Frontiers in reproductive health最新文献

Objective: To evaluate the predictive value of hematologic inflammatory indices derived from complete blood count (CBC) parameters for in vitro fertilization (IVF) outcomes in women with unexplained infertility, and to determine their potential role as biomarkers of subclinical inflammation affecting reproductive success.

Materials and methods: This retrospective cohort study included 430 women with unexplained infertility who underwent IVF/ICSI cycles at Ege University Hospital between January 2020 and January 2025. CBC parameters and derived systemic inflammatory indices-including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)-were measured on the ovulation trigger day. Patients were divided into pregnant and non-pregnant groups according to clinical pregnancy outcomes. Demographic, hormonal, hematologic, and embryologic variables were compared using appropriate statistical tests, and logistic regression and ROC analyses were performed to identify independent predictors of pregnancy.

Results: None of the CBC-derived inflammatory indices showed significant differences between pregnant and non-pregnant groups (all p > 0.05). ROC analysis revealed poor discriminative ability for predicting pregnancy (AUC values 0.48-0.52). In contrast, embryologic variables-particularly the number of two-pronuclei (2PN) embryos and total embryos-were independent predictors of clinical pregnancy (p < 0.05), while excessive oocyte yield was inversely associated with pregnancy (p = 0.028).

Conclusion: Systemic inflammatory indices derived from CBC parameters, including NLR, PLR, MLR, SII, SIRI, and PIV, do not predict IVF/ICSI outcomes in women with unexplained infertility. Embryologic parameters, especially 2PN and total embryo counts, remain the most reliable predictors of clinical pregnancy.

Background: Menopause is a universal biological event whose experience is shaped by cultural and ethnic factors. The available literature reveals a wide range of perspectives across contexts and population groups, including women from diverse ethnic backgrounds. However, differences persist in how symptoms are conceptualized, expressed, and managed according to sociocultural environments. This scoping review aims to map the existing evidence on menopausal experiences among different ethnic groups and to identify recurring thematic patterns.

Methods: The review followed the Joanna Briggs Institute methodology for scoping reviews and was reported in accordance with PRISMA-ScR guidelines. Articles were retrieved from seven databases-Medline/PubMed, Web of Science, and Scopus-using database-specific search strategies. No language or time restrictions were applied. Studies were analyzed descriptively, and quality appraisal was conducted following the interpretive criteria proposed by Dixon-Woods et al.

Results: Out of 446 initial records, 374 remained eligible for title and abstract screening after duplicate removal; 63 full texts were assessed, and 20 studies met the inclusion criteria. Ethnic differences were observed in both the prevalence and interpretation of symptoms: African American and Hispanic women exhibited a greater emotional and vasomotor symptom burden, whereas Asian and Indigenous women tended to frame the menopausal transition as a natural or developmental process.

Conclusion: This scoping review highlights that menopause is not merely a biological phenomenon but a culturally embedded experience shaped by ethnicity, belief systems, and social position. Substantial ethnic differences exist in the perception, reporting, and meaning attributed to menopausal symptoms.

Objective: To characterize a rare fetal complex chromosomal rearrangement (CCR) derived from a maternal balanced translocation using integrated G-banding and CNV-seq analysis.

Methods: Integrated G-banding and CNV-seq enabled precise karyotypic determination in the fetus, with familial verification confirming its derivation.

Results: Karyotype analysis confirmed that the pregnant woman was a carrier of a balanced translocation, 46,XX,t(10;13)(p15;q22), while her husband had a normal karyotype. Combined G-banding and CNV-seq analyses diagnosed the fetal karyotype as 47,U,t(10;13)(p15;q22)mat,+der(13)t(10;13)dmat, resulting from 3:1 meiotic segregation of the maternal balanced translocation.

Conclusion: This case confirms the pivotal role of integrated G-banding and CNV-seq in diagnosing complex chromosomal rearrangements. For families with a high recurrence risk, PGT is a mandatory intervention to prevent subsequent adverse reproductive outcomes.

Introduction: Due to long-standing systemic xenophobia in the Dominican Republic (DR), women of Haitian descent are underrepresented in national health data. This study examined menstrual hygiene management (MHM) and other reproductive health concerns in a migrant-dense community to inform future health studies and potential interventions.

Methods: An anonymous cross-sectional survey was offered in a low-income community near Santo Domingo over two, one-week periods from October 2023 to April 2024. Eligible participants were at least 14 years old. Reproductive health-related factors were assessed among participants who had menstruated in the last 12 months. Multivariable adjusted modified Poisson regression was used to identify factors associated with sub-optimal MHM, defined by lack of water and/or soap, privacy, or safe menstrual products.

