Reproductive biomedicine online最新文献_第7页

Changing the narrative for poor-prognosis patients in IVF: unlocking success through a multicycle approach. 改变体外受精预后不良患者的叙述：通过多周期方法解锁成功。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-16 DOI: 10.1016/j.rbmo.2026.105465

Alberto Vaiarelli, Carlo Alviggi, Juan Antonio Garcia Velasco, Marcos Horton, Peter Humaidan, Antonio La Marca, Marilena Taggi, Danilo Cimadomo, Laura Rienzi, Filippo M Ubaldi

Recent advances in IVF have shifted the focus towards maximizing treatment efficacy and efficiency. Traditionally, IVF success has been evaluated on a cycle-by-cycle basis. Advancements such as individualized ovarian stimulation protocols, gonadotrophin-releasing hormone agonist triggers, cryopreservation techniques and embryo selection strategies, including preimplantation genetic testing for aneuploidies, have improved precision medicine in IVF, optimizing clinical outcomes. Despite these developments, certain patient groups - especially those with low ovarian response and/or advanced age - still face lower success rates per IVF cycle initiated. Considering the reproductive system's physiology, which often requires multiple attempts for success, and drawing from the experience of intrauterine insemination, a shift from a single-cycle focus to a multicycle strategy is now needed. A multicycle approach, adopting approaches such as oocyte/embryo accumulation from several stimulations or two consecutive stimulations (e.g. DuoStim), enables the advance planning of multiple attempts. It helps shorten time to pregnancy, reduces treatment discontinuation and offers support for patients facing setbacks. To be effective, this strategy must include personalized psychological counselling to manage emotional stress and prepare patients for possible failures, which are major causes of discontinuation. Evidence shows that well-informed, supported patients are more likely to persist in treatment, leading to higher cumulative success rates.

体外受精的最新进展已将重点转向最大限度地提高治疗效果和效率。传统上，试管婴儿的成功是在一个周期一个周期的基础上评估的。诸如个体化卵巢刺激方案、促性腺激素释放激素激动剂触发、冷冻保存技术和胚胎选择策略，包括非整倍体的植入前基因检测等方面的进步，提高了体外受精的精准医学水平，优化了临床结果。尽管有这些进展，某些患者群体-特别是卵巢反应低和/或高龄的患者-每个试管婴儿周期的成功率仍然较低。考虑到生殖系统的生理机能，通常需要多次尝试才能成功，并借鉴宫内人工授精的经验，现在需要从单周期转向多周期策略。多周期方法，通过多次刺激或两次连续刺激（如十二指肠刺激）来积累卵母细胞/胚胎，可以提前规划多次尝试。它有助于缩短怀孕时间，减少治疗中断，并为面临挫折的患者提供支持。为了有效，这一战略必须包括个性化的心理咨询，以管理情绪压力，并使患者为可能的失败做好准备，这是中断治疗的主要原因。有证据表明，消息灵通、得到支持的患者更有可能坚持治疗，从而导致更高的累积成功率。

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引用次数: 0

Sexual intercourse and vaginal absorption of progesterone (SexVAP): a cross-over randomized prospective pilot study 性交和阴道孕酮吸收（SexVAP）：一项交叉随机前瞻性先导研究。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-07-18 DOI: 10.1016/j.rbmo.2025.105166

Noemie Ranisavljevic , Anaïs Rolland , Marie-Christine Picot , Manuela Lotierzo , Fanchon Herman , Martha Duraes , Sophie Brouillet , Tal Anahory

Research question

Does use of male condoms during sexual intercourse affect serum progesterone levels in women taking hormonal replacement therapy (HRT) with vaginal progesterone, compared with unprotected sexual intercourse and sexual abstinence as the reference for progesterone absorption?

Design

A prospective, randomized, crossover pilot study was conducted (n = 40 couples). Eligible participants were infertile heterosexual couples. Women (aged 18–40 years; BMI <32 kg/m²) received oestradiol and vaginal micronized progesterone suppositories. Couples were excluded if men reported erectile or ejaculatory disorders. Upon initiation of progesterone, sexual abstinence was mandated, except for two planned intercourses as part of the study, one with and one without a condom. Progesterone serum levels were assessed three times: on day 2 of progesterone (during abstinence), on day 3 (10 h after the first planned sexual intercourse) and day 7 of progesterone (10 h after the second planned sexual intercourse).

