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Bone mineralization in children aged 7-10 years born after ART with frozen and fresh embryo transfer. 冷冻和新鲜胚胎移植ART后出生的7-10岁儿童骨矿化。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-11 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf055
Elisabeth Waldemar Grønlund, Anna Sophie Lebech Kjaer, Louise Laub Asserhøj, Ikram Mizrak, Tine Dahlsgaard Clausen, Per Laub Madsen, Anja Pinborg, Rikke Beck Jensen
<p><strong>Study question: </strong>Does height-adjusted bone mineral content (BMC) at 7-10 years of age differ between children conceived after ART with frozen embryo transfer (FET) compared to children conceived after ART with fresh embryo transfer (fresh-ET) or naturally conceived (NC) children?</p><p><strong>Summary answer: </strong>Children conceived after FET had an increased BMC corrected for height compared with fresh-ET and NC when adjusted for confounders, a difference primarily mediated by the higher birthweight (BW) found in children conceived after FET compared with fresh-ET and NC.</p><p><strong>What is known already: </strong>Children conceived after ART with FET have a higher BW compared to NC children, while the opposite association is known for fresh-ET. In NC children, BW is positively associated with BMC and bone mineral density (BMD), but bone health in children born after ART is scarcely explored with inconsistent results.</p><p><strong>Study design size duration: </strong>This study was a retrospective cohort study as part of the 'Health in Childhood following Assisted Reproductive Technology' (HiCART) cohort, consisting of 606 singletons (292 boys), conceived after FET (n = 200), fresh-ET (n = 203), and NC (n = 203) born from November 2009 to December 2013. The children were 7-10 years old when clinically examined, and the study was conducted from January 2019 to September 2021.</p><p><strong>Participants/materials setting methods: </strong>Children were identified through the Danish Medical Birth Registry and Danish IVF Registry. These registries were also used to collect information regarding ART treatment, pregnancy, and delivery. The clinical examination involved anthropometric measurements, pubertal staging, fasting blood samples, and a whole-body dual-energy x-ray absorptiometry (DXA) scan. Both parents completed a questionnaire on background information regarding themselves and their child. The three groups were compared pairwise using univariate linear regression, and possible confounders and mediators were adjusted for using multiple linear regression analysis.</p><p><strong>Main results and the role of chance: </strong>Crude values of BMC corrected for height did not differ between children born after FET, fresh-ET, or NC. When adjusted for relevant confounders, children born after FET had a statistically significant higher BMC corrected for height compared with both fresh-ET and NC. After further adjustment for BW SD score, the differences in BMC corrected for height disappeared, and no statistically significant differences in BMC corrected for height between any of the three groups were found. Factors potentially affecting bone mineralization, such as calcium, parathyroid hormone (PTH), insulin-like growth factor-1 (IGF-1), lean mass, and physical activity in childhood, did not differ between the three groups.</p><p><strong>Limitations reasons for caution: </strong>All relevant confounders were adjusted for, al
研究问题:在7-10岁时,接受ART合并冷冻胚胎移植(FET)的儿童与接受ART合并新鲜胚胎移植(fresh- et)或自然受孕(NC)的儿童相比,身高调整骨矿物质含量(BMC)有差异吗?摘要回答:经混杂因素调整后,FET后怀孕的儿童与新鲜et和NC相比,身高校正后的BMC增加,差异主要是由FET后怀孕的儿童与新鲜et和NC相比的出生体重(BW)较高介导的。已知情况:与未接受ART治疗的儿童相比,接受FET治疗后出生的儿童体重更高,而未接受FET治疗的儿童体重则相反。在NC儿童中,体重与BMC和骨密度(BMD)呈正相关,但对ART后出生儿童的骨骼健康几乎没有研究,结果不一致。研究设计规模持续时间:本研究是一项回顾性队列研究,作为“辅助生殖技术后儿童健康”(HiCART)队列的一部分,包括606名单胎(292名男孩),分别是2009年11月至2013年12月出生的FET (n = 200)、新鲜et (n = 203)和NC (n = 203)。临床检查时,这些儿童的年龄为7-10岁,研究于2019年1月至2021年9月进行。参与者/材料设置方法:通过丹麦医学出生登记处和丹麦试管婴儿登记处确定儿童。这些登记还用于收集有关抗逆转录病毒治疗、妊娠和分娩的信息。临床检查包括人体测量、青春期分期、空腹血液样本和全身双能x线吸收仪(DXA)扫描。父母双方都完成了一份关于他们自己和孩子的背景信息的调查问卷。使用单变量线性回归对三组进行两两比较,并使用多元线性回归分析调整可能的混杂因素和中介因素。主要结果和机会的作用:在FET,新鲜et或NC后出生的儿童中,身高校正的BMC粗值没有差异。当对相关混杂因素进行调整后,与新鲜et和NC相比,FET后出生的儿童的身高校正BMC具有统计学意义上的更高。进一步调整BW SD评分后,身高校正BMC的差异消失,三组之间身高校正BMC的差异无统计学意义。潜在影响骨矿化的因素,如钙、甲状旁腺激素(PTH)、胰岛素样生长因子-1 (IGF-1)、瘦体重和儿童时期的体育活动,在三组之间没有差异。注意的局限性:所有相关的混杂因素都进行了调整,尽管不孕的原因无法获得,因此存在残留混杂的风险。使用家长问卷调查儿童的身体活动水平设置了信息偏差的风险。研究结果的更广泛意义:与新鲜et和NC后怀孕的儿童相比,FET后怀孕的儿童体重增加与7-10岁时身高校正BMC增加有关。需要对FET后的妊娠和新生儿进行纵向研究,以探索体重增加的原因及其对长期骨骼健康的可能影响。研究经费/竞争利益:本研究由诺和诺德基金会(批准号:NNF18OC0034092, NFF19OC0054340)和Rigshospitalet研究基金会资助。ap已获得Gedeon Richter、Ferring Pharmaceuticals、Merck和Cryos的资助;Gedeon Richter、Ferring Pharmaceuticals、Merck、Cryos和IBSA的咨询费;Gedeon Richter、Ferring Pharmaceuticals、Merck和Organon的演讲费;以及Gedeon Richter的旅行补助其余作者声明无利益冲突。试验注册号:ClinicalTrials.gov标识符:NCT03719703。
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引用次数: 0
Levothyroxine supplementation and pregnancy outcomes in women with thyroid disorders: an umbrella review of systematic reviews and meta-analyses of randomized controlled trials. 甲状腺疾病妇女补充左旋甲状腺素与妊娠结局:随机对照试验的系统评价和荟萃分析综述
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-08 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf036
Jing Wang, Jiashu Li, Jing Zhang, Aihua Liu, Wanyu Yang, Xiaodan Zhai, Weiping Teng, Yongze Li, Zhongyan Shan
<p><strong>Study question: </strong>Does levothyroxine (LT4) treatment reduce adverse pregnancy outcomes in pregnant women with thyroid dysfunction?</p><p><strong>Summary answer: </strong>LT4 treatment significantly reduces the risks of pregnancy loss, preterm delivery, and gestational hypertension, with no significant impacts on rates of live birth, placental abruption, or gestational diabetes.</p><p><strong>What is known already: </strong>Multiple meta-analyses have examined the impact of LT4 on pregnancy outcomes, but quantitative confidence assessments are still lacking. Thus, an umbrella review is needed to systematically synthesize and assess the quality of this evidence.</p><p><strong>Study design size duration: </strong>This umbrella review of systematic reviews and meta-analyses used PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews. Searches included studies published in English or Chinese up to 20 March 2025.</p><p><strong>Participants/materials setting methods: </strong>Included studies were systematic reviews or meta-analyses of randomized controlled trials assessing the effects of LT4 on pregnancy outcomes in women with subclinical hypothyroidism (SCH) or thyroid peroxidase antibody (TPOAb) positivity. A set of 24 associations across six pregnancy outcomes were analyzed: pregnancy loss, preterm delivery, live birth, placental abruption, gestational hypertension, and gestational diabetes. Methodological quality was assessed using AMSTAR 1, and evidence quality was graded using GRADE. Sensitivity analyses were conducted to confirm robustness.