Human reproduction open最新文献

{"title":"A blended preconception lifestyle programme for couples undergoing IVF: lessons learned from a multicentre randomised controlled trial","authors":"Tessy Boedt, Eline Dancet, Diane De Neubourg, Sofie Vereeck, Jan Seghers, Katleen Van der Gucht, Ben Van Calster, Carl Spiessens, Sharon Lie Fong, Christophe Matthys","doi":"10.1093/hropen/hoad036","DOIUrl":"https://doi.org/10.1093/hropen/hoad036","url":null,"abstract":"Abstract STUDY QUESTION What is the effect of a blended preconception lifestyle programme on reproductive and lifestyle outcomes of couples going through their first 12 months of IVF as compared to an attention control condition? SUMMARY ANSWER This randomized controlled trial (RCT) was stopped prematurely because of the coronavirus disease 2019 (Covid-19) pandemic but the available data did not suggest that a blended preconception lifestyle programme could meaningfully affect time to ongoing pregnancy or other reproductive and lifestyle outcomes. WHAT IS KNOWN ALREADY Increasing evidence shows associations between a healthy lifestyle and IVF success rates. Lifestyle programmes provided through a mobile phone application have yet to be evaluated by RCTs in couples undergoing IVF. STUDY DESIGN, SIZE, DURATION A multicentre RCT (1:1) was carried out. The RCT started in January 2019 and was prematurely stopped because of the Covid-19 pandemic, leading to a reduced sample size (211 couples initiating IVF) and change in primary outcome (cumulative ongoing pregnancy to time to ongoing pregnancy). PARTICIPANTS/MATERIALS, SETTING, METHODS Heterosexual couples initiating IVF in five fertility clinics were randomized between an attention control arm and an intervention arm for 12 months. The attention control arm received treatment information by mobile phone in addition to standard care. The intervention arm received the blended preconception lifestyle (PreLiFe)-programme in addition to standard care. The PreLiFe-programme included a mobile application, offering tailored advice and skills training on diet, physical activity and mindfulness, in combination with motivational interviewing over the telephone. The primary outcome was ‘time to ongoing pregnancy’. Secondary reproductive outcomes included the Core Outcome Measures for Infertility Trials and IVF discontinuation. Changes in the following secondary lifestyle outcomes over 3 and 6 months were studied in both partners: diet quality, fruit intake, vegetable intake, total moderate to vigorous physical activity, sedentary behaviour, emotional distress, quality of life, BMI, and waist circumference. Finally, in the intervention arm, acceptability of the programme was evaluated and actual use of the mobile application part of the programme was tracked. Analysis was according to intention to treat. MAIN RESULTS AND THE ROLE OF CHANCE A total of 211 couples were randomized (105 control arm, 106 intervention arm). The hazard ratio of the intervention for time to ongoing pregnancy was 0.94 (95% CI 0.63 to 1.4). Little to no effect on other reproductive or lifestyle outcomes was identified. Although acceptability of the programme was good (6/10), considerable proportions of men (38%) and 9% of women did not actively use all the modules of the mobile application (diet, physical activity, or mindfulness). LIMITATIONS, REASONS FOR CAUTION The findings of this RCT should be considered exploratory, as the Covid-19 p","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135839299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of iron in the pathogenesis of endometriosis: a systematic review.","authors":"James Wyatt, Sean M Fernando, Simon George Powell, Christopher J Hill, Ilyas Arshad, Chris Probert, Shakil Ahmed, Dharani K Hapangama","doi":"10.1093/hropen/hoad033","DOIUrl":"https://doi.org/10.1093/hropen/hoad033","url":null,"abstract":"<p><strong>Study question: </strong>What is the role of iron in the pathophysiology of endometriosis?</p><p><strong>Summary answer: </strong>Iron excess is demonstrated wherever endometriotic tissues are found and is associated with oxidative stress, an inflammatory micro-environment, and cell damage; the iron-mediated oxidative stress is independently linked to subfertility, symptom severity, and malignant transformation.</p><p><strong>What is known already: </strong>Iron is found in excess in endometriotic tissues, and multiple mechanisms have been studied and posited to explain this. It is clear that iron excess plays a vital role in promoting oxidative stress and cell damage. The evidence base is large, but no comprehensive reviews exist to summarize our understanding and highlight the overarching themes to further our understanding and suggest future directions of study for the field.</p><p><strong>Study design size duration: </strong>This systematic review with a thematic analysis retrieved studies from the PubMed, Embase, Web of Science, and Cochrane Library databases and searches were conducted from inception through to August 2022. Human and animal studies published in the English language were included and identified using a combination of exploded MeSH terms ('Iron' and 'Endometriosis') and free-text search terms ('Iron', 'Ferric', 'Ferrous', 'Endometriosis', 'Endometrioma').