Results

Among the 40 couples included, 30 couples were suitable for per protocol analysis. On average, serum progesterone levels were 0.21 ng/ml (± 5.26) lower after an unprotected intercourse compared with sexual abstinence; serum progesterone levels were 1.52 ng/ml (± 5.09) higher after an intercourse with a condom compared with sexual abstinence. The linear mixed model showed no significant effect for condom use to affect the variation in progesterone levels (P = 0.08).

Conclusion

Sexual intercourse did not significantly affect serum progesterone levels during an HRT cycle using vaginal progesterone suppositories. Vaginal absorption of progesterone was similar regardless of whether a male condom was used.

研究问题：在性交过程中使用男用避孕套是否会影响使用阴道孕酮激素替代疗法（HRT）的女性的血清孕酮水平，并与无保护性交和禁欲作为孕酮吸收的参考进行比较？设计：进行前瞻性、随机、交叉先导研究（n = 40对夫妇）。合格的参与者是不育的异性恋夫妇。女性（年龄18-40岁，BMI 2）接受雌二醇和阴道微孕酮栓剂。如果男性报告有勃起或射精障碍，则夫妇被排除在外。在开始使用黄体酮后，除了两次作为研究一部分的计划性交，一次带避孕套，一次不带避孕套，性生活被强制禁欲。测定孕酮血清水平3次：孕酮治疗第2天（禁欲期间）、第3天（第一次计划性交后10小时）和第7天（第二次计划性交后10小时）。结果：入选的40对夫妇中，有30对适合进行方案分析。与禁欲相比，无保护性交后血清黄体酮水平平均降低0.21 ng/ml（±5.26）；与不性交相比，使用避孕套性交后血清孕酮水平升高1.52 ng/ml（±5.09）。线性混合模型显示，使用避孕套对孕酮水平变化无显著影响（P = 0.08）。结论：在使用阴道孕酮栓剂的HRT周期中，性交对血清孕酮水平无显著影响。无论是否使用男用避孕套，阴道对黄体酮的吸收都是相似的。

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引用次数: 0

Peri-conceptional maternal vulnerability risk score and embryonic growth: the Rotterdam Periconception Cohort 妊娠期母体脆弱性风险评分和胚胎生长：鹿特丹妊娠期队列。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-06-12 DOI: 10.1016/j.rbmo.2025.105085

Teuntje Wieles , Hilmar Bijma , Sharissa Smith , Lotte Voskamp , Sten Willemsen , Régine Steegers-Theunissen

Research question

What is the association of peri-conceptional maternal vulnerability, assessed through a weighted multi-domain risk score with embryonic growth?

Design

638 pregnancies were included from the Rotterdam Periconception Cohort. Data on nine vulnerability factors (encompassing lifestyle, mental health and environmental factors) were obtained through self-administered questionnaires. The Periconceptional Vulnerability Risk Score (PVRS) was calculated using weighted estimates of associations between vulnerability factors and ‘Big 3’ pregnancy outcomes (congenital anomalies, preterm birth and small for gestational age). Embryonic growth was assessed by repeated first-trimester 3D transvaginal ultrasound measurements of crown-rump length and embyronic volume, analyzed with VR-software.

Results

For the total study population, the PVRS ranged from –0.071 to 0.320 (median 0.131). Higher PVRS values were significantly associated with reduced embryonic growth trajectories (CRL: β = –0.58 mm, 95% CI –0.94 to –0.23, P = 0.001; embryonic volume: β = –0.31 cm³, 95% CI –0.49 to –0.13, P = 0.001). Subgroup analyses revealed significant negative associations in naturally conceived pregnancies (CRL: β = –0.82 mm, 95% CI –1.48 to –0.16, P = 0.015; embryonic volume: β = –0.39 cm³, 95% CI –0.71 to –0.08, P = 0.015) and in overweight women (CRL: β = –0.91 mm, 95% CI –1.55 to –0.27, P = 0.006; embryonic volume: β = –0.51 cm³, 95% CI –0.82 to –0.21, P = 0.001).

