Reproductive Biomedicine Online[JOURNAL]
Sun
200 papers
Can artificial intelligence models provide reliable medical counselling to fertility patients?
Alcalay I, Weissman A, Ganer Herman H … +12 more , Tsafrir A, Friedman M, Weiner E, Orvieto R, Polyzos NP, Dahan MH, Polyakov A, Fischer R, Esteves SC, Ata B, Franasiak JM, Mizrachi Y
Reprod Biomed Online · 2026 Feb · PMID 41475300 · Publisher ↗
RESEARCH QUESTION: Can generative artificial intelligence (AI) models provide reliable counselling to fertility patients regarding real-world clinical questions? DESIGN: In this cross-sectional study, 12 clinical questio...
RESEARCH QUESTION: Can generative artificial intelligence (AI) models provide reliable counselling to fertility patients regarding real-world clinical questions? DESIGN: In this cross-sectional study, 12 clinical questions were developed to reflect common, real-life dilemmas encountered during fertility workup and treatment. Responses to each question were generated by two experienced fertility specialists, and two AI models - ChatGPT and Gemini. Eight leading internationally recognized fertility experts, blinded to the source of each reply, independently rated all the responses on a scale from 1 (strongly disagree) to 10 (strongly agree). Ratings were compared across all four repliers using non-parametric statistical tests. RESULTS: The replies authored by physicians received significantly higher overall scores than those generated by AI models (P < 0.001). The median scores were highest for Doctor A (9.0), followed by Doctor B (8.0), then ChatGPT (7.0) and finally Gemini, which received the lowest score (4.5). The proportion of high-scoring responses (≥8) was greatest for Doctor A (70.8%), followed by Doctor B (56.3%), then ChatGPT (47.9%) and finally Gemini (35.4%) (P < 0.001). CONCLUSIONS: Experienced fertility specialists outperformed generative AI models in providing accurate responses to complex clinical questions. Despite the growing accessibility and sophistication of AI tools, their use for individualized fertility counselling remains limited. Continued refinement and clinical validation of AI tools are essential before they can be considered reliable for patient-specific guidance. At present, AI should be viewed as a complementary resource rather than a substitute for expert clinical judgement.
Network meta-analysis of progestogen administration routes for luteal phase support in fresh embryo transfer IVF cycles.
Griesinger G, Wang Q, Labarta E … +5 more , Li R, Manipalviratn S, Murdia K, Pabuccu E, Kahler E
Reprod Biomed Online · 2026 Feb · PMID 41475299 · Publisher ↗
The route of administration significantly influences the pharmacokinetics of progestogens. For luteal phase support (LPS) after fresh embryo transfer in IVF, ESHRE recommends vaginal, intramuscular, subcutaneous progeste...
The route of administration significantly influences the pharmacokinetics of progestogens. For luteal phase support (LPS) after fresh embryo transfer in IVF, ESHRE recommends vaginal, intramuscular, subcutaneous progesterone or oral dydrogesterone. This network meta-analysis evaluated the relative effectiveness of progestogen administration routes on clinical pregnancy rate (CPR) and live birth rate (LBR) in fresh IVF cycles. A systematic review identified peer-reviewed, published randomized controlled trials (RCTs) comparing individual progestogens (versus placebo or other progestogens) and reporting CPR. Studies involving frozen-thawed transfers, non-progestogenic LPS or non-available formulations were excluded. Of the 24 RCTs included, oral administration was the only route reaching statistical significance for increased CPR, although overlapping confidence intervals across comparisons indicate uncertainty in clinically relevant superiority. For LBR, only oral and intramuscular routes demonstrated statistically significant improvement versus placebo; vaginal and subcutaneous did not. These findings, supported by sensitivity analyses excluding low-quality and older studies, suggest that oral and intramuscular progestogens may be more effective in improving IVF outcomes, but outcome differences require further studies. This study substantially advances the evidence base by integrating recent data, applying rigorous quality assessment standards and using state-of-the-art network meta-analytic methodology, contributing to refining recommendations for optimal progestogenic LPS in fresh IVF cycles.
Trend analysis of the burden of PCOS and related infertility in China and worldwide between 1990 and 2021.
Liang Q
Reprod Biomed Online · 2026 Feb · PMID 41456540 · Publisher ↗
RESEARCH QUESTION: What is the global and Chinese burden of polycystic ovary syndrome (PCOS) and infertility attributable to PCOS on the basis of age-standardized calculations from 1990 to 2021? DESIGN: Using open data f...
