To investigate the association between an abnormal hysterosalpingogram (HSG) and obstetrical and neonatal outcomes.

A retrospective cohort study comparing outcomes between women with normal versus abnormal tubal patency and uterine cavity on HSG.

Among 2181 women included in the study, 494 (22.6%) had an abnormal HSG. Of these, 207 (42%) presented with uterine abnormalities, 336 (68%) with tubal abnormalities and 49 (10%) with both. The study identified 232 clinical pregnancies in the abnormal HSG group and 814 pregnancies in controls. Women with abnormal HSG showed higher rates of preterm labour (PTL) compared to controls (13.6% vs. 7.7%, p < 0.05, n = 1687). Multivariate analysis revealed that any HSG abnormality was associated with an increased risk of PTL (aOR 2.39, 1.04-5.51). When analysing by type of abnormality, uterine abnormalities increased the risk of preeclampsia (aOR 2.86, 1.06-7.7) and low birthweight (aOR 2.31, 1.0-5.35), while tubal abnormalities were specifically associated with increased risk of PTL (aOR 3.87, 1.63-9.19).

An abnormal HSG study was associated with adverse obstetrical outcomes. Specifically, uterine abnormalities increased the risk of preeclampsia and birthweight below 10th percentile, while tubal abnormalities were associated with a heightened risk of PTL.

The role of follicular fluid phosphate for reproductive health and oocyte maturation is unclear. This study investigates the relationship between follicular fluid vs serum phosphate concentrations and the possible link with sex steroids during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at a Danish fertility clinic.

A prospective cohort of infertile women who attended Danfert Fertility clinic (Copenhagen, Denmark) and received IVF or ICSI treatment between June 2015 and February 2017. Correlation analyses were performed with Spearman's Rank or Pearson's correlation, while categorical variables were analyzed with Chi-squared test.

In total, 110 participants were included in the study, and 33 of these achieved a live birth. Phosphate concentrations were higher in the follicular fluid compared to corresponding serum samples (1.16 mmol/L vs. 1.06 mmol/L, p = 0.002) and there was a positive correlation between serum and follicular fluid phosphate concentrations (r = 0.43, p = 0.007). A positive trend was also found for calcium concentrations, though not statistically significant (r = 0.31, p = 0.060). Correlation analysis also showed a positive correlation between concentrations of phosphate and calcium in follicular fluid (r = 0.41, p < 0.001). A positive correlation was observed between concentrations of phosphate and testosterone in follicular fluid (r = 0.34, p < 0.001). When stratified into tertiles, we found no significant differences between live birth rates in follicular fluid phosphate (p = 0.624), calcium (p = 0.207), or testosterone (p = 0.841).

This study found that follicular fluid phosphate concentrations are higher than serum phosphate concentrations, suggesting possible local regulation. However, no significant association was found between follicular phosphate and ART outcomes. Further research is needed to explore its potential role in reproductive physiology.

Clinicaltrials.gov (NCT02437578; registration date 2015/04/16).

Approximately half of male factor infertility cases are idiopathic, indicating a need for new methods to supplement male fertility assessment.

The objective of this study was to identify differences in the sperm transcriptomes of men with different clinical fertility status. We hypothesized that sperm mRNA profiling could distinguish men presenting for fertility assessment from proven fertile men.

We compared two groups of study participants: men who presented for infertility assessment (n = 53, "infertility"), and men without a history of infertility who had fathered a child and were presenting for vasectomy (n = 14, "proven fertile" control). Study participants provided a semen sample for semen analysis and sperm mRNA sequencing. Differentially abundant genes were identified, and a gene expression summary score was constructed to test the ability of RNA-seq data to differentiate between study populations.

The semen parameter that best differentiated between study populations was motility (area under the ROC curve = 0.746). In RNA-seq analysis, 1885 total differentially abundant transcripts were identified (q < 0.05, fold difference ≥ 2), 1004 (53.3%) of which were downregulated in infertility study participants. The Gene Ontology term, spermatogenesis, was enriched, with 40 out of 44 differentially abundant genes downregulated in infertility study participants. A gene expression summary score consisting of 100 upregulated and 100 downregulated genes was able to differentiate between the two groups of study participants.

Sperm mRNAs differed between proven fertile and infertility study men. Known fertility-associated genes, including PRM1 and PRM2, and potentially novel fertility markers, including HOOK1 and SPATA6, were downregulated in infertility study samples. Future studies should test these results for reproducibility and test whether novel biomarker candidates can provide mechanistic information about etiologies of idiopathic male infertility.

