Can hyaluronan-enriched transfer medium (HETM) improve reproductive outcomes in frozen single euploid blastocyst transfers after preimplantation genetic testing for aneuploidy (PGT-A)?
Design
Retrospective analysis of 445 patients (549 cycles), who had PGT-A embryo transfers that used HETM (EmbryoGlue) versus standard medium. Subgroup analyses were conducted based on blastocyst morphology, maternal age and previous implantation failure.
Results
No significant differences were found between HETM and control groups in the main reproductive outcomes, including positive HCG rates (72.27% versus 70.23%, P = 0.648), clinical pregnancy (80.23% versus 84.11%, P = 0.440), live birth rates (66.28% versus 72.85%, P = 0.237), and miscarriage rates (13.95% and 11.26%, P = 0.404).
Subgroup analyses by blastocyst cohort quality, maternal age and previous implantation failure showed no statistically significant benefit of HETM. On transfers of poor morphology (C-grade) blastocysts, HETM was associated with a significantly higher HCG-positive rate (79.17% for HETM versus 52.94% for the control group, P = 0.021), but this did not translate into improved clinical pregnancy (52.63% HETM versus 68.89% control group; P = 0.231) or live birth rates (47.37% HETM versus 62.22% control group; P = 0.284).
Conclusions
HETM did not provide a significant advantage in reproductive outcomes after single euploid blastocyst transfer. Its limited benefit in specific subgroups, such as poor morphology embryos, warrants cautious use and further research.
{"title":"Hyaluronan-enriched transfer media in PGT-A cycles: a stratified cohort analysis","authors":"Pierfrancesco Greco , Flavia Costanzi , Ilaria Listorti , Maria Teresa Varricchio , Katarzyna Litwicka , Cristiana Arrivi , Cecilia Mencacci , Ermanno Greco , Alessandro Colasante","doi":"10.1016/j.rbmo.2025.105235","DOIUrl":"10.1016/j.rbmo.2025.105235","url":null,"abstract":"<div><h3>Research question</h3><div>Can hyaluronan-enriched transfer medium (HETM) improve reproductive outcomes in frozen single euploid blastocyst transfers after preimplantation genetic testing for aneuploidy (PGT-A)?</div></div><div><h3>Design</h3><div>Retrospective analysis of 445 patients (549 cycles), who had PGT-A embryo transfers that used HETM (EmbryoGlue) versus standard medium. Subgroup analyses were conducted based on blastocyst morphology, maternal age and previous implantation failure.</div></div><div><h3>Results</h3><div>No significant differences were found between HETM and control groups in the main reproductive outcomes, including positive HCG rates (72.27% versus 70.23%, <em>P</em> = 0.648), clinical pregnancy (80.23% versus 84.11%, <em>P</em> = 0.440), live birth rates (66.28% versus 72.85%, <em>P</em> = 0.237), and miscarriage rates (13.95% and 11.26%, <em>P</em> = 0.404).</div><div>Subgroup analyses by blastocyst cohort quality, maternal age and previous implantation failure showed no statistically significant benefit of HETM. On transfers of poor morphology (C-grade) blastocysts, HETM was associated with a significantly higher HCG-positive rate (79.17% for HETM versus 52.94% for the control group, <em>P</em> = 0.021), but this did not translate into improved clinical pregnancy (52.63% HETM versus 68.89% control group; <em>P</em> = 0.231) or live birth rates (47.37% HETM versus 62.22% control group; <em>P</em> = 0.284).</div></div><div><h3>Conclusions</h3><div>HETM did not provide a significant advantage in reproductive outcomes after single euploid blastocyst transfer. Its limited benefit in specific subgroups, such as poor morphology embryos, warrants cautious use and further research.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105235"},"PeriodicalIF":3.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885634","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}
Pub Date : 2025-09-05DOI: 10.1016/j.rbmo.2025.105242
Rebecca Goldstein , Alexandra Benoit , Michaël Grynberg , Louise Vrtovsnik , Sophia Rakrouki , Céleste Becquart , Ines Sellami , Claire Vinolas , Vincent Puy , Florence Eustache , Anne Mayeur , Maeliss Peigné , Charlotte Sonigo
Research question
What are the fertility outcomes in women with endometriosis who attempt to conceive at least 2 years after undergoing fertility preservation.
