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The declining efficiency of IVF in the USA. 美国体外受精效率的下降。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-02 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoag004
Norbert Gleicher, Sonia Gayete-Lafuente, Lara Guijarro-Baude, Pasquale Patrizio, David F Albertini, David H Barad

Study question: Has the efficiency of IVF cycles in the USA declined between 2012 and 2021?

Summary answer: National U.S. data show a continuous linear decline in IVF cycle efficiency between 2012 and 2021.

What is known already: Previous studies reported that live birth rates after IVF increased until 2010 but subsequently declined, potentially due to the introduction of IVF 'add-ons' and changes in clinical practice.

Study design size duration: Retrospective cohort study, using publicly available national U.S. IVF outcome data reported annually to the Centers for Disease Control and Prevention (CDC) for the period 2012-2021.

Participants/materials setting methods: CDC annual reports were used as a data source. Extracted variables included a number of IVF cycle starts, embryo transfers, embryo banking cycles, and live births. IVF 'treatment efficiency' was calculated as the proportion of live births per initiated cycle (intent-to-treat analysis).

Main results and the role of chance: Over the study period, IVF cycle starts increased by 234.7% (176 274 to 413 776), embryo transfers by 150.3% (134 471 to 202 121), and embryo banking cycles by 902.3% (18 585 to 167 689). Live births increased by 179.2% (51 286 to 91 906). However, cycle efficiency declined from 29.1% in 2012 to 22.2% in 2021, a relative reduction of 23.4%, with an approximately linear decline across the decade.

Limitations reasons for caution: The study is based on aggregate CDC data without patient-level granularity. Therefore, analyses could not control for confounding factors such as parity, infertility diagnosis, or detailed age subgroups. Embryo banking practices also complicate year-to-year comparisons of live birth rates.

Wider implications of the findings: These findings suggest that despite substantial growth in IVF cycle numbers, treatment efficiency has progressively declined in the USA over the last decade. This decline coincided with a rapid increase in the use of embryo banking and other IVF 'add-ons'. The results raise concern about current clinical practices and highlight the need for critical re-evaluation of routine interventions in IVF.

Study funding/competing interests: No external funding was received for this study. NG and DHB hold patents related to androgen treatment in females (DHEA) with numbers US8067400B2, US8501718B2, and US9375436B2 (listed in USPTO/public records and assigned to American Infertility of New York). They also receive royalties from Nutraceuticals LLC, which has helped commercialize DHEA as a nutritional supplement.

Trial registration number: N/A.

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引用次数: 0
Optimizing the protocol for modified natural cycle frozen embryo transfer (mNC-FET): a multicentre, single-blinded randomized controlled trial. 优化改良自然周期冷冻胚胎移植(mNC-FET)方案:一项多中心、单盲随机对照试验
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-13 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoag003
Marte Saupstad, Clara Colombo, Sara Johanna Bergenheim, Nina Pistoljevic-Kristiansen, Tine Vrist Dam, Jeanette Wulff Bogstad, Lisbeth Prætorius, Nina la Cour Freiesleben, Anna Klajnbard, Birgitte Oxlund-Mariegaard, Peter Humaidan, Ellen Christine Leth Løkkegaard, Merete Husth, Ulla Breth Knudsen, Anette Gabrielsen, Julie Lyng Forman, Morten Rønn Petersen, Kristine Løssl, Anja Pinborg
<p><strong>Study question: </strong>Can the use of progesterone luteal phase support (LPS) and timing of blastocyst transfer, at 6 versus 7 days following hCG-trigger, improve the live birth rate (LBR) in modified natural cycle (mNC) frozen-thawed embryo transfer (FET)?</p><p><strong>Summary answer: </strong>Use of LPS and advanced timing of blastocyst transfer did not significantly improve the LBR in mNC-FET.</p><p><strong>What is known already: </strong>Transfer of a frozen-thawed blastocyst in the mNC protocol is routinely conducted 7 days after the ovulation trigger, and progesterone LPS is commonly used despite limited evidence.</p><p><strong>Study design size duration: </strong>This multicentre, single-blinded, randomized controlled superiority trial investigated the effect of LPS and timing of blastocyst transfer on live birth rates following mNC-FET conducted from January 2019 to February 2024. Using an online randomization programme, patients were randomized 1:1:1:1 to: (A) transfer day 6 following ovulation trigger (Day 0) with LPS; (B) transfer day 7 with LPS; (C) transfer day 6 without LPS; (D) transfer day 7 without LPS. Use of LPS was masked from treating clinicians. The sample size calculation required 604 women to participate to detect an increase in live birth rate from 21% in control groups (LPS: C + D, timing: B + D) to 31% in intervention groups (LPS: A + B, timing: A + C). In total, 679 women were enrolled, and 610 women were randomized. Ultimately, 602 women (A: n = 151; B: n = 150; C: n = 149; D: n = 152) were included in the per-transfer analyses.</p><p><strong>Participants/materials setting methods: </strong>Participants were women aged 18-41 years undergoing mNC-FET with a single autologous good-quality blastocyst, from eight public fertility clinics at tertiary care centres across Denmark.</p><p><strong>Main results and the role of chance: </strong>Our study found that use of LPS did not significantly affect the LBR compared with no LPS: 34.9% (105/301) versus 31.9% (96/301) (adjusted risk difference (aRD) 3.18, 95% CI: -4.13 to 10.49; <i>P</i> = 0.39). Comparing blastocyst transfer on Day 6 versus Day 7, there was again no significant difference in LBR: 33.8% (99/300) versus 33.0% (99/302) (aRD -0.62, 95% CI: -7.99 to 6.75; <i>P</i> = 0.87).</p><p><strong>Limitations reasons for caution: </strong>The sample size calculation was based on LBRs of studies using transfer of slow-frozen and cleavage stage embryos, but today's LBRs are higher. Consequently, the sample size might not have been sufficient to detect discrete differences in reproductive outcomes under present conditions. Further, despite using liberal inclusion criteria, most women participating were young (≤35 years) and lean, and had a good quality embryo available for transfer, giving them an <i>a priori</i> good treatment prognosis. Hence, our findings might not apply to all women undergoing mNC-FET.</p><p><strong>Wider implications of the findings: </strong
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引用次数: 0
Frozen versus fresh embryo transfer on perinatal outcomes-do endometrial preparation methods matter? 冷冻胚胎移植与新鲜胚胎移植对围产期结果的影响——子宫内膜准备方法重要吗?