</p><p><strong>Main results and the role of chance: </strong>Eleven meta-analyses were included. High-quality evidence showed that LT4 treatment reduced the risks of pregnancy loss (RR = 0.43; class III evidence), preterm delivery (RR = 0.56; class III evidence), and gestational hypertension (RR = 0.63; class IV evidence). Moderate-to-low-quality evidence indicated no significant impact on rates of live birth, placental abruption, or gestational diabetes. Of the 24 associations, 22 were rated as high confidence and two as medium confidence based on AMSTAR 1. Sensitivity analyses confirmed the robustness of the findings, but treatment effects varied according to the study population, treatment timing, and method. For pregnancy loss and preterm delivery outcomes, the risk was significantly reduced only when LT4 treatment was initiated in early pregnancy (pregnancy loss: RR = 0.60, <i>P</i> = 0.03; RR = 0.59, <i>P</i> = 0.003; preterm labor: RR = 0.58, <i>P </i>< 0.0001; RR = 0.46, <i>P</i> < 0.00001). Additionally, women with TSH levels greater than 4.0 mU/l derived greater benefits from LT4 treatment compared to those with TSH levels between 2.5 and 4.0 mU/l.</p><p><strong>Limitations reasons for caution: </strong>Limitations include small sample sizes, potential biases (selection and reporting), and language restrictions to English and Chinese studies, which may affec
研究问题:左旋甲状腺素(LT4)治疗是否能减少甲状腺功能障碍孕妇的不良妊娠结局?总结回答:LT4治疗可显著降低流产、早产和妊娠期高血压的风险,对活产、胎盘早剥或妊娠期糖尿病的发生率无显著影响。已知情况:多项荟萃分析已经研究了LT4对妊娠结局的影响,但仍然缺乏定量的信心评估。因此,有必要对这些证据的质量进行系统的综合和评估。研究设计规模持续时间:本综述使用PubMed、Embase、Web of Science和Cochrane系统综述数据库对系统综述和荟萃分析进行综述。检索包括截至2025年3月20日以英文或中文发表的研究。参与者/材料设置方法:纳入的研究是评估LT4对亚临床甲状腺功能减退症(SCH)或甲状腺过氧化物酶抗体(TPOAb)阳性妇女妊娠结局影响的随机对照试验的系统评价或荟萃分析。研究人员分析了6种妊娠结局的24项关联:流产、早产、活产、胎盘早剥、妊娠期高血压和妊娠期糖尿病。采用AMSTAR 1评估方法学质量,采用GRADE对证据质量进行分级。进行敏感性分析以确认稳健性。主要结果和偶然性的作用:包括11项荟萃分析。高质量证据显示,LT4治疗降低了妊娠丢失(RR = 0.43, III类证据)、早产(RR = 0.56, III类证据)和妊娠期高血压(RR = 0.63, IV类证据)的风险。中等到低质量的证据表明,对活产率、胎盘早剥或妊娠糖尿病没有显著影响。在24个协会中,根据AMSTAR 1, 22个被评为高可信度,2个被评为中等可信度。敏感性分析证实了研究结果的稳健性,但治疗效果因研究人群、治疗时间和方法而异。对于妊娠丢失和早产结局,只有在妊娠早期开始LT4治疗时,风险才会显著降低(妊娠丢失:RR = 0.60, P = 0.03; RR = 0.59, P = 0.003;早产:RR = 0.58, P)谨慎的局限性原因:局限性包括样本量小,潜在的偏差(选择和报告),以及对中英文研究的语言限制,这可能会影响推广。研究结果的更广泛意义:通过整合高质量的证据,本研究证实LT4可以降低甲状腺功能障碍孕妇的妊娠丢失和早产风险,支持其在特定人群的临床应用,如TPOAb阳性或TSH > 4.0 mU/l的SCH患者,并警告过度治疗的风险。本研究结果为临床精准干预提供了依据。未来的研究应通过标准化的大型研究来解决异质性问题,明确剂量阈值,评估LT4对母婴的长期健康影响,进一步完善指南,优化风险分层管理。研究经费/利益竞争:国家重点研发计划项目(批准号:2023YFC2508300、2023YFC2508303、2023YFC2508305)、国家科技重大专项项目(批准号:2024ZD0533403)、国家自然科学基金项目(批准号:82100831、81570709、82470826)资助。所有作者都声明没有利益冲突。注册号:CRD42024586105。
{"title":"Levothyroxine supplementation and pregnancy outcomes in women with thyroid disorders: an umbrella review of systematic reviews and meta-analyses of randomized controlled trials.","authors":"Jing Wang, Jiashu Li, Jing Zhang, Aihua Liu, Wanyu Yang, Xiaodan Zhai, Weiping Teng, Yongze Li, Zhongyan Shan","doi":"10.1093/hropen/hoaf036","DOIUrl":"10.1093/hropen/hoaf036","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Does levothyroxine (LT4) treatment reduce adverse pregnancy outcomes in pregnant women with thyroid dysfunction?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;LT4 treatment significantly reduces the risks of pregnancy loss, preterm delivery, and gestational hypertension, with no significant impacts on rates of live birth, placental abruption, or gestational diabetes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Multiple meta-analyses have examined the impact of LT4 on pregnancy outcomes, but quantitative confidence assessments are still lacking. Thus, an umbrella review is needed to systematically synthesize and assess the quality of this evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;This umbrella review of systematic reviews and meta-analyses used PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews. Searches included studies published in English or Chinese up to 20 March 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;Included studies were systematic reviews or meta-analyses of randomized controlled trials assessing the effects of LT4 on pregnancy outcomes in women with subclinical hypothyroidism (SCH) or thyroid peroxidase antibody (TPOAb) positivity. A set of 24 associations across six pregnancy outcomes were analyzed: pregnancy loss, preterm delivery, live birth, placental abruption, gestational hypertension, and gestational diabetes. Methodological quality was assessed using AMSTAR 1, and evidence quality was graded using GRADE. Sensitivity analyses were conducted to confirm robustness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Eleven meta-analyses were included. High-quality evidence showed that LT4 treatment reduced the risks of pregnancy loss (RR = 0.43; class III evidence), preterm delivery (RR = 0.56; class III evidence), and gestational hypertension (RR = 0.63; class IV evidence). Moderate-to-low-quality evidence indicated no significant impact on rates of live birth, placental abruption, or gestational diabetes. Of the 24 associations, 22 were rated as high confidence and two as medium confidence based on AMSTAR 1. Sensitivity analyses confirmed the robustness of the findings, but treatment effects varied according to the study population, treatment timing, and method. For pregnancy loss and preterm delivery outcomes, the risk was significantly reduced only when LT4 treatment was initiated in early pregnancy (pregnancy loss: RR = 0.60, &lt;i&gt;P&lt;/i&gt; = 0.03; RR = 0.59, &lt;i&gt;P&lt;/i&gt; = 0.003; preterm labor: RR = 0.58, &lt;i&gt;P &lt;/i&gt;&lt; 0.0001; RR = 0.46, &lt;i&gt;P&lt;/i&gt; &lt; 0.00001). Additionally, women with TSH levels greater than 4.0 mU/l derived greater benefits from LT4 treatment compared to those with TSH levels between 2.5 and 4.0 mU/l.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;Limitations include small sample sizes, potential biases (selection and reporting), and language restrictions to English and Chinese studies, which may affec","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 3","pages":"hoaf036"},"PeriodicalIF":11.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115095","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
Generating human primordial germ cell-like cells from pluripotent stem cells: a scoping review of in vitro methods. 从多能干细胞中产生人类原始生殖细胞样细胞:体外方法的范围综述。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-04 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf056
Madalena Vaz Santos, Ilse J de Bruin, Nina Dartée, Mathangi Lakshmipathi, Geert Hamer, Callista L Mulder, Willy M Baarends, Ans M M Van Pelt, Susana M Chuva De Sousa Lopes