Design
This retrospective, observational, bicentric cohort study included women diagnosed with endometriosis confirmed by imaging (pelvic magnetic resonance imaging or ultrasonography) who underwent at least one controlled ovarian stimulation cycle for fertility preservation between 1 July 2013 and 31 December 2019.
Results
Among 200 participants, follow-up data were available for 184, of whom 76 (41.3%) had attempted to conceive by the end-point (15 February 2023). The median number of oocytes and/or embryos vitrified per patient was 14 (interquartile range [IQR] 8–20). Being in a relationship at the initial consultation was significantly associated with later conception attempts (70.7% versus 25.7%, P < 0.0001). Overall, 48 (63.2%) achieved a pregnancy: 50% naturally, 37.5% using frozen material, and 12.5% via a new IVF attempt with fresh oocytes. Live birth occurred in 31 (40.8%). Among those who had attempted conception, the 4-year cumulative pregnancy incidence following fertility preservation was estimated at 55% (95% CI 45–68%). The cryopreserved material utilization rate was estimated at 48% (95% CI 37–63%) 5 years after fertility preservation. Nulliparity (hazard ratio [HR] 1.43, 95% CI [1.00–2.06] ) and having frozen embryos (HR 2.34, 95% CI [1.65–3.33]) were significant predictors of material use over the follow-up period.
Conclusions
Despite the known detrimental effects of endometriosis on fertility, a majority of women who attempted to conceive following fertility preservation achieved pregnancy, with a substantial proportion conceiving naturally. Half of these used their cryopreserved material, supporting fertility preservation as part of comprehensive reproductive counselling in endometriosis care.
研究问题子宫内膜异位症患者在接受保存生育能力至少2年后尝试怀孕的生育结果是什么？这项回顾性、观察性、双中心队列研究纳入了2013年7月1日至2019年12月31日期间接受至少一个控制卵巢刺激周期以保持生育能力的经影像学（盆腔磁共振成像或超声检查）确诊为子宫内膜异位症的女性。结果在200名参与者中，有184人获得随访数据，其中76人（41.3%）在终点（2023年2月15日）尝试怀孕。每位患者玻璃化卵母细胞和/或胚胎的中位数为14个（四分位数范围[IQR] 8-20）。在初次咨询时处于恋爱关系中与后来的受孕尝试显著相关（70.7%对25.7%,P < 0.0001）。总体而言，48例（63.2%）成功怀孕：50%自然受孕，37.5%使用冷冻材料，12.5%通过新鲜卵母细胞进行新的IVF尝试。活产31例（40.8%）。在尝试受孕的患者中，保留生育能力后的4年累计妊娠发生率估计为55% （95% CI 45-68%）。冷冻保存后5年的材料利用率估计为48% （95% CI 37-63%）。未生育（风险比[HR] 1.43, 95% CI[1.00-2.06]）和冷冻胚胎（风险比[HR] 2.34, 95% CI[1.65-3.33]）是随访期间材料使用的重要预测因素。结论：尽管已知子宫内膜异位症对生育能力有不利影响，但大多数尝试保留生育能力的妇女都成功怀孕，其中很大一部分是自然受孕。其中一半使用了冷冻保存的材料，支持将生育能力保存作为子宫内膜异位症护理中全面生殖咨询的一部分。
{"title":"Reproductive outcomes following fertility preservation in women with endometriosis","authors":"Rebecca Goldstein , Alexandra Benoit , Michaël Grynberg , Louise Vrtovsnik , Sophia Rakrouki , Céleste Becquart , Ines Sellami , Claire Vinolas , Vincent Puy , Florence Eustache , Anne Mayeur , Maeliss Peigné , Charlotte Sonigo","doi":"10.1016/j.rbmo.2025.105242","DOIUrl":"10.1016/j.rbmo.2025.105242","url":null,"abstract":"<div><h3>Research question</h3><div>What are the fertility outcomes in women with endometriosis who attempt to conceive at least 2 years after undergoing fertility preservation.</div></div><div><h3>Design</h3><div>This retrospective, observational, bicentric cohort study included women diagnosed with endometriosis confirmed by imaging (pelvic magnetic resonance imaging or ultrasonography) who underwent at least one controlled ovarian stimulation cycle for fertility preservation between 1 July 2013 and 31 December 2019.</div></div><div><h3>Results</h3><div>Among 200 participants, follow-up data were available for 184, of whom 76 (41.3%) had attempted to conceive by the end-point (15 February 2023). The median number of oocytes and/or embryos vitrified per patient was 14 (interquartile range [IQR] 8–20). Being in a relationship at the initial consultation was significantly associated with later conception attempts (70.7% versus 25.7%, <em>P</em> < 0.0001). Overall, 48 (63.2%) achieved a pregnancy: 50% naturally, 37.5% using frozen material, and 12.5% via a new IVF attempt with fresh oocytes. Live birth occurred in 31 (40.8%). Among those who had attempted conception, the 4-year cumulative pregnancy incidence following fertility preservation was estimated at 55% (95% CI 45–68%). The cryopreserved material utilization rate was estimated at 48% (95% CI 37–63%) 5 years after fertility preservation. Nulliparity (hazard ratio [HR] 1.43, 95% CI [1.00–2.06] ) and having frozen embryos (HR 2.34, 95% CI [1.65–3.33]) were significant predictors of material use over the follow-up period.</div></div><div><h3>Conclusions</h3><div>Despite the known detrimental effects of endometriosis on fertility, a majority of women who attempted to conceive following fertility preservation achieved pregnancy, with a substantial proportion conceiving naturally. Half of these used their cryopreserved material, supporting fertility preservation as part of comprehensive reproductive counselling in endometriosis care.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105242"},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927751","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}