Results: Among 148 participants who menstruated in the past 12 months, over half (53.0%) reported that menstrual materials were unaffordable sometimes (43.5%) or always (9.5%), and more than one-third (38.1%) reported menses interfering with regular duties. Overall, 21.6% had sub-optimal MHM; although 94% of women reported using disposable pads to manage menses, 14.2% were also using cloth (n = 19) or underwear/diapers (n = 2). Other factors contributing to sub-optimal MHM were lack of privacy (4.1%) and lack of soap (8.7%). In analyses adjusted for age, educational attainment, employment status, and menstrual product affordability, Haitian-born women were more likely to have sub-optimal MHM (aPR = 7.25; 95% CI 4.23-12.4). Compared to women with optimal MHM, women with sub-optimal MHM were more likely to report "Poor" general health (46.9% vs. 19.8%, p = 0.004) and menses interfering with regular duties (56.3% vs. 32.8%, p = 0.015), and were less likely to report reliable contraceptive use (43.3% vs. 68.5%, p = 0.011) and prenatal care at last pregnancy (79.3% vs. 95.3%, p = 0.005). Haitian-born women were also more likely to have intersecting sub-optimal MHM and contraceptive gap or lack of prior prenatal care (20.4% vs. 2.2%, p = 0.001).

Conclusions: Sub-optimal MHM and its association with other reproductive health concerns was common in this migrant-dense community, notably appearing more frequently among Haitian-born women. Our preliminary findings suggest opportunities for future research and context-appropriate approaches addressing structural barriers to menstrual and reproductive health-particularly for migrant populations.

Background: Assisted reproductive technology (ART) is widely used, yet potential effects on androgen-sensitive male genital development remain a concern. Anoscrotal distance (ASD), a validated marker of prenatal androgen exposure, may differ in ART-conceived infants. This study compared ASD and urogenital anomalies among male newborns conceived via frozen-thawed embryo transfer (FET) using natural-cycle (tNC) or hormone-replacement therapy (HRT) protocols versus natural conception (NC).

Methods: In this retrospective cohort of 432 singleton male births (156 NC, 132 FET-tNC, 144 FET-HRT) delivered between 2021 and 2023, neonatal outcomes, including ASD, hypospadias, and undescended testes (UDT), were assessed. Group comparisons were performed using standard statistical tests, and exploratory modelling was conducted to identify variables most strongly distinguishing conception groups.

Results: Median ASD was significantly longer in NC infants (26.2 mm) than in FET-tNC (24.9 mm) and FET-HRT (24.6 mm) infants (p < 0.001), with no difference between FET protocols. Hypospadias was less frequent in FET-HRT than FET-tNC infants (p = 0.031), while UDT was more common in NC than FET-tNC infants (p = 0.041). Exploratory modelling identified ASD as the strongest discriminator across conception groups.

Conclusions: Male infants conceived via FET consistently exhibited shorter neonatal ASD than naturally conceived infants, suggesting subtle alterations in androgen-sensitive genital development. These findings underscore the importance of incorporating careful genital assessment and ART-specific counseling into neonatal care.

Objectives: This study aimed to assess the content and reliability of videos discussing the oral contraceptive pill (OCP) on TikTok, the popular social media platform amongst adults aged 18-24, to gauge the dialogue surrounding birth control on TikTok.

Methods: We conducted a quantitative content analysis. The top 100 TikTok videos in English under each of the six hashtags related to OCPs were collected. Video content, engagement metrics (likes, comments, shares), and creator attributes were analyzed by two independent reviewers, with a third to arbitrate discrepancies.

Results: 307 videos were included in the final data set with an average of 134,891 likes, 1,080 comments, and 7,483 shares. Healthcare providers created 27% of videos and 85.5% of these videos were educational. The majority of videos (73%) were created by non-healthcare providers and 54.4% discussed OCPs in a negative tone. Side effects were mentioned in 79% of videos, and 64% of these videos carried a negative tone regarding OCP side effects. Discontinuing OCPs was discussed in 24% of videos, and 83% of these videos carried a negative tone.

Conclusions: The most frequently discussed topic was the side effects of OCPs, with the majority framed negatively. Approximately one quarter of videos addressed discontinuing OCPs, often portraying cessation as beneficial. In the post-Roe v. Wade era, understanding how OCP experiences are portrayed on TikTok highlights the importance of physician-patient collaboration to support informed contraceptive decision-making and move beyond narratives that focus primarily on negative experiences.