Conclusions

The PVRS provides a weighted measure of maternal vulnerability, significantly associated with reduced embryonic growth, particularly in naturally conceived pregnancies and overweight women. Although no causality can be inferred from this study, the observed associations suggest that a broad peri-conceptional vulnerability assessment could help to identify potentially modifiable risk factors.

研究问题：通过加权多域风险评分评估的孕周母体脆弱性与胚胎生长之间的关联是什么？设计：从鹿特丹围孕期队列中纳入638例妊娠。通过自我填写的问卷获得了9个易受伤害因素（包括生活方式、心理健康和环境因素）的数据。围孕期脆弱性风险评分（PVRS）是利用脆弱性因素与“三大”妊娠结局（先天性异常、早产和小于胎龄）之间关联的加权估计来计算的。胚胎生长通过妊娠早期反复的三维经阴道超声测量冠臀长和胚胎体积来评估，并使用vr软件进行分析。结果：在整个研究人群中，PVRS范围为-0.071至0.320（中位数为0.131）。较高的PVRS值与胚胎生长轨迹减少显著相关（CRL: β = -0.58 mm, 95% CI -0.94至-0.23,P = 0.001；胚胎体积：β = -0.31 cm³，95% CI -0.49至-0.13,P = 0.001）。子群分析显示重大的负面联想自然受孕的怀孕(CRL:β = -0.82毫米,95%可信区间-1.48到-0.16,P = 0.015;胚胎体积:β = ³-0.39厘米,95%可信区间-0.71到-0.08,P = 0.015)和超重女性(CRL:β = -0.91毫米,95%可信区间-1.55到-0.27,P = 0.006;胚胎体积:β = ³-0.51厘米,95%可信区间-0.82到-0.21,P = 0.001)。结论：PVRS提供了孕产妇脆弱性的加权衡量标准，与胚胎生长减少显著相关，特别是在自然妊娠和超重妇女中。虽然不能从这项研究中推断出因果关系，但观察到的关联表明，一个广泛的孕期脆弱性评估可以帮助识别潜在的可改变的风险因素。

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引用次数: 0

Fast to fastest: single-step sucrose dilution to direct hydration of vitrified-warmed human blastocysts 快速到最快：一步蔗糖稀释到玻璃化加热的人类囊胚的直接水化。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-08-18 DOI: 10.1016/j.rbmo.2025.105219

Mitchel C Schiewe

With the publication of several recent papers on new vitrification and post-warming protocols, Reproductive BioMedicine Online has brought well-deserved attention to the evolving landscape of cryopreservation practices for human oocytes and embryos. These new protocols aim to improve efficiency, reliability, cost-effectiveness and, potentially, safety and the developmental trajectory. Vitrification protocols have changed from long to short (as in ‘fast and furious’) and post-warming dilutions have changed from a multistep process to a fast single-step process. However, we may yet see warming protocols that forgo elution in non-permeable solutes in favour of an even faster method – rehydration directly in culture medium.

随着最近几篇关于新的玻璃化和后加热协议的论文的发表，生殖生物医学在线引起了人们对人类卵母细胞和胚胎冷冻保存实践的关注。这些新方案旨在提高效率、可靠性、成本效益，并可能提高安全性和发展轨迹。玻璃化规程已经从长时间变为短时间（就像在“速度与激情”中一样），暖化后的稀释已经从多步骤过程变为快速的单步骤过程。然而，我们可能还会看到变暖协议放弃在不渗透性溶质中洗脱，而采用一种更快的方法——直接在培养基中再水化。

引用次数: 0

Investigating phototoxicity of optical coherence tomography imaging in porcine and human spermatozoa 研究猪和人精子光学相干断层成像的光毒性。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-07-24 DOI: 10.1016/j.rbmo.2025.105175

Marie Claire Aquilina , Julien Camard , Wisdom Igiogbe , Taylor Sanderson , Lucy Abbott , Darren K. Griffin , Adrian Podoleanu , Peter Ellis , Giuseppe Silvestri , Manuel J. Marques

Research question

Does exposure to near-infra-red optical coherence tomography (OCT) laser radiation induce phototoxic effects in porcine and human spermatozoa?