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-12 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoag002
Haowen Zou, Deirdre Zander-Fox, Nicole Au, Yanhe Liu, Beverley Vollenhoven, Mark P Green, Rui Wang
<p><strong>Study question: </strong>Are there differences between perinatal outcomes following frozen versus fresh embryo transfer in IVF, and do endometrium preparation methods contribute to the differences?</p><p><strong>Summary answer: </strong>Compared with fresh embryo transfers, frozen transfers, regardless of hormone replacement treatment or natural treatment cycles, were associated with lower chances of preterm birth, low birth weight, and small for gestational age, but higher chances of caesarean section, high birth weight, and large for gestational age.</p><p><strong>What is known already: </strong>Frozen embryo transfer has been increasing over the past two decades, but its associated perinatal risks and underlying reasons remain controversial. Most existing observational studies have not accounted for multiple cycles from the same couple or known patients' characteristics or treatment protocols, such as endometrial preparation methods, in the analysis. Existing birthweight centile charts are likely to underestimate intra-uterine growth restriction due to the inclusion of deliveries following obstetric interventions.</p><p><strong>Study design size duration: </strong>This multicentre retrospective cohort study used routinely collected clinical data of 8081 women undergoing IVF who gave birth to 9243 babies (6125 from the frozen and 3118 from fresh transfer cycles) in 12 IVF clinics across two states in Australia between 2015 and 2021, with follow-up data up to 2023.</p><p><strong>Participants/materials setting methods: </strong>Individuals undergoing autologous-oocyte IVF cycles who had singleton live births were included. An individual could have multiple treatment cycles included. Perinatal outcomes included preterm birth, low/high birth weight, small-/large-for-gestational-age, and caesarean section. The birthweight percentiles were calculated based on the New Australian birthweight centiles, where interventions-initiated births were excluded. Multivariable Poisson regression with robust variance was used to analyse all outcomes. Generalized estimating equations (GEEs) were used to account for the cluster effects of multiple embryo transfer cycles of the same individual. Adjusted risk ratios with 95% confidence intervals (CIs) were reported for each outcome. The adjusted model accounted for potential confounding factors, including female age, parity, semen source, ovulatory disorders, preimplantation genetic testing for aneuploidy, blastocyst transfer, number of embryos transferred, and site. In subgroup analysis, frozen transfers with different endometrial preparation methods (hormone replacement and natural cycles) were compared to the fresh transfers.</p><p><strong>Main results and the role of chance: </strong>Compared with births in the fresh group, births in the frozen transfer group were less likely to be preterm (8.9% vs 13.7%, adjusted risk ratio (aRR) 0.66 0.58-0.76), low birth weight (5.3% vs 8.5%, aRR 0.66, 0.55-0.78), an
研究问题:体外受精中冷冻胚胎移植和新鲜胚胎移植的围产期结局是否存在差异,子宫内膜准备方法是否导致了这种差异?摘要回答:与新鲜胚胎移植相比,冷冻胚胎移植,无论激素替代治疗还是自然治疗周期,早产、低出生体重和小胎龄的几率较低,但剖腹产、高出生体重和大胎龄的几率较高。已知情况:冷冻胚胎移植在过去二十年中一直在增加,但其相关的围产期风险和潜在原因仍然存在争议。大多数现有的观察性研究在分析中没有考虑到来自同一对夫妇的多个周期或已知的患者特征或治疗方案,如子宫内膜准备方法。由于纳入了产科干预后分娩,现有的出生体重百分位图可能低估了子宫内生长限制。研究设计规模持续时间:这项多中心回顾性队列研究常规收集了2015年至2021年间澳大利亚两个州12家试管婴儿诊所8081名接受试管婴儿的妇女的临床数据,这些妇女生育了9243名婴儿(6125名来自冷冻试管婴儿,3118名来自新鲜试管婴儿),随访数据一直持续到2023年。参与者/材料设置方法:接受自体卵母细胞体外受精周期且单胎活产的个体包括在内。一个人可能有多个治疗周期。围产期结局包括早产、低/高出生体重、小/大胎龄和剖腹产。出生体重百分位数是根据新澳大利亚出生体重百分位数计算的,其中不包括干预引起的出生。采用鲁棒方差的多变量泊松回归分析所有结果。采用广义估计方程(GEEs)来解释同一个体的多个胚胎移植周期的聚类效应。报告了每个结果的校正风险比,95%置信区间(ci)。调整后的模型考虑了潜在的混杂因素,包括女性年龄、胎次、精液来源、排卵障碍、着床前非整倍体基因检测、囊胚移植、移植的胚胎数量和位置。在亚组分析中,将不同子宫内膜制备方法(激素替代和自然周期)的冷冻移植与新鲜移植进行比较。主要结果和机会的作用:与出生在新鲜组相比,出生在冷冻转移集团不太可能早产(8.9% vs 13.7%,调整后的风险比(aRR) 0.66 0.58 -0.76),低出生体重(5.3% vs 8.5%, aRR 0.66, 0.55 - -0.78),和小胎龄(4.2% vs 7.9%, aRR 0.62, 0.51 - -0.75),但更可能是剖腹产(57.5% vs 50.4%, aRR 1.14, 95%可信区间1.09 - -1.19),高出生体重(10.1% vs 7.0%, aRR 1.43, 1.21 - -1.68),和large-for-gestational-age (20.0% vs 13.6%, aRR 1.37, 1.23 - -1.53)。当比较激素替代或自然周期冷冻移植与新鲜移植时,差异保持一致。注意的局限性:回顾性研究的性质引入了残留混淆的固有挑战。研究结果的更广泛意义:结果表明,在冷冻和新鲜胚胎移植周期之间,与围产期结局相关的出生体重差异不太可能是由于在冷冻周期中使用子宫内膜准备方案的差异,而可能归因于其他因素,包括新鲜周期中子宫内膜特征受损或冷冻周期中玻璃化和加热胚胎的过程。研究经费/竞争利益:H.Z.获得了莫纳什大学的研究奖学金。N.A.获得了澳大利亚政府研究培训计划奖学金的支持。R.W.获得了NHMRC新兴领导研究者资助(2009767)。D.Z.和M.G.报告说,他们是本研究分析数据的公司的雇员。没有其他作者的利益冲突报告。试验注册号:无。
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引用次数: 0
Comprehensive 16S rRNA gene sequencing and meta-transcriptomic analyses of the female reproductive tract microbiota: two molecular profiles with different messages. 女性生殖道微生物群16S rRNA基因综合测序及meta转录组学分析:两种不同信息的分子图谱
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-01-06 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoag001
Alberto Sola-Leyva, Inmaculada Pérez-Prieto, Analuce Canha-Gouveia, Eduardo Salas-Espejo, Nerea M Molina, Eva Vargas, Apostol Apostolov, Amruta D S Pathare, Sergio Vela-Moreno, Susana Ruiz-Durán, Bárbara Romero, Rocío Sánchez, José Antonio Castilla-Alcalá, Merli Saare, Ganesh Acharya, Andres Salumets, Signe Altmäe
