Reproductive biomedicine online最新文献_第8页

Beyond Cosmetic Implications: Hirsutism as a Determinant of Health Perception in Women with PCOS 多毛症是多囊卵巢综合征女性健康感知的决定因素

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105313

Aslihan Yurtkal , Mujde Canday , Özde Sakarya

OBJECTIVE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

IMPACT STATEMENT

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.

目的多囊卵巢综合征（PCOS）是一种复杂的异质性疾病，涉及内分泌、生殖、代谢和心理健康等多个领域。这项研究强调了被忽视的多毛症的社会心理负担，这是雄激素过多的明显迹象，对妇女的健康和生活质量有影响。虽然多囊卵巢综合征的一个标志，其影响超出了外观，影响身份和社会功能超出了临床措施可以捕捉。本研究比较了多囊卵巢综合征（PCOS）患者伴多毛症和不伴多毛症的SF-36评分，以评估该症状是否独立导致身心健康下降。材料和方法本横断面研究纳入118名新诊断为多囊卵巢综合征的妇女，该研究基于2018年国际指南，该指南是2003年鹿特丹标准的更新。所有参与者在接受诊断信息之前完成SF-36问卷，以评估健康相关生活质量（HRQoL）。参与者根据是否存在多毛症进行分组，并相应地比较SF-36分量表得分。结果共对118例诊断为PCOS的女性进行了sa评估。与没有多毛症的参与者相比，有多毛症的参与者在SF-36问卷的身体功能（p=0.030）、一般健康（p=0.007）、活力（p=0.031）和心理健康（p=0.024）领域的得分明显较低。其他分量表差异无统计学意义。这些结果表明，多毛症与多囊卵巢综合征妇女的生理和心理健康状况下降有关。结论：研究结果表明，即使在没有明显代谢功能障碍的情况下，多囊卵巢综合征女性的多毛症与HRQoL降低独立相关。这表明多毛症不仅仅是一个美容问题，而且是整体健康的重要决定因素。在精准医疗时代，这些结果要求对多囊卵巢综合征采取更全面、以症状为重点的治疗方法，从生理和心理两方面着手。认识和管理可见的雄激素过量的负担应该是个体化护理的核心组成部分。未来的研究应探讨症状模式、文化背景和应对方式如何塑造多囊卵巢综合征的生活经历，以更好地为整体干预提供信息。影响声明：本研究表明，多毛症显著损害多囊卵巢综合征（PCOS）女性生活质量的多个方面，加强了对综合的、以患者为中心的方法的需求，以解决该综合征的代谢和社会心理领域。

{"title":"Beyond Cosmetic Implications: Hirsutism as a Determinant of Health Perception in Women with PCOS","authors":"Aslihan Yurtkal , Mujde Canday , 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}

引用次数: 0

Comparison of The Effects of Oral and Vaginal Micronized Progesterone Types for Luteal Phase Support in ART Treatments 口服和阴道微量黄体酮在ART治疗中黄体期支持的效果比较

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105309

Mustafa Erdogan , Vehbi Yavuz Tokgoz

OBJECTIVE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

All data are presented in Table 1.

CONCLUSIONS

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.

IMPACT STATEMENT

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.

目的比较口服地孕酮、阴道微孕酮凝胶和阴道微孕酮胶囊在辅助生殖技术中支持黄体期对周期和妊娠结局的影响，指导临床应用。材料与方法对988例新鲜胚胎移植辅助生殖患者进行回顾性分析。记录人口统计学和临床特征（年龄、BMI、不孕症持续时间和类型、基础FSH、LH、雌激素和AMH水平）、刺激参数（刺激持续时间、促性腺激素总剂量、子宫内膜厚度、取出和成熟卵母细胞数量、受精率）和妊娠结局（hCG阳性、临床妊娠和活产率）。根据黄体期支持分组：口服地屈孕酮（3 × 10 mg）、阴道孕酮凝胶（2 × 90 mg）、阴道微胶囊（3 × 200 mg）。比较三组患者的临床、实验室和妊娠结局。结果各组的平均年龄和BMI具有可比性。基础激素参数（FSH， LH， AMH）和窦卵泡计数无显著差异，表明卵巢储备相似。虽然回收的卵母细胞数量没有显著差异，但口服地屈孕酮组需要更长时间的刺激和更高的总促性腺激素剂量。妊娠结局各组相似，但口服地屈孕酮组临床妊娠率较低，活产率无显著差异。所有数据见表1。结论口服地孕酮、阴道孕酮凝胶和阴道微粉孕酮在新鲜胚胎移植周期中支持黄体期的有效性和安全性数据有限。很少有研究直接比较这三种方法。在我们的研究中，尽管口服地孕酮组的刺激时间更长，促性腺激素剂量更高，但所有组的周期和妊娠结局具有可比性。需要进一步的研究来证实这些发现。影响声明：在这种情况下，我们进行了当前的研究，发现尽管口服地屈孕酮组的刺激持续时间和促性腺激素的总剂量更高，但三种不同方法之间的周期结局和妊娠结果并没有不同。