RESEARCH QUESTION: What is the global and Chinese burden of polycystic ovary syndrome (PCOS) and infertility attributable to PCOS on the basis of age-standardized calculations from 1990 to 2021? DESIGN: Using open data from the Global Burden of Disease (GBD) database from 1990 to 2021, this study analysed the characteristics of PCOS and infertility attributable to PCOS in China and worldwide. Joinpoint was used to calculate the average annual percentage change (AAPC) and the corresponding 95% CI. An autoregressive integrated moving average (ARIMA) model was used to project the burden of disease from 2022 to 2036. RESULTS: From 1990 to 2021, the AAPC of the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life years rate (ASDR) of PCOS in China were 2%, 2% and 2.1%, respectively. Worldwide, the respective figures were 0.8%, 0.8% and 0.8%, respectively. The AAPC for ASPR and age-standardized years lived with disability rate (ASYR) for the global burden of infertility attributable to PCOS were 1% and 0.9%, respectively, compared with 1.9% and 2%, respectively, in China. By 2036, ASIR, ASPR and ASDR of PCOS in China are projected to increase to 71.64/100,000, 1912.27/100,000 and 16.48/100,000, respectively. Globally, these rates are projected to reach 68.64/100,000, 1934.92/100,000 and 16.91/100,000, respectively. ASPR and ASYR for infertility attributable to PCOS are predicted to continue their upward trend. CONCLUSION: From 1990 to 2021, the burden of PCOS and infertility attributable to PCOS continued to rise in China and globally, making PCOS a major public health problem. Raising public awareness of this common disease in order to reduce complications has become a public health priority that needs attention.
Myo-inositol in reproductive management of women with PCOS: holy grail for medical practice or demon for scientific evidence?
Palomba S, Seminara G, Aversa A
Reprod Biomed Online · 2026 Feb · PMID 41456539 · Publisher ↗
Myo-inositol has gained widespread use in the management of infertility associated with polycystic ovary syndrome (PCOS), driven by its proposed role in improving insulin sensitivity and ovarian function. Despite its pop...
Myo-inositol has gained widespread use in the management of infertility associated with polycystic ovary syndrome (PCOS), driven by its proposed role in improving insulin sensitivity and ovarian function. Despite its popularity in clinical practice, the evidence supporting myo-inositol's efficacy in enhancing fertility outcomes remains limited and inconclusive. Current international and national guidelines do not endorse myo-inositol as a first-line treatment for PCOS-related infertility, either as monotherapy or in combination with ovulation induction agents. Even if early studies suggest potential benefits when used alongside clomiphene citrate or gonadotrophins, these findings are often outdated or misaligned with contemporary treatment protocols that favour letrozole and gonadotrophin-releasing hormone antagonist regimens. In the context of IVF, myo-inositol may reduce gonadotrophin requirements and improve some intermediate/secondary outcomes, although data on live births and long-term efficacy are lacking. This commentary critically evaluates the current literature on use of myo-inositol in PCOS fertility care, emphasizing the need for well-designed, adequately powered randomized controlled trials that reflect current clinical standards. Until stronger evidence is available, myo-inositol should not be routinely recommended in fertility protocols for PCOS but reserved for individualized cases within an evidence-based framework.
Attributes of a large cohort of human seminal extracellular vesicles with varied sperm features.
Cheng YS, Chen HY, Liu CM … +4 more , Hou HC, Lin YC, Lin TY, Lin SC
Reprod Biomed Online · 2026 Feb · PMID 41455341 · Publisher ↗
RESEARCH QUESTION: Do human seminal plasma extracellular vesicles (SPEV) vary with distinct sperm features and possess clinical relevance for male infertility? DESIGN: Semen samples were provided for analysis: normozoosp...
RESEARCH QUESTION: Do human seminal plasma extracellular vesicles (SPEV) vary with distinct sperm features and possess clinical relevance for male infertility? DESIGN: Semen samples were provided for analysis: normozoospermic (n = 64); oligozoospermic (n = 35); asthenozoospermic (n = 51); teratozoospermic (n = 16); and azoospermic cases (n = 134). Size-exclusion chromatography was used to isolate SPEV, and concentration and size distribution were assessed via nanoparticle tracking analysis. Protein concentrations were measured using BCA Protein Assay Kits. Continuous variables were analysed as mean with a 95% CI. RESULTS: Highest mean SPEV concentration was observed in the normozoospermic group (4.9 × 10/ml; 95% CI 3.5 -6.3 × 10/ml); lowest mean concentration was found in azoospermic group (0.6 × 10/ml; 95% CI 0.5 -0.8 × 10/ml). Pearson coefficients of SPEV concentration with sperm count, progressive motility and total motile sperm count were 0.250, 0.344 and 0.433, respectively. Mean SPEV size from infertile men with non-obstructive azoospermia (NOA) is significantly smaller than that from men who have undergone a vasectomy or with obstructive azoospermia (151.3 nm, 95% CI 147.6 to 155.0 nm versus 159.4 nm, 95% CI 154.0 to 164.8 nm, P = 0.049). Mean protein content per SPEV particle is significantly higher in the NOA group than the vasectomy or obstructive azoospermia group (93.41 ag, 95% CI 50.67 to 132.6 ag versus 44.24 ag, 95% CI 24.74 to 63.74 ag, P < 0.001). The AUC curve is 0.702 (P < 0.001). CONCLUSION: Concentration of SPEV significantly correlates with total motile spermatozoa. Protein content per SPEV particle may be a potential marker to distinguish obstructive azoospermia from NOA.