<p><strong>Study question: </strong>How do the methods and outcomes of established protocols to specify human primordial germ cell-like cells (hPGCLCs) <i>in vitro</i> compare to each other?</p><p><strong>Summary answer: </strong>All analyzed protocols were successful in generating hPGCLCs, and a few were able to induce further germ cell maturation.</p><p><strong>What is known already: </strong>There are a variety of protocols for generating hPGCLCs <i>in vitro</i>, each with its own advantages and disadvantages. To date no comparison has been made, hindering the practical application of <i>in vitro</i>-derived hPGCLCs in research and the advancement toward generating mature germ cells.</p><p><strong>Study design size duration: </strong>For this scoping review, a systematic search for protocols was conducted in the databases Scopus and Web of Science, including publications since 2010. Search terms included human, differentiation/specification/induction, germ cell/oogonia/spermatogonia, and primordial.</p><p><strong>Participants/materials setting methods: </strong>Two separate authors performed the database search according to the inclusion/exclusion criteria. The data regarding the materials and methods as well as results of the included articles were extracted and organized based on protocol (cell type and culture system) and outcome.</p><p><strong>Main results and the role of chance: </strong>A systematic search revealed 32 articles describing the generation of hPGCLCs. Of these, 24 articles contained an original hPGCLC differentiation protocol and 8 articles provided an extension of a previously published protocol. The extension protocols focused either on extending hPGCLC culture or maturing hPGCLCs further. The articles were compared regarding protocol methods and differentiation outcomes. The data showed that differentiation in 2D or 3D, in the presence of bone morphogenetic protein 4 (BMP4) (or retinoic acid), activated the WNT and NODAL signaling pathways to induce hPGCLCs. Further maturation (based on gene expression) was also achieved, depending on the inclusion of subsequent differentiation steps. The 2D culture systems showed high efficiency and scalability, while the 3D culture systems were more suitable for germ cell maturation purposes. Further improvements would include a deeper assessment of epigenetic and gene expression, functional analyses, and use of multiple cell lines to reflect protocol versatility.</p><p><strong>Limitations reasons for caution: </strong>Only literature has been compared; no extensive experimental comparison or a meta-analysis was performed due to the heterogeneity in outcome measurements.</p><p><strong>Wider implications of the findings: </strong>This review offers a comparison of hPGCLC differentiation protocols and aims to aid researchers in selecting appropriate protocols and making informed modifications to the culture conditions to achieve efficient germ cell differentiation.</p><p><strong>Study fun
研究问题:在体外指定人类原始生殖细胞样细胞(hpgclc)的既定方案的方法和结果如何比较?总结回答:所有分析的方案都成功地产生了hpgclc,并且少数方案能够诱导进一步的生殖细胞成熟。已知情况:有多种体外生成hpgclc的方案,每种方案都有自己的优点和缺点。到目前为止,还没有进行比较,这阻碍了体外来源的hpgclc在研究中的实际应用和成熟生殖细胞的产生。研究设计规模持续时间:对于本次范围综述,在Scopus和Web of Science数据库中进行了系统的协议搜索,包括2010年以来的出版物。搜索词包括人类,分化/规范/诱导,生殖细胞/卵原细胞/精原细胞和原始。受试者/材料设置方法:由两位独立作者根据纳入/排除标准进行数据库检索。根据方案(细胞类型和培养系统)和结果对纳入文章的材料和方法相关数据进行提取和整理。主要结果和偶然性的作用:系统检索显示了32篇描述hpgclc产生的文章。其中,24篇文章包含原始的hPGCLC分化方案,8篇文章提供了先前发表的方案的扩展。扩展协议的重点要么是扩展hPGCLC培养,要么是进一步成熟hPGCLC。比较两篇文章的治疗方案、方法和鉴别结果。数据显示,在2D或3D分化中,在骨形态发生蛋白4 (BMP4)(或视黄酸)存在下,激活WNT和NODAL信号通路诱导hpgclc。进一步的成熟(基于基因表达)也实现了,这取决于随后的分化步骤的包含。二维培养系统具有较高的效率和可扩展性,而三维培养系统更适合生殖细胞成熟目的。进一步的改进将包括更深入的表观遗传和基因表达评估、功能分析,以及使用多细胞系来反映方案的通用性。局限性:仅比较了文献;由于结果测量的异质性,没有进行广泛的实验比较或荟萃分析。研究结果的更广泛意义:本综述提供了hPGCLC分化方案的比较,旨在帮助研究人员选择合适的方案,并对培养条件进行知情修改,以实现有效的生殖细胞分化。研究经费/竞争利益:本研究由ZonMW (PSIDER 10250022120001)和Novo Nordisk Foundation (reNEW NNF21CC0073729)资助。作者声明无利益冲突。注册号:无。
{"title":"Generating human primordial germ cell-like cells from pluripotent stem cells: a scoping review of <i>in vitro</i> methods.","authors":"Madalena Vaz Santos, Ilse J de Bruin, Nina Dartée, Mathangi Lakshmipathi, Geert Hamer, Callista L Mulder, Willy M Baarends, Ans M M Van Pelt, Susana M Chuva De Sousa Lopes","doi":"10.1093/hropen/hoaf056","DOIUrl":"10.1093/hropen/hoaf056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;How do the methods and outcomes of established protocols to specify human primordial germ cell-like cells (hPGCLCs) &lt;i&gt;in vitro&lt;/i&gt; compare to each other?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;All analyzed protocols were successful in generating hPGCLCs, and a few were able to induce further germ cell maturation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;There are a variety of protocols for generating hPGCLCs &lt;i&gt;in vitro&lt;/i&gt;, each with its own advantages and disadvantages. To date no comparison has been made, hindering the practical application of &lt;i&gt;in vitro&lt;/i&gt;-derived hPGCLCs in research and the advancement toward generating mature germ cells.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;For this scoping review, a systematic search for protocols was conducted in the databases Scopus and Web of Science, including publications since 2010. Search terms included human, differentiation/specification/induction, germ cell/oogonia/spermatogonia, and primordial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;Two separate authors performed the database search according to the inclusion/exclusion criteria. The data regarding the materials and methods as well as results of the included articles were extracted and organized based on protocol (cell type and culture system) and outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;A systematic search revealed 32 articles describing the generation of hPGCLCs. Of these, 24 articles contained an original hPGCLC differentiation protocol and 8 articles provided an extension of a previously published protocol. The extension protocols focused either on extending hPGCLC culture or maturing hPGCLCs further. The articles were compared regarding protocol methods and differentiation outcomes. The data showed that differentiation in 2D or 3D, in the presence of bone morphogenetic protein 4 (BMP4) (or retinoic acid), activated the WNT and NODAL signaling pathways to induce hPGCLCs. Further maturation (based on gene expression) was also achieved, depending on the inclusion of subsequent differentiation steps. The 2D culture systems showed high efficiency and scalability, while the 3D culture systems were more suitable for germ cell maturation purposes. Further improvements would include a deeper assessment of epigenetic and gene expression, functional analyses, and use of multiple cell lines to reflect protocol versatility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;Only literature has been compared; no extensive experimental comparison or a meta-analysis was performed due to the heterogeneity in outcome measurements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Wider implications of the findings: &lt;/strong&gt;This review offers a comparison of hPGCLC differentiation protocols and aims to aid researchers in selecting appropriate protocols and making informed modifications to the culture conditions to achieve efficient germ cell differentiation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study fun","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 4","pages":"hoaf056"},"PeriodicalIF":11.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187787","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