{"title":"Comparison of The Effects of Oral and Vaginal Micronized Progesterone Types for Luteal Phase Support in ART Treatments","authors":"Mustafa Erdogan , 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}

引用次数: 0

Fertility preservation and family-building in transgender and non-binary patients: 14 years at a UK centre. 跨性别和非二元患者的生育能力保存和家庭建设：在英国中心的14年。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-24 DOI: 10.1016/j.rbmo.2025.105361

Ellen Davenport-Pleasance, Mimi Arian-Schad, Rukma Bhattacharya, Mona Rahmati, Elena Linara-Demakakou, Nick Macklon, Kaj Rydman, Jemma Garratt, Kamal K Ahuja

Research question: How is assisted reproductive technology used by trans and/or non-binary (TNB) individuals and their partners at London Women's Clinic?

Design: This retrospective observational study examined treatments undertaken by TNB people at London Women's Clinic between 2011 and 2025. Demographic information on patients' age, body mass index, anti-Mullerian hormone, antral follicle count and history of gender-affirming hormone therapy/surgery was analysed. Outcomes included the types of treatment pursued, ongoing pregnancies, and live births.

Results: Sixty-four individuals who identified as TNB (n = 42) or had a TNB partner (n = 22) attended the clinic. Treatments included egg freezing (22 cycles), intrauterine insemination (IUI; 17 cycles) and IVF (25 cycles). A minority of IVF cycles involved intra-partner donation (reciprocal IVF; 2/25) or donor eggs (2/25). Three couples' journeys involved surrogacy arrangements. Most TNB individuals attended the clinic with a partner (n = 30), with the exception of those undertaking egg freezing. Of the individuals/couples attempting pregnancy (n =24), most (n =20) were using donor spermatozoa, with the exception of four couples (two involving transgender women who had frozen spermatozoa, and two involving cisgender men). Thirteen live births were achieved and four individuals were discharged from the clinic with ongoing pregnancies.

Conclusions: TNB individuals in the UK are successfully using the spectrum of assisted reproduction options, often with donor gametes and occasionally surrogacy, to build families. In this study, IVF out-performed IUI, underscoring that with inclusive, legally informed care pathways, family formation for TNB patients is both feasible and effective.

研究问题：在伦敦妇女诊所，跨性别和/或非二元性（TNB）个体及其伴侣如何使用辅助生殖技术？设计：这项回顾性观察性研究调查了2011年至2025年间伦敦妇女诊所TNB患者接受的治疗。分析患者年龄、体重指数、抗苗勒管激素、窦卵泡计数和性别确认激素治疗/手术史等人口统计学信息。结果包括所追求的治疗类型、持续妊娠和活产。结果：64名确诊为TNB （n = 42）或有TNB伴侣（n = 22）的人参加了诊所。治疗包括卵子冷冻（22个周期）、宫内人工授精（IUI； 17个周期）和体外受精（IVF）（25个周期）。少数试管婴儿周期涉及伴侣内捐赠（互惠试管婴儿；2/25）或捐赠卵子（2/25）。三对夫妇的旅行涉及代孕安排。大多数TNB患者与伴侣一起就诊（n = 30），进行卵子冷冻的患者除外。在试图怀孕的个人/夫妇中（n =24），大多数（n =20）使用捐赠精子，除了四对夫妇（两对涉及冷冻精子的变性女性，两对涉及顺性男性）。实现了13例活产，有4人因怀孕而出院。结论：在英国，TNB个体成功地使用了一系列的辅助生殖选择，通常是通过供体配子和偶尔的代孕来建立家庭。在本研究中，IVF优于IUI，强调通过包容、合法的护理途径，TNB患者的家庭组建是可行和有效的。