Design

Computer-assisted sperm analysis (CASA) was used to determine whether OCT laser illumination at or above levels typically used for imaging alters sperm motility. Flow cytometry was used to determine the impact of irradiation on sperm acrosome reaction status, DNA fragmentation, and membrane integrity. Additionally, in-vitro time-lapse OCT imaging of a porcine cumulus–oocyte complex with irradiated spermatozoa was performed to determine whether irradiated spermatozoa interact with and penetrate the cumulus oophorus. Finally, human spermatozoa were irradiated and analysed using CASA and flow cytometric techniques.

Results

All irradiated samples showed no significant difference in sperm DNA damage or CASA sperm motility parameters, including average path velocity, straight line velocity or curvilinear velocity, compared with their matched manipulation control, suggesting that sample irradiation did not compromise sperm viability, even when using an optical power of more than one order of magnitude greater than that typically required to image embryos. Proof-of-concept OCT imaging suggested that motility of irradiated spermatozoa during cumulus interaction was not affected by radiation.

Conclusions

No significant effect on the kinetics of boar and human spermatozoa was observed following near-infra-red OCT laser radiation. Future work will investigate the fertilization process and embryo development following near-infra-red OCT laser radiation.

研究问题：暴露于近红外光学相干断层扫描（OCT）激光辐射是否会引起猪和人精子的光毒性作用？设计：使用计算机辅助精子分析（CASA）来确定通常用于成像的OCT激光照明水平或更高水平是否会改变精子活力。流式细胞术检测辐照对精子顶体反应状态、DNA断裂和膜完整性的影响。此外，对猪卵积云与辐照精子的体外延时OCT成像，以确定辐照精子是否与卵积云相互作用并穿透卵积云。最后，用CASA和流式细胞术对人精子进行辐照和分析。结果：与匹配的操作对照相比，所有辐照样品在精子DNA损伤或CASA精子运动参数（包括平均路径速度、直线速度或曲线速度）方面没有显着差异，这表明样品辐照不会损害精子活力，即使使用比胚胎成像通常所需的光功率大一个数量级以上的光功率。概念验证OCT成像表明，在积云相互作用期间，受辐照精子的运动不受辐射的影响。结论：近红外OCT激光照射对猪和人精子动力学无明显影响。未来的工作将研究近红外OCT激光照射后的受精过程和胚胎发育。

{"title":"Investigating phototoxicity of optical coherence tomography imaging in porcine and human spermatozoa","authors":"Marie Claire Aquilina , Julien Camard , Wisdom Igiogbe , Taylor Sanderson , Lucy Abbott , Darren K. Griffin , Adrian Podoleanu , Peter Ellis , Giuseppe Silvestri , Manuel J. Marques","doi":"10.1016/j.rbmo.2025.105175","DOIUrl":"10.1016/j.rbmo.2025.105175","url":null,"abstract":"<div><h3>Research question</h3><div>Does exposure to near-infra-red optical coherence tomography (OCT) laser radiation induce phototoxic effects in porcine and human spermatozoa?</div></div><div><h3>Design</h3><div>Computer-assisted sperm analysis (CASA) was used to determine whether OCT laser illumination at or above levels typically used for imaging alters sperm motility. Flow cytometry was used to determine the impact of irradiation on sperm acrosome reaction status, DNA fragmentation, and membrane integrity. Additionally, in-vitro time-lapse OCT imaging of a porcine cumulus–oocyte complex with irradiated spermatozoa was performed to determine whether irradiated spermatozoa interact with and penetrate the cumulus oophorus. Finally, human spermatozoa were irradiated and analysed using CASA and flow cytometric techniques.</div></div><div><h3>Results</h3><div>All irradiated samples showed no significant difference in sperm DNA damage or CASA sperm motility parameters, including average path velocity, straight line velocity or curvilinear velocity, compared with their matched manipulation control, suggesting that sample irradiation did not compromise sperm viability, even when using an optical power of more than one order of magnitude greater than that typically required to image embryos. Proof-of-concept OCT imaging suggested that motility of irradiated spermatozoa during cumulus interaction was not affected by radiation.</div></div><div><h3>Conclusions</h3><div>No significant effect on the kinetics of boar and human spermatozoa was observed following near-infra-red OCT laser radiation. Future work will investigate the fertilization process and embryo development following near-infra-red OCT laser radiation.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 1","pages":"Article 105175"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596979","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}

引用次数: 0

Effect of constant (5%) versus gradient (8%–2%) oxygen concentration on sibling human blastocyst development 恒定（5%）氧浓度与梯度（8%-2%）氧浓度对同胞囊胚发育的影响。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-08-07 DOI: 10.1016/j.rbmo.2025.105207

Peter Slatinšek , Milan Reljič , Borut Kovačič

Research question

Does a gradient of oxygen concentration, decreasing from 8% to 2% during prolonged embryo culture, yield a higher percentage of morphologically optimal blastocysts compared with a static 5% oxygen atmosphere?