Accurate identification of abnormal ploidy using an artificial intelligence model in preimplantation genetic testing. 利用人工智能模型在胚胎植入前基因检测中准确识别异常倍性。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-02 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf054
Pingyuan Xie, Rijing Pang, Luyao Zeng, Shuoping Zhang, Lei Sun, Kaisen Yang, Xiaoyi Yang, Shuang Zhou, Senlin Zhang, Guangjian Liu, Yueqiu Tan, Liang Hu, Fei Gong, Jia Fei, Ge Lin
<p><strong>Study question: </strong>Can ultra-low-coverage whole-genome sequencing (ulc-WGS) accurately identify abnormal ploidy during preimplantation genetic testing (PGT)?</p><p><strong>Summary answer: </strong>The artificial intelligence (AI)-based PGT-Plus model demonstrates high accuracy in ploidy detection, offering a cost-effective solution that enhances clinical utility of PGT.</p><p><strong>What is known already: </strong>The predominant PGT for aneuploidy can identify chromosomal aneuploidies but cannot determine ploidy status. Transferring embryos with ploidy abnormalities can result in miscarriage and molar pregnancy. On the other hand, in ART, fertilization is assessed by morphological pronuclear assessment at the zygote stage. However, it has a low specificity in the prediction of abnormal ploidy status and embryos deemed abnormally fertilized can yield healthy pregnancies. Accurately identified abnormal ploidy in PGT-A can resolve current limitations and expand the utility range of PGT-A. Several studies have identified ploidy abnormalities; however, they were mainly based on single-nucleotide polymorphism (SNP) arrays or needed to combine additional targeted-next-generation sequencing (NGS) information. Studies based on ulc-WGS remain scarce.</p><p><strong>Study design size duration: </strong>The study consisted of two stages: methodology establishment and validation. An AI model, named PGT-Plus, was developed using 653 samples with known ploidy status, which was further validated using 792 different ploidy status samples. In the clinical application stage, the approach was used to analyse the ploidy status of 19 103 normally fertilized PGT blastocysts and 140 single pronucleus (1PN)-derived blastocysts collected between May 2022 and December 2023. All blastocysts were tested using trophectoderm biopsy and NGS.</p><p><strong>Participants/materials setting methods: </strong>The methodology is based on the ulc-WGS data. First, based on samples with known ploidy status: the heterozygosity rate of high-frequency biallelic SNPs, the likelihood ratio (LLR) of alleles was calculated under different assumptions ('both parental homologs' [BPH] from a single parent, 'single parental homolog' [SPH] from each parent, disomy, and monosomy) by leveraging allele frequencies and linkage disequilibrium (LD) measured in the 1000 genomes project database. Twenty-three continuous candidate features derived from heterozygosity rates and LLRs of chromosomes or selected windows were included to establish the ploidy prediction AI model. Gini importance analysis and multicollinearity mitigation was performed for feature selection, then the performance of Random Forest (RF), Support Vector Machine (SVM), and Logistic Regression for modelling was compared. Subsequently, the parameter optimization was performed based on the RF model. Ploidy constitution concordance was evaluated in known ploidy status samples. The frequency of abnormal ploidy in normal fert
研究问题:超低覆盖率全基因组测序(ulc-WGS)能否在胚胎植入前基因检测(PGT)中准确识别异常倍性?基于人工智能(AI)的PGT- plus模型在倍性检测方面具有很高的准确性,为提高PGT的临床应用提供了一种经济高效的解决方案。已知情况:非整倍体的主要PGT可以识别染色体非整倍体,但不能确定倍体状态。移植具有倍性异常的胚胎可导致流产和磨牙妊娠。另一方面,在抗逆转录病毒技术中,受精是通过合子阶段的形态原核评估来评估的。然而,它在预测异常倍性状态方面的特异性较低,被认为异常受精的胚胎可以产生健康的妊娠。准确识别PGT-A异常倍性可以解决目前PGT-A的局限性,扩大PGT-A的使用范围。一些研究已经发现了倍性异常;然而,它们主要基于单核苷酸多态性(SNP)阵列或需要结合额外的靶向下一代测序(NGS)信息。基于ulc-WGS的研究仍然很少。研究设计规模和持续时间:研究包括两个阶段:方法学建立和验证。利用已知倍性状态的653个样本建立了名为PGT-Plus的人工智能模型,并使用792个不同倍性状态的样本进一步验证了该模型。在临床应用阶段,该方法分析了2022年5月至2023年12月收集的19103个正常受精的PGT囊胚和140个单原核(1PN)来源囊胚的倍性状况。所有囊胚均采用滋养外胚层活检和NGS检测。参与者/材料设置方法:方法基于ulc-WGS数据。首先,基于已知倍性状态的样本:高频双等位基因snp的杂合率,利用1000基因组计划数据库中测量的等位基因频率和连锁不平衡(LD),在不同的假设(来自单亲的“双亲同源”[BPH],来自每个亲本的“单亲同源”[SPH],来自二体和单体)下计算等位基因的似然比(LLR)。纳入23个连续候选特征,这些特征来自于染色体的杂合率和llr或选择的窗口,以建立倍性预测AI模型。采用基尼重要性分析和多重共线性缓解方法进行特征选择,然后比较随机森林(RF)、支持向量机(SVM)和逻辑回归(Logistic Regression)的建模性能。随后,基于射频模型进行了参数优化。对已知倍性状态样本进行倍性结构一致性评价。评估正常受精PGT囊胚和1pn囊胚(包括常规IVF和ICSI)异常倍性的频率。主要结果和偶然性的作用:与SVM和Logistic回归相比,收集了11个特征用于模型架构;RF在倍性检测方面具有优异的性能。AI模型对全基因组单倍体(GW-UPD)的AUC为1,对三倍体的AUC为1,对二倍体的AUC为0.99。在792个验证样本中,99.5%的样本被人工智能模型成功检测,该模型对倍性分类的准确率为100%。在临床应用阶段,在19103份PGT样本中,19069份使用该模型成功分析,其中110份(0.57%)鉴定为异常倍性胚胎。其中,12.7%(14/110)为GW-UPD, 87.3%(96/110)为三倍体。移植二倍体囊胚5563例,成功妊娠3478例。随后对217例自然流产和935例产前诊断样本进行倍性分析,未发现异常倍性。此外,140个1PN胚胎中,40个(28.6%)表现为GW-UPD, 3个(2.1%)表现为三倍体,97个(69.3%)被确定为双亲本和正常受精。在97个双亲本胚胎中,46个为二倍体,11个为嵌合体,40个为非整倍体。在授精方式方面,ICSI中异常倍性的百分比明显高于常规IVF (P)。局限性:一些罕见的倍性异常,如具有相同数量染色体的多倍体和倍性嵌合体不能准确识别。此外,由于无法从父母双方获得DNA,因此无法确定异常倍性的起源。研究结果的更广泛意义:PGT-Plus AI模型提供了一种基于传统PGT-A数据的倍性评估方法,并直接集成到标准PGT-A工作流程中。
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引用次数: 0
Reply: Paternal age and neonatal health: unraveling epigenetic pathways. 回复:父亲年龄和新生儿健康:揭示表观遗传途径。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-01 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf053
Wenxue Xiong, Xijia Tang, Lu Han, Li Ling
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引用次数: 0
Paternal age and neonatal health: unraveling epigenetic pathways. 父亲年龄和新生儿健康:揭示表观遗传途径。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-01 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf052
Yuquan Yuan, Chengzhi Zhao
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引用次数: 0
Genetic determinants of testicular sperm extraction outcomes: insights from a large multicentre study of men with non-obstructive azoospermia. 睾丸精子提取结果的遗传决定因素:来自非阻塞性无精子症男性的大型多中心研究的见解。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-29 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf049