Pub Date : 2025-09-02DOI: 10.1016/j.rbmo.2025.105239
Qianqian Liang
Research question
What is the global and Chinese burden of polycystic ovary syndrome (PCOS) and infertility attributable to PCOS on the basis of age-standardized calculations from 1990 to 2021?
Design
Using open data from the Global Burden of Disease (GBD) database from 1990 to 2021, this study analysed the characteristics of PCOS and infertility attributable to PCOS in China and worldwide. Joinpoint was used to calculate the average annual percentage change (AAPC) and the corresponding 95% CI. An autoregressive integrated moving average (ARIMA) model was used to project the burden of disease from 2022 to 2036.
Results
From 1990 to 2021, the AAPC of the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life years rate (ASDR) of PCOS in China were 2%, 2% and 2.1%, respectively. Worldwide, the respective figures were 0.8%, 0.8% and 0.8%, respectively. The AAPC for ASPR and age-standardized years lived with disability rate (ASYR) for the global burden of infertility attributable to PCOS were 1% and 0.9%, respectively, compared with 1.9% and 2%, respectively, in China. By 2036, ASIR, ASPR and ASDR of PCOS in China are projected to increase to 71.64/100,000, 1912.27/100,000 and 16.48/100,000, respectively. Globally, these rates are projected to reach 68.64/100,000, 1934.92/100,000 and 16.91/100,000, respectively. ASPR and ASYR for infertility attributable to PCOS are predicted to continue their upward trend.
Conclusion
From 1990 to 2021, the burden of PCOS and infertility attributable to PCOS continued to rise in China and globally, making PCOS a major public health problem. Raising public awareness of this common disease in order to reduce complications has become a public health priority that needs attention.
{"title":"Trend analysis of the burden of PCOS and related infertility in China and worldwide between 1990 and 2021","authors":"Qianqian Liang","doi":"10.1016/j.rbmo.2025.105239","DOIUrl":"10.1016/j.rbmo.2025.105239","url":null,"abstract":"<div><h3>Research question</h3><div>What is the global and Chinese burden of polycystic ovary syndrome (PCOS) and infertility attributable to PCOS on the basis of age-standardized calculations from 1990 to 2021?</div></div><div><h3>Design</h3><div>Using open data from the Global Burden of Disease (GBD) database from 1990 to 2021, this study analysed the characteristics of PCOS and infertility attributable to PCOS in China and worldwide. Joinpoint was used to calculate the average annual percentage change (AAPC) and the corresponding 95% CI. An autoregressive integrated moving average (ARIMA) model was used to project the burden of disease from 2022 to 2036.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the AAPC of the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life years rate (ASDR) of PCOS in China were 2%, 2% and 2.1%, respectively. Worldwide, the respective figures were 0.8%, 0.8% and 0.8%, respectively. The AAPC for ASPR and age-standardized years lived with disability rate (ASYR) for the global burden of infertility attributable to PCOS were 1% and 0.9%, respectively, compared with 1.9% and 2%, respectively, in China. By 2036, ASIR, ASPR and ASDR of PCOS in China are projected to increase to 71.64/100,000, 1912.27/100,000 and 16.48/100,000, respectively. Globally, these rates are projected to reach 68.64/100,000, 1934.92/100,000 and 16.91/100,000, respectively. ASPR and ASYR for infertility attributable to PCOS are predicted to continue their upward trend.</div></div><div><h3>Conclusion</h3><div>From 1990 to 2021, the burden of PCOS and infertility attributable to PCOS continued to rise in China and globally, making PCOS a major public health problem. Raising public awareness of this common disease in order to reduce complications has become a public health priority that needs attention.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105239"},"PeriodicalIF":3.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842369","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}
Pub Date : 2025-08-31DOI: 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.