<p><strong>Study question: </strong>Does the analysis of endometrial microbes provide the same information when using DNA or RNA sequencing-based techniques?</p><p><strong>Summary answer: </strong>DNA vs RNA-based microbial analysis techniques demonstrated significant microbial compositional differences and lack of transcriptionally active lactobacilli in the endometrium.</p><p><strong>What is known already: </strong>Our understanding of the endometrial microbiome is primarily based on DNA-based 16S rRNA gene profiling, but DNA detection does not imply the presence of living microbes. While this method is cost-effective and widely used, it has notable limitations, including the underestimation of microbial diversity, abundance, and functionality, as well as limited species-level resolution. While the microbiome reflects DNA-based characterization, the microbiota more precisely captures metabolically active communities. In this context, meta-transcriptomic analysis, an RNA-based approach, addresses these shortcomings by capturing functional transcripts that are actively expressed in living microbes.</p><p><strong>Study design size duration: </strong>This cross-sectional study consisted of 49 reproductive-aged women (27-42 years old) who were receiving ART. By simultaneously analysing the microbial composition and gene expression within female reproductive tract samples, we sought to provide a more comprehensive understanding of the microbiota and functional potential of these samples.</p><p><strong>Participants/materials setting methods: </strong>Vaginal swabs, endometrial brushing, and endometrial biopsy samples were collected from 49 participants during the mid-secretory phase of their menstrual cycle, 6-9 days after the luteinizing hormone surge for parallel 16S rRNA gene sequencing and meta-transcriptome analyses. For DNA-based analysis, the 16S rRNA gene V4 region was sequenced. For RNA-based analysis, total RNA was extracted followed by ribosomal RNA depletion. Strand-specific total RNA sequencing libraries were prepared and sequenced. Taxonomy was assigned by using Kraken2 (v2.2.1), and Bracken (v2.7).</p><p><strong>Main results and the role of chance: </strong>Our findings suggest that in low-microbial-biomass environments such as the endometrium, the correlation between 16S rRNA gene sequencing and meta-transcriptomics is relatively weak. This highlights the limitations of microbial analysis of low-microbial-biomass samples. Alternatively, microbial functions and genome activity may be tissue-specific and dependent on the host tissue environment. Moreover, RNA-based analysis provides higher resolution in detecting certain pathogens, even within the endometrium.</p><p><strong>Large scale data: </strong>The data presented in the study are deposited in the NCBI SRA Database, accession number PRJNA1247240.</p><p><strong>Limitations reasons for caution: </strong>High levels of host RNA and the low abundance of microbial reads in the endometriu
{"title":"Comprehensive 16S rRNA gene sequencing and meta-transcriptomic analyses of the female reproductive tract microbiota: two molecular profiles with different messages.","authors":"Alberto Sola-Leyva, Inmaculada Pérez-Prieto, Analuce Canha-Gouveia, Eduardo Salas-Espejo, Nerea M Molina, Eva Vargas, Apostol Apostolov, Amruta D S Pathare, Sergio Vela-Moreno, Susana Ruiz-Durán, Bárbara Romero, Rocío Sánchez, José Antonio Castilla-Alcalá, Merli Saare, Ganesh Acharya, Andres Salumets, Signe Altmäe","doi":"10.1093/hropen/hoag001","DOIUrl":"10.1093/hropen/hoag001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Does the analysis of endometrial microbes provide the same information when using DNA or RNA sequencing-based techniques?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;DNA vs RNA-based microbial analysis techniques demonstrated significant microbial compositional differences and lack of transcriptionally active lactobacilli in the endometrium.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Our understanding of the endometrial microbiome is primarily based on DNA-based 16S rRNA gene profiling, but DNA detection does not imply the presence of living microbes. While this method is cost-effective and widely used, it has notable limitations, including the underestimation of microbial diversity, abundance, and functionality, as well as limited species-level resolution. While the microbiome reflects DNA-based characterization, the microbiota more precisely captures metabolically active communities. In this context, meta-transcriptomic analysis, an RNA-based approach, addresses these shortcomings by capturing functional transcripts that are actively expressed in living microbes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;This cross-sectional study consisted of 49 reproductive-aged women (27-42 years old) who were receiving ART. By simultaneously analysing the microbial composition and gene expression within female reproductive tract samples, we sought to provide a more comprehensive understanding of the microbiota and functional potential of these samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;Vaginal swabs, endometrial brushing, and endometrial biopsy samples were collected from 49 participants during the mid-secretory phase of their menstrual cycle, 6-9 days after the luteinizing hormone surge for parallel 16S rRNA gene sequencing and meta-transcriptome analyses. For DNA-based analysis, the 16S rRNA gene V4 region was sequenced. For RNA-based analysis, total RNA was extracted followed by ribosomal RNA depletion. Strand-specific total RNA sequencing libraries were prepared and sequenced. Taxonomy was assigned by using Kraken2 (v2.2.1), and Bracken (v2.7).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Our findings suggest that in low-microbial-biomass environments such as the endometrium, the correlation between 16S rRNA gene sequencing and meta-transcriptomics is relatively weak. This highlights the limitations of microbial analysis of low-microbial-biomass samples. Alternatively, microbial functions and genome activity may be tissue-specific and dependent on the host tissue environment. Moreover, RNA-based analysis provides higher resolution in detecting certain pathogens, even within the endometrium.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Large scale data: &lt;/strong&gt;The data presented in the study are deposited in the NCBI SRA Database, accession number PRJNA1247240.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;High levels of host RNA and the low abundance of microbial reads in the endometriu","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2026 1","pages":"hoag001"},"PeriodicalIF":11.1,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12866996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Ovarian ferroptosis induced by androgen is involved in pathogenesis of PCOS. 更正:雄激素所致卵巢铁下垂参与了PCOS的发病机制。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-22 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf078

[This corrects the article DOI: 10.1093/hropen/hoae013.].