Beyond morphology: a multi-protein analysis of single blastocyst conditioned medium to predict pregnancy potential of embryos.
Chen P, Huang C, Zhang H … +6 more , Zhong H, Xiong F, Liu Z, Zeng Y, Sun Q, Diao L
Reprod Biomed Online · 2026 Feb · PMID 41455340 · Publisher ↗
RESEARCH QUESTION: Can a non-invasive approach predicting embryonic pregnancy potential be developed by analysing proteins in single blastocyst conditioned medium (SBCM)? DESIGN: Patients with infertility who underwent v...
RESEARCH QUESTION: Can a non-invasive approach predicting embryonic pregnancy potential be developed by analysing proteins in single blastocyst conditioned medium (SBCM)? DESIGN: Patients with infertility who underwent vitrified-warmed single blastocyst transfer (January 2021-December 2023) were included in this study. SBCM corresponding to transferred blastocysts was collected and analysed using highly sensitive single-molecule array technology to quantify the concentrations of 12 candidate proteins (n = 1390). Key proteins were selected for model development for prediction of clinical pregnancy using a training set (n = 240), and subsequently validated with a test set (n = 60). Performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curves. RESULTS: Among the 12 proteins examined, elevated concentrations of interleukin-8 (IL-8) (P < 0.001) and beta-human chorionic gonadotrophin (B-HCG) (P = 0.009) were associated with a significantly higher clinical pregnancy rate, whereas elevated C-C motif chemokine 5 (RANTES, 'regulated on activation, normal T cell expressed and secreted') was associated with a significantly lower pregnancy rate (P < 0.001). Individual biomarkers demonstrated modest discriminatory capacity for predicting clinical pregnancy for IL-8 (AUC = 0.600; P = 0.03), B-HCG (AUC = 0.588; P = 0.002) and RANTES (AUC = 0.397; P = 0.001). A multi-protein prediction model integrating these three biomarkers exhibited superior discriminatory performance (AUC = 0.722), and significantly outperformed each individual protein marker (P ≤ 0.005). The combined model incorporating both the multi-protein signature and morphological grading parameters achieved optimal predictive accuracy (AUC = 0.744). These findings were validated in an independent test set (AUC = 0.724). CONCLUSIONS: This study establishes a novel multi-protein model for predicting clinical pregnancy. The combination of IL-8, B-HCG and RANTES in SBCM provides a promising non-invasive approach for embryo selection, particularly when integrated with morphological assessment.
From -196°C to -80°C: redefining standards in sperm biobanking technology.
Cimini C, Ramal-Sanchez M, Valbonetti L … +6 more , Paoletti R, Raspa M, Colosimo A, Scavizzi F, Bernabò N, Barboni B
Reprod Biomed Online · 2026 Feb · PMID 41453291 · Publisher ↗
The preservation of spermatozoa through cryopreservation is a cornerstone of reproductive medicine, genetic biodiversity conservation and biomedical research. Traditionally, liquid nitrogen (LN2) storage at -196°C has be...
The preservation of spermatozoa through cryopreservation is a cornerstone of reproductive medicine, genetic biodiversity conservation and biomedical research. Traditionally, liquid nitrogen (LN2) storage at -196°C has been considered the gold standard for sperm biobanking. The high costs, logistical challenges and safety concerns associated with LN2, however, have prompted a reevaluation of alternative cryopreservation methods. This review traces the historical evolution of sperm cryopreservation, from its inception in 1938 to modern technological advancements, and proposes a paradigm shift towards ultra-low freezers operating at -80°C. Emerging evidence suggests that ultra-low freezers offer a cost-effective, sustainable and accessible alternative for sperm biobanking, particularly benefiting research institutions in low- and middle-income countries. Comparative analyses indicate that spermatozoa stored at -80°C retain fertilization potential over extended periods, challenging long-standing assumptions about the necessity of LN2. Additionally, the integration of cryoprotectants and antioxidants could further enhance the viability of spermatozoa stored in ultra-low freezers, mitigating concerns about DNA integrity and oxidative stress. By decentralizing sperm biobanking and reducing dependence on LN2, this approach fosters a more inclusive, resilient and environmentally sustainable system for the preservation of genetic resources.
Emotional experience of Danish men during fertility treatment: qualitative study on engagement, hope and loss.