Antoni Riera-Escamilla, Mohamed M Arafa, Ginevra Farnetani, Miguel J Xavier, Manon S Oud, Ahmad A Majzoub, Liliana Ramos, Chiara Abrardo, Matilde Spinelli, Daniel Moreno-Mendoza, Giuseppe Defazio, Elisabet Ars, Marc Pybus, Josvany R Sánchez Curbelo, Haitham T Elbardisi, Shoaib Nawaz, Najeeb Syed, Eduard Ruiz-Castané, Godfried W van der Heijden, Khalid A Fakhro, Joris A Veltman, Csilla Krausz
<p><strong>Study question: </strong>What is the diagnostic yield and the pre-testicular sperm extraction (TESE) prognostic value of a non-obstructive azoospermia (NOA)-specific virtual gene panel?</p><p><strong>Summary answer: </strong>The diagnostic yield in our cohort was 6.1%, and by combining our data with published literature, we identified 11 genes compatible with testicular sperm production and 19 genes associated with no sperm retrieval in carriers of pathogenic (P) or likely pathogenic (LP) mutations.</p><p><strong>What is known already: </strong>Azoospermia, the most severe form of male infertility, affects ∼1% of the male population, with TESE being the primary treatment option. However, in NOA, TESE fails in nearly 50% of cases and existing clinical parameters are unable to predict TESE failure. Over the past decade, next-generation sequencing (NGS) has identified several candidate NOA genes, but their diagnostic utility and impact on TESE outcomes have not been fully explored.</p><p><strong>Study design size and duration: </strong>A literature search was addressed to identify well-established NOA genes for designing a specific virtual gene panel for NOA. Our retrospective study analysed the diagnostic yield of the NGS-based virtual gene panel, comprising 145 genes, in 571 men affected by idiopathic NOA with known TESE outcomes. Subsequently, a second literature search was performed to identify carriers of LP/P variants in the genes where we identified mutations, focusing on individuals with known TESE outcomes. This approach allowed us to integrate the published data with our findings and predict a genotype-phenotype correlation between the affected genes and TESE success.</p><p><strong>Participants/materials settings methods: </strong>571 NOA patients with known TESE outcomes were recruited in two European and one Middle East centres. Variants were obtained from a whole-exome sequencing dataset and crossed with the 145 genes of the virtual gene panel. After a filtering process, variants were manually assessed and classified according to ACMG guidelines by using two methods: (i) In order to compare our data with previously published studies, we applied ACMG-AMP guidelines along with ClinGen recommendations used by other similar studies. (ii) A new approach was used to optimize ACMG-AMP guidelines with all ClinGen recommendations and incorporated NOA-specific rules addressing phenotypic, locus, and allelic heterogeneity. LP and P variants were confirmed by Sanger sequencing.</p><p><strong>Main results and the role of chance: </strong>By using the new variant classification approach adapted for NOA, we identified LP/P variants in 6.1% of patients, with a higher yield (9.4%) in cases with negative TESE outcomes and maturation arrest (11.7%). By integrating our findings with the literature, we highlight 19 genes recurrently associated with negative TESE outcomes and 11 genes associated with positive sperm retrieval either in the testis o
研究问题:非阻塞性无精子症(NOA)特异性虚拟基因面板的诊断率和睾丸前精子提取(TESE)预后价值是什么?总结:在我们的队列中,诊断率为6.1%,通过将我们的数据与已发表的文献相结合,我们确定了11个与睾丸精子产生相容的基因,以及19个与致病性(P)或可能致病性(LP)突变携带者无精子提取相关的基因。已知情况:无精子症是男性不育症最严重的形式,影响约1%的男性人口,TESE是主要的治疗选择。然而,在NOA中,近50%的病例TESE失败,现有的临床参数无法预测TESE失败。在过去的十年中,下一代测序(NGS)已经确定了几个候选的NOA基因,但它们的诊断效用和对TESE结果的影响尚未得到充分的探索。研究设计的大小和持续时间:通过文献检索来确定已建立的NOA基因,以便为NOA设计特定的虚拟基因面板。我们的回顾性研究分析了基于ngs的虚拟基因面板的诊断结果,包括145个基因,在571名患有特发性NOA且已知TESE结果的男性中。随后,我们进行了第二次文献检索,以确定我们发现突变的基因中LP/P变异的携带者,重点关注已知TESE结果的个体。这种方法使我们能够将已发表的数据与我们的发现结合起来,并预测受影响基因与TESE成功之间的基因型-表型相关性。参与者/材料设置方法:在两个欧洲和一个中东中心招募了571例已知TESE结局的NOA患者。从全外显子组测序数据集中获得变异,并与虚拟基因面板的145个基因杂交。经过筛选过程后,根据ACMG指南使用两种方法对变量进行手动评估和分类:(i)为了将我们的数据与先前发表的研究进行比较,我们应用了ACMG- amp指南以及其他类似研究使用的ClinGen建议。(ii)采用了一种新的方法来优化ACMG-AMP指南,包括所有ClinGen建议,并纳入了针对表型、基因座和等位基因异质性的noaa特异性规则。通过Sanger测序确认LP和P变异。主要结果和偶然性的作用:通过使用适用于NOA的新的变异分类方法,我们在6.1%的患者中发现了LP/P变异,在TESE阴性结果和成熟停止(11.7%)的病例中发现了更高的率(9.4%)。通过将我们的研究结果与文献相结合,我们强调了19个与TESE阴性结果反复相关的基因,以及11个与睾丸或精液中精子回收阳性相关的基因。TESE推荐用于11个特定基因中LP或P变异的患者。值得注意的是,这些基因中有6个位于X染色体上,因此,这些变异将强制性地传递给女儿,并可能增加雄性后代与noa相关的不育风险。我们观察到9个基因,其中我们鉴定了LP/P变异,之前已经在卵巢早衰(POI)个体中描述过。其中,8例与男性TESE阴性结果相关。此外,我们提出了在我们的NOA患者队列中发生突变的另外七个基因作为新的POI候选基因。这些基因尚未被认为是POI候选基因,但在小鼠模型中敲除它们会导致女性不育。大规模数据:LP/P变异已提交给ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/).Limitations谨慎的原因:NOA是遗传异质性的,我们的小组排除了那些仅在单个受试者或单个家族中报告的基因。虽然这可能会限制我们研究中的诊断率,但它确保了只分析与NOA有明确关系的基因。虽然在我们的队列中,所有患者的TESE结果都是已知的,但在已发表的研究中,突变携带者通常无法获得这一信息。因此,在同一基因中携带P变异的患者总数仍然相对较少,限制了我们的最终结论。然而,即使与阳性取精相关的基因携带者数量相对较低,也不会限制我们关于TESE预测的结论。另一方面,除了TEX11、SYCE1和MSH4外,与TESE阴性结果相关的基因有必要谨慎,每个基因都有10例或更多的TESE阴性病例。研究结果的更广泛含义:我们的研究是在已知TESE结果的最大可用NOA队列中进行的。它不仅提供了对noa特异性虚拟基因面板的诊断潜力的估计,而且还促进了对影响TESE结果的遗传因素的理解。 在我们的研究中,有一半的基因发生了突变,并呈现出tse阳性结果,这已经为临床决策提供了信息。观察到的基因型-表型相关性可能有助于在TESE之前进行个性化决策,以便进行手术或避免不必要的侵入性治疗。它提供了有价值的见解,可以为临床管理策略提供信息,并有可能提供基于基因图谱的个性化治疗。使用两种不同的变异分类方法强调了以前的研究可能高估了诊断率,强调了针对男性不育症的标准化变异分类方法的必要性。我们的研究还强调了NOA和poi相关基因之间的重叠,这对患病个体的女性兄弟姐妹的遗传咨询具有重要的临床意义。研究经费/竞争利益:这项工作由西班牙卫生部卡洛斯三世研究所- fis FONDOS FEDER(批准号PI20/01562和PI23/00425)和授予C.K.和a.r.e的范可尼研究基金资助。本文基于成本行动CA20119 (ANDRONET)的工作,由成本(欧洲科学与技术合作)(www.cost.eu)支持。C.K A.R.-E。, g.f., M.J.X, M.S.O, c.a., m.s.,和e.r.c。是行动的成员。本研究还得到了卡塔尔国家研究基金(QNRF)的资助,资助项目为NPRP12S-0318-190394,并获得了Wellcome Trust (209451 to J.A.V.)的科学研究者奖。作者声明没有利益冲突。
{"title":"Genetic determinants of testicular sperm extraction outcomes: insights from a large multicentre study of men with non-obstructive azoospermia.","authors":"Antoni Riera-Escamilla, Mohamed M Arafa, Ginevra Farnetani, Miguel J Xavier, Manon S Oud, Ahmad A Majzoub, Liliana Ramos, Chiara Abrardo, Matilde Spinelli, Daniel Moreno-Mendoza, Giuseppe Defazio, Elisabet Ars, Marc Pybus, Josvany R Sánchez Curbelo, Haitham T Elbardisi, Shoaib Nawaz, Najeeb Syed, Eduard Ruiz-Castané, Godfried W van der Heijden, Khalid A Fakhro, Joris A Veltman, Csilla Krausz","doi":"10.1093/hropen/hoaf049","DOIUrl":"10.1093/hropen/hoaf049","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;What is the diagnostic yield and the pre-testicular sperm extraction (TESE) prognostic value of a non-obstructive azoospermia (NOA)-specific virtual gene panel?