[更正文章DOI: 10.1093/hropen/hoae013.]。
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引用次数: 0
Reply: Reassessing pre-existing comorbidity patterns in testicular cancer: controversies and future directions. 回复:重新评估睾丸癌的既存合并症模式:争议和未来方向。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-13 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoaf080
Marie Juul Ornstrup, Agnethe Berglund, Mads Agerbæk, Claus Højbjerg Gravholt
{"title":"Reply: Reassessing pre-existing comorbidity patterns in testicular cancer: controversies and future directions.","authors":"Marie Juul Ornstrup, Agnethe Berglund, Mads Agerbæk, Claus Højbjerg Gravholt","doi":"10.1093/hropen/hoaf080","DOIUrl":"10.1093/hropen/hoaf080","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2026 1","pages":"hoaf080"},"PeriodicalIF":11.1,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reassessing pre-existing comorbidity patterns in testicular cancer: controversies and future directions. 重新评估睾丸癌先前存在的合并症模式:争议和未来的方向。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-13 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoaf079
Yinwei Chen, Yi Liu, Chang Liu
{"title":"Reassessing pre-existing comorbidity patterns in testicular cancer: controversies and future directions.","authors":"Yinwei Chen, Yi Liu, Chang Liu","doi":"10.1093/hropen/hoaf079","DOIUrl":"10.1093/hropen/hoaf079","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2026 1","pages":"hoaf079"},"PeriodicalIF":11.1,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atopic dermatitis and fecundity: a Danish National Birth Cohort study. 特应性皮炎与生育能力:丹麦国家出生队列研究。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-08 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoaf077
Camilla L Kjersgaard, Anne Gaml-Sørensen, Pernille J Clemmensen, Linn H Arendt, Siri E Håberg, Onyebuchi A Arah, Mette Deleuran, Cecilia H Ramlau-Hansen
<p><strong>Study question: </strong>Do women with atopic dermatitis have higher fecundity than those without?</p><p><strong>Summary answer: </strong>Pregnant women with a history of atopic dermatitis had a slightly shorter time-to-pregnancy (TTP) and a lower risk of conceiving using infertility treatment than those without.</p><p><strong>What is known already: </strong>Atopic dermatitis has a characteristic T-helper-2-cell-skewed immune response that mirrors the immune shift in pregnancy, which is necessary for the pregnant woman's immune response to tolerate the fetus. Therefore, it has been hypothesized that atopic dermatitis may be advantageous for conception and pregnancy maintenance. However, this has not yet been investigated.</p><p><strong>Study design size duration: </strong>This cohort study included 88 713 pregnant women from the population-based Danish National Birth Cohort (DNBC), who were enrolled between 1996 and 2002.</p><p><strong>Participants/materials setting methods: </strong>The women were defined as having atopic dermatitis if, in a computer-assisted interview conducted around gestational week 17, they reported having ever been diagnosed with atopic dermatitis by a doctor. The women were also asked whether the pregnancy was planned or unplanned, to report their TTP within one of five prespecified categories, and whether they had conceived with the use of infertility treatment. We used multinomial logistic regression models to assess associations between atopic dermatitis and fecundity in seven categories: (TTP <1 month, 1-2 months, 3-5 months, 6-12 months, >12 months, pregnant after infertility treatment or unplanned). In addition, we modeled TTP as dichotomous outcomes using logistic regression: subfecundity (TTP ≥6 months vs <6 months) and infertility (TTP >12 months vs ≤12 months). We also assessed women with an atopic constitution (atopic dermatitis, allergic rhinitis, asthma, and food allergies), as this is associated with more severe atopic dermatitis.</p><p><strong>Main results and the role of chance: </strong>Overall, 3641 (4.1%) women reported ever having had atopic dermatitis. Compared to women without atopic dermatitis, women with atopic dermatitis had a lower relative risk ratio (RRR) of having a TTP >12 months: 0.83 (95% CI: 0.72; 0.96), and use of infertility treatment, RRR: 0.81 (95% CI: 0.69; 0.94). Moreover, women with atopic dermatitis had a lower odds ratio (OR) of subfecundity: 0.89 (95% CI: 0.82; 0.96) and infertility: 0.85 (95% CI: 0.77; 0.95) than women without in the logistic regression model. Results were robust across several sub-analyses.</p><p><strong>Limitations reasons for caution: </strong>The results can only be generalized to women who eventually conceive, since the DNBC consists only of women who successfully conceived.</p><p><strong>Wider implications of the findings: </strong>The findings support the hypothesis of an immunological benefit in conceiving when having atopic dermatitis. The res