Sylvest R, Schmidt L, Pinborg A … +1 more , Ziebe S
Reprod Biomed Online · 2026 Feb · PMID 41448982 · Publisher ↗
RESEARCH QUESTION: How does being in fertility treatment affect men, and how can healthcare professionals better involve and support men throughout the process? DESIGN: Semi-structured qualitative interview study with 15...
RESEARCH QUESTION: How does being in fertility treatment affect men, and how can healthcare professionals better involve and support men throughout the process? DESIGN: Semi-structured qualitative interview study with 15 men (aged 31-47 years) undergoing fertility treatment. Four men had used donor semen. Six couples had experienced a pregnancy loss. Participants were recruited through fertility clinics, patient organizations and social media. Data were collected in 2023 and 2024 and analysed using qualitative content analysis. RESULTS: The following themes emerged from the interview data: involvement; hope (becoming a father and keeping positive); loss (psychological burden, control and masculinity); and lasting impact. Involvement and inclusion of men during fertility treatment were of critical importance. The men observed that this entails efforts from healthcare professionals to actively engage them and a recognition of their own responsibility in the process. The men saw the fertility journey as a shared and important issue. All participants expressed a profound sense of hope and motivation rooted in their aspiration to eventually become fathers. The men described experiencing the loss of dreams, hope, sense of masculinity and a sense of control. Experiencing infertility had a lasting effect on them, affecting them mentally, socially, sexually and financially, regardless of whether or not they ended up having children. CONCLUSION: It is important that men are acknowledged and included in the fertility treatment process. Healthcare professionals need to recognize the effect of infertility on men aspiring to become fathers and their need to play a meaningful role during fertility treatment.
IVF/ICSI or surgery as first approach for the treatment of infertility associated with ovarian and deep infiltrating endometriosis? A systematic review and meta-analysis.
Riemma G, García-Velasco JA, Abrão MS … +13 more , Leone Roberti Maggiore U, Vignali M, Solima E, Ceccaroni M, Chiantera V, Moawad GN, Laganà AS, Agrifoglio V, De Franciscis P, Donna MCD, D'Amato A, Favilli A, Etrusco A
Reprod Biomed Online · 2026 Feb · PMID 41447907 · Publisher ↗
This systematic review and meta-analysis (CRD42024588171) compared the effectiveness of surgery followed by IVF/intracytoplasmic sperm injection (IVF/ICSI) with direct IVF/ICSI (i.e. without previous surgery) on the repr...
This systematic review and meta-analysis (CRD42024588171) compared the effectiveness of surgery followed by IVF/intracytoplasmic sperm injection (IVF/ICSI) with direct IVF/ICSI (i.e. without previous surgery) on the reproductive outcomes of infertile women with ovarian endometriomas (OMA) and deep infiltrating endometriosis (DIE), analysing 22 studies with 3590 participants. Surgery followed by IVF/ICSI did not improve the live birth rate significantly in patients with OMA (OR 0.89, 95% CI 0.68-1.16) or DIE (OR 1.82, 95% CI 0.70-4.77). The clinical pregnancy rate was also unaffected by surgery (OMA: OR 1.13, 95% CI 0.80-1.59; DIE: OR 1.28, 95% CI 0.71-2.31). The pregnancy loss rate remained comparable between the surgical and non-surgical groups. In the OMA subgroup, surgery reduced the concentration of anti-Müllerian hormone (mean difference -0.57, 95% CI -1.02 to -0.12) and number of retrieved oocytes (mean difference -1.24, 95% CI -1.70 to -0.77) significantly. These findings highlight the importance of careful consideration of the ovarian reserve when opting for surgical intervention. Consequently, IVF/ICSI should be prioritized as the initial treatment for infertility in patients with endometriosis, reserving surgery for symptom management, patient-specific factors, or clearly defined clinical indications to optimize reproductive outcomes and patient safety. However, the very low certainty of evidence, the available study designs, and their inherent limitations warrant caution when interpreting such findings.
Clinical efficacy of AdhesioRT-guided personalized embryo transfers: a prospective randomized controlled trial.
Chow-Shi-Yée M, Kadoch E, Stebenne ME … +2 more , Tadevosyan A, Kadoch IJ
Reprod Biomed Online · 2026 Feb · PMID 41447906 · Publisher ↗
RESEARCH QUESTION: How effective is AdhesioRT in predicting endometrial receptivity, and how does its application affect clinical outcomes, such as pregnancy rates, in the context of personalized embryo transfers (pET)?...