Our results support the hypothesis that sperm mRNA abundance differs by clinical fertility status.

The relationship between triglyceride-glucose (TyG) index and all-cause or cardiovascular mortality among infertile women remains unclear. In this study, we intended to utilize a national cohort from National Health and Nutrition Examination Survey (NHANES) to check the association between them.

Ten datasets from the NHANES database spanning almost 20 years were used as the data source and were combined within National Death Index for mortality follow-up. Multiple-variable Cox proportionate hazards regression models and three others were employed in this study to for assessing relationships among TyG index levels with all-cause and cardiovascular mortality. SPSS (version 29.0) and online websites were utilized for conducting the primary statistical analyses.

1,450 female participants were identified in this study. The samples were classified based on TyG index quartiles (7.05-11.95). The TyG index had a mean of 8.58±0.66. Participants with higher TyG indices were older-aged, had greater body mass index (BMI), and a stronger likelihood of having hypertension and diabetes (P < 0.05). Participants whose TyG indices were higher were older in age, along with increased BMI, and blood pressure along with diabetes (P < 0.05). Significant positive associations were observed among the TyG index and total mortality in the crude model (HR: 1.81, 95% CI: 1.27-2.58). Correlation persisted in Model 2 (following the adjustment of age and race) and Model 3 (following the adjustment of age, race, BMI, education, family poverty income ratio, smoking and drinking habits, menstrual regularity, hypertension, and diabetes). The TyG index did not affect the cardiovascular mortality in infertile women.

TyG index levels were in positive association with all-cause mortality within the female infertile population.

Sjögren syndrome (SS) is a systemic autoimmune disease with a variety of clinical presentations. Successful pregnancies and deliveries among these patients remain challenging. This manuscript describes a case report of diagnosis, detailed clinical management, and successful pregnancy and delivery of a patient of SS, which treated by immunosuppressive agents, especially cyclosporine A (CsA) and assisted reproductive technology.

A 31-year-old female had been experiencing persistent infertility with a 5-year-long history. However, the results indicated that patent fallopian tubes, an ovulatory cycle, and normal semen analysis.

After obtaining clinical manifestations, medical history, and the serum biochemical and salivary gland histopathology examination results, main causes such as tubal factor, impaired endometrial function, endocrine dysfunctions and male factors were excluded, and the final diagnosis was SS-induced autoimmune infertility.

The patient was treated with immunosuppressive agents and assisted reproductive technology. After 5 failed attempts of assisted reproductive technology treatment and treatment with 3 immunosuppressive agents, the application of a relatively potent immunosuppressive agent CsA was finally used and a high-quality frozen-thawed blastocyst embryo was transferred.

A clinical pregnancy was confirmed. The newborn was delivered by elective cesarean section and showed normal development over the 1-year follow-up.

The accurate diagnosis of autoimmune infertility requires a combination of clinical presentation, medical history, and biochemical findings, and, if available, histopathology examinations. The role of immunosuppressive agents, especially CsA is crucial for the clinical management of autoimmune infertility.

Do the main psychoactive phytocannabinoid delta-9-tetrahydrocannabinol (THC) and its non-psychoactive analog cannabidiol (CBD) affect human sperm function?

THC and CBD affect the sperm-specific Ca2+ channel CatSper, suppress activation of the channel by progesterone (P4) and prostaglandin E1 (PGE1), and THC also alters human sperm function in vitro.

Marijuana (Cannabis sativa) is one of the most commonly used recreational drugs worldwide. Although the effects of phytocannabinoids on semen parameters have been studied, there is no evidence of a direct impact of THC and CBD on human sperm.

We investigated the effects of the major psychoactive phytocannabinoid, THC, its non-psychoactive analog, CBD, and their major metabolites on Ca2+ influx via CatSper in human spermatozoa. THC and CBD were selected to further evaluate their action on P4-, PGE1-, and pH-induced activation of CatSper. The effects of THC and CBD on sperm motility, penetration into viscous media, and acrosome reaction (AR) were also assessed.