{"title":"Fertility preservation and family-building in transgender and non-binary patients: 14 years at a UK centre.","authors":"Ellen Davenport-Pleasance, Mimi Arian-Schad, Rukma Bhattacharya, Mona Rahmati, Elena Linara-Demakakou, Nick Macklon, Kaj Rydman, Jemma Garratt, Kamal K Ahuja","doi":"10.1016/j.rbmo.2025.105361","DOIUrl":"https://doi.org/10.1016/j.rbmo.2025.105361","url":null,"abstract":"<p><strong>Research question: </strong>How is assisted reproductive technology used by trans and/or non-binary (TNB) individuals and their partners at London Women's Clinic?</p><p><strong>Design: </strong>This retrospective observational study examined treatments undertaken by TNB people at London Women's Clinic between 2011 and 2025. Demographic information on patients' age, body mass index, anti-Mullerian hormone, antral follicle count and history of gender-affirming hormone therapy/surgery was analysed. Outcomes included the types of treatment pursued, ongoing pregnancies, and live births.</p><p><strong>Results: </strong>Sixty-four individuals who identified as TNB (n = 42) or had a TNB partner (n = 22) attended the clinic. Treatments included egg freezing (22 cycles), intrauterine insemination (IUI; 17 cycles) and IVF (25 cycles). A minority of IVF cycles involved intra-partner donation (reciprocal IVF; 2/25) or donor eggs (2/25). Three couples' journeys involved surrogacy arrangements. Most TNB individuals attended the clinic with a partner (n = 30), with the exception of those undertaking egg freezing. Of the individuals/couples attempting pregnancy (n =24), most (n =20) were using donor spermatozoa, with the exception of four couples (two involving transgender women who had frozen spermatozoa, and two involving cisgender men). Thirteen live births were achieved and four individuals were discharged from the clinic with ongoing pregnancies.</p><p><strong>Conclusions: </strong>TNB individuals in the UK are successfully using the spectrum of assisted reproduction options, often with donor gametes and occasionally surrogacy, to build families. In this study, IVF out-performed IUI, underscoring that with inclusive, legally informed care pathways, family formation for TNB patients is both feasible and effective.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"105361"},"PeriodicalIF":3.5,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166342","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

Low risk of endometrioma infection after oocyte retrieval. 取卵后子宫内膜瘤感染风险低。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-22 DOI: 10.1016/j.rbmo.2025.105344

Guillaume Parpex, Mathilde Bourdon, Louis Marcellin, Manon Sorel, Chloé Maignien, Corinne Bordonné, Caroline Charlier, Catherine Patrat, Pietro Santulli, Charles Chapron

Research question: What is the incidence of endometrioma infections requiring surgical drainage following oocyte retrieval in women with ovarian endometrioma?

Design: This retrospective observational cohort study included women aged 18-43 years with a confirmed radiological diagnosis of ovarian endometrioma who underwent ovarian stimulation and oocyte retrieval for IVF/intracytoplasmic sperm injection (ICSI) or fertility preservation between January 2018 and December 2023 at a single tertiary academic centre. All procedures were performed under standardized aseptic conditions with antibiotic prophylaxis. Transcystic puncture was performed when deemed necessary. The primary outcome was the incidence of endometrioma infections requiring surgical drainage within 30 days after oocyte retrieval.

Results: Oocyte retrievals were performed in 1102 out of 1668 cycles (66.1%) for IVF/ICSI and in 566 cycles (33.9%) for fertility preservation. Bilateral endometriomas were present in 322 of 880 patients (36.6%), with a mean cyst (SD) diameter of 31.5 ± 22.7 mm. Endometriomas larger than 30 mm accounted for 295 of 649 cases (45.5%). Intentional transcystic puncture was performed in 76 of 1148 applicable procedures (6.6%), and endometrioma drainage during oocyte retrieval occurred in 52 cases (4.5%). Endometrioma infections requiring surgical drainage occurred in 6 of 1668 procedures (0.36%). Only one infection was reported following transcystic puncture (1.3%). No cases of sepsis or septic shock occurred. Five infections were managed with ultrasound-guided transvaginal drainage; one required laparoscopic surgery.

Conclusions: The incidence of endometrioma infection requiring surgical intervention after oocyte retrieval, including after transcystic puncture, is low. These findings support the safety of assisted reproductive techniques in women with endometriomas.