{"title":"Fast and furious: live birth outcomes in 1266 infants born after one-step warming of vitrified human blastocysts","authors":"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","doi":"10.1016/j.rbmo.2025.105238","DOIUrl":"10.1016/j.rbmo.2025.105238","url":null,"abstract":"<div><h3>Research question</h3><div>Does one-step rehydration in the warming protocol for human blastocysts result in healthy live births?</div></div><div><h3>Design</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 1","pages":"Article 105238"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757525","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}
Research question: Does maternal occupational exposure to endocrine-disrupting chemicals (EDC) during pregnancy affect reproductive hormone concentrations in adult sons?
Design: Data from a cross-sectional study of 2326 Swiss conscripts collected between 2005 and 2017 were analysed. On inclusion, the conscripts’ mothers completed a detailed questionnaire about their pregnancy. A job-exposure matrix was used to assess exposure to 10 categories of potential EDC. Reproductive hormones – FSH, LH, total and free testosterone, oestradiol and sex hormone-binding globulin (SHBG) – were determined in serum samples from all conscripts whose mothers were exposed to EDC during pregnancy (n = 138) and a random sample of non-exposed conscripts (n = 276). Multiple linear regression analyses were adjusted for potential confounders.
Results: Prenatal exposure to phthalates or alkyl phenolic compounds was significantly associated with higher FSH concentrations (aβ = 0.26, 95% CI 0.03–0.49, and aβ = 0.22, 95% CI 0.02–0.42, respectively) and prenatal exposure to pesticides was significantly associated with higher SHBG concentrations (aβ = 0.22, 95% CI 0.05–0.38). No statistically significant associations were found between other EDC categories and reproductive hormones.
Conclusions: Maternal occupational exposure to certain types of EDC during pregnancy was associated with the concentrations of reproductive hormones in adult sons. These findings require replication in larger, prospective population studies.
研究问题：母亲在怀孕期间接触内分泌干扰化学物质（EDC）是否会影响成年儿子的生殖激素浓度？设计：对2005年至2017年间收集的2326名瑞士应征入伍者的横断面研究数据进行分析。入伍后，应征入伍者的母亲完成了一份详细的怀孕问卷。工作暴露矩阵用于评估10类潜在EDC的暴露。生殖激素——卵泡刺激素、黄体生成素、总睾酮和游离睾酮、雌二醇和性激素结合球蛋白（SHBG）——测定了母亲在怀孕期间暴露于EDC的所有应征士兵（ = 138）和随机抽样的未暴露的应征士兵（ = 276）的血清样本。多重线性回归分析对潜在混杂因素进行调整。结果：产前暴露于邻苯二甲酸酯或烷基酚类化合物与较高的FSH浓度显著相关（aβ = 0.26,95% CI 0.03-0.49，和aβ = 0.22,95% CI 0.02-0.42），产前暴露于农药与较高的SHBG浓度显著相关（aβ = 0.22,95% CI 0.05-0.38）。其他EDC类别与生殖激素之间无统计学意义的关联。结论：母亲在怀孕期间职业性暴露于某些类型的EDC与成年儿子的生殖激素浓度有关。这些发现需要在更大规模的前瞻性人群研究中得到验证。
{"title":"Prenatal occupational exposure to endocrine-disrupting chemicals during pregnancy and adult male reproductive hormones","authors":"Pauline Blanc-Petitjean , Rita Rahban , Brigitte Dananché , Alfred Senn , Fanny Zufferey , Eric Stettler , Luc Multigner , Serge Nef , Ronan Garlantézec","doi":"10.1016/j.rbmo.2025.105236","DOIUrl":"10.1016/j.rbmo.2025.105236","url":null,"abstract":"<div><div><strong>Research question</strong>: Does maternal occupational exposure to endocrine-disrupting chemicals (EDC) during pregnancy affect reproductive hormone concentrations in adult sons?