RESEARCH QUESTION: How effective is AdhesioRT in predicting endometrial receptivity, and how does its application affect clinical outcomes, such as pregnancy rates, in the context of personalized embryo transfers (pET)? DESIGN: AdhesioRT was employed to evaluate endometrial receptivity in a cohort of patients undergoing infertility assessment. The study included two endometrial biopsies during a substituted frozen embryo transfer cycle after 6 or 8 full days of progesterone treatment, where the gene expression of 10 specific biomarkers was analysed using quantitative reverse transcription polymerase chain reaction. Samples were categorized as receptive, partially receptive or non-receptive. The AdhesioRT group (n = 50) underwent pET guided by AdhesioRT recommendations, while the control group (n = 54) followed the standard clinic protocol. RESULTS: AdhesioRT identified a potential shift in the window of implantation (WOI) in 64% of the AdhesioRT group, yet pET led to a lower pregnancy rate compared with the control group (28% vs 61%). Transfers after 6 full days of progesterone treatment, as recommended by AdhesioRT, achieved a 59% pregnancy rate, whereas those with a suggested WOI shift (transfer at a different time point than after 6 full days of progesterone treatment) achieved a 20% pregnancy rate. CONCLUSION: Surprisingly, AdhesioRT-guided embryo transfers did not lead to higher pregnancy rates, indicating that deviating from the standard transfer day (i.e. after 6 full days of progesterone treatment) may reduce the success of embryo implantation.
Preimplantation genetic testing for aneuploidy 'rescues' poor-quality blastocysts and increases embryo availability for transfer: a 9-year single centre analysis.
Hashimi BA, Harvey KE, Harvey SC … +4 more , Linara-Demakakou E, Griffin DK, Ahuja K, Macklon N
Reprod Biomed Online · 2026 Jan · PMID 41435727 · Publisher ↗
RESEARCH QUESTION: Does preimplantation genetic testing for aneuploidy (PGT-A) and the transfer of euploid poor-quality blastocysts (PQB) reduce the number of transfers needed to achieve live births compared with the tra...
RESEARCH QUESTION: Does preimplantation genetic testing for aneuploidy (PGT-A) and the transfer of euploid poor-quality blastocysts (PQB) reduce the number of transfers needed to achieve live births compared with the transfer of their untested counterparts? DESIGN: Single-centre retrospective cohort study conducted between 2015 and 2024 (PGT-A blastocysts: n = 7332 from 2258 cycles; n = 1344). Transfer outcomes were analysed for a subset of 74 cycles involving tested PQB and compared with 192 cycles involving untested PQB during the same period. RESULTS: High-quality blastocysts (AA, AB, BA and BB) were most likely to be euploid (P < 2.2e-16), whereas PQB (CC, DC, CD and DD) were more likely to be aneuploid (P < 2.2e-16). Embryos that reached the blastocyst stage by day 5 had a higher likelihood of being euploid. Among transferred PQB, PGT-A did not significantly affect the pregnancy rate (33.3% versus 23.4%); however, the miscarriage rate was significantly lower in the PGT-A-tested group (13.6% versus 51.2%, P = 0.003). The number of live births was higher in the PGT-A group (26.4 % versus 11.1%, P = 0.004) and with the transfer of day-5 frozen blastocysts. Live births were observed from blastocysts with the poorest expansion and morphology scores. No significant differences were observed in gestational age or birth weight between the PGT-A and untested groups. CONCLUSIONS: A clinically relevant proportion of PQB are euploid, PQB can result in live births and euploid transfer is associated with lower miscarriage rates. In combination, this suggests that PQB should not be routinely discarded, particularly if they are prior-tested using PGT-A.
Magnetic-activated cell sorting non-apoptotic sperm selection improves DNA fragmentation and reproductive outcomes: systematic review and meta-analysis.
Falquet Guillem M, Pacheco R, Gisbert-Iranzo A … +5 more , Cano-Extremera M, Gil Juliá M, Navarro-Gomezlechon A, Hervas I, Garrido N
Reprod Biomed Online · 2026 Jan · PMID 41406673 · Publisher ↗
Medically assisted reproduction (MAR) relies on semen quality for success. While conventional sperm selection techniques such as density gradient centrifugation and swim-up are commonly used, they overlook essential mole...