</p><p><strong>Participants/materials setting methods: </strong>This review was reported in accordance with the PRISMA guidelines. All studies reporting original data concerning the role of iron or iron complexes in the pathophysiology of endometriosis were included. Studies that did not report original data or provided a review of the field were excluded. Bias analysis was completed for each included study by using the Newcastle-Ottawa scoring system.</p><p><strong>Main results and the role of chance: </strong>There were 776 records identified and these were screened down to 53 studies which met the eligibility criteria, including 6 animal and 47 human studies, with 3556 individual participants. Iron excess is demonstrated in various tissues and fluids, including ovarian endometriomas, ovarian follicles, ectopic endometriotic lesions, and peritoneal fluid. Markers of oxidative stress are strongly associated with high iron levels, and aberrant expression of iron-transport proteins has been demonstrated. Abnormal resistance to ferroptosis is likely. Iron-mediated oxidative stress is responsible for a pro-inflammatory micro-environment and is linked to subfertility, symptom severity, and, possibly, malignant transformation.</p><p><strong>Limitations reasons for caution: </strong>A minority of the included studies were of objectively low quality with a high risk of bias and may lead to misleading conclusions. Additionally, multiple studies failed to appropriately characterize the included patients by known confounding variables, such as menstrual cycle phase, which ma","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad033"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10483386","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}

{"title":"Reply to: Anti-anonymity should not be taken more seriously than other positions on gamete donation.","authors":"Daniel Groll","doi":"10.1093/hropen/hoac060","DOIUrl":"https://doi.org/10.1093/hropen/hoac060","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac060"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/b3/hoac060.PMC9838311.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9100288","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}

{"title":"Caution is needed when communicating analyses based on an apple to orange comparison.","authors":"Birgit Alsbjerg, Peter Humaidan","doi":"10.1093/hropen/hoad016","DOIUrl":"https://doi.org/10.1093/hropen/hoad016","url":null,"abstract":"It was with great interest that we read ‘The effect of frozen embryo transfer regimen on the association between serum progesterone and live birth: a multi-centre prospective cohort study (ProFET)’ by Melo et al. (2022). From their data, the authors concluded that overall serum progesterone levels (P4) <7.8 ng/ml are associated with reduced odds of live birth in frozen embryo transfer (FET). Interestingly, the authors previously published a meta-analysis (Melo et al., 2021) based on several cohort studies of HRT-FET cycles using vaginal progesterone for luteal phase support and reporting a higher P4 cut-off <10 ng/ml for the reproductive outcome. Thus, in that analysis, higher serum P4 levels were associated with increased ongoing pregnancy or live birth rates (LBRs). An important question to ask in relation to the newest publication by Melo et al. (2022) would be: is this suggested new cut-off of serum P4 of 7.8 ng/ml more accurate than 10 ng/ml, and is this cut-off applicable to all FET protocols? Reading the publication carefully reveals that the present study was powered to 900 FET cycles; however, only a total of 398 cycles were included in the final analysis. Furthermore, the cohort of FET protocols was very heterogeneous, including HRT-FET, true natural cycle (t-NC), and modified natural cycle (m-NC), in which ovulation is induced with a trigger bolus of hCG. In this context, we have to bear in mind that the FET protocols mentioned are very different in terms of basic endocrinology, first and foremost when considering serum P4. Thus, the natural cycle has a circadian luteal phase progesterone pattern due to the endogenous production of progesterone from the corpus luteum and importantly, in the new Melo et al. (2022) study, a huge variation in the type of ‘NC FET’ protocols was allowed. Thus, different hCG-trigger doses (5000 vs 6500 IE) were used which will definitely have an impact on circulating luteal P4; moreover, in some cycles, no hCG trigger (t-NC) was used and some cycles had vaginal progesterone support whereas others did not. Finally, different dosing and types of vaginal micronized progesterone were used (CyclogestR , UtrogestanR ). Altogether, within a cohort of 45 ‘NC FET’, there might have been as many as nine different combinations; importantly, these