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;The diagnostic yield in our cohort was 6.1%, and by combining our data with published literature, we identified 11 genes compatible with testicular sperm production and 19 genes associated with no sperm retrieval in carriers of pathogenic (P) or likely pathogenic (LP) mutations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Azoospermia, the most severe form of male infertility, affects ∼1% of the male population, with TESE being the primary treatment option. However, in NOA, TESE fails in nearly 50% of cases and existing clinical parameters are unable to predict TESE failure. Over the past decade, next-generation sequencing (NGS) has identified several candidate NOA genes, but their diagnostic utility and impact on TESE outcomes have not been fully explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size and duration: &lt;/strong&gt;A literature search was addressed to identify well-established NOA genes for designing a specific virtual gene panel for NOA. Our retrospective study analysed the diagnostic yield of the NGS-based virtual gene panel, comprising 145 genes, in 571 men affected by idiopathic NOA with known TESE outcomes. Subsequently, a second literature search was performed to identify carriers of LP/P variants in the genes where we identified mutations, focusing on individuals with known TESE outcomes. This approach allowed us to integrate the published data with our findings and predict a genotype-phenotype correlation between the affected genes and TESE success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials settings methods: &lt;/strong&gt;571 NOA patients with known TESE outcomes were recruited in two European and one Middle East centres. Variants were obtained from a whole-exome sequencing dataset and crossed with the 145 genes of the virtual gene panel. After a filtering process, variants were manually assessed and classified according to ACMG guidelines by using two methods: (i) In order to compare our data with previously published studies, we applied ACMG-AMP guidelines along with ClinGen recommendations used by other similar studies. (ii) A new approach was used to optimize ACMG-AMP guidelines with all ClinGen recommendations and incorporated NOA-specific rules addressing phenotypic, locus, and allelic heterogeneity. LP and P variants were confirmed by Sanger sequencing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;By using the new variant classification approach adapted for NOA, we identified LP/P variants in 6.1% of patients, with a higher yield (9.4%) in cases with negative TESE outcomes and maturation arrest (11.7%). By integrating our findings with the literature, we highlight 19 genes recurrently associated with negative TESE outcomes and 11 genes associated with positive sperm retrieval either in the testis o","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 3","pages":"hoaf049"},"PeriodicalIF":11.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981120","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
A new human in vitro model of cytotypic and testosterone-producing organoids derived from testicular tissue of transgender women. 从变性女性睾丸组织中提取的细胞型和产生睾酮的类器官体外模型。
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-20 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf043
Samuel Madureira Silva, Frédéric Chalmel, Andrea Errico, Katerina Papageorgiou, Guillaume Richer, Edith Chan Sock Peng, Antoine D Rolland, Kelly Tilleman, Guy T'Sjoen, Ilaria Dando, Tamara Vanhaecke, Ellen Goossens, Yoni Baert
<p><strong>Study question: </strong>Can testicular tissue from trans women (trans tissue) be used to create human testicular organoids?</p><p><strong>Summary answer: </strong>Testosterone-producing and cytotypic human testicular organoids with bicompartmental architecture can be successfully generated from trans tissue.</p><p><strong>What is known already: </strong>Testicular organoids are a promising tool for studying testicular function and the effects of toxicants. Immature testicular cells are currently the most efficient at forming organoids that closely recapitulate seminiferous tubule-like architecture and functions. However, the scarcity of immature human testicular tissue limits its use in high-throughput applications. Conversely, trans tissue is abundantly available and characterized by an immature phenotype.</p><p><strong>Study design size duration: </strong>Trans tissue-derived organoids (trans organoids) were histologically and androgenically compared to reference organoids derived from immature (prepubertal and pubertal) and adult cisgender testicular tissues. Additionally, long-term testosterone production and gonadotrophic stimulation were assessed in trans organoids. To evaluate their cytotypic and transcriptomic resemblance to reference testicular tissue stages, trans organoids were compared at the gene expression level to prepubertal, pubertal, and adult cisgender tissues, along with their tissue of origin.</p><p><strong>Participants/materials setting methods: </strong>Testicular tissue samples from transgender women, as well as from prepubertal, pubertal, and adult cisgender donors, were used to generate testicular organoids and to compare organoid formation efficiency and testosterone production according to tissue origin. These samples also served as references for transcriptomic comparisons with organoids derived from transgender women's testicular tissue at Day 14 of culture. Testicular organoids were generated and cultured using 3D Petri Dish<sup>®</sup> platforms. Histochemistry and immunofluorescence staining were employed to characterize cellular composition and spatial organization. Testosterone production in culture media was assessed using electrochemiluminescence immunoassays. RNA was extracted and sequenced from organoids derived from transgender women, as well as from tissue samples of all donor groups. Deconvolution and differential gene expression analyses were performed to compare the organoids with testicular tissues across all groups.</p><p><strong>Main results and the role of chance: </strong>Trans organoids form compartmentalized, cytotypic <i>de novo</i> tissues similar to those from pubertal testicular tissue. Additionally, trans organoids exhibit significant testosterone production, sustain this function over extended culture periods, and respond to gonadotrophic stimulation. Deconvolved bulk RNAseq data indicate that cell population proportions within these organoids are close to those in prepubertal a