</div><div><strong>Design</strong>: Data from a cross-sectional study of 2326 Swiss conscripts collected between 2005 and 2017 were analysed. On inclusion, the conscripts’ mothers completed a detailed questionnaire about their pregnancy. A job-exposure matrix was used to assess exposure to 10 categories of potential EDC. Reproductive hormones – FSH, LH, total and free testosterone, oestradiol and sex hormone-binding globulin (SHBG) – were determined in serum samples from all conscripts whose mothers were exposed to EDC during pregnancy (<em>n</em> = 138) and a random sample of non-exposed conscripts (<em>n</em> = 276). Multiple linear regression analyses were adjusted for potential confounders.</div><div><strong>Results</strong>: Prenatal exposure to phthalates or alkyl phenolic compounds was significantly associated with higher FSH concentrations (aβ = 0.26, 95% CI 0.03–0.49, and aβ = 0.22, 95% CI 0.02–0.42, respectively) and prenatal exposure to pesticides was significantly associated with higher SHBG concentrations (aβ = 0.22, 95% CI 0.05–0.38). No statistically significant associations were found between other EDC categories and reproductive hormones.</div><div><strong>Conclusions</strong>: Maternal occupational exposure to certain types of EDC during pregnancy was associated with the concentrations of reproductive hormones in adult sons. These findings require replication in larger, prospective population studies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105236"},"PeriodicalIF":3.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929261","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}
Pub Date : 2025-08-30DOI: 10.1016/j.rbmo.2025.105237
Idan Alcalay , Ariel Weissman , Hadas Ganer Herman , Avi Tsafrir , Matan Friedman , Eran Weiner , Raoul Orvieto , Nikolaos P Polyzos , Michael H Dahan , Alex Polyakov , Robert Fischer , Sandro C Esteves , Baris Ata , Jason M Franasiak , Yossi Mizrachi
Research question
Can generative artificial intelligence (AI) models provide reliable counselling to fertility patients regarding real-world clinical questions?
Design
In this cross-sectional study, 12 clinical questions were developed to reflect common, real-life dilemmas encountered during fertility workup and treatment. Responses to each question were generated by two experienced fertility specialists, and two AI models – ChatGPT and Gemini. Eight leading internationally recognized fertility experts, blinded to the source of each reply, independently rated all the responses on a scale from 1 (strongly disagree) to 10 (strongly agree). Ratings were compared across all four repliers using non-parametric statistical tests.
Results
The replies authored by physicians received significantly higher overall scores than those generated by AI models (P < 0.001). The median scores were highest for Doctor A (9.0), followed by Doctor B (8.0), then ChatGPT (7.0) and finally Gemini, which received the lowest score (4.5). The proportion of high-scoring responses (≥8) was greatest for Doctor A (70.8%), followed by Doctor B (56.3%), then ChatGPT (47.9%) and finally Gemini (35.4%) (P < 0.001).
Conclusions
Experienced fertility specialists outperformed generative AI models in providing accurate responses to complex clinical questions. Despite the growing accessibility and sophistication of AI tools, their use for individualized fertility counselling remains limited. Continued refinement and clinical validation of AI tools are essential before they can be considered reliable for patient-specific guidance. At present, AI should be viewed as a complementary resource rather than a substitute for expert clinical judgement.