The effects of phytocannabinoids on CatSper activity were investigated on semen samples from healthy volunteers and men with homozygous deletion of the CATSPER2 gene using kinetic Ca2+ fluorimetry and patch-clamp recordings. Motility was assessed by computer-assisted sperm analysis (CASA). Sperm penetration into viscous media was assessed using a modified Kremer test. The AR was evaluated by flow cytometry using Pisum sativum agglutinin-stained spermatozoa.

Both THC and CBD increased the intracellular calcium concentration with CBD inducing a greater increase compared to THC. These Ca2+ signals were abolished in men with homozygous deletion of the CATSPER2 gene demonstrating that they are mediated through CatSper. THC suppressed the P4- and the PGE1-induced Ca2+ increase with a half-maximal inhibitory concentration (IC50) of 1.88 ± 1.15 µM and 0.98 ± 1.10, respectively. CBD also suppressed the P4- and PGE1-induced Ca2+ signal with an IC50 of 2.47 ± 1.12 µM and 6.14 ± 1.08 µM, respectively. The P4 and PGE1 responses were also suppressed by THC and CBD metabolites, yet with greatly reduced potency and/or efficacy. THC and CBD were found to inhibit the Ca2+ influx evoked by intracellular alkalization via NH4Cl, with THC featuring a higher potency compared to CBD. In conclusion, THC and CBD inhibit both the ligand-dependent and -independent activation of CatSper in a dose-dependent manner. This indicates that these phytocannabinoids are genuine CatSper inhibitors rather than P4 and PGE1 antagonists. Finally, THC, but not CBD, impaired sperm hyperactivation and penetration into viscous media and induced a small increase in AR.

Future studies are needed to assess whether cannabis consumption can affect fertility since this study was in vitro.

The action of THC and CBD on CatSper in human sperm may interfere with the fertilization process, but the impact on fertility remains to be elucidated. THC inhibits the P4 and the PGE1 response more potently than CBD and most previously described CatSper inhibitors. THC can be used as a starting point for the development of non-hormonal contraceptives targeting CatSper.

This work was supported by the Swiss Center for Applied Human Toxicology (SCAHT), the Département de l'Instruction Publique (DIP) of the State of Geneva and the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation). The authors declare that no conflicts of interest have been identified that might affect the impartiality of the research reported.

N/A.

The relationship between uric acid to high-density lipoprotein (HDL) cholesterol ratio (UHR) and female infertility remains unclear. The aim of our study was to explore the correlation between UHR and fertility in US adults.

Data from the National Health and Nutrition Examination Survey from 2013 to 2018 was analyzed in this study. UHR was considered the independent variable, and female infertility was the dependent variable. Multivariable logistic regression and smooth curve fitting were conducted to evaluate the correlation between UHR and infertility. Subgroup and sensitivity analyses were utilized to assess the stability of the findings.

UHR in transform and female infertility proved to have a positive relationship in logistic regression models, and this relationship remained significant after adjusting for all possible confounding factors (odds ratio [OR] = 1.86, 95% confidence interval: 1.28-2.69, p = 0.001). When UHR was split into four quartile groups, individuals in Tertiles 2, 3, and 4 separately had a 1.84, 1.86, and 2.02 times greater incidence of female infertility than those in Tertile 1. A positive linear relationship between UHR and female infertility incidence was demonstrated using smooth curve fitting. The results of the subgroup analysis revealed consistent correlations and no difference in the UHR index and infertility subgroups (p for interaction tests  >0.05).

This national study identified the association between a higher prevalence of female infertility and an elevated UHR. The findings suggested that UHR levels could be useful in predicting the incidence of infertility. The management of UHR should be given more consideration.

Male infertility is a significant reproductive issue affecting a considerable number of couples worldwide. While there are various causes of male infertility, genetic factors play a crucial role in its development. We focused on identifying and analyzing the high-risk nsSNPs in DNAH1 and DNAH17 genes, which encode proteins involved in sperm motility. A total of 20 nsSNPs for DNAH1 and 10 nsSNPs for DNAH17 were analyzed using various bioinformatics tools including SIFT, PolyPhen-2, CADD, PhD-SNPg, VEST-4, and MutPred2. As a result, V1287G, L2071R, R2356W, R3169C, R3229C, E3284K, R4096L, R4133C, and A4174T in DNAH1 gene and C1803Y, C1829Y, R1903C, and L3595P in DNAH17 gene were identified as high-risk nsSNPs. These nsSNPs were predicted to decrease protein stability, and almost all were found in highly conserved amino acid positions. Additionally, 4 nsSNPs were observed to alter post-translational modification status. Furthermore, the interaction network analysis revealed that DNAH1 and DNAH17 interact with DNAH2, DNAH3, DNAH5, DNAH7, DNAH8, DNAI2, DNAL1, CFAP70, DNAI3, DNAI4, ODAD1, and DNAI7, demonstrating the importance of DNAH1 and DNAH17 proteins in the overall functioning of the sperm motility machinery. Taken together, these findings revealed the detrimental effects of identified high-risk nsSNPs on protein structure and function and highlighted their potential relevance to male infertility. Further studies are warranted to validate these findings and to elucidate the underlying mechanisms.