研究问题:患有特应性皮炎的女性比没有的女性生育能力更高吗?总结回答:有特应性皮炎史的孕妇比没有特应性皮炎史的孕妇怀孕时间(TTP)略短,使用不孕症治疗的怀孕风险较低。已知情况:特应性皮炎具有典型的t -辅助性2细胞倾斜免疫反应,这反映了怀孕期间的免疫变化,这是孕妇免疫反应耐受胎儿所必需的。因此,假设特应性皮炎可能有利于受孕和妊娠维持。然而,这一点尚未得到调查。研究设计规模持续时间:该队列研究包括88713名孕妇,她们来自以人群为基础的丹麦国家出生队列(DNBC),于1996年至2002年间入组。参与者/材料设置方法:在妊娠第17周前后进行的计算机辅助访谈中,如果妇女报告曾被医生诊断为特应性皮炎,则将其定义为患有特应性皮炎。这些妇女还被问及怀孕是有计划的还是计划外的,在五个预先指定的类别中报告她们的TTP,以及她们是否在使用不孕症治疗的情况下怀孕。我们使用多项逻辑回归模型评估特应性皮炎与生育能力之间的关系,分为七个类别:(TTP 12个月,不孕治疗后怀孕或计划外)。此外,我们使用逻辑回归将TTP建模为二分类结果:次繁殖力(TTP≥6个月vs 12个月vs≤12个月)。我们还评估了患有特应性体质(特应性皮炎、过敏性鼻炎、哮喘和食物过敏)的女性,因为这与更严重的特应性皮炎有关。主要结果和偶然性的作用:总体而言,3641名(4.1%)女性报告曾患过特应性皮炎。与没有特应性皮炎的女性相比,特应性皮炎女性在12个月内发生TTP的相对风险比(RRR)较低:0.83 (95% CI: 0.72; 0.96),使用不孕症治疗的相对风险比(RRR): 0.81 (95% CI: 0.69; 0.94)。此外,在logistic回归模型中,患有特应性皮炎的女性生育能力低下的优势比(OR)为0.89 (95% CI: 0.82; 0.96),不孕症的优势比(OR)为0.85 (95% CI: 0.77; 0.95)低于没有患有特应性皮炎的女性。结果在几个子分析中是稳健的。注意的局限性:结果只能推广到最终怀孕的女性,因为DNBC只包括成功怀孕的女性。研究结果的更广泛意义:研究结果支持了特应性皮炎对怀孕有免疫益处的假设。这一结果让患有特应性皮炎的女性感到放心。然而,这一假设应该在没有怀孕条件的更广泛的妇女人群中进一步验证。研究经费/竞争利益:这项工作得到了丹麦独立研究委员会(资助号DFF-1030-00164B)、奥胡斯大学和Fonden基金会的支持。k ærsgaard, Sunds,挪威研究理事会(项目编号:320656),通过其卓越中心资助计划(项目编号:262700),并由欧盟(ERC, BIOSFER, 101071773)共同资助。然而,本文表达的观点和意见仅代表作者的观点和意见,并不一定反映欧盟或欧洲研究理事会的观点和意见。欧盟和授权机构都不能对此负责。本出版物是ReproUnion合作研究的一部分,由欧盟Intereg V ÖKS(20200407)共同资助。M.D.获得了来自AbbVie、LEO Pharma、Eli Lilly、Incyte、La Roche Posay、NUMAB Therapeutics、Pfizer、Regeneron Pharmaceuticals Inc.、Sanofi Genzyme、Almirall、Union Therapeutics、Kymab和UCB的咨询费(包括参与顾问委员会);LEO Pharma和赛诺菲健赞(Sanofi Genzyme)的旅行支持;Mustela, Galderma, Leo Pharma, Sanofi Genzyme和La Roche Posay的演讲费;欧洲皮肤病和性病学会杂志(JEADV)的部分编辑。这些coi都与本文无关。其余的作者声明他们没有利益冲突。试验注册号:无。
{"title":"Atopic dermatitis and fecundity: a Danish National Birth Cohort study.","authors":"Camilla L Kjersgaard, Anne Gaml-Sørensen, Pernille J Clemmensen, Linn H Arendt, Siri E Håberg, Onyebuchi A Arah, Mette Deleuran, Cecilia H Ramlau-Hansen","doi":"10.1093/hropen/hoaf077","DOIUrl":"10.1093/hropen/hoaf077","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Do women with atopic dermatitis have higher fecundity than those without?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Pregnant women with a history of atopic dermatitis had a slightly shorter time-to-pregnancy (TTP) and a lower risk of conceiving using infertility treatment than those without.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Atopic dermatitis has a characteristic T-helper-2-cell-skewed immune response that mirrors the immune shift in pregnancy, which is necessary for the pregnant woman's immune response to tolerate the fetus. Therefore, it has been hypothesized that atopic dermatitis may be advantageous for conception and pregnancy maintenance. However, this has not yet been investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;This cohort study included 88 713 pregnant women from the population-based Danish National Birth Cohort (DNBC), who were enrolled between 1996 and 2002.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;The women were defined as having atopic dermatitis if, in a computer-assisted interview conducted around gestational week 17, they reported having ever been diagnosed with atopic dermatitis by a doctor. The women were also asked whether the pregnancy was planned or unplanned, to report their TTP within one of five prespecified categories, and whether they had conceived with the use of infertility treatment. We used multinomial logistic regression models to assess associations between atopic dermatitis and fecundity in seven categories: (TTP &lt;1 month, 1-2 months, 3-5 months, 6-12 months, &gt;12 months, pregnant after infertility treatment or unplanned). In addition, we modeled TTP as dichotomous outcomes using logistic regression: subfecundity (TTP ≥6 months vs &lt;6 months) and infertility (TTP &gt;12 months vs ≤12 months). We also assessed women with an atopic constitution (atopic dermatitis, allergic rhinitis, asthma, and food allergies), as this is associated with more severe atopic dermatitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Overall, 3641 (4.1%) women reported ever having had atopic dermatitis. Compared to women without atopic dermatitis, women with atopic dermatitis had a lower relative risk ratio (RRR) of having a TTP &gt;12 months: 0.83 (95% CI: 0.72; 0.96), and use of infertility treatment, RRR: 0.81 (95% CI: 0.69; 0.94). Moreover, women with atopic dermatitis had a lower odds ratio (OR) of subfecundity: 0.89 (95% CI: 0.82; 0.96) and infertility: 0.85 (95% CI: 0.77; 0.95) than women without in the logistic regression model. Results were robust across several sub-analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;The results can only be generalized to women who eventually conceive, since the DNBC consists only of women who successfully conceived.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Wider implications of the findings: &lt;/strong&gt;The findings support the hypothesis of an immunological benefit in conceiving when having atopic dermatitis. The res","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2026 1","pages":"hoaf077"},"PeriodicalIF":11.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Organoids simulating the bovine oviduct mediate the embryo-maternal interface via extracellular vesicle-transmitted signaling. 模拟牛输卵管的类器官通过细胞外囊泡传递信号介导胚胎-母体界面。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-05 eCollection Date: 2026-01-01 DOI: 10.1093/hropen/hoaf076
Nico G Menjivar, Ahmed Gad, Riley E Thompson, Mindy A Meyers, Soham Ghosh, Fiona K Hollinshead, Dawit Tesfaye