{"title":"Can artificial intelligence models provide reliable medical counselling to fertility patients?","authors":"Idan Alcalay , Ariel Weissman , Hadas Ganer Herman , Avi Tsafrir , Matan Friedman , Eran Weiner , Raoul Orvieto , Nikolaos P Polyzos , Michael H Dahan , Alex Polyakov , Robert Fischer , Sandro C Esteves , Baris Ata , Jason M Franasiak , Yossi Mizrachi","doi":"10.1016/j.rbmo.2025.105237","DOIUrl":"10.1016/j.rbmo.2025.105237","url":null,"abstract":"<div><h3>Research question</h3><div>Can generative artificial intelligence (AI) models provide reliable counselling to fertility patients regarding real-world clinical questions?</div></div><div><h3>Design</h3><div>In this cross-sectional study, 12 clinical questions were developed to reflect common, real-life dilemmas encountered during fertility workup and treatment. Responses to each question were generated by two experienced fertility specialists, and two AI models – ChatGPT and Gemini. Eight leading internationally recognized fertility experts, blinded to the source of each reply, independently rated all the responses on a scale from 1 (strongly disagree) to 10 (strongly agree). Ratings were compared across all four repliers using non-parametric statistical tests.</div></div><div><h3>Results</h3><div>The replies authored by physicians received significantly higher overall scores than those generated by AI models (<em>P</em> < 0.001). The median scores were highest for Doctor A (9.0), followed by Doctor B (8.0), then ChatGPT (7.0) and finally Gemini, which received the lowest score (4.5). The proportion of high-scoring responses (≥8) was greatest for Doctor A (70.8%), followed by Doctor B (56.3%), then ChatGPT (47.9%) and finally Gemini (35.4%) (<em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Experienced fertility specialists outperformed generative AI models in providing accurate responses to complex clinical questions. Despite the growing accessibility and sophistication of AI tools, their use for individualized fertility counselling remains limited. Continued refinement and clinical validation of AI tools are essential before they can be considered reliable for patient-specific guidance. At present, AI should be viewed as a complementary resource rather than a substitute for expert clinical judgement.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105237"},"PeriodicalIF":3.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878896","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}
Pub Date : 2025-08-23DOI: 10.1016/j.rbmo.2025.105233
Yu-Sheng Cheng , Hsing-Yi Chen , Chia-Min Liu , Hsiu-Chiung Hou , Yu-Chiao Lin , Tsung-Yen Lin , Shih-Chieh Lin
Research question
Do human seminal plasma extracellular vesicles (SPEV) vary with distinct sperm features and possess clinical relevance for male infertility?
Design
Semen samples were provided for analysis: normozoospermic (n = 64); oligozoospermic (n = 35); asthenozoospermic (n = 51); teratozoospermic (n = 16); and azoospermic cases (n = 134). Size-exclusion chromatography was used to isolate SPEV, and concentration and size distribution were assessed via nanoparticle tracking analysis. Protein concentrations were measured using BCA Protein Assay Kits. Continuous variables were analysed as mean with a 95% CI.
Results
Highest mean SPEV concentration was observed in the normozoospermic group (4.9 × 1010/ml; 95% CI 3.5 –6.3 × 1010/ml); lowest mean concentration was found in azoospermic group (0.6 × 1010/ml; 95% CI 0.5 –0.8 × 1010/ml). Pearson coefficients of SPEV concentration with sperm count, progressive motility and total motile sperm count were 0.250, 0.344 and 0.433, respectively. Mean SPEV size from infertile men with non-obstructive azoospermia (NOA) is significantly smaller than that from men who have undergone a vasectomy or with obstructive azoospermia (151.3 nm, 95% CI 147.6 to 155.0 nm versus 159.4 nm, 95% CI 154.0 to 164.8 nm, P = 0.049). Mean protein content per SPEV particle is significantly higher in the NOA group than the vasectomy or obstructive azoospermia group (93.41 ag, 95% CI 50.67 to 132.6 ag versus 44.24 ag, 95% CI 24.74 to 63.74 ag, P < 0.001). The AUC curve is 0.702 (P < 0.001).
Conclusion
Concentration of SPEV significantly correlates with total motile spermatozoa. Protein content per SPEV particle may be a potential marker to distinguish obstructive azoospermia from NOA.
