt; 0.001) and threatened preterm labor (60.4% vs. 9.3%; p &lt; 0.001) were significantly more frequent in the referral group. Comorbidities increased referral risk 3.43 times (95% CI: 1.23–9.54; p = 0.018), and threatened preterm labor increased it 13.32 times (95% CI: 3.34–53.12; p &lt; 0.001). Other factors did not significantly affect referral status.</div></div><div><h3>CONCLUSIONS</h3><div>More than half of ART pregnancies in this tertiary setting required specialist perinatology input, due to maternal comorbidities and early signs of preterm labor. Integrating fertility clinics with tertiary centers and establishing clear referral pathways may improve outcomes by enabling early identification and management of high-risk cases.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study supports classifying ART pregnancies as high-risk and emphasizes the need for structured referral to tertiary perinatology centers to improve maternal and neonatal outcomes.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105320"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532681","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":"Pelvic Floor Imaging and Function in Women with Premature Ovarian Insufficiency","authors":"Seda Ates ,&nbsp;Ceren Unal ,&nbsp;Seyma Haskoylu Sahin ,&nbsp;Ozgur Oktem ,&nbsp;Serdar Aydin","doi":"10.1016/j.rbmo.2025.105324","DOIUrl":"10.1016/j.rbmo.2025.105324","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Premature ovarian insufficiency (POI) causes long-term estrogen deficiency, leading to stiffer fascia, muscle atrophy, and pelvic floor weakening. As POI occurs early in life, it offers a unique model to study estrogen-related pelvic floor changes independent of aging. This study aimed to: assess PFM function in POI using the PERFECT scheme(Power, Endurance, Repetition, Fast contractions, Every Contraction Timed); quantify levator ani morphology and dynamic response using four-dimensional transperineal ultrasound(TPUS); and assess the effect of systemic estrogen replacement therapy (ERT) in the POI cohort.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A prospective, cross-sectional, case–control study was conducted with 40 POI patients and 40 age-matched eumenorrheic controls. Pelvic floor performance was graded with the PERFECT scheme. TPUS quantified the levator hiatus’ anteroposterior (AP) diameter and area at rest, maximal voluntary contraction, and Valsalva. Delta values (e.g., ∆HA Rest→Contraction) were computed, statistical comparisons included Welch’s t-test, Fisher’s exact test, and Pearson correlation(α = 0.05). The POI group was stratified by ERT use (ERT-Yes n = 22; ERT-No n = 18).</div></div><div><h3>RESULTS</h3><div>Women with POI had higher BMI and parity despite matching for age. PERFECT grading revealed a lower repetition capacity in POI, whereas power, endurance and fast contractions did not differ. TPUS demonstrated a consistently wider levator hiatus in POI at rest and during contraction, confirming structural widening(Table). Greater hiatal narrowing from rest to contraction correlated modestly with higher power and endurance scores. Within POI, ERT users showed slightly greater sagittal narrowing during contraction, but all other delta and biometry variables were unchanged.</div></div><div><h3>CONCLUSIONS</h3><div>POI is characterized by significant morphological levator widening without concomitant loss of contractile strength. Early estrogen deficiency appears to remodel pelvic-floor structure before functional compromise. Correlations between hiatal narrowing and PERFECT scores suggest that TPUS-derived delta metrics capture physiologically relevant muscle recruitment. The marginal contraction benefit observed in ERT users implies that systemic estrogen may slow but not reverse established morphological change.</div></div><div><h3>IMPACT STATEMENT</h3><div>TPUS-detected hiatal enlargement could therefore serve as an early marker for targeted pelvic-floor physiotherapy and longitudinal monitoring in women with POI.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105324"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532685","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":"Beyond Cosmetic Implications: Hirsutism as a Determinant of Health Perception in Women with PCOS","authors":"Aslihan Yurtkal ,&nbsp;Mujde Canday ,&nbsp;Özde Sakarya","doi":"10.1016/j.rbmo.2025.105313","DOIUrl":"10.1016/j.rbmo.2025.105313","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Polycystic ovary syndrome (PCOS) is a complex and heterogeneous condition that spans endocrinology, reproduction, metabolism and mental health. This study highlights the overlooked psychosocial burden of hirsutism, a visible sign of hyperandrogenism, on women’s perceived health and quality of life. Though a hallmark of PCOS, its impact extends beyond appearance, influencing identity and social functioning beyond what clinical measures can capture. This study compares SF-36 scores in PCOS patients with and without hirsutism to assess whether the symptom independently contributes to reduced physical and mental well-being.