研究问题:变性女性的睾丸组织(trans tissue)可以用来制造人类睾丸类器官吗?总结回答:具有双室结构的睾酮分泌和细胞型人类睾丸类器官可以成功地从跨组织中产生。已知情况:睾丸类器官是研究睾丸功能和毒物影响的一个很有前途的工具。目前,未成熟的睾丸细胞在形成类器官方面是最有效的,这些类器官与精管一样的结构和功能非常相似。然而,未成熟人类睾丸组织的稀缺性限制了其在高通量应用中的使用。相反,反式组织大量可用,其特征是不成熟的表型。研究设计规模持续时间:与未成熟(青春期前和青春期)和成年顺性睾丸组织的参考类器官相比,反组织来源的类器官在组织学和雄激素学上进行了比较。此外,长期睾酮分泌和促性腺刺激在反类器官中被评估。为了评估它们的细胞型和转录组学与参考睾丸组织阶段的相似性,我们在基因表达水平上比较了反式类器官与青春期前、青春期和成年顺性组织及其起源组织的差异。参与者/材料设置方法:使用变性女性、青春期前、青春期和成年顺性供体的睾丸组织样本来生成睾丸类器官,并根据组织来源比较类器官的形成效率和睾丸激素的产生。这些样本也可以作为转录组学比较的参考,在培养的第14天与来自跨性别女性睾丸组织的类器官进行比较。使用3D Petri Dish®平台生成和培养睾丸类器官。组织化学和免疫荧光染色表征细胞组成和空间组织。使用电化学发光免疫分析法评估培养基中睾酮的产生。从变性女性的类器官以及所有供体组的组织样本中提取RNA并进行测序。进行反褶积和差异基因表达分析,将所有组的类器官与睾丸组织进行比较。主要结果和突变的作用:反式类器官形成区隔化的细胞型新生组织,类似于青春期睾丸组织。此外,反式类器官表现出显著的睾酮分泌,在较长的培养周期内维持这一功能,并对促性腺刺激有反应。去卷积的大量RNAseq数据表明,这些类器官中的细胞群体比例接近青春期前和青春期睾丸组织中的细胞群体比例。基因表达聚集在青春期前和跨组织旁的类器官。功能分析显示,反式类器官与青春期前、青春期和反式组织共享不同的细胞过程。激素治疗的持续时间、小管内抗勒氏激素(一种不成熟的标志物)的表达以及供体组织中小管周围肌样细胞的比例等因素被发现可以预测转化类器官的成功形成。大规模数据:由于参与者隐私问题,大量RNA-seq原始和预处理数据存储在布鲁塞尔自由大学(VUB)机构数据存储库(VUB/IVTD/1/000001)中,访问受限。请联系Yoni Baert教授(yoni.baert@vub.be)获取数据。注意事项的局限性:本研究没有以方便的方式获得变性女性供体的激素数据。反褶积数据只允许比较细胞比例,而不是绝对数字。研究结果的更广泛意义:这项研究强调了反类器官作为一种新的、道德上可持续的基于人类的男性生殖健康研究、生殖毒理学和内分泌干扰研究模型的潜力。虽然反式组织是一种有价值的未成熟组织替代品,但进一步的研究应集中在优化类器官结构、评估其在生殖毒性测试中的应用以及促进生殖细胞分化方面。研究经费/利益冲突:本研究得到了VUB研究委员会(OZR4004)到s.m.s.,科学研究基金会-弗兰德斯(G026223N)和科学基金Willy Gepts到y.b.,战略研究计划89从VUB到e.g.和Mireille Aerens主席到T.V.的财政支持。作者声明没有利益冲突。
{"title":"A new human <i>in vitro</i> model of cytotypic and testosterone-producing organoids derived from testicular tissue of transgender women.","authors":"Samuel Madureira Silva, Frédéric Chalmel, Andrea Errico, Katerina Papageorgiou, Guillaume Richer, Edith Chan Sock Peng, Antoine D Rolland, Kelly Tilleman, Guy T'Sjoen, Ilaria Dando, Tamara Vanhaecke, Ellen Goossens, Yoni Baert","doi":"10.1093/hropen/hoaf043","DOIUrl":"10.1093/hropen/hoaf043","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Can testicular tissue from trans women (trans tissue) be used to create human testicular organoids?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Testosterone-producing and cytotypic human testicular organoids with bicompartmental architecture can be successfully generated from trans tissue.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Testicular organoids are a promising tool for studying testicular function and the effects of toxicants. Immature testicular cells are currently the most efficient at forming organoids that closely recapitulate seminiferous tubule-like architecture and functions. However, the scarcity of immature human testicular tissue limits its use in high-throughput applications. Conversely, trans tissue is abundantly available and characterized by an immature phenotype.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;Trans tissue-derived organoids (trans organoids) were histologically and androgenically compared to reference organoids derived from immature (prepubertal and pubertal) and adult cisgender testicular tissues. Additionally, long-term testosterone production and gonadotrophic stimulation were assessed in trans organoids. To evaluate their cytotypic and transcriptomic resemblance to reference testicular tissue stages, trans organoids were compared at the gene expression level to prepubertal, pubertal, and adult cisgender tissues, along with their tissue of origin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;Testicular tissue samples from transgender women, as well as from prepubertal, pubertal, and adult cisgender donors, were used to generate testicular organoids and to compare organoid formation efficiency and testosterone production according to tissue origin. These samples also served as references for transcriptomic comparisons with organoids derived from transgender women's testicular tissue at Day 14 of culture. Testicular organoids were generated and cultured using 3D Petri Dish&lt;sup&gt;®&lt;/sup&gt; platforms. Histochemistry and immunofluorescence staining were employed to characterize cellular composition and spatial organization. Testosterone production in culture media was assessed using electrochemiluminescence immunoassays. RNA was extracted and sequenced from organoids derived from transgender women, as well as from tissue samples of all donor groups. Deconvolution and differential gene expression analyses were performed to compare the organoids with testicular tissues across all groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Trans organoids form compartmentalized, cytotypic &lt;i&gt;de novo&lt;/i&gt; tissues similar to those from pubertal testicular tissue. Additionally, trans organoids exhibit significant testosterone production, sustain this function over extended culture periods, and respond to gonadotrophic stimulation. Deconvolved bulk RNAseq data indicate that cell population proportions within these organoids are close to those in prepubertal a","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 3","pages":"hoaf043"},"PeriodicalIF":11.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981061","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
Blood plasma trimethylamine N-oxide and related metabolites and asthenozoospermia odds: a hospital-based matched case-control study in China. 血浆三甲胺n -氧化物及相关代谢物与弱精子症的几率:中国一项基于医院的匹配病例对照研究
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-18 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf045
Ze Xing, Meng-Meng Xie, Hui-Han Wang, Qi Cui, Xiao-Bin Wang
<p><strong>Study question: </strong>Are blood plasma trimethylamine N-oxide (TMAO) and related metabolites linked to the odds of asthenozoospermia?</p><p><strong>Summary answer: </strong>Increased blood plasma TMAO levels were positively associated with the odds of asthenozoospermia, while elevated levels of choline and L-carnitine were related to reduced asthenozoospermia odds, implying that TMAO and its related metabolites might play an important role in the development of asthenozoospermia.</p><p><strong>What is known already: </strong>Sperm motility and concentration are profoundly impaired by excessive reactive oxygen species (ROS). A positive correlation has been established between ROS levels and TMAO, which is regarded as a key regulatory factor for initiating mitochondrial ROS production. However, the precise interplay between TMAO and its metabolites and sperm quality remains inconclusive and insufficient.</p><p><strong>Study design size duration: </strong>This case-control study was conducted from June 2020 to December 2020. A total of 314 pairs of asthenozoospermia cases and normozoospermia controls, matched based on age, BMI, and smoking status, were included.</p><p><strong>Participants/materials setting methods: </strong>Blood plasma levels of TMAO and five related metabolites, such as choline, betaine, L-carnitine, methionine, and dimethylglycine, were measured using a liquid chromatography system coupled with tandem mass spectrometry. Multivariable conditional logistic regression models were used to estimate the odds ratios (ORs) and corresponding 95% CIs.