研究问题：卵巢子宫内膜异位瘤患者取卵后需要手术引流的子宫内膜异位瘤感染的发生率是多少？设计：本回顾性观察队列研究纳入了2018年1月至2023年12月在单一三级学术中心接受卵巢刺激和卵母细胞提取以进行体外受精/胞浆内单精子注射（ICSI）或保留生育能力的18-43岁放射学诊断为卵巢子宫内膜异位瘤的女性。所有操作均在标准化无菌条件下进行，并采用抗生素预防。必要时进行经囊穿刺。主要结果是子宫内膜瘤感染的发生率，需要在卵母细胞取出后30天内进行手术引流。结果：在IVF/ICSI的1668个周期中，有1102个周期（66.1%）进行了卵母细胞提取，566个周期（33.9%）进行了生育保存。880例患者中有322例（36.6%）存在双侧子宫内膜瘤，平均囊肿（SD）直径为31.5±22.7 mm。649例中大于30mm的子宫内膜瘤占295例（45.5%）。1148例手术中有76例（6.6%）进行了有意的经囊穿刺，52例（4.5%）在取卵过程中发生子宫内膜瘤引流。1668例手术中有6例（0.36%）发生子宫内膜瘤感染，需要手术引流。经囊穿刺后仅1例感染（1.3%）。无脓毒症或感染性休克病例发生。5例患者行超声引导下阴道引流术；其中一个需要腹腔镜手术。结论：卵母细胞取出后（包括经囊穿刺后）子宫内膜瘤感染需要手术干预的发生率较低。这些发现支持子宫内膜异位瘤妇女辅助生殖技术的安全性。

{"title":"Low risk of endometrioma infection after oocyte retrieval.","authors":"Guillaume Parpex, Mathilde Bourdon, Louis Marcellin, Manon Sorel, Chloé Maignien, Corinne Bordonné, Caroline Charlier, Catherine Patrat, Pietro Santulli, Charles Chapron","doi":"10.1016/j.rbmo.2025.105344","DOIUrl":"https://doi.org/10.1016/j.rbmo.2025.105344","url":null,"abstract":"<p><strong>Research question: </strong>What is the incidence of endometrioma infections requiring surgical drainage following oocyte retrieval in women with ovarian endometrioma?</p><p><strong>Design: </strong>This retrospective observational cohort study included women aged 18-43 years with a confirmed radiological diagnosis of ovarian endometrioma who underwent ovarian stimulation and oocyte retrieval for IVF/intracytoplasmic sperm injection (ICSI) or fertility preservation between January 2018 and December 2023 at a single tertiary academic centre. All procedures were performed under standardized aseptic conditions with antibiotic prophylaxis. Transcystic puncture was performed when deemed necessary. The primary outcome was the incidence of endometrioma infections requiring surgical drainage within 30 days after oocyte retrieval.</p><p><strong>Results: </strong>Oocyte retrievals were performed in 1102 out of 1668 cycles (66.1%) for IVF/ICSI and in 566 cycles (33.9%) for fertility preservation. Bilateral endometriomas were present in 322 of 880 patients (36.6%), with a mean cyst (SD) diameter of 31.5 ± 22.7 mm. Endometriomas larger than 30 mm accounted for 295 of 649 cases (45.5%). Intentional transcystic puncture was performed in 76 of 1148 applicable procedures (6.6%), and endometrioma drainage during oocyte retrieval occurred in 52 cases (4.5%). Endometrioma infections requiring surgical drainage occurred in 6 of 1668 procedures (0.36%). Only one infection was reported following transcystic puncture (1.3%). No cases of sepsis or septic shock occurred. Five infections were managed with ultrasound-guided transvaginal drainage; one required laparoscopic surgery.</p><p><strong>Conclusions: </strong>The incidence of endometrioma infection requiring surgical intervention after oocyte retrieval, including after transcystic puncture, is low. These findings support the safety of assisted reproductive techniques in women with endometriomas.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"105344"},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126171","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

Plastic pollution in human reproduction: should we worry? 人类生殖中的塑料污染：我们应该担心吗？

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-13 DOI: 10.1016/j.rbmo.2025.105343

Martina Broggiato, Stefania Pezzana, Chiara Scaccabarozzi, Francesca Parisi, Claudia Vanetti, Chiara Katerina Guinea Montalvo, Valeria M Savasi, Claudio Fenizia