Background: Chronic prostatitis type IIIb/chronic pelvic pain syndrome (CP/CPPS) poses significant therapeutic challenges. This study aimed to investigate and compare the clinical efficacy and safety of low-intensity pulsed ultrasound (LIPUS) versus tamsulosin for treating CP/CPPS.

Methods: In this randomized controlled trial, 65 patients with CP/CPPS were allocated to two groups. Group A (n = 35) received LIPUS treatment twice weekly, while Group B (n = 30) received tamsulosin sustained-release capsules (0.2 mg, once nightly). The treatment duration was four weeks for all patients. Outcomes were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), Self-Rating Anxiety Scale (SAS), and International Index of Erectile Function-5 (IIEF-5) at baseline and 4 weeks post-intervention.

Results: After 4 weeks, both groups showed significant improvements in all NIH-CPSI domains (pain, urinary, quality of life), SAS, and IIEF-5 scores compared to baseline (all P < 0.05). Group A demonstrated significantly greater improvement in pain symptoms than Group B (P < 0.05), whereas Group B showed superior improvement in urinary symptoms compared to Group A (P < 0.05). No statistically significant differences were found between the groups for the remaining symptom domains (P > 0.05).

Conclusion: Both LIPUS and tamsulosin significantly alleviated CP/CPPS-related symptoms with a favorable safety profile. LIPUS was more effective for pain relief, while tamsulosin was superior for urinary symptoms. Combination therapy may represent a promising approach for managing CP/CPPS.

Endometriomas are a common manifestation of endometriosis in women of reproductive age and pose a clinical challenge due to their association with pain, infertility, and compromised ovarian reserve. Surgical removal through cystectomy remains the standard intervention, but compelling evidence demonstrates its deleterious impact on ovarian reserve and potential acceleration of ovarian aging. These concerns have prompted an investigation of less invasive alternatives. Among these, ethanol sclerotherapy has emerged as a promising, minimally invasive, often ultrasound-guided procedure offering cyst resolution with minimal trauma to ovarian tissue. This mini-review synthesizes current evidence on ethanol sclerotherapy for the management of endometriomas, with an emphasis on clinical outcomes and implications for fertility preservation. Evidence indicates that ethanol sclerotherapy is highly effective technically, with low rates of major complications. Pain relief is achievable, recurrence rates can be reduced with longer ethanol exposure, and ovarian reserve is preserved compared with cystectomy. Assisted reproduction outcomes suggest comparable pregnancy rates, with some data supporting a higher oocyte yield following sclerotherapy. Nevertheless, the quality of evidence is limited, predominantly derived from observational studies, and results vary regarding long-term efficacy and reproductive outcomes. Ethanol sclerotherapy is best considered a minimally invasive, fertility-sparing option for women seeking to avoid surgery or preserve reproductive potential. Future randomized controlled trials should clarify its role relative to cystectomy and expectant management, establish optimal procedural parameters, and assess long-term outcomes, including ovarian reserve, live birth rates, and cost-effectiveness.

Persistently thin endometrium remains one of the hardest challenges in reproductive medicine, often linked to implantation failure and poor pregnancy outcome. Growing evidence implicates deficient uterine blood supply in the pathogenesis of an inadequately thin endometrial lining. This narrative review synthesizes current knowledge on how endometrial vascularization influences endometrial thickness (EMT) and receptivity. We outline the normal endometrial structure and vascular physiology, then examine the pathophysiological features of thin endometrium, highlighting mechanistic studies that demonstrate impaired angiogenesis, reduced microvessel density, and tissue hypoxia in thin endometrial tissue. Doppler ultrasound studies consistently show that women with thin endometrium have reduced endometrial and subendometrial blood flow and higher resistance indices. Clinical correlations indicate that poor endometrial perfusion is associated with lower implantation and pregnancy rates in assisted reproduction. We review diagnostic tools for assessing endometrial perfusion, including two-dimensional (2D) and three-dimensional (3D) Doppler ultrasound measures of uterine and subendometrial blood flow. Therapeutic strategies aiming to improve uterine blood supply, such as vasoactive medications, intrauterine infusion of platelet-rich plasma (PRP), stem cell therapies, and other angiogenic treatments, often result in a marginal improvement of EMT and pregnancy outcomes. While these interventions show promise, limitations include small sample sizes and heterogeneous study designs. We discuss future directions, emphasizing the need for larger trials and a deeper understanding of angiogenic signaling in the endometrium. In conclusion, converging evidence supports poor endometrial blood supply as a key contributor to persistently thin endometrium. Future therapies that specifically target enhancement of endometrial blood supply may prove to be effective tools for improving endometrial growth and fertility outcomes.