Design

This prospective sibling-split study included 658 cumulus-oocyte complexes from 44 intracytoplasmic sperm injection (ICSI) cycles (January 2022 to January 2023), alternately assigned to a control group (static 5% oxygen) or an intervention group (stepwise oxygen reduction: 8% on days 0-3, 5% on day 3, and 2% until days 5 or 6).

Results

Early embryo morphology was similar between groups. By day 5, following exposure to 2% oxygen from day 3, the control group produced a significantly higher proportion of clinically used blastocysts (47.3%, 122/258 vs. 36.9%, 97/263; P = 0.0161). Rates of morphologically optimal day-5 blastocysts were comparable (14.7%, 38/258 vs. 10.3%, 27/263; P = 0.2373). Time-lapse analysis showed delayed initiation of blastulation (P = 0.0024), blastocyst formation (P < 0.001), and expansion (P < 0.001) in the intervention group. Because of this delay, embryologists were more likely to select blastocysts for fresh transfer from the control group in a blinded procedure (P = 0.0088). Morphometric analysis showed significantly larger blastocyst cross-sectional area in the control group (28,198 ± 4139 vs. 25,994 ± 4657 µm²; P = 0.0014), consistent with more advanced expansion under constant 5% oxygen.

Conclusions

Gradually lowering oxygen from 8% to 2% during the second half of embryo culture resulted in delayed blastulation and fewer clinically used blastocysts when compared with culture under static 5% oxygen.

研究问题：在长时间的胚胎培养过程中，氧气浓度从8%下降到2%的梯度，与静态的5%氧气环境相比，是否能产生更高比例的形态最佳囊胚？设计：这项前瞻性的兄弟姐妹分离研究包括来自44个胞浆内单精子注射（ICSI）周期（2022年1月至2023年1月）的658个卵母细胞堆积复合物，交替分配到对照组（静态5%氧气）或干预组（逐步氧气减少：0-3天8%，第3天5%，第5或6天2%）。结果：两组间早期胚胎形态相似。第5天，从第3天开始暴露于2%的氧气中，对照组产生的临床使用囊胚比例显著高于对照组（47.3%,122/258 vs. 36.9%, 97/263; P = 0.0161）。形态学最佳的第5天囊胚率具有可比性（14.7%,38/258 vs. 10.3%, 27/263; P = 0.2373）。延时分析显示，干预组囊胚起始延迟（P = 0.0024），囊胚形成延迟（P < 0.001），囊胚扩张延迟（P < 0.001）。由于这种延迟，胚胎学家更有可能在盲法程序中从对照组中选择囊胚进行新鲜移植（P = 0.0088）。形态计量学分析显示，对照组囊胚截面积显著增大（28,198±4139 vs. 25,994±4657µm2; P = 0.0014），与5%恒定氧气条件下更晚期的扩张相一致。结论：在胚胎培养的后半段，将氧气浓度从8%逐渐降低到2%，与5%的静态氧气培养相比，会导致囊胚发育延迟，临床使用囊胚数量减少。

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引用次数: 0

Double-stranded sperm DNA fragmentation assessed using comet assay is associated with recurrent pregnancy loss 使用彗星测定法评估双链精子DNA片段与复发性妊娠丢失相关。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-08-05 DOI: 10.1016/j.rbmo.2025.105184

Andrew Drakeley , Rebecca L. Lunt , Emily Newton , Rachel C. Gregoire , Linda Watkins , Katerina Bambang , Ann-Maria Ellard , Craig J. Ledgerwood , Lewis Rae , Alastair Sloan , Martin Lawlor , Lynsey Poots , Luca Moore , Elizabeth Bailie , Sara H. McDowell , Jordi Ribas-Maynou , Tara Moore

Research question

Do men attending a recurrent miscarriage clinic have high double-stranded sperm DNA damage compared with a sperm donor population?