研究问题：人精浆细胞外囊泡（SPEV）是否随精子特征的不同而变化，与男性不育有临床相关性？提供精液样本用于分析：正常精子（n = 64）；oligozoospermic (n = 35);asthenozoospermic (n = 51);teratozoospermic (n = 16);无精子病例（n = 134）。采用粒径排除色谱法分离SPEV，并通过纳米颗粒跟踪分析评估其浓度和粒径分布。使用BCA蛋白测定试剂盒测定蛋白浓度。连续变量以95% CI的平均值进行分析。结果正常精子组SPEV平均浓度最高（4.9 × 1010/ml, 95% CI 3.5 ~ 6.3 × 1010/ml）；无精子组平均浓度最低（0.6 × 1010/ml; 95% CI 0.5 -0.8 × 1010/ml）。SPEV浓度与精子数量、精子渐进活动力和精子总活动力的Pearson系数分别为0.250、0.344和0.433。非阻塞性无精子症（NOA）不育男性的平均SPEV大小明显小于输精管切除术或阻塞性无精子症男性（151.3 nm, 95% CI 147.6 ~ 155.0 nm vs 159.4 nm, 95% CI 154.0 ~ 164.8 nm, P = 0.049）。NOA组每个SPEV颗粒的平均蛋白质含量显著高于输精管切除术或阻塞性无精子症组（93.41 ag, 95% CI 50.67 ~ 132.6 ag vs . 44.24 ag, 95% CI 24.74 ~ 63.74 ag, P < 0.001）。AUC曲线为0.702 （P < 0.001）。结论SPEV浓度与精子总活精子数显著相关。每个SPEV颗粒的蛋白质含量可能是区分阻塞性无精子症和NOA的潜在标志。
{"title":"Attributes of a large cohort of human seminal extracellular vesicles with varied sperm features","authors":"Yu-Sheng Cheng , Hsing-Yi Chen , Chia-Min Liu , Hsiu-Chiung Hou , Yu-Chiao Lin , Tsung-Yen Lin , Shih-Chieh Lin","doi":"10.1016/j.rbmo.2025.105233","DOIUrl":"10.1016/j.rbmo.2025.105233","url":null,"abstract":"<div><h3>Research question</h3><div>Do human seminal plasma extracellular vesicles (SPEV) vary with distinct sperm features and possess clinical relevance for male infertility?</div></div><div><h3>Design</h3><div>Semen samples were provided for analysis: normozoospermic (<em>n</em> = 64); oligozoospermic (<em>n</em> = 35); asthenozoospermic (<em>n</em> = 51); teratozoospermic (<em>n</em> = 16); and azoospermic cases (<em>n</em> = 134). Size-exclusion chromatography was used to isolate SPEV, and concentration and size distribution were assessed via nanoparticle tracking analysis. Protein concentrations were measured using BCA Protein Assay Kits. Continuous variables were analysed as mean with a 95% CI.</div></div><div><h3>Results</h3><div>Highest mean SPEV concentration was observed in the normozoospermic group (4.9 × 10<sup>10</sup>/ml; 95% CI 3.5 –6.3 × 10<sup>10</sup>/ml); lowest mean concentration was found in azoospermic group (0.6 × 10<sup>10</sup>/ml; 95% CI 0.5 –0.8 × 10<sup>10</sup>/ml). Pearson coefficients of SPEV concentration with sperm count, progressive motility and total motile sperm count were 0.250, 0.344 and 0.433, respectively. Mean SPEV size from infertile men with non-obstructive azoospermia (NOA) is significantly smaller than that from men who have undergone a vasectomy or with obstructive azoospermia (151.3 nm, 95% CI 147.6 to 155.0 nm versus 159.4 nm, 95% CI 154.0 to 164.8 nm, <em>P</em> = 0.049). Mean protein content per SPEV particle is significantly higher in the NOA group than the vasectomy or obstructive azoospermia group (93.41 ag, 95% CI 50.67 to 132.6 ag versus 44.24 ag, 95% CI 24.74 to 63.74 ag, <em>P</em> < 0.001). The AUC curve is 0.702 (<em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Concentration of SPEV significantly correlates with total motile spermatozoa. Protein content per SPEV particle may be a potential marker to distinguish obstructive azoospermia from NOA.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105233"},"PeriodicalIF":3.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842370","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}
Pub Date : 2025-08-22DOI: 10.1016/j.rbmo.2025.105230
Silke Dyer , Liezel Potgieter , Frissiano Honwana , Eman Elgindy , Rudolph Kantum Adageba , Mohamed Khrouf , Jean Claude Kolani , Faye Iketubosin , Paul Le Roux , Paversan Archary , African Network and Registry for Assisted Reproductive Technology
Research question
What were the utilization, effectiveness and safety of assisted reproductive technology (ART) in Africa in 2021 and 2022?