</p><p><strong>Main results and the role of chance: </strong>Compared with the lowest quartile, a significant association was observed between blood plasma TMAO level (OR = 1.80, 95% CI = 1.16-2.81) and the odds of asthenozoospermia for the highest quartile. In contrast, choline (OR = 0.59, 95% CI = 0.37-0.92) and L-carnitine (OR = 0.58, 95% CI = 0.37-0.90) levels were significant inversely associated with the odds of asthenozoospermia. Additionally, for each per SD change, significant dose-response relationships were noted with increased odds of asthenozoospermia linked to elevated TMAO (OR = 1.31, 95% CI = 1.12-1.55), as well as L-carnitine (OR = 0.79, 95% CI = 0.67-0.93) and total methyl donors exposure (OR = 0.82, 95% CI = 0.70-0.96) levels.</p><p><strong>Limitations reasons for caution: </strong>We cannot infer causality from this study due to the case-control study. Since the current study was conducted on a population of Chinese men, the extrapolated results may not accurately reflect other regions or populations. As blood plasma TMAO and its metabolites were measured at a single time point and may not accurately represent long-term concentrations, the enduring effects on sperm quality may not be fully captured. Another limitation of the current study lies in its relatively modest sample size, which may have been insufficient to reach statistical power in subgroup analyses
研究问题:血浆三甲胺n -氧化物(TMAO)和相关代谢物与弱精子症的几率有关吗?摘要回答:血浆TMAO水平升高与弱精子症发生率呈正相关,而胆碱和左旋肉碱水平升高与弱精子症发生率降低相关,提示TMAO及其相关代谢物可能在弱精子症的发生中起重要作用。已知情况:过多的活性氧(ROS)会严重损害精子的活力和浓度。活性氧水平与氧化三甲胺之间存在正相关关系,氧化三甲胺被认为是启动线粒体活性氧生成的关键调节因子。然而,TMAO及其代谢物与精子质量之间的确切相互作用仍然是不确定和不充分的。研究设计规模持续时间:本病例对照研究于2020年6月至2020年12月进行。共有314对弱精子症患者和正常精子症对照组,根据年龄、BMI和吸烟状况进行匹配。参与者/材料设置方法:采用液相色谱联用串联质谱法测量血浆中TMAO和五种相关代谢物(如胆碱、甜菜碱、左旋肉碱、蛋氨酸和二甲基甘氨酸)的水平。采用多变量条件logistic回归模型估计优势比(ORs)和相应的95% ci。主要结果及偶然性的作用:与最低四分位数相比,最高四分位数的血浆TMAO水平(OR = 1.80, 95% CI = 1.16-2.81)与弱精子症的几率显著相关。相比之下,胆碱(OR = 0.59, 95% CI = 0.37-0.92)和左旋肉碱(OR = 0.58, 95% CI = 0.37-0.90)水平与弱精子症的发生率呈显著负相关。此外,对于每一个SD变化,显著的剂量-反应关系被注意到,与TMAO升高(OR = 1.31, 95% CI = 1.12-1.55)以及左旋肉碱(OR = 0.79, 95% CI = 0.67-0.93)和总甲基供体暴露(OR = 0.82, 95% CI = 0.70-0.96)水平相关的弱精子症的几率增加。注意的局限性:由于是病例对照研究,我们不能从本研究中推断出因果关系。由于目前的研究是在中国男性人群中进行的,推断的结果可能无法准确反映其他地区或人群。由于血浆TMAO及其代谢物是在单个时间点测量的,可能不能准确地代表长期浓度,因此可能无法完全捕获对精子质量的持久影响。当前研究的另一个局限性在于其相对适度的样本量,这可能不足以在亚组分析中达到统计效力。研究结果的更广泛含义:该研究表明,血浆TMAO水平升高与弱精子症的几率增加有关,而胆碱和左旋肉碱浓度升高可降低弱精子症的几率。我们的研究结果为TMAO及其代谢物可能作为弱精子症的潜在生物标志物提供了新的证据。研究资金/竞争利益:本研究未收到任何资金。所有作者无利益冲突需要声明。试验注册号:无。
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引用次数: 0
Association of social determinants of health and age at menopause: NHANES 1999-2018 observational study. 健康的社会决定因素与绝经年龄的关联:NHANES 1999-2018观察性研究
IF 11.1 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-18 eCollection Date: 2025-01-01 DOI: 10.1093/hropen/hoaf050
Yu Guan, Qian Liu, Zhimin Deng, Sirui Liu, Jia Liang, Yujie Zou, Tailang Yin, Dongdong Tang, Jue Liu, Yan Zhang
<p><strong>Study question: </strong>Do social determinants of health (SDoH) influence the age at menopause among women?</p><p><strong>Summary answer: </strong>In our study, adverse SDoH, particularly family low income-to-poverty ratio (PIR), low education level, and the marital status of being widowed, are associated with earlier age at menopause.</p><p><strong>What is known already: </strong>Some prior studies have considered certain SDoH variables (such as educational attainment and marital status) as potential factors influencing age at menopause, but systematic evidence clearly defining the relationship between multidimensional SDoH and menopausal age remains lacking.</p><p><strong>Study design size duration: </strong>This cross-sectional analysis included 6083 naturally menopausal women from 10 cycles (1999-2018) of the United States National Health and Nutrition Examination Survey (NHANES) and excluded cases of surgical menopause.</p><p><strong>Participants/materials setting methods: </strong>The participants were derived from a nationally representative sample of the NHANES 1999-2018 in the USA. Eight SDoH variables were assessed: employment, PIR, food security, education, healthcare access, health insurance, housing stability, and marital status. Age at menopause was determined by self-reported last menstrual period among women with natural menopause. This study constructed weighted multivariate linear regression models and weighted quantile sum (WQS) analyses and calculated regression coefficients (β) and their 95% CIs. Subgroup analyses and sensitivity analyses were used to verify the robustness of our findings.</p><p><strong>Main results and the role of chance: </strong>After adjusting for relevant confounding factors, adverse PIR, education level, and marital status (such as being widowed) were significantly associated with earlier age at menopause. Specifically, compared to women with a PIR ≥500%, women with a PIR between 100% and 300% or PIR ≤100% had an earlier age at menopause by 0.877 years (95% CI: -1.526, -0.229, <i>P</i> = 0.008) and 1.296 years (95% CI: -2.105, -0.487, <i>P</i> = 0.002), respectively. Additionally, compared to women with an educational level of college or above, women with a high school education or less than a high school education had earlier age at menopause by 1.262 years (High school: 95% CI = -1.914, -0.609, <i>P</i> < 0.001) and 1.403 years (Less than high school: 95% CI = -2.062, -0.743, <i>P</i> < 0.001), respectively. Compared to women who were married or living with a partner, widowed women had earlier age at menopause by 1.363 years (95% CI = -1.887, -0.839, <i>P</i> < 0.001). Analysis using a WQS regression model based on decile categorization demonstrated that each 1-unit increase in the composite exposure index of adverse SDoH factors was associated with 3.302 years earlier age at menopause in women (95% CI = -4.129, -2.476, <i>P</i> < 0.001). The PIR contributed most substantially to the inver
研究问题:健康的社会决定因素(SDoH)是否影响女性绝经年龄?摘要回答:在我们的研究中,不良的性激素水平,特别是家庭低收入与贫困比(PIR)、低教育水平和丧偶的婚姻状况与绝经年龄提前有关。已知情况:一些先前的研究认为某些SDoH变量(如受教育程度和婚姻状况)是影响绝经年龄的潜在因素,但仍然缺乏明确定义多维SDoH与绝经年龄之间关系的系统证据。研究设计规模持续时间:该横断面分析包括来自美国国家健康与营养调查(NHANES) 10个周期(1999-2018)的6083名自然绝经妇女,并排除手术绝经病例。参与者/材料设置方法:参与者来自美国NHANES 1999-2018的全国代表性样本。评估了8个SDoH变量:就业、PIR、食品安全、教育、医疗保健获取、健康保险、住房稳定性和婚姻状况。绝经年龄由自然绝经妇女自我报告的最后一次月经确定。本研究构建多元加权线性回归模型和加权分位数和(WQS)分析,计算回归系数(β)及其95% ci。采用亚组分析和敏感性分析来验证我们研究结果的稳健性。主要结果及偶然性的作用:在调整相关混杂因素后,不良PIR、受教育程度、婚姻状况(如丧偶)与绝经年龄提前显著相关。具体而言,与PIR≥500%的女性相比,PIR在100%至300%之间或PIR≤100%的女性绝经年龄分别提前0.877年(95% CI: -1.526, -0.229, P = 0.008)和1.296年(95% CI: -2.105, -0.487, P = 0.002)。此外,与大学及以上学历的女性相比,高中学历或高中以下学历的女性绝经年龄提前1.262年(高中学历:95% CI = -1.914, -0.609, P P P P P)。谨慎的局限性原因:横断面设计限制了因果推理。尽管进行了敏感性分析,但未测量的混杂因素(如胎次、以前使用的激素、化学物质暴露)和回忆偏差可能仍然存在。研究结果的更广泛含义:这些发现证实了针对经济稳定、住房安全、就业支持和医疗保健获取的综合多维干预措施的实施,这可能比单一维度的政策调整产生更大的效益。此外,物质剥夺因素对生殖衰老的影响可能比之前认为的要大得多。研究经费/利益竞争:国家重点研发计划项目(2023YFC2705700)、武汉大学人民医院跨学科创新人才基金项目(JCRCYG-2022-009)、国家自然科学基金项目(72474005)资助。所有作者声明没有利益竞争。试验注册号:无。
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引用次数: 0
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