Medically assisted reproduction (MAR) relies on semen quality for success. While conventional sperm selection techniques such as density gradient centrifugation and swim-up are commonly used, they overlook essential molecular sperm characteristics, limiting their effectiveness in predicting the success of MAR. To address this, advanced selection techniques have been developed, including magnetic-activated cell sorting (MACS). This meta-analysis evaluates the effect of MACS compared with conventional sperm selection techniques on MAR reproductive outcomes, seminal parameters, and sperm DNA fragmentation (DNAf) levels. Systematic searches in PubMed, Web of Science and Scopus identified 41 studies that met the inclusion criteria. Results indicate that while MACS reduces sperm DNAf significantly (mean difference = -4.32, 95% CI -6.29 to -2.36; P < 0.0001), it does not significantly improve clinical pregnancy (OR = 1.47, 95% CI 0.94-2.30, P = 0.09), spontaneous miscarriage (OR = 0.92, 95% CI 0.40-2.12; P = 0.85) or live birth (OR = 1.55, 95% CI 0.78-3.11; P = 0.21) rates in artificial insemination cycles. However, in intracytoplasmic sperm injection cycles, MACS demonstrates significant improvements in implantation rate per transferred embryo (OR = 1.28, 95% CI 1.02-1.62; P = 0.04), clinical pregnancy (OR = 1.41, 95% CI 1.19-1.66; P < 0.00001) and live birth (OR = 1.31, 95% CI 1.09-1.58; P = 0.004) rates per embryo transfer, particularly in patients with high DNAf levels. Despite variability in other clinical parameters and study limitations such as data heterogeneity, the study results suggest a potential benefit of MACS in a specific subgroup of infertile patients, underscoring the need for personalized evaluation and further research to refine its clinical indications.
Fast to fastest: single-step sucrose dilution to direct hydration of vitrified-warmed human blastocysts.
Schiewe MC
Reprod Biomed Online · 2026 Jan · PMID 41391204 · Publisher ↗
With the publication of several recent papers on new vitrification and post-warming protocols, Reproductive BioMedicine Online has brought well-deserved attention to the evolving landscape of cryopreservation practices f...
With the publication of several recent papers on new vitrification and post-warming protocols, Reproductive BioMedicine Online has brought well-deserved attention to the evolving landscape of cryopreservation practices for human oocytes and embryos. These new protocols aim to improve efficiency, reliability, cost-effectiveness and, potentially, safety and the developmental trajectory. Vitrification protocols have changed from long to short (as in 'fast and furious') and post-warming dilutions have changed from a multistep process to a fast single-step process. However, we may yet see warming protocols that forgo elution in non-permeable solutes in favour of an even faster method - rehydration directly in culture medium.
Serum progesterone monitoring after embryo transfer.
Tesarik J
Reprod Biomed Online · 2026 Jan · PMID 41391203 · Publisher ↗
Abstract loading — click title to view on PubMed.
Fast and furious: live birth outcomes in 1266 infants born after one-step warming of vitrified human blastocysts.
Liebermann J, Brohammer R, Wagner Y … +13 more , Parus A, Macias C, Suda N, Vanderpool A, Petrus G, Sarris O, Even K, Smith R, Sutherland S, Jasulaitis S, Hirshfeld-Cytron J, Sipe C, Uhler M
Reprod Biomed Online · 2026 Jan · PMID 41391202 · Publisher ↗
RESEARCH QUESTION: Does one-step rehydration in the warming protocol for human blastocysts result in healthy live births? DESIGN: A total of 2411 frozen embryo transfers using a short one-step rehydration protocol and 26...
RESEARCH QUESTION: Does one-step rehydration in the warming protocol for human blastocysts result in healthy live births? DESIGN: A total of 2411 frozen embryo transfers using a short one-step rehydration protocol and 2606 frozen embryo transfers using the multi-step protocol were available for analysis. One-step warming was performed at 37°C in 1M sucrose for 1 min. This study examined the gestational age at delivery and birth weight of male and female infants for both protocols. RESULTS: In the one-step warming protocol, 1266 infants were born. The overall live birth rate was 51.3%, average gestational age was 37.6 weeks, and average birth weight was 3267 g. The sex distribution was 49% male versus 51% female. Male infants were, on average, 70 g heavier than female infants (3305 g versus 3235 g, respectively). In the multi-step warming protocol, 1323 infants were born. The average gestational age was 37.6 weeks, and average birth weight was 3252 g. The sex distribution was 52% male versus 48% female. Male infants were, on average, 139 g heavier than female infants (3318 g vs 3179 g, respectively). There were no significant differences between the two warming groups in terms of live birth and miscarriage rates, gestational age and birth weight. CONCLUSIONS: Short one-step rehydration during warming of human blastocysts for 1 min in 1M sucrose led to healthy infants born at term with corresponding birth weight. This one-step rehydration protocol has been shown to be safe and effective, and it has now been validated with 1266 live births.
Double-stranded sperm DNA fragmentation assessed using comet assay is associated with recurrent pregnancy loss.
Drakeley A, Lunt RL, Newton E … +14 more , Gregoire RC, Watkins L, Bambang K, Ellard AM, Ledgerwood CJ, Rae L, Sloan A, Lawlor M, Poots L, Moore L, Bailie E, McDowell SH, Ribas-Maynou J, Moore T
Reprod Biomed Online · 2026 Jan · PMID 41371000 · Publisher ↗
RESEARCH QUESTION: Do men attending a recurrent miscarriage clinic have high double-stranded sperm DNA damage compared with a sperm donor population? DESIGN: This prospective cohort study included 100 men attending a rec...