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This cross-sectional study included 118 women newly diagnosed with PCOS based on the 2018 International Guideline, an update of the 2003 Rotterdam criteria. All participants completed the SF-36 questionnaire to assess health-related quality of life (HRQoL) prior to receiving diagnostic information. Participants were grouped by the presence or absence of hirsutism and SF-36 subscale scores were compared accordingly.</div></div><div><h3>RESULTS</h3><div>A total of 118 women diagnosed with PCOS were evaluated. Participants with hirsutism reported significantly lower scores in the Physical Functioning (p=0.030),General Health (p=0.007),Vitality (p=0.031) and Mental Health (p=0.024) domains of the SF-36 questionnaire compared to those without hirsutism. Other subscales did not show statistically significant differences. These results indicate that hirsutism is associated with reduced physical and psychological well-being in women with PCOS.</div></div><div><h3>CONCLUSIONS</h3><div>Our findings indicate that hirsutism is independently associated with reduced HRQoL in women with PCOS, even in the absence of overt metabolic dysfunction. This suggests that hirsutism is not merely a cosmetic concern but a significant determinant of overall well-being. In the era of precision medicine,these results call for a more comprehensive, symptom-focused approach to PCOS that addresses both physical and psychosocial dimensions. Recognizing and managing the burden of visible androgen excess should be a central component of individualized care. Future research should explore how symptom patterns, cultural context, and coping styles shape the lived experience of PCOS to better inform holistic interventions.</div></div><div><h3>IMPACT STATEMENT</h3><div>This study reveals that hirsutism significantly impairs multiple aspects of quality of life in women with PCOS, reinforcing the need for comprehensive, patient-centered approaches that address both metabolic and psychosocial domains of the syndrome.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105313"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532779","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 The Effects of Oral and Vaginal Micronized Progesterone Types for Luteal Phase Support in ART Treatments","authors":"Mustafa Erdogan ,&nbsp;Vehbi Yavuz Tokgoz","doi":"10.1016/j.rbmo.2025.105309","DOIUrl":"10.1016/j.rbmo.2025.105309","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Our study aims to compare the impact of the use of oral dydrogesterone, vaginal micronized progesterone gel and vaginal micronized progesterone capsule for luteal phase support in assisted reproductive techniques in terms of cycle and pregnancy outcomes and to guide the clinical approach.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A total of 988 patients undergoing fresh embryo transfer in assisted reproductive treatments were retrospectively evaluated. Demographic and clinical characteristics (age, BMI, infertility duration and type, basal FSH, LH, estrogen, and AMH levels), stimulation parameters (stimulation duration, total gonadotropin dose, endometrial thickness, number of retrieved and mature oocytes, fertilization rate), and pregnancy outcomes (hCG positivity, clinical pregnancy, and live birth rates) were recorded. Patients were grouped according to luteal phase support: oral dydrogesterone (3 × 10 mg), vaginal progesterone gel (2 × 90 mg), and vaginal micronized progesterone capsule (3 × 200 mg). Clinical, laboratory, and pregnancy outcomes were compared among the three groups.</div></div><div><h3>RESULTS</h3><div>The mean age and BMI were comparable across all groups. Basal hormonal parameters (FSH, LH, AMH) and antral follicle counts showed no significant differences, indicating similar ovarian reserves. Although the number of retrieved oocytes did not differ significantly, the oral dydrogesterone group required longer stimulation and higher total gonadotropin doses. Pregnancy outcomes were similar among groups, though the oral dydrogesterone group had a lower clinical pregnancy rate, with no significant difference in live birth rates.</div><div>All data are presented in Table 1.</div></div><div><h3>CONCLUSIONS</h3><div>Data on the efficacy and safety of oral dydrogesterone, vaginal progesterone gel, and vaginal micronized progesterone for luteal phase support in fresh embryo transfer cycles remain limited. Few studies have compared these three methods directly. In our study, despite longer stimulation and higher gonadotropin doses in the oral dydrogesterone group, cycle and pregnancy outcomes were comparable across all groups. Further research is needed to confirm these findings.