differences will invariably result in significant differences in luteal P4 profiles. Furthermore, in the cohort of HRT-FET cycles, we also learn that important differences were allowed in terms of different vaginal micronized progesterone products, differences in dosing regimen and differences in no use or use of a combination of subcutaneous (s.c.) progesterone (LubionR ), 25 mg once daily or twice daily. For monitoring, the authors state that blood sampling was performed 4–6 h after the last administration of exogenous progesterone. Again, the reader might ask, what does ‘approximately’ mean? One hour, two hours—or more? Timing of luteal phase blood sampling is crucial, espe","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad016"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/9c/hoad016.PMC10234700.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9570237","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}

{"title":"ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma<sup />.","authors":"Alexandros Rodolakis,&nbsp;Giovanni Scambia,&nbsp;François Planchamp,&nbsp;Maribel Acien,&nbsp;Attilio Di Spiezio Sardo,&nbsp;Martin Farrugia,&nbsp;Michael Grynberg,&nbsp;Maja Pakiz,&nbsp;Kitty Pavlakis,&nbsp;Nathalie Vermeulen,&nbsp;Gianfranco Zannoni,&nbsp;Ignacio Zapardiel,&nbsp;Kirsten Louise Tryde Macklon","doi":"10.1093/hropen/hoac057","DOIUrl":"https://doi.org/10.1093/hropen/hoac057","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;How should fertility-sparing treatment of patients with endometrial carcinoma be performed?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Forty-eight recommendations were formulated on fertility-sparing treatment of patients with endometrial carcinoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;The standard surgical treatment of endometrial carcinoma consisting of total hysterectomy with bilateral salpingo-oophorectomy drastically affects the quality of life of patients and creates a challenge for clinicians. Recent evidence-based guidelines of the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) provide comprehensive guidelines on all relevant issues of diagnosis and treatment in endometrial carcinoma in a multidisciplinary setting. While addressing also work-up for fertility preservation treatments and the management and follow-up for fertility preservation, it was considered relevant to further extend the guidance on fertility-sparing treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;A collaboration was set up between the ESGO, the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE), aiming to develop clinically relevant and evidence-based guidelines focusing on key aspects of fertility-sparing treatment in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;ESGO/ESHRE/ESGE nominated an international multidisciplinary development group consisting of practising clinicians and researchers who have demonstrated leadership and expertise in the care and research of endometrial carcinoma (11 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2016, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgement was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 95 independent international practitioners in cancer care delivery and patient representatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;The multidisciplinary development group formulated 48 recommendations in four sections; patient selection, tumour clinicopathological characteristics, treatment and special issues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;Of the 48 recommendations, none could be based on level I evidence and only 16 could be based on level II evidence, implicating that 66% of the recommendations are supported only by observational data, professional experience and consensus of the development group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Wider implication","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac057"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10681673","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}

{"title":"Spermatogenesis after gonadotoxic childhood treatment: follow-up of 12 patients.","authors":"E Delgouffe,&nbsp;A Braye,&nbsp;V Vloeberghs,&nbsp;I Mateizel,&nbsp;C Ernst,&nbsp;A Ferster,&nbsp;C Devalck,&nbsp;H Tournaye,&nbsp;I Gies,&nbsp;E Goossens","doi":"10.1093/hropen/hoad029","DOIUrl":"https://doi.org/10.1093/hropen/hoad029","url":null,"abstract":"<p><strong>Study question: </strong>What is the long-term impact of presumed gonadotoxic treatment during childhood on the patient's testicular function at adulthood?</p><p><strong>Summary answer: </strong>Although most patients showed low testicular volumes and some degree of reproductive hormone disruption 12.3 (2.3-21.0) years after gonadotoxic childhood therapy, active spermatogenesis was demonstrated in the semen sample of 8 out of the 12 patients.