RESEARCH QUESTION: Do men attending a recurrent miscarriage clinic have high double-stranded sperm DNA damage compared with a sperm donor population? DESIGN: This prospective cohort study included 100 men attending a recurrent miscarriage clinic, and 81 sperm donors from a European sperm bank who had proven fertility. All semen samples were evaluated using the Examen Lab alkaline (Exact) comet assay, which identifies the global (single and double strand) DNA damage, and the neutral (Extend) comet assay, measuring only double-stranded sperm DNA fragmentation (dsSDF). RESULTS: Semen analysis showed that 66 male partners of women with a history of recurrent miscarriage were classified as being within normal parameters. Of these, however, 66 men (61%) had raised global SDF, and 52% had raised dsSDF. When evaluating each test separately, the Exact comet (global SDF) assay presented an area under the curve (AUC) of 0.690 (95% CI 0.623-0.756), with the neutral Extend comet (dsSDF only) assay having an AUC of 0.876 (95% CI 0.834-0.914), and the incidence of damage showed an improved AUC of 0.909 (95% CI 0.874-0.940). CONCLUSIONS: This study of male factor SDF in a large cohort of men attending a recurrent miscarriage clinic, where they are rarely the focus of clinical investigation, shows a strong association with dsSDF and male factor-driven miscarriage contribution, highlighting the importance of male investigation in couples experiencing recurrent pregnancy loss.
Does total motile sperm count predict embryo quality and ICSI success in young normal-weight women? A retrospective multicentre study.
Crafa A, Cannarella R, Navarro-Gomezlechon A … +5 more , Pacheco-Rendón RM, Condorelli RA, La Vignera S, Calogero AE, Garrido N
Reprod Biomed Online · 2026 Jan · PMID 41365118 · Publisher ↗
RESEARCH QUESTION: Can the fresh and post-selection total motile sperm count (TMSC) predict intracytoplasmic sperm injection (ICSI) outcomes? DESIGN: This multicentre retrospective cohort study involved couples with infe...
RESEARCH QUESTION: Can the fresh and post-selection total motile sperm count (TMSC) predict intracytoplasmic sperm injection (ICSI) outcomes? DESIGN: This multicentre retrospective cohort study involved couples with infertility (>12 months) undergoing ICSI. Participants were divided into five groups by baseline TMSC: group I, less than 1 million; group II, 1 to less than 5 million; group III, 5 to less than 10 million; group IV, 10-20 million; and group V, over 20 million. The primary outcome was the cumulative live birth rate, with secondary outcomes of oocyte fertilization rate, embryo number/quality, biochemical and clinical pregnancy rates and miscarriage rate. RESULTS: In total 5813 couples met the inclusion criteria. After adjustment for confounding factors, the TMSC of fresh samples was positively correlated with the oocyte fertilization rate, with higher values observed in all groups compared with group I (P < 0.001). Moreover, TMSC appears to influence the cumulative live birth rate for oocytes used (hazard ratio [HR] 1.25, 95% CI 1.05-1.48, adjusted P = 0.0116), while no difference was observed when the number of embryos transferred and transfers were considered. Finally, no difference was found in embryo quality or other reproductive outcomes. For post-selection TMSC, none of the groups had a higher fertilization rate than group I after adjusting for confounding factors. CONCLUSIONS: This study suggests that changes in TMSC alone can predict the oocyte fertilization rate and slightly influence the cumulative live birth rate, particularly when considering the total number of inseminated oocytes. These underscore the critical role of sperm quality in the success of ICSI. However, other female and/or male parameters may also contribute to the outcomes.
Short conventional IVF, big impact: navigating protocol variations towards standardization.
Carullo G, Makieva S, Xie M … +3 more , Casalechi M, Vigano P, Leeners B
Reprod Biomed Online · 2026 Jan · PMID 41365117 · Publisher ↗
The field of assisted reproductive technology (ART) has undergone substantial progress in recent years, particularly in the refinement of insemination techniques. Despite the widespread use of various methods, however, a...
The field of assisted reproductive technology (ART) has undergone substantial progress in recent years, particularly in the refinement of insemination techniques. Despite the widespread use of various methods, however, a definitive consensus on the optimal insemination protocols, particularly within conventional IVF, remains elusive. From oocyte-sperm incubations lasting mere seconds to extended overnight strategies, the variability in approaches has contributed to inconsistent outcomes and practices across fertility clinics. This review critically examines the range of protocols used in short insemination conventional IVF and scrutinizes the underlying rationale behind different incubation durations and methodologies. By summarizing the available evidence, the aim is to discern patterns that could inform the development of a unified protocol, thereby standardizing short conventional IVF practices. Ultimately, this review emphasizes the urgent need for evidence-based guidelines to streamline conventional IVF procedures, ensuring improved clinical outcomes and greater consistency in practice across the global landscape of ART.