<p><strong>Study question: </strong>Does the implementation of a three-dimensional (3D) organoid model system that stably emulates some key functional, structural, and biological complexities of the oviduct provide a favorable apical environment for the production of extracellular vesicles (EVs) that exert an influence on early embryo development <i>in vitro</i>?</p><p><strong>Summary answer: </strong>Our findings show that <i>in vitro</i>, epithelium dependably propagates highly differentiated oviductal organoids containing both networks of ciliated and secretory cells capable of producing <i>in vivo</i>-like, cargo-specific oviductal extracellular vesicles (oEVs) with the capacity to improve the quality of <i>in vitro</i>-produced embryos under conditions of heat stress (HS).</p><p><strong>What is known already: </strong>Recapitulating the maternal contribution that persists during preimplantation embryonic development <i>in vitro</i> is a substantial scientific challenge due to both technical limitations and the significant gaps in our scientific knowledge concerning the maternal-embryonic cellular and molecular dialogue. As a result of the limited access to suitable model systems and the inability to directly observe this process <i>in vivo</i>, this early stage of embryonic development has often been described as particularly elusive and an enigmatic stage of development. Irrespectively, oEVs have recently been identified as key players in mediating the biological information transfer of the embryo-oviduct interactions, which beneficially contributes to the early development of embryos <i>in vitro</i>.</p><p><strong>Study design size duration: </strong>Over a 2-year period, resected ovaries from intact reproductive tracts (n = 10; a pool of two bovine animals per replicate) containing both complete contralateral and ipsilateral oviducts from assessed stage II, diestrus tracts were processed for the generation of oviductal organoids. Afterward, enriched oEVs from 3D organoids and <i>in vivo</i>-collected oviductal fluid (OF) were co-cultured with bovine presumptive zygotes from Day 1 to Day 3 and continued until the blastocyst stage for further evaluation.</p><p><strong>Participants/materials setting methods: </strong>Organoids were characterized by light microscopy, gene expression, immunofluorescence, and 3D reconstruction, as well as histological two-dimensional (2D) cross-sectioning. Enriched oEVs from conditioned organoid culture media and OF were characterized using transmission electron microscopy, nanoparticle tracking analysis, and western blotting. Following the establishment of a stable oEV production system, bovine zygotes were divided into five groups [38.5°C Control, 41°C Control, 41°C N-EVs (oEVs derived from organoids cultured under thermoneutral conditions), 41°C S-EVs (oEVs derived from organoids cultured HS conditions), 41°C Ovi-EVs (oEVs collected from diestrus OF)] and cultured until the blastocyst stage. Following the pr
研究问题:三维(3D)类器官模型系统的实现是否能够稳定地模拟输卵管的一些关键功能、结构和生物学复杂性,为细胞外囊泡(ev)的产生提供有利的顶端环境,从而影响体外早期胚胎发育?我们的研究结果表明,在体外,上皮可靠地繁殖高度分化的输卵管类器官,包括纤毛细胞和分泌细胞网络,能够产生体内样的,货物特异性的输卵管细胞外囊泡(oEVs),具有在热应激(HS)条件下提高体外生产胚胎质量的能力。已知情况:由于技术限制和我们关于母体-胚胎细胞和分子对话的科学知识的重大差距,在体外着床前胚胎发育期间持续存在的母体贡献是一项重大的科学挑战。由于获得合适的模型系统的机会有限,并且无法在体内直接观察这一过程,胚胎发育的这一早期阶段经常被描述为特别难以捉摸和神秘的发育阶段。此外,oEVs最近被确定为介导胚胎-输卵管相互作用的生物信息传递的关键参与者,这有利于体外胚胎的早期发育。研究设计规模持续时间:超过2年的时间,从完整的生殖道切除的卵巢(n = 10;每个重复2只牛)包含评估期生殖道的完整对侧和同侧输卵管,处理以产生输卵管类器官。之后,从3D类器官和体内收集的输卵管液(OF)中富集的oEVs与牛推定受精卵共培养第1天至第3天,并持续到囊胚阶段进行进一步评估。参与者/材料设置方法:通过光镜、基因表达、免疫荧光、3D重建以及组织学二维(2D)横切面对类器官进行表征。通过透射电镜、纳米颗粒跟踪分析和western blotting对条件类器官培养基和OF中富集的oev进行了表征。在建立稳定的卵细胞生成系统后,将牛受精卵分为5组[38.5°C对照,41°C对照,41°C n -卵细胞(来自热中性条件下培养的类器官的卵细胞),41°C s -卵细胞(来自HS条件下培养的类器官的卵细胞),41°C卵细胞-卵细胞(来自鼠疫的卵细胞)],并培养至囊胚期。在体外培养的第1天至第3天,记录oEVs的存在或不存在,从而记录卵裂率和囊胚发育率。我们还对滋养外胚层(CDX2)和内细胞团(SOX2)多能性标记蛋白进行了共免疫染色,检测了整体DNA损伤(phospho-γH2A)。X),并在单个胚胎中对候选胚胎质量基因CDX2、SOX2、POU5F1、NANOG和关键应激调节基因BAX、BCL-2、PRDX1、SOD1、HSP70和HSP90进行实时定量PCR检测。此外,通过对H3K9ac、竞争标记H3K27ac和H3K27me3的扰动,分析了oev对发育胚胎表观遗传景观的影响,以及它们在个体胚胎中标记DNA甲基转移酶(DNMT1、DNMT3A、DNMT3B)的相对表达。主要结果和偶发因素的作用:本研究采用三维培养系统生成输卵管类器官,模拟母体环境对HS的反应,并生成体内样oEVs,用于提高体外胚胎在应激条件下的存活率和活力。有趣的是,我们的研究结果也有效地证明了首次尝试支持从3D输卵管类器官、2D输卵管上皮细胞和体内收集的持续存在于OF中的oev中释放的ev包装mirna的新兴相似性。这种方法的目的是维持一种机制替代,在强大的产生生理相关的oEVs,以改善目前的体外培养系统,传统上绕过输卵管。该模型系统还创新性地增强了我们对ev介导的、发生在体内的母胚通信的认识。大规模数据:无。局限性:这是一项体外研究,类器官培养的条件可能不完全反映体内环境,就输卵管的细胞外基质和复杂血管化而言。 此外,考虑到本研究中使用的3D类器官的极性,富集的oEVs群体主要代表基底外侧分泌物,而不是体内常规的根尖分泌物。研究结果的更广泛意义:这些结果提供了一个未知的尝试,通过体外培养的3D输卵管类器官分泌的oev来概括胚胎-母体的纳米通信。因此,我们的模型为结合输卵管信号调节体外胚胎发育奠定了基础,为进一步研究母体环境可能促进胚胎发育早期成功的机制提供了一个动态系统,并为促进当前体外胚胎生产技术的进步提供了有价值的见解。研究经费/竞争利益:本研究由美国农业部通过nfa - afri博士前奖学金授予N.G.M.(资助号2023-67011-40511),以及学院研究委员会,科罗拉多州立大学研究副校长办公室的资金支持。作者证明,没有竞争利益可能影响本研究的行为或结果。
{"title":"Organoids simulating the bovine oviduct mediate the embryo-maternal interface via extracellular vesicle-transmitted signaling.","authors":"Nico G Menjivar, Ahmed Gad, Riley E Thompson, Mindy A Meyers, Soham Ghosh, Fiona K Hollinshead, Dawit Tesfaye","doi":"10.1093/hropen/hoaf076","DOIUrl":"10.1093/hropen/hoaf076","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Does the implementation of a three-dimensional (3D) organoid model system that stably emulates some key functional, structural, and biological complexities of the oviduct provide a favorable apical environment for the production of extracellular vesicles (EVs) that exert an influence on early embryo development &lt;i&gt;in vitro&lt;/i&gt;?