Design
Cross-sectional cycle-based data collected from voluntarily participating centres.
Results
Data were reported by 63 centres in 14 countries in 2021, and 69 centres in 16 countries in 2022. In 2021, there were 26,481 autologous aspirations and 29,523 autologous transfers (58.8% fresh transfers), 2681 transfers after oocyte donation, and 2074 cycles utilizing preimplantation genetic testing (PGT). In 2022, there were 31,596 autologous aspirations and 35,109 autologous transfers (55.8% fresh transfers), 3393 transfers after oocyte donation, and 2297 cycles utilizing PGT. In both years, the mean age of women undergoing autologous fresh transfers was 34 years, with a mean number of 2.3 embryos per transfer. In 2021, the pregnancy rate was 38.1% per fresh transfer and 41.9% per frozen embryo transfer, with a cumulative pregnancy rate per aspiration of 44.2%. In 2022, these rates were 36.5%, 42.6% and 43.6%, respectively. In total, 16,549 pregnancies were lost to follow-up. Based on reported outcomes, the multiple delivery rate was ≥20% following most procedures. Most multiples were born preterm and had substantially increased perinatal mortality compared with singletons. Elective single embryo transfer provided the best balance of ART effectiveness and safety. Ten-year trends documented stable effectiveness in fresh cycles, increasing effectiveness in frozen cycles, and no decline in multiple delivery rates.
Conclusion
This report marks the 10th anniversary of the African Network and Registry for Assisted Reproductive Technology (ANARA). ANARA’s annual reports represent and critically inform regional ART development based on real-world evidence and national, regional and global cooperation.
{"title":"Assisted reproductive technology in Africa: the African Network and Registry for ART, 2021 and 2022","authors":"Silke Dyer , Liezel Potgieter , Frissiano Honwana , Eman Elgindy , Rudolph Kantum Adageba , Mohamed Khrouf , Jean Claude Kolani , Faye Iketubosin , Paul Le Roux , Paversan Archary , African Network and Registry for Assisted Reproductive Technology","doi":"10.1016/j.rbmo.2025.105230","DOIUrl":"10.1016/j.rbmo.2025.105230","url":null,"abstract":"<div><h3>Research question</h3><div>What were the utilization, effectiveness and safety of assisted reproductive technology (ART) in Africa in 2021 and 2022?</div></div><div><h3>Design</h3><div>Cross-sectional cycle-based data collected from voluntarily participating centres.</div></div><div><h3>Results</h3><div>Data were reported by 63 centres in 14 countries in 2021, and 69 centres in 16 countries in 2022. In 2021, there were 26,481 autologous aspirations and 29,523 autologous transfers (58.8% fresh transfers), 2681 transfers after oocyte donation, and 2074 cycles utilizing preimplantation genetic testing (PGT). In 2022, there were 31,596 autologous aspirations and 35,109 autologous transfers (55.8% fresh transfers), 3393 transfers after oocyte donation, and 2297 cycles utilizing PGT. In both years, the mean age of women undergoing autologous fresh transfers was 34 years, with a mean number of 2.3 embryos per transfer. In 2021, the pregnancy rate was 38.1% per fresh transfer and 41.9% per frozen embryo transfer, with a cumulative pregnancy rate per aspiration of 44.2%. In 2022, these rates were 36.5%, 42.6% and 43.6%, respectively. In total, 16,549 pregnancies were lost to follow-up. Based on reported outcomes, the multiple delivery rate was ≥20% following most procedures. Most multiples were born preterm and had substantially increased perinatal mortality compared with singletons. Elective single embryo transfer provided the best balance of ART effectiveness and safety. Ten-year trends documented stable effectiveness in fresh cycles, increasing effectiveness in frozen cycles, and no decline in multiple delivery rates.</div></div><div><h3>Conclusion</h3><div>This report marks the 10<sup>th</sup> anniversary of the African Network and Registry for Assisted Reproductive Technology (ANARA). ANARA’s annual reports represent and critically inform regional ART development based on real-world evidence and national, regional and global cooperation.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105230"},"PeriodicalIF":3.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885635","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}
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