Design

This prospective cohort study included 100 men attending a recurrent miscarriage clinic, and 81 sperm donors from a European sperm bank who had proven fertility. All semen samples were evaluated using the Examen Lab alkaline (Exact) comet assay, which identifies the global (single and double strand) DNA damage, and the neutral (Extend) comet assay, measuring only double-stranded sperm DNA fragmentation (dsSDF).

Results

Semen analysis showed that 66 male partners of women with a history of recurrent miscarriage were classified as being within normal parameters. Of these, however, 66 men (61%) had raised global SDF, and 52% had raised dsSDF. When evaluating each test separately, the Exact comet (global SDF) assay presented an area under the curve (AUC) of 0.690 (95% CI 0.623–0.756), with the neutral Extend comet (dsSDF only) assay having an AUC of 0.876 (95% CI 0.834–0.914), and the incidence of damage showed an improved AUC of 0.909 (95% CI 0.874–0.940).

Conclusions

This study of male factor SDF in a large cohort of men attending a recurrent miscarriage clinic, where they are rarely the focus of clinical investigation, shows a strong association with dsSDF and male factor-driven miscarriage contribution, highlighting the importance of male investigation in couples experiencing recurrent pregnancy loss.

研究问题：与精子捐赠者相比，参加复发性流产诊所的男性是否有较高的双链精子DNA损伤？设计：这项前瞻性队列研究包括100名在复发性流产诊所就诊的男性，以及81名来自欧洲精子库的证明有生育能力的捐精者。所有精液样本均使用Examen Lab碱性（Exact）彗星测定法进行评估，该方法可识别整体（单链和双链）DNA损伤，而中性（Extend）彗星测定法仅测量双链精子DNA片段（dsSDF）。结果：精液分析显示66例有反复流产史的女性的男性伴侣在正常范围内。然而，其中66名男性（61%）提高了全球SDF， 52%提高了dsSDF。当单独评估每个测试时，精确彗星（全球SDF）检测的曲线下面积（AUC）为0.690 (95% CI 0.623-0.756)，中性延伸彗星（仅dsSDF）检测的AUC为0.876 (95% CI 0.834-0.914)，损伤发生率的AUC为0.909 （95% CI 0.874-0.940）。结论：本研究对在复发性流产诊所就诊的大量男性进行了男性因子SDF的研究，该研究显示，dsSDF与男性因素驱动的流产贡献有很强的关联，突出了男性调查在复发性流产夫妇中的重要性。

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引用次数: 0

Fast and furious: live birth outcomes in 1266 infants born after one-step warming of vitrified human blastocysts 速度与激情：1266名在玻璃化人类囊胚一步加热后出生的婴儿的活产结果。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-08-31 DOI: 10.1016/j.rbmo.2025.105238

Juergen Liebermann, Rebecca Brohammer, Yuri Wagner, Allison Parus, Cynthia Macias, Nivek Suda, Alexis Vanderpool, Gabija Petrus, Olivia Sarris, Kelly Even, Ru Smith, Shelby Sutherland, Sue Jasulaitis, Jennifer Hirshfeld-Cytron, Christopher Sipe, Meike Uhler

Research question

Does one-step rehydration in the warming protocol for human blastocysts result in healthy live births?

Design

A total of 2411 frozen embryo transfers using a short one-step rehydration protocol and 2606 frozen embryo transfers using the multi-step protocol were available for analysis. One-step warming was performed at 37°C in 1M sucrose for 1 min. This study examined the gestational age at delivery and birth weight of male and female infants for both protocols.

Results

In the one-step warming protocol, 1266 infants were born. The overall live birth rate was 51.3%, average gestational age was 37.6 weeks, and average birth weight was 3267 g. The sex distribution was 49% male versus 51% female. Male infants were, on average, 70 g heavier than female infants (3305 g versus 3235 g, respectively). In the multi-step warming protocol, 1323 infants were born. The average gestational age was 37.6 weeks, and average birth weight was 3252 g. The sex distribution was 52% male versus 48% female. Male infants were, on average, 139 g heavier than female infants (3318 g vs 3179 g, respectively). There were no significant differences between the two warming groups in terms of live birth and miscarriage rates, gestational age and birth weight.