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Our findings show that &lt;i&gt;in vitro&lt;/i&gt;, epithelium dependably propagates highly differentiated oviductal organoids containing both networks of ciliated and secretory cells capable of producing &lt;i&gt;in vivo&lt;/i&gt;-like, cargo-specific oviductal extracellular vesicles (oEVs) with the capacity to improve the quality of &lt;i&gt;in vitro&lt;/i&gt;-produced embryos under conditions of heat stress (HS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Recapitulating the maternal contribution that persists during preimplantation embryonic development &lt;i&gt;in vitro&lt;/i&gt; is a substantial scientific challenge due to both technical limitations and the significant gaps in our scientific knowledge concerning the maternal-embryonic cellular and molecular dialogue. As a result of the limited access to suitable model systems and the inability to directly observe this process &lt;i&gt;in vivo&lt;/i&gt;, this early stage of embryonic development has often been described as particularly elusive and an enigmatic stage of development. Irrespectively, oEVs have recently been identified as key players in mediating the biological information transfer of the embryo-oviduct interactions, which beneficially contributes to the early development of embryos &lt;i&gt;in vitro&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;Over a 2-year period, resected ovaries from intact reproductive tracts (n = 10; a pool of two bovine animals per replicate) containing both complete contralateral and ipsilateral oviducts from assessed stage II, diestrus tracts were processed for the generation of oviductal organoids. Afterward, enriched oEVs from 3D organoids and &lt;i&gt;in vivo&lt;/i&gt;-collected oviductal fluid (OF) were co-cultured with bovine presumptive zygotes from Day 1 to Day 3 and continued until the blastocyst stage for further evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;Organoids were characterized by light microscopy, gene expression, immunofluorescence, and 3D reconstruction, as well as histological two-dimensional (2D) cross-sectioning. Enriched oEVs from conditioned organoid culture media and OF were characterized using transmission electron microscopy, nanoparticle tracking analysis, and western blotting. Following the establishment of a stable oEV production system, bovine zygotes were divided into five groups [38.5°C Control, 41°C Control, 41°C N-EVs (oEVs derived from organoids cultured under thermoneutral conditions), 41°C S-EVs (oEVs derived from organoids cultured HS conditions), 41°C Ovi-EVs (oEVs collected from diestrus OF)] and cultured until the blastocyst stage. Following the pr","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2026 1","pages":"hoaf076"},"PeriodicalIF":11.1,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Parental and cell-division origin analysis to reduce false-positives in mosaic embryos for preimplantation genetic testing. 亲代和细胞分裂起源分析,以减少镶嵌胚胎植入前基因检测的假阳性。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-01 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf075
Qi Zhang, Guicen Liu, Yezhou Xiang, Yangyun Zou, Yulin Chen, Yingying Xia, Shun Xiong, Tao Fu, Jiang Wang, Yan Jiang, Jiaojiao Xiong, Xiaodong Zhang, Sijia Lu, Dongyun Liu, Guoning Huang, Tingting Lin
<p><strong>Study question: </strong>Can parental and cell-division origin analysis identify the false-positive chromosomal aberrations in mosaic embryos detected during preimplantation genetic testing for aneuploidy (PGT-A)?</p><p><strong>Summary answer: </strong>Parental origin analysis reclassified over half of mosaic embryos as euploid to reduce diagnostic uncertainty, and cell-division origin analysis effectively differentiated mitotic from meiotic errors to guide evidence-based mosaic embryo transfer.</p><p><strong>What is known already: </strong>Mosaic embryos pose significant challenges in PGT-A, with reported detection rates varying widely (2-35.6%) due to biological and technical factors, but current methods lack reliable approaches to distinguish true mosaicism from technical artifacts. Decisions regarding mosaic embryo transfer remain conservative and hampered by inadequate understanding of the origins of errors (mitotic vs meiotic) and limited data on long-term neonatal outcomes.</p><p><strong>Study design size duration: </strong>In this retrospective study, we analyzed 9062 PGT-A results and 8645 amniocentesis samples from 2021 to 2024 to investigate the difference in mosaicism rates between PGT treatment and prenatal diagnosis. An analysis of parental and cell-division origins was performed on 1221 consecutive results from PGT-A and PGT for monogenic disorders (PGT-M) from 259 patients across 304 treatment cycles in 2024. Multi-site re-biopsies of 36 donated embryos and the clinical outcomes of 19 mosaic embryo transfers were analyzed in 2024 and 2025.</p><p><strong>Participants/materials setting methods: </strong>An innovative algorithm, termed parental haplotype trace (PH-trace), was developed to identify the genetic origin of chromosomal aberrations for mosaic verification. Briefly, biallelic homozygous single-nucleotide polymorphisms (SNPs) in the parental genome exhibit equal allelic frequencies in euploid embryos. When chromosomal aberrations occur, these SNPs show an allelic bias toward either the maternal or paternal genome. We defined the ratio of maternal-biased SNPs to paternal-biased SNPs as the uneven score to quantitatively assess the parental origin of chromosomal aberrations. Receiver operating characteristic (ROC) curve analysis based on uneven scores from euploid and aneuploid embryos was used to determine critical thresholds for identifying false-positive mosaic embryos. Additionally, heterozygous SNPs in the parental genome were used to determine the cell-division origin of chromosomal aberrations. To validate our findings, we performed multi-site re-biopsies of aneuploid and mosaic embryos.</p><p><strong>Main results and the role of chance: </strong>The prevalence of mosaicism differed significantly between PGT-A and prenatal diagnosis (12.2% vs 0.9%, <i>P </i>< 0.001). Parental origin analysis based on PH-trace reclassified 52.6% of mosaic embryos as euploid and increased the overall rate of usable embryos by 8