Micro- and nanoplastics (MNP) are pervasive pollutants, detected in every ecosystem. Human exposure is extensive, and their capacity to cross biological barriers and accumulate in tissues raises growing concerns about reproductive health and pregnancy outcomes. Research has shown the presence of MNP in human placenta, fetal meconium and amniotic fluid, confirming their ability to reach the fetal compartment, potentially increasing risks for fetal development. In women, MNP have also been detected in follicular fluid, although their specific effects remain to be determined. In-vitro studies have reported MNP-induced placental vascular damage, whereas murine models suggest impaired ovarian function, reduced oocyte quality and decreased pregnancy rates after MNP exposure. In men, MNP have been identified in testicular tissue and semen. Animal studies report decreased sperm count and quality, likely because of oxidative stress, hormonal disruption and inflammation. Various techniques are available for detecting MNP in biological tissues. Mass and Raman spectroscopy are among the most widely used, each offering specific advantages and limitations. Interpreting experimental data also requires caution, as many in-vitro and in-vivo models use unrealistically high doses of pristine polymers lacking environmental additives, potentially limiting the relevance of their findings to real-world exposures.

微塑料和纳米塑料（MNP）是无处不在的污染物，在每个生态系统中都能检测到。人类接触是广泛的，它们跨越生物屏障并在组织中积累的能力日益引起人们对生殖健康和妊娠结局的关注。研究表明，MNP存在于人胎盘、胎粪和羊水中，证实了它们能够到达胎室，潜在地增加了胎儿发育的风险。在妇女中，卵泡液中也检测到MNP，但其具体影响仍有待确定。体外研究报道了MNP诱导的胎盘血管损伤，而小鼠模型显示MNP暴露后卵巢功能受损，卵母细胞质量下降，妊娠率下降。在男性中，已在睾丸组织和精液中发现MNP。动物研究报告精子数量和质量下降，可能是因为氧化应激、激素紊乱和炎症。多种技术可用于检测生物组织中的MNP。质量光谱学和拉曼光谱学是应用最广泛的两种方法，它们各自具有特定的优点和局限性。解释实验数据也需要谨慎，因为许多体外和体内模型使用不切实际的高剂量原始聚合物，缺乏环境添加剂，潜在地限制了他们的发现与现实世界暴露的相关性。

{"title":"Plastic pollution in human reproduction: should we worry?","authors":"Martina Broggiato, Stefania Pezzana, Chiara Scaccabarozzi, Francesca Parisi, Claudia Vanetti, Chiara Katerina Guinea Montalvo, Valeria M Savasi, Claudio Fenizia","doi":"10.1016/j.rbmo.2025.105343","DOIUrl":"https://doi.org/10.1016/j.rbmo.2025.105343","url":null,"abstract":"<p><p>Micro- and nanoplastics (MNP) are pervasive pollutants, detected in every ecosystem. Human exposure is extensive, and their capacity to cross biological barriers and accumulate in tissues raises growing concerns about reproductive health and pregnancy outcomes. Research has shown the presence of MNP in human placenta, fetal meconium and amniotic fluid, confirming their ability to reach the fetal compartment, potentially increasing risks for fetal development. In women, MNP have also been detected in follicular fluid, although their specific effects remain to be determined. In-vitro studies have reported MNP-induced placental vascular damage, whereas murine models suggest impaired ovarian function, reduced oocyte quality and decreased pregnancy rates after MNP exposure. In men, MNP have been identified in testicular tissue and semen. Animal studies report decreased sperm count and quality, likely because of oxidative stress, hormonal disruption and inflammation. Various techniques are available for detecting MNP in biological tissues. Mass and Raman spectroscopy are among the most widely used, each offering specific advantages and limitations. Interpreting experimental data also requires caution, as many in-vitro and in-vivo models use unrealistically high doses of pristine polymers lacking environmental additives, potentially limiting the relevance of their findings to real-world exposures.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"105343"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137718","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

Exposure to endocrine-disrupting chemicals in follicular fluid: implications for assisted reproductive technology outcomes. 暴露于卵泡液中干扰内分泌的化学物质：对辅助生殖技术结果的影响

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-13 DOI: 10.1016/j.rbmo.2025.105341

Yuxin Jiang, Xiaoyu Long, Yongxiu Hao, Lixue Chen, Tian Tian, Yue Zhao

Research question: Are endocrine-disrupting chemicals (EDC) in follicular fluid associated with assisted reproductive technology (ART) outcomes among women undergoing ART treatment?