Conclusions

Short one-step rehydration during warming of human blastocysts for 1 min in 1M sucrose led to healthy infants born at term with corresponding birth weight. This one-step rehydration protocol has been shown to be safe and effective, and it has now been validated with 1266 live births.

研究问题：人类胚泡升温方案中的一步补液是否会导致健康的活产？设计：共有2411例采用短一步补液方案的冷冻胚胎移植和2606例采用多步骤方案的冷冻胚胎移植可用于分析。一步加热，37°C， 1M蔗糖，1分钟。本研究检查了两种方案的男婴和女婴的分娩胎龄和出生体重。结果：在一步升温方案中，1266名婴儿出生。总活产率为51.3%，平均胎龄37.6周，平均出生体重3267 g。性别分布为男性49%，女性51%。男婴平均比女婴重70克（分别为3305克和3235克）。在多步骤升温方案中，1323名婴儿出生。平均胎龄37.6周，平均出生体重3252 g。性别分布为52%的男性和48%的女性。男婴平均比女婴重139克（分别为3318克和3179克）。两组在活产率、流产率、胎龄和出生体重方面没有显著差异。结论：人胚泡在1M蔗糖中加热1 min，短时间一步补液可导致健康的足月婴儿出生体重。这种一步补液方案已被证明是安全有效的，目前已在1266例活产婴儿中得到验证。

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引用次数: 0

Real-life experience with transvaginal radiofrequency ablation in infertile patients with types 2 and 3 fibroids 经阴道射频消融治疗2型和3型肌瘤不孕患者的实际经验

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-06-14 DOI: 10.1016/j.rbmo.2025.105104

María Cerrillo , Javier Martínez-Salazar , Cristina Fernández , Pedro Royo , Alberto Vázquez , Elkin Muñoz , Víctor H. Gómez , José Puente , Antonio Requena , Juan A. García-Velasco

Research question

Transvaginal radiofrequency ablation (TRFA) may offer a safe and effective alternative to surgery for infertile women with type 2 or 3 fibroids under 4 cm diameter that compromise the uterine cavity.

Methods

In this study, 36 patients underwent ultrasound-guided TRFA between 2020 and 2023. Main outcomes were fibroid volume reduction at 1, 3, and 6 months, and post-procedure reproductive results.

Results

Mean baseline fibroid volume was 19.29 cm³, decreasing to 9.6 cm³ at 1 month, 4.39 cm³ at 3 months, and 4.07 cm³ at 6 months, reflecting >75% reduction. Mild pain and minimal bleeding occurred in 22% of patients; hysteroscopic removal of protruding fibroids was required in 22%. Among the 25 women undergoing subsequent ART, pregnancy and miscarriage rates per treated patient were 68% and 16%, respectively; live births occurred in 52%, with most deliveries at full-term. Caesarean delivery rate was 69.2%.

Conclusions

TRFA appears to be a safe and effective alternative to surgery for infertile women with type 2 or 3 fibroids under 4 cm in diameter that compromise the uterine cavity. The procedure does not seem to affect reproductive outcomes, and this study is the first to assess the effect of TRFA on ART.

研究问题：对于2型或3型肌瘤直径小于4厘米且危及子宫腔的不孕妇女，经阴道射频消融（TRFA）可能是一种安全有效的替代手术的方法。方法在本研究中，36例患者在2020年至2023年期间接受了超声引导下的TRFA。主要结果是1、3和6个月时肌瘤体积减少，以及术后生殖结果。结果平均基线肌瘤体积为19.29 cm3, 1个月时降至9.6 cm3, 3个月时降至4.39 cm3, 6个月时降至4.07 cm3，缩小了75%。22%的患者出现轻度疼痛和少量出血；22%的患者需要宫腔镜切除突出的肌瘤。在随后接受抗逆转录病毒治疗的25名妇女中，每名接受治疗的患者的怀孕率和流产率分别为68%和16%；52%为活产，多数为足月分娩。剖宫产率为69.2%。结论strfa对于直径小于4cm的2型或3型肌瘤累及子宫腔的不孕症患者是一种安全有效的手术治疗方法。该过程似乎不影响生殖结果，本研究首次评估TRFA对ART的影响。

