Pub Date : 2025-09-11eCollection Date: 2025-01-01DOI: 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
{"title":"Bone mineralization in children aged 7-10 years born after ART with frozen and fresh embryo transfer.","authors":"Elisabeth Waldemar Grønlund, Anna Sophie Lebech Kjaer, Louise Laub Asserhøj, Ikram Mizrak, Tine Dahlsgaard Clausen, Per Laub Madsen, Anja Pinborg, Rikke Beck Jensen","doi":"10.1093/hropen/hoaf055","DOIUrl":"10.1093/hropen/hoaf055","url":null,"abstract":"<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","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 4","pages":"hoaf055"},"PeriodicalIF":11.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132917","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}
<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
{"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":"<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","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}
Pub Date : 2025-09-04eCollection Date: 2025-01-01DOI: 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":"<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","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}
Pub Date : 2025-09-02eCollection Date: 2025-01-01DOI: 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
{"title":"Accurate identification of abnormal ploidy using an artificial intelligence model in preimplantation genetic testing.","authors":"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","doi":"10.1093/hropen/hoaf054","DOIUrl":"10.1093/hropen/hoaf054","url":null,"abstract":"<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","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 4","pages":"hoaf054"},"PeriodicalIF":11.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132931","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}
Pub Date : 2025-09-01eCollection Date: 2025-01-01DOI: 10.1093/hropen/hoaf053
Wenxue Xiong, Xijia Tang, Lu Han, Li Ling
{"title":"Reply: Paternal age and neonatal health: unraveling epigenetic pathways.","authors":"Wenxue Xiong, Xijia Tang, Lu Han, Li Ling","doi":"10.1093/hropen/hoaf053","DOIUrl":"10.1093/hropen/hoaf053","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 3","pages":"hoaf053"},"PeriodicalIF":11.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115122","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}
Pub Date : 2025-08-29eCollection Date: 2025-01-01DOI: 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
{"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":"<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","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}
Pub Date : 2025-08-20eCollection Date: 2025-01-01DOI: 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":"<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","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}
Pub Date : 2025-08-18eCollection Date: 2025-01-01DOI: 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。
{"title":"Blood plasma trimethylamine N-oxide and related metabolites and asthenozoospermia odds: a hospital-based matched case-control study in China.","authors":"Ze Xing, Meng-Meng Xie, Hui-Han Wang, Qi Cui, Xiao-Bin Wang","doi":"10.1093/hropen/hoaf045","DOIUrl":"10.1093/hropen/hoaf045","url":null,"abstract":"<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","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 3","pages":"hoaf045"},"PeriodicalIF":11.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981140","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}
<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。
{"title":"Association of social determinants of health and age at menopause: NHANES 1999-2018 observational study.","authors":"Yu Guan, Qian Liu, Zhimin Deng, Sirui Liu, Jia Liang, Yujie Zou, Tailang Yin, Dongdong Tang, Jue Liu, Yan Zhang","doi":"10.1093/hropen/hoaf050","DOIUrl":"10.1093/hropen/hoaf050","url":null,"abstract":"<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","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2025 3","pages":"hoaf050"},"PeriodicalIF":11.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031249","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}