Design: This prospective cohort study involved 176 women who underwent ART treatment in China. The concentrations of 76 EDC, across five categories, in follicular fluid were quantified. Generalized linear models (with and without restricted cubic splines to account for non-linear relationships) and Bayesian kernel machine regression (BKMR) models were utilized.

Results: Fifteen EDC exhibited significant negative associations with at least one conventional IVF/intracytoplasmic sperm injection (ICSI) outcome. Notably, mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) was consistently associated with reductions in all conventional IVF/ICSI outcomes, including the numbers of retrieved oocytes, mature oocytes, two pronuclear zygotes, blastocysts and high-quality embryos. Similarly, 3,5-di-tert-butyl-4-hydroxybenzoic acid (BHT-COOH) was negatively associated with all conventional IVF/ICSI outcomes except the number of blastocysts. No significant negative associations were observed between individual EDC and pregnancy outcomes, including the live birth rate. BKMR model analyses revealed that combinations of EDC were significantly associated with reductions in the numbers of retrieved oocytes and mature oocytes, and the probability of biochemical pregnancy. Among EDC combinations, phthalates (PAE) and bisphenol S (BPS) were identified as dominant contributors to adverse conventional IVF/ICSI outcomes and the biochemical pregnancy rate, respectively. Stratified and interaction analyses further indicated that stronger associations with conventional IVF/ICSI outcomes were observed among women aged ≤33 years.

Conclusions: Elevated concentrations of EDC in follicular fluid were associated with adverse ART outcomes, both as individual compounds and in combination. MECPP, BHT-COOH, PAE and BPS were identified as key EDC. Moreover, the associations were modified by age, with stronger adverse effects observed in younger women.

研究问题：在接受辅助生殖技术（ART）治疗的妇女中，卵泡液中的内分泌干扰化学物质（EDC）是否与辅助生殖技术（ART）的结果相关？设计：这项前瞻性队列研究涉及176名在中国接受抗逆转录病毒治疗的妇女。对卵泡液中5类76种EDC的浓度进行了定量分析。使用广义线性模型（有或没有限制三次样条来解释非线性关系）和贝叶斯核机回归（BKMR）模型。结果：15例EDC与至少一项常规IVF/胞浆内单精子注射（ICSI）结果呈显著负相关。值得注意的是，单（2-乙基-5-羧戊基）邻苯二甲酸酯（MECPP）始终与所有常规IVF/ICSI结果的降低相关，包括获得的卵母细胞、成熟卵母细胞、两个原核受精卵、囊胚和高质量胚胎的数量。同样，3,5-二叔丁基-4-羟基苯甲酸（BHT-COOH）与除囊胚数量外的所有常规IVF/ICSI结果呈负相关。未观察到个体EDC与妊娠结局（包括活产率）之间存在显著负相关。BKMR模型分析显示，EDC组合与取出的卵母细胞数量和成熟卵母细胞数量的减少以及生化妊娠的概率显著相关。在EDC联合用药中，邻苯二甲酸酯（PAE）和双酚S （BPS）分别被认为是导致常规IVF/ICSI不良结局和生化妊娠率的主要因素。分层和相互作用分析进一步表明，在年龄≤33岁的女性中，观察到与常规IVF/ICSI结果有更强的关联。结论：卵泡液中EDC浓度升高与抗逆转录病毒治疗的不良结果相关，无论是单独的化合物还是联合使用。MECPP、BHT-COOH、PAE和BPS被确定为关键EDC。此外，这种关联随着年龄的变化而改变，在年轻女性中观察到更强的不良反应。