</p><p><strong>What is known already: </strong>In recent decades, experimental testicular tissue banking programmes have been set up to safeguard the future fertility of young boys requiring chemo- and/or radiotherapy with significant gonadotoxicity. Although the risk of azoospermia following such therapies is estimated to be high, only limited long-term data are available on the reproductive potential at adulthood.</p><p><strong>Study design size duration: </strong>This single-centre prospective cohort study was conducted between September 2020 and February 2023 and involved 12 adult patients.</p><p><strong>Participants/materials setting methods: </strong>This study was carried out in a tertiary care centre and included 12 young adults (18.1-28.3 years old) who had been offered testicular tissue banking prior to gonadotoxic treatment during childhood. All patients had a consultation and physical examination with a fertility specialist, a scrotal ultrasound to measure the testicular volumes and evaluate the testicular parenchyma, a blood test for assessment of reproductive hormones, and a semen analysis.</p><p><strong>Main results and the role of chance: </strong>Testicular tissue was banked prior to the gonadotoxic treatment for 10 out of the 12 included patients. Testicular volumes were low for 9 patients, and 10 patients showed some degree of reproductive hormone disruption. Remarkably, ongoing spermatogenesis was demonstrated in 8 patients at a median 12.3 (range 2.3-21.0) years post-treatment.</p><p><strong>Limitations reasons for caution: </strong>This study had a limited sample size, making additional research with a larger study population necessary to verify these preliminary findings.</p><p><strong>Wider implications of the findings: </strong>These findings highlight the need for multicentric research with a larger study population to establish universal inclusion criteria for immature testicular tissue banking.</p><p><strong>Study funding/competing interests: </strong>This study was conducted with financial support from the Research Programme of the Research Foundation-Flanders (G010918N), Kom Op Tegen Kanker, and Scientific Fund Willy Gepts (WFWG19-03). The authors declare no competing interests.</p><p><strong>Trial registration number: </strong>NCT04202094; https://clinicaltrials.gov/ct2/show/NCT04202094?id=NCT04202094&draw=2&rank=1 This study was registered on 6 December 2019, and the first patient was enrolled on 8 September 2020.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad029"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/14/hoad029.PMC10403430.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955864","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}

{"title":"The impact of small and asymptomatic intramural and subserosal fibroids on female fertility: a case-control study.","authors":"Valentina Bonanni,&nbsp;Marco Reschini,&nbsp;Irene La Vecchia,&nbsp;Marta Castiglioni,&nbsp;Ludovico Muzii,&nbsp;Paolo Vercellini,&nbsp;Edgardo Somigliana","doi":"10.1093/hropen/hoac056","DOIUrl":"https://doi.org/10.1093/hropen/hoac056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Do small and asymptomatic intramural and subserosal uterine fibroids affect female fertility?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Small and asymptomatic fibroids that do not encroach the endometrial cavity appear to not markedly affect female fertility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;The available evidence on uterine fibroids and fertility is limited. Most information has been obtained in IVF settings by comparing the success in women affected and not affected by fibroids. These studies have shown a detrimental effect of submucosal and possibly intramural fibroids. However, this study design provides information only on embryo implantation, not on female fertility in general.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;A retrospective observational case-control study on 200 women whose partner was diagnosed with severe male infertility and 200 women with unexplained infertility was conducted. If the null hypothesis (that fibroids do not affect fertility) is valid, one would expect a similar prevalence of fibroids in the two study groups. Conversely, if fibroids do impact fertility, one would expect a higher prevalence among women with unexplained infertility. The study was carried out at the Infertility Unit of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico covering a 5-year period between January 2014 and June 2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;We retrospectively recruited women seeking pregnancy whose partner was repeatedly documented to have a sperm concentration below 1 million/ml and matched them by age and study period to a group of women with unexplained infertility. The latter group of women was considered as a case group (infertile subjects), while the former group of women was considered as a control group (reflecting the general female population). Women with fibroids could be included in both study groups; only those with submucosal lesions were excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Fibroids