Assisted reproductive technology in Latin America: the Latin American Registry, 2022.
Zegers-Hochschild F, Crosby JA, Musri C … +7 more , Petermann-Rocha F, Martinez G, Nakagawa H, Morente C, Roque A, Palma-Govea A, Latin American Network of Assisted Reproduction
Reprod Biomed Online · 2026 Jan · PMID 41353791 · Publisher ↗
RESEARCH QUESTION: What are the trends and effects of assisted reproductive technology (ART) interventions on the effectiveness and safety of ART carried out in Latin America during 2022. DESIGN: Retrospective collection...
RESEARCH QUESTION: What are the trends and effects of assisted reproductive technology (ART) interventions on the effectiveness and safety of ART carried out in Latin America during 2022. DESIGN: Retrospective collection of cycle-based multinational data obtained from ART procedures carried out by 204 accredited institutions in 16 countries. RESULTS: In total 123,265 initiated cycles resulted in 19,663 deliveries and 22,203 births. Use of ART varied greatly, from 643.3 cycles/million inhabitants in Uruguay to 28.8 in Guatemala. In autologous cycles, the proportion of women aged ≥40 years represents 35.1% of cycles, whereas women <34 years represents only 18.8%. The proportion of single embryo transfers (SET) increased from 42.4% in 2021 to 47.3% in 2022. Out of 22,203 babies born, 77.4% were singletons, 21.7% twins and 0.9% triplets or more. Intracytoplasmic sperm injection represented 85.4% of fertilization techniques, and blastocyst transfer increased from 79.3% in 2021 to 85.3% in 2022. Delivery rate after fresh blastocyst elective single embryo transfer (32.6%) was significantly higher than after the transfer of one frozen embryo transfer (FET) from freeze-all cycle (25.2%) (P = 0.0001). The number of aspirations leading to preimplantation genetic testing increased 2.6 times in 6 years, and significantly increased delivery rates/transfer (P ≤ 0.008) and reduced miscarriage at all ages (P ≤ 0.004) in autologous cycles, but not in oocyte donation cycles. Delivery rates after fresh transfer of embryos from vitrified-warmed donated oocytes, generated similar outcome to FET from fresh oocyte donation cycles (P = 0.5621). Perinatal mortality increased from 7.5‰ in singletons to 22.8‰ in twins. CONCLUSION: Systematic collection of cycle-based multinational data contributes to cooperative sustained development and helps implement evidence-based reproductive decisions.
Does systemic LH concentration influence live birth rate in programmed single euploid frozen embryo transfer cycles?
Marqueta L, Lawrenz B, Kalafat E … +5 more , Gallego RD, Ruiz F, Melado L, Khatib IE, Fatemi H
Reprod Biomed Online · 2026 Jan · PMID 41353790 · Publisher ↗
RESEARCH QUESTION: Does systemic LH concentration influence live birth rate (LBR) in programmed single euploid frozen embryo transfer (seFET) cycles? DESIGN: Retrospective cohort study including 758 programmed seFET cycl...
RESEARCH QUESTION: Does systemic LH concentration influence live birth rate (LBR) in programmed single euploid frozen embryo transfer (seFET) cycles? DESIGN: Retrospective cohort study including 758 programmed seFET cycles between January 2018 and September 2023, prepared with oral oestradiol and vaginal progesterone. Serum oestradiol, progesterone and LH were measured at the start of preparation and up to 3 days before initiation of vaginal progesterone. Patients were stratified in percentile groups according to LH concentration before oestradiol and vaginal progesterone administration. The impacts of LH concentration and its slope on LBR were assessed. RESULTS: Pregnancy rate, pregnancy loss rate and LBR were 66.7%, 18.0% and 48.7%, respectively. Outcome groups were comparable in terms of female age at retrieval and transfer, anti-Müllerian hormone, male age, luteal phase support, and hormone concentrations before initiation of oestradiol and vaginal progesterone. No significant differences in LBR were seen between LH percentile groups. No significant trend was seen when categorizing the increase in LH concentration as small, moderate or substantial. Multi-nomial regression analysis showed that poorer embryo quality (inner cell mass grade C versus A; P = 0.005), biopsy on day 6/7 versus day 5 (P = 0.01), and higher body mass index (P = 0.031) were more likely to result in a negative pregnancy test than a live birth. Neither oestradiol nor LH concentrations prior to vaginal progesterone administration, nor their increase, were significantly associated with outcomes. CONCLUSIONS: Systemic LH concentration before vaginal progesterone administration does not influence LBR in programmed seFET cycles.
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