{"title":"Exposure to endocrine-disrupting chemicals in follicular fluid: implications for assisted reproductive technology outcomes.","authors":"Yuxin Jiang, Xiaoyu Long, Yongxiu Hao, Lixue Chen, Tian Tian, Yue Zhao","doi":"10.1016/j.rbmo.2025.105341","DOIUrl":"https://doi.org/10.1016/j.rbmo.2025.105341","url":null,"abstract":"<p><strong>Research question: </strong>Are endocrine-disrupting chemicals (EDC) in follicular fluid associated with assisted reproductive technology (ART) outcomes among women undergoing ART treatment?</p><p><strong>Design: </strong>This prospective cohort study involved 176 women who underwent ART treatment in China. The concentrations of 76 EDC, across five categories, in follicular fluid were quantified. Generalized linear models (with and without restricted cubic splines to account for non-linear relationships) and Bayesian kernel machine regression (BKMR) models were utilized.</p><p><strong>Results: </strong>Fifteen EDC exhibited significant negative associations with at least one conventional IVF/intracytoplasmic sperm injection (ICSI) outcome. Notably, mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) was consistently associated with reductions in all conventional IVF/ICSI outcomes, including the numbers of retrieved oocytes, mature oocytes, two pronuclear zygotes, blastocysts and high-quality embryos. Similarly, 3,5-di-tert-butyl-4-hydroxybenzoic acid (BHT-COOH) was negatively associated with all conventional IVF/ICSI outcomes except the number of blastocysts. No significant negative associations were observed between individual EDC and pregnancy outcomes, including the live birth rate. BKMR model analyses revealed that combinations of EDC were significantly associated with reductions in the numbers of retrieved oocytes and mature oocytes, and the probability of biochemical pregnancy. Among EDC combinations, phthalates (PAE) and bisphenol S (BPS) were identified as dominant contributors to adverse conventional IVF/ICSI outcomes and the biochemical pregnancy rate, respectively. Stratified and interaction analyses further indicated that stronger associations with conventional IVF/ICSI outcomes were observed among women aged ≤33 years.</p><p><strong>Conclusions: </strong>Elevated concentrations of EDC in follicular fluid were associated with adverse ART outcomes, both as individual compounds and in combination. MECPP, BHT-COOH, PAE and BPS were identified as key EDC. Moreover, the associations were modified by age, with stronger adverse effects observed in younger women.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"105341"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150472","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

Synergistic effect of transfer of blastocyst and embryo vitrification on birth weight: a retrospective cohort study. 囊胚移植和胚胎玻璃化对出生体重的协同作用：一项回顾性队列研究。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-09 DOI: 10.1016/j.rbmo.2025.105340

Ming Li, Qingqing Tao, Zhengyang Zhao, Jin Huang, Ying Lian, Ping Liu, Qin Li, Rong Li, Jie Qiao

Research question: Does the synergistic interaction between blastocyst-stage embryo transfer and vitrification in assisted reproductive technology increase the risk of adverse neonatal outcomes, specifically elevated birth weight z-scores and a higher incidence of clinically concerning large for gestational age (LGA) or macrosomia in offspring?

Design: In this cohort study, multivariable regression analyses were conducted to examine the association between embryo transfer strategies (fresh versus frozen; cleavage versus blastocyst stage) and the birth weight z-score of singletons, as well as the incidence of LGA and macrosomia among 42,190 singleton live births from the Center for Reproductive Medicine at Peking University Third Hospital between 2012 and 2022.

Results: Compared with cleavage-stage embryo transfer, newborns resulting from blastocyst-stage transfers had significantly higher birth weight z-scores (P < 0.001), LGA (P < 0.001) and macrosomia (P = 0.013). Frozen embryo transfer (only vitrified-warmed) was associated with increased birth weight z-scores (P = 0.001), LGA (P = 0.004) and macrosomia (P = 0.007), compared with fresh embryo transfers. A significant synergetic effect of blastocyst transfer and vitrified-warmed transfer concerning the LGA was found (relative excess risks due to interaction = 0.24; 95% CI 0.06 to 0.42; P = 0.022 for multiplicative interaction term) on the additive and multiplicative scales.

Conclusions: Blastocyst stage and embryo vitrification were associated with elevated birth weight z-scores and an increased likelihood of LGA, with evidence of a synergistic effect. These findings support the importance of personalized clinical decision-making in the use of vitrified-warmed cleavage-stage transfer, particularly in the absence of clear medical indications.

研究问题：辅助生殖技术中囊胚期胚胎移植和玻璃化之间的协同相互作用是否会增加新生儿不良结局的风险，特别是出生体重z-评分升高和后代临床有关大胎龄（LGA）或巨大儿的更高发生率？设计：本队列研究采用多变量回归分析，探讨2012 - 2022年北京大学第三医院生殖医学中心42,190例单胎活产婴儿中，胚胎移植策略（新鲜与冷冻、卵裂与囊胚期）与单胎出生体重z-score、LGA和巨大儿发生率之间的关系。结果：与卵裂期胚胎移植相比，囊胚期移植的新生儿出生体重z-score （P < 0.001）、LGA （P < 0.001）和巨大儿（P = 0.013）显著高于卵裂期胚胎移植。与新鲜胚胎移植相比，冷冻胚胎移植（仅玻璃化加热）与出生体重z-score (P = 0.001),LGA （P = 0.004）和巨大儿（P = 0.007）增加相关。发现囊胚移植和玻璃化热移植对LGA有显著的协同效应（相互作用的相对超额风险 = 0.24;95% CI 0.06 ~ 0.42；乘法相互作用项P = 0.022）。结论：囊胚期和胚胎玻璃化与出生体重z分数升高和LGA可能性增加有关，有证据表明存在协同效应。这些发现支持在使用玻璃化加热的卵裂期移植时个性化临床决策的重要性，特别是在没有明确医学指征的情况下。