were diagnosed in 31 women (16%) with unexplained infertility and in 32 women (16%) with severe male factor infertility. The adjusted odds ratio of carrying fibroids in women with unexplained infertility was 0.91 (95% CI: 0.52-1.58). Subgroup analyses according to number, dimension and location of fibroids failed to highlight an increased risk of infertility in any group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;This is a retrospective study and some inaccuracies in fibroids detection cannot be ruled out. Moreover, the relatively small sample size hampers robust subgroup analyses. Even though we excluded women with patent causes of infertility, some women with specific causes of infertility could have been included among controls (yet are expected to account for &lt;10% of the group).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Wider implications of the findings: &lt;/strong&gt;This study suggests that small fibroids that do not en","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac056"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/a9/hoac056.PMC9782921.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800657","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}

{"title":"Stimulating fertility awareness: the importance of getting the language right.","authors":"H Mertes,&nbsp;J Harper,&nbsp;J Boivin,&nbsp;M Ekstrand Ragnar,&nbsp;B Grace,&nbsp;M Moura-Ramos,&nbsp;S Rautakallio-Hokkanen,&nbsp;M Simopoulou,&nbsp;K Hammarberg,&nbsp;On Behalf Of The International Reproductive Health Education Collaboration Irhec","doi":"10.1093/hropen/hoad009","DOIUrl":"https://doi.org/10.1093/hropen/hoad009","url":null,"abstract":"<p><p>While education about fertility is not intrinsically controversial, finding the right language to communicate the topic can be challenging, as there are several risks of unintended negative effects such as dissonance, anxiety, culpability, and stigma due to social norming. In this article, we share some of our learnings from promoting fertility awareness in the hope that they will inspire further debate and research on this topic. Starting from the ethical principles of respect for reproductive autonomy, avoiding harm (in terms of stigma or anxiety) and inclusivity, we have formulated five recommendations: (i) frame fertility awareness messages with (reproductive) autonomy in mind and aim to be inclusive of those who do not represent the traditional nuclear family; (ii) be empathetic and steer clear of blame; (iii) avoid scaremongering and offer a positive angle; (iv) give due consideration to both women and men in fertility health messaging; and (v) tailor the messages to particular contexts and audiences and develop resources in close collaboration with the target groups.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 2","pages":"hoad009"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/b7/hoad009.PMC10112336.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442196","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}

{"title":"Anti-anonymity should not be taken more seriously than other positions on gamete donation.","authors":"Guido Pennings","doi":"10.1093/hropen/hoac059","DOIUrl":"https://doi.org/10.1093/hropen/hoac059","url":null,"abstract":"Sir, In a recent response to my debate article (Pennings, 2022) on the forgotten group of donor-conceived persons (DCPs), Daniel Groll intended to show that my claim that ‘people who accept the antianonymity position should also accept the anti-donation position’ (the ‘equivalence argument’) is wrong (Groll, 2022). However, I did not make that claim (Pennings, 2022). Most of his argument is directed against a ‘straw man’ construction that makes a much stronger claim than the one I actually made. This ‘rephrasing’ of my main point makes it relatively easy to score. I (merely) argued that the anti-donation position should be recognized as equivalent to the anti-anonymity position as it is supported by the same type of arguments. This is a weaker claim that assumes no logical or dialectical pressure from one position to another. The reply offered by Dr Groll to that point is far from clear. He acknowledges, and I fully agree with him on that point, that the voices of DCPs have no epistemic authority. Lived experience cannot ground epistemic authority on many different aspects of gamete donation such as parental responsibility or the importance of genetic information. He concludes that we should not defer to the views of the DCPs but that we should take them very seriously. The problem is that he does not explain what ‘taking views very seriously’ means. But the problem goes deeper than that. When he recognizes that the views of DCPs have no special epistemic authority, he needs to explain why we should, nevertheless, take these views very seriously. He gives four reasons. One reason is that their voices have been comparatively absent. However, that cannot be a justification to why we should include these views, or any other view for that matter. Another