研究问题:亲代和细胞分裂起源分析能否识别在植入前非整倍体基因检测(PGT-A)中检测到的马赛克胚胎中的假阳性染色体畸变?摘要回答:亲本起源分析将一半以上的镶嵌胚胎重新分类为整倍体,减少诊断的不确定性;细胞分裂起源分析有效区分有丝分裂和减数分裂错误,指导循证镶嵌胚胎移植。已知情况:由于生物和技术因素,嵌合胚胎对PGT-A构成了重大挑战,报道的检出率差异很大(2-35.6%),但目前的方法缺乏可靠的方法来区分真正的嵌合与技术人工制品。关于镶嵌胚胎移植的决定仍然是保守的,并且由于对错误的起源(有丝分裂与减数分裂)的理解不足以及关于新生儿长期结局的数据有限而受到阻碍。研究设计规模持续时间:在这项回顾性研究中,我们分析了2021年至2024年9062例PGT- a结果和8645例羊膜穿刺术样本,以研究PGT治疗与产前诊断之间嵌合率的差异。研究人员对2024年304个治疗周期内259例患者的PGT- a和PGT治疗单基因疾病(PGT- m)的1221个连续结果进行了亲代和细胞分裂起源分析。分析了2024年和2025年36例捐赠胚胎的多部位再活检和19例马赛克胚胎移植的临床结果。参与者/材料设置方法:开发了一种称为亲本单倍型痕量(ph -痕量)的创新算法,用于鉴定染色体畸变的遗传起源,以进行镶嵌验证。简而言之,亲本基因组中的双等位基因纯合单核苷酸多态性(snp)在整倍体胚胎中表现出相同的等位基因频率。当染色体畸变发生时,这些snp显示出对母系或父系基因组的等位基因偏倚。我们将母亲偏倚snp与父亲偏倚snp的比例定义为不均匀分数,以定量评估染色体畸变的亲本起源。基于整倍体和非整倍体胚胎不均匀得分的受试者工作特征(ROC)曲线分析用于确定鉴定假阳性镶嵌胚胎的临界阈值。此外,亲本基因组中的杂合snp被用来确定染色体畸变的细胞分裂起源。为了验证我们的发现,我们对非整倍体和马赛克胚胎进行了多位点重新活检。主要结果和机会的作用:镶嵌现象的发生率在PGT-A和产前诊断之间存在显著差异(12.2% vs 0.9%, P)。注意的局限性:我们的双层分析方法依赖于亲代和胚胎基因组中足够数量的信息性snp(例如,每个染色体畸变超过30个信息性snp)。此外,该方法的临床意义需要通过长期随访研究进一步验证。研究结果的广泛意义:本研究提出了一种识别假阳性嵌合胚胎的有效策略,从而提高胚胎在临床治疗中的利用。通过阐明嵌合体的细胞分裂起源,我们的发现为胚胎学家优先考虑胚胎移植提供了基于证据的标准。此外,这种方法可以减少整倍体胚胎可用性有限的患者的体外受精周期次数和相关费用。研究经费/利益竞争:国家自然科学基金项目(82371728)、重庆市中青年医学精英人才项目(YXGD202555)、重庆市科卫委协同医学研究重点项目(2026ZDXM004)、重庆市科技创新与应用发展专项项目(CSTB2022TIAD-KPX0146)、重庆市自然科学基金项目(CSTB2023NSCQ-MSX0443)资助。作者没有竞争利益需要申报。试验注册号:无。
{"title":"Parental and cell-division origin analysis to reduce false-positives in mosaic embryos for preimplantation genetic testing.","authors":"Qi Zhang, Guicen Liu, Yezhou Xiang, Yangyun Zou, Yulin Chen, Yingying Xia, Shun Xiong, Tao Fu, Jiang Wang, Yan Jiang, Jiaojiao Xiong, Xiaodong Zhang, Sijia Lu, Dongyun Liu, Guoning Huang, Tingting Lin","doi":"10.1093/hropen/hoaf075","DOIUrl":"10.1093/hropen/hoaf075","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Can parental and cell-division origin analysis identify the false-positive chromosomal aberrations in mosaic embryos detected during preimplantation genetic testing for aneuploidy (PGT-A)?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Parental origin analysis reclassified over half of mosaic embryos as euploid to reduce diagnostic uncertainty, and cell-division origin analysis effectively differentiated mitotic from meiotic errors to guide evidence-based mosaic embryo transfer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Mosaic embryos pose significant challenges in PGT-A, with reported detection rates varying widely (2-35.6%) due to biological and technical factors, but current methods lack reliable approaches to distinguish true mosaicism from technical artifacts. Decisions regarding mosaic embryo transfer remain conservative and hampered by inadequate understanding of the origins of errors (mitotic vs meiotic) and limited data on long-term neonatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;In this retrospective study, we analyzed 9062 PGT-A results and 8645 amniocentesis samples from 2021 to 2024 to investigate the difference in mosaicism rates between PGT treatment and prenatal diagnosis. An analysis of parental and cell-division origins was performed on 1221 consecutive results from PGT-A and PGT for monogenic disorders (PGT-M) from 259 patients across 304 treatment cycles in 2024. Multi-site re-biopsies of 36 donated embryos and the clinical outcomes of 19 mosaic embryo transfers were analyzed in 2024 and 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;An innovative algorithm, termed parental haplotype trace (PH-trace), was developed to identify the genetic origin of chromosomal aberrations for mosaic verification. Briefly, biallelic homozygous single-nucleotide polymorphisms (SNPs) in the parental genome exhibit equal allelic frequencies in euploid embryos. When chromosomal aberrations occur, these SNPs show an allelic bias toward either the maternal or paternal genome. We defined the ratio of maternal-biased SNPs to paternal-biased SNPs as the uneven score to quantitatively assess the parental origin of chromosomal aberrations. Receiver operating characteristic (ROC) curve analysis based on uneven scores from euploid and aneuploid embryos was used to determine critical thresholds for identifying false-positive mosaic embryos. Additionally, heterozygous SNPs in the parental genome were used to determine the cell-division origin of chromosomal aberrations. To validate our findings, we performed multi-site re-biopsies of aneuploid and mosaic embryos.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;The prevalence of mosaicism differed significantly between PGT-A and prenatal diagnosis (12.2% vs 0.9%, &lt;i&gt;P &lt;/i&gt;&lt; 0.001). Parental origin analysis based on PH-trace reclassified 52.6% of mosaic embryos as euploid and increased the overall rate of usable embryos by 8","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 4","pages":"hoaf075"},"PeriodicalIF":11.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12714397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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