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引用次数: 0

Assisted reproductive technology in Latin America: the Latin American Registry, 2022 拉丁美洲的辅助生殖技术：拉丁美洲登记处，2022年

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2026-01-01 Epub Date: 2025-08-16 DOI: 10.1016/j.rbmo.2025.105216

Fernando Zegers-Hochschild , Javier A Crosby , Carolina Musri , Fanny Petermann-Rocha , Gustavo Martinez , Hitomi Nakagawa , Carlos Morente , Armando Roque , Ana Palma-Govea , Latin American Network of Assisted Reproduction

Research question

What are the trends and effects of assisted reproductive technology (ART) interventions on the effectiveness and safety of ART carried out in Latin America during 2022.

Design

Retrospective collection of cycle-based multinational data obtained from ART procedures carried out by 204 accredited institutions in 16 countries.

Results

In total 123,265 initiated cycles resulted in 19,663 deliveries and 22,203 births. Use of ART varied greatly, from 643.3 cycles/million inhabitants in Uruguay to 28.8 in Guatemala. In autologous cycles, the proportion of women aged ≥40 years represents 35.1% of cycles, whereas women <34 years represents only 18.8%. The proportion of single embryo transfers (SET) increased from 42.4% in 2021 to 47.3% in 2022. Out of 22,203 babies born, 77.4% were singletons, 21.7% twins and 0.9% triplets or more. Intracytoplasmic sperm injection represented 85.4% of fertilization techniques, and blastocyst transfer increased from 79.3% in 2021 to 85.3% in 2022. Delivery rate after fresh blastocyst elective single embryo transfer (32.6%) was significantly higher than after the transfer of one frozen embryo transfer (FET) from freeze-all cycle (25.2%) (P = 0.0001). The number of aspirations leading to preimplantation genetic testing increased 2.6 times in 6 years, and significantly increased delivery rates/transfer (P ≤ 0.008) and reduced miscarriage at all ages (P ≤ 0.004) in autologous cycles, but not in oocyte donation cycles. Delivery rates after fresh transfer of embryos from vitrified–warmed donated oocytes, generated similar outcome to FET from fresh oocyte donation cycles (P = 0.5621). Perinatal mortality increased from 7.5‰ in singletons to 22.8‰ in twins.

Conclusion

Systematic collection of cycle-based multinational data contributes to cooperative sustained development and helps implement evidence-based reproductive decisions.

研究问题：2022年在拉丁美洲开展的辅助生殖技术（ART）干预措施的趋势和对ART有效性和安全性的影响是什么？设计回顾性收集16个国家204个认可机构开展的抗逆转录病毒治疗程序中获得的基于周期的多国数据。结果共123265例启动周期，分娩19663例，分娩22203例。抗逆转录病毒治疗的使用差异很大，从乌拉圭的643.3次/百万居民到危地马拉的28.8次/百万居民。在自体周期中，年龄≥40岁的女性占周期的35.1%，而34岁的女性仅占18.8%。单胚胎移植（SET）的比例从2021年的42.4%增加到2022年的47.3%。在22203名出生的婴儿中，77.4%是单胎，21.7%是双胞胎，0.9%是三胞胎或更多。胞浆内单精子注射占受精技术的85.4%，囊胚移植从2021年的79.3%增加到2022年的85.3%。新鲜囊胚选择性单胚胎移植后的分娩率（32.6%）显著高于冷冻全周期单胚胎移植（FET）后的分娩率（25.2%）（P = 0.0001）。6年内进行着床前基因检测的次数增加了2.6倍，在自体周期中显著增加了分娩/移植率（P≤0.008），并减少了所有年龄段的流产（P≤0.004），而在卵母细胞捐赠周期中则没有。从玻璃化加热的捐赠卵母细胞中新鲜移植胚胎后的分娩率与新鲜卵母细胞捐赠周期产生的FET相似（P = 0.5621）。围产期死亡率从单胎的7.5‰上升到双胞胎的22.8‰。结论基于周期的跨国数据系统收集有助于合作可持续发展，有助于实施循证生殖决策。

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引用次数: 0