reason is that we cannot get access to these views without asking the DCPs. That is correct, but the question was why (not how) we should take these views into account in the first place. A further reason is that the DCPs did not voluntarily participate in their conception. However, Dr Groll recognizes that this is the case for everyone, not just the DCPs. This lack of voluntariness creates an asymmetry between the procreators and the procreated. Again, although correct, no explanation is offered about what the implications of this asymmetry are, for DCPs and all other people. So that leaves us with the remaining reason: DCPs have a substantial interest. I accept this reason and I also believe that we need to talk to the DCPs in order to find out what these interests are. DCPs who believe that they are harmed because of a rule or measure that is part of the practice of gamete donation have a strong reason to try to change the rule or measure to avoid harm. However, not only are there several parties involved (DCPs, intended parents, donors), but within each party there are different opinions. All of these parties have a substantial but differing interest. As I have argued, the harm and interest are c","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac059"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/f5/hoac059.PMC9838314.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9100287","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}

{"title":"Mind the mechanical strength: tailoring a 3D matrix to encapsulate isolated human preantral follicles.","authors":"Arezoo Dadashzadeh,&nbsp;Saeid Moghassemi,&nbsp;Alexis Peaucelle,&nbsp;Carolina M Lucci,&nbsp;Christiani A Amorim","doi":"10.1093/hropen/hoad004","DOIUrl":"https://doi.org/10.1093/hropen/hoad004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Would a hydrogel with similar mechanical properties to the human ovarian cortex support preantral follicle development?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Yes, our tailored PEGylated fibrin hydrogel was shown to significantly improve follicle growth &lt;i&gt;in vitro.&lt;/i&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;One of the main challenges in developing an engineered ovary is to provide a 3D matrix that supports the follicle architecture and the interaction between granulosa cells and the oocyte as they are essential for folliculogenesis. Thanks to its biocompatibility and bioactivity, fibrin has been employed to fabricate a 3D matrix to encapsulate ovarian follicles. However, follicles lose their physical support within a few days owing to rapid fibrin degradation. Therefore, different strategies, including physical and chemical modifications, have been developed to enhance the stability of fibrin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;By developing a matrix made of a synthetic (polyethylene glycol: PEG) and natural polymer (fibrin), we aimed to overcome fibrin degradation by the chemical reaction of PEGylation and tailor a PEGylated fibrin hydrogel formulation with mechanical strength similar to the ovarian cortex in women of reproductive age. To this end, response surface methodology was employed to obtain a tailored formulation of PEGylated fibrin. This hydrogel was then tested to encapsulate and support isolated human preantral follicles &lt;i&gt;in vitro.&lt;/i&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;A PEGylated fibrin formulation was tailored using mathematical modeling software to mimic the mechanical properties of human ovarian tissue at reproductive age. Human preantral follicles were isolated from 11 patients of reproductive age and encapsulated in the tailored hydrogels, which were cultured &lt;i&gt;in vitro&lt;/i&gt; for 4 or 7 days. Follicle survival and diameter were assessed on Days 1 and 7. Furthermore, the follicles were subjected to confocal microscopy to evaluate their growth (Ki67 staining) on Day 7 and analyze cell-cell communication (connexin 43 and transzonal projection staining) on Day 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;In this study, mathematical modeling was applied to achieve the biomechanically tailored PEGylated fibrin formulation by targeting the specific goal of 3178 ± 245 Pascal, Young's modulus of ovarian cortical tissue in reproductive-age women. Our results demonstrated that the PEGylated fibrin hydrogel consisting of 39.06 mg/ml of PEGylated fibrinogen and 50.36 IU/ml of thrombin was the optimum condition with the desirability of 97.5%. This tailored hydrogel yielded a high follicle survival rate (83%) after 7 days of &lt;i&gt;in vitro&lt;/i&gt; culture and supported its development up to the secondary stage. Follicle growth was confirmed by the presence of Ki67-positive granulosa cells on Day 7. Additionally, connexin 43 and Phalloidin stai","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 2","pages":"hoad004"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9248449","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}