</div></div><div><h3>IMPACT STATEMENT</h3><div>In this context, we performed the current study and it was to be found that cycle outcomes and pregnancy results were not different between three different methods even though the duration of stimulation and total dose of gonadotropins were higher in the oral dydrogesterone group.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105309"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532854","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":"Response to: Representation of study in recent RBMO Commentary","authors":"Juan A. Garcia-Velasco,&nbsp;Michael Alper,&nbsp;Antonio Capalbo,&nbsp;Robert Casper,&nbsp;Human Fatemi,&nbsp;Thomas Molinaro,&nbsp;Filipo Ubaldi,&nbsp;Antonio Pellicer","doi":"10.1016/j.rbmo.2025.105338","DOIUrl":"10.1016/j.rbmo.2025.105338","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105338"},"PeriodicalIF":3.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401747","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":"Representation of study in recent RBMO Commentary","authors":"Dorit Kieslinger,&nbsp;Carlijn Vergouw,&nbsp;Nils Lambalk,&nbsp;all authors of the SelecTIMO study","doi":"10.1016/j.rbmo.2025.105337","DOIUrl":"10.1016/j.rbmo.2025.105337","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 6","pages":"Article 105337"},"PeriodicalIF":3.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145392615","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":"Reproductive medicine and human embryo research: rethinking risk through the lens of Aristotle’s phronesis","authors":"Maxime Chaillot ,&nbsp;Maxence Gaillard ,&nbsp;Laurent David ,&nbsp;Thomas Freour","doi":"10.1016/j.rbmo.2025.105287","DOIUrl":"10.1016/j.rbmo.2025.105287","url":null,"abstract":"<div><div>In the field of assisted reproductive technology (ART) and human embryo research, clinicians and scientists regularly face decisions that blend scientific uncertainty with profound ethical complexity. As innovation accelerates in these fast-moving fields, ethical navigation can be challenging. Guidelines, regulations and protocols generally provide structure, yet often fall short of offering sufficient moral clarity. In this complex and evolving landscape, we propose that Aristotle’s famous concept of <em>phronesis</em> – practical wisdom, i.e. the ability to make morally sound decisions in complex, real-life situations by balancing knowledge, experience and ethical judgement – can offer an essential tool for navigating choices in ART and/or human embryo research where evidence, ethics and lived human experiences intersect.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105287"},"PeriodicalIF":3.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967001","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":"Do faster, do better: frozen embryo transfer outcomes with one-step warming protocol at different embryos stages.","authors":"Rossella Fucci, Patrizia Falcone, Francesco Capodanno, Sara Rubini, Andrea Gallinelli, Vincenzo Lofiego, Silvia De Stefani, Mariangela Primiterra, Elisabetta Coccia, Elisabetta Baldi, Simone Palini","doi":"10.1016/j.rbmo.2025.104874","DOIUrl":"10.1016/j.rbmo.2025.104874","url":null,"abstract":"<p><strong>Research question: </strong>What effect does the use of a rapid warming method of vitrified embryos have on survival and pregnancy?</p><p><strong>Design: </strong>A comparison of two different warming embryos protocols: long protocol (group 1, n = 486) and a new fast protocol (group 2, n = 413) for blastocyst and cleavage stage frozen embryo transfers at two IVF centres: Assisted Reproductive Technology Centre, Careggi University Hospital Firenze and IVF Unit, 'Cervesi' Hospital Cattolica. Total pregnancy rate was considered primary outcome, and embryo survival rate, clinical pregnancy rate, miscarriage rate, ongoing pregnancy rate and mean time required for warming procedure were considered secondary outcomes.</p><p><strong>Results: </strong>The same embryo survival rate was observed in the two groups. Total and clinical pregnancy rates seemed to be higher, but not statistically different, in group 2 compared with group 1 (29.5% versus 26.7% and 27.6% versus 22.6%, respectively). Conversely, a statistically significant reduction in miscarriage rate was found in group 2 compared with group 1 (18.0% versus 32.3%, P = 0.009). Similarly, a significant increase in pregnancy rate at 26 gestational weeks or over was observed in group 2 compared with group 1 (66.9% versus 80.3%, P = 0.016). Finally, a difference in time required for warming procedures was found in favour of group 2.</p><p><strong>Conclusions: </strong>The use of the fast warming protocol is a valid alternative to the classic warming protocol, and allows a reduction in the time needed to carry out the procedure and the workload of embryologists in an IVF laboratory.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 4","pages":"104874"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812282","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}