{"title":"Synergistic effect of transfer of blastocyst and embryo vitrification on birth weight: a retrospective cohort study.","authors":"Ming Li, Qingqing Tao, Zhengyang Zhao, Jin Huang, Ying Lian, Ping Liu, Qin Li, Rong Li, Jie Qiao","doi":"10.1016/j.rbmo.2025.105340","DOIUrl":"https://doi.org/10.1016/j.rbmo.2025.105340","url":null,"abstract":"<p><strong>Research question: </strong>Does the synergistic interaction between blastocyst-stage embryo transfer and vitrification in assisted reproductive technology increase the risk of adverse neonatal outcomes, specifically elevated birth weight z-scores and a higher incidence of clinically concerning large for gestational age (LGA) or macrosomia in offspring?</p><p><strong>Design: </strong>In this cohort study, multivariable regression analyses were conducted to examine the association between embryo transfer strategies (fresh versus frozen; cleavage versus blastocyst stage) and the birth weight z-score of singletons, as well as the incidence of LGA and macrosomia among 42,190 singleton live births from the Center for Reproductive Medicine at Peking University Third Hospital between 2012 and 2022.</p><p><strong>Results: </strong>Compared with cleavage-stage embryo transfer, newborns resulting from blastocyst-stage transfers had significantly higher birth weight z-scores (P < 0.001), LGA (P < 0.001) and macrosomia (P = 0.013). Frozen embryo transfer (only vitrified-warmed) was associated with increased birth weight z-scores (P = 0.001), LGA (P = 0.004) and macrosomia (P = 0.007), compared with fresh embryo transfers. A significant synergetic effect of blastocyst transfer and vitrified-warmed transfer concerning the LGA was found (relative excess risks due to interaction = 0.24; 95% CI 0.06 to 0.42; P = 0.022 for multiplicative interaction term) on the additive and multiplicative scales.</p><p><strong>Conclusions: </strong>Blastocyst stage and embryo vitrification were associated with elevated birth weight z-scores and an increased likelihood of LGA, with evidence of a synergistic effect. These findings support the importance of personalized clinical decision-making in the use of vitrified-warmed cleavage-stage transfer, particularly in the absence of clear medical indications.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"105340"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143392","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

Response to: Representation of study in recent RBMO Commentary 回应：在最近的RBMO评论研究的代表性。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-04 DOI: 10.1016/j.rbmo.2025.105338

Juan A. Garcia-Velasco, Michael Alper, Antonio Capalbo, Robert Casper, Human Fatemi, Thomas Molinaro, Filipo Ubaldi, Antonio Pellicer

引用次数: 0

Representation of study in recent RBMO Commentary 最近RBMO评论中的研究表现。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-04 DOI: 10.1016/j.rbmo.2025.105337

Dorit Kieslinger, Carlijn Vergouw, Nils Lambalk, all authors of the SelecTIMO study

引用次数: 0

Reproductive medicine and human embryo research: rethinking risk through the lens of Aristotle’s phronesis 生殖医学和人类胚胎研究：通过亚里士多德的phronesis透镜重新思考风险。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-10-03 DOI: 10.1016/j.rbmo.2025.105287

Maxime Chaillot , Maxence Gaillard , Laurent David , Thomas Freour

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 phronesis – 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.

在辅助生殖技术（ART）和人类胚胎研究领域，临床医生和科学家经常面临混合科学不确定性和深刻的伦理复杂性的决定。随着这些快速发展领域的创新加速，道德导航可能具有挑战性。指导方针、规章和协议通常提供结构，但往往不能提供足够的道德清晰度。在这种复杂和不断发展的环境中，我们提出亚里士多德著名的实践智慧概念，即在复杂的现实生活中通过平衡知识、经验和道德判断做出道德合理决策的能力，可以为在ART和/或人类胚胎研究中导航选择提供重要工具，在这些研究中，证据、伦理和人类生活经验交叉。

引用次数: 0