The role of healthcare professionals (HCPs) is paramount in improving fertility awareness and practices. This study aimed to explore the level of infertility knowledge among primary care providers in Fez-Meknes, Morocco.

A cross-sectional study was carried out in July-September 2023 concerning HCPs practicing in primary care establishments employing a snowball sampling technique. The questionnaire was designed and validated by an expert panel of sexual and reproductive health (SRH). It was consisted of 14 items concerning infertility knowledge and gives a score between 0 and 14. The basic infertility knowledge score (BIKS) was obtained to assess HCPs knowledge level.

641 HCPs were included; they had low level about basic knowledge of infertility. The total BIKS average of HCPs was found to be "05.08 ± 01.99". The mean nurses' score was "5.11 ± 2.02" and midwives' score was "5.03±;1.93". Three-quarters (75.4%) of respondents scored <7 to the 14 questions. Almost 60% did not know neither the meaning of primary infertility nor secondary infertility; just 27.9% reported that infertility is considered a disease by the WHO, and only 9% recognized the prevalence of infertility in Morocco. Education level and practicing setting were significantly associated with correct responses, 10-3 and 0,02, respectively.

The finding of our survey asserts that nurses and midwives in primary healthcare lack basic knowledge about infertility. It is essential to provide them an appropriate education to assist Moroccan couple who are seeking their parental project as part of the promotion of SHR for all.

The prevalence of infertility among reproductive-age couples in Indonesia is around 10-15%. Lack of understanding, misleading myths, and negative attitudes could result in improper behavior. This study aims to reveal the discrepancy between perception and behavior towards infertility in urban and rural areas in Indonesia.

A cross-sectional study using an internet-based questionnaire was given to 408 individuals, divided into two groups, Java and outside Java, representing urban and rural populations. The study included Indonesian citizens over 18 who were willing to participate, encompassing individuals of both genders, regardless of their fertility status. All participants completed the questionnaire from October 2020 to April 2021.

Half of the respondents from both groups consider infertility a disease. All respondents have excellent access to information. Although more than 80% of subjects from each group had been exposed to infertility information, a better understanding was observed in the urban community. Most subjects answered that smoking is the leading risk factor for infertility, followed by stress and advanced age. More respondents in rural areas have the wrong perception that stress causes infertility. Furthermore, they seek unwarranted advice, as 19.5% came to midwives and only 9.1% came to general practitioners. This study showed that 35.6% of subjects in the urban group and 41.6% in the rural group are considered late to seek healthcare assistance. Most respondents from both groups accept using Assisted Reproductive Technology and fertility-enhancing drugs as treatment options.

Infertility misconceptions are more prevalent in rural groups than in urban groups. Fertility education among both groups needs to be improved to optimize the chance of conceiving and having a healthy baby.

Defects in sperm size and form, known as teratozoospermia, can adversely impair sperm motility and its ability to fertilize an oocyte. Teratozoospermia has been most often linked with genetic abnormalities with close to 100 genes known.

The primary objective of this study was to investigate the genetic basis of oligoasthenoteratozoospermic infertility in an infertile man.

We performed the whole exome sequencing, followed by in silico filtration of observed genetic variations. Filtered rare variants were assessed for their pathogenic nature on the basis of scores assigned by various in-silico tools and their biological relevance to sperm structural development. The potential pathogenic mutation was validated by Sanger sequencing.

Our study identified a homozygous substitution, c.4511A > G, in the SPAG17 gene as a potential pathogenic mutation associated with oligoasthenoteratozoospermic infertility in the case under investigation. The mutation resulted in the substitution of asparagine with serine at the 1504th amino acid position in a protein of 2,223 amino acids. This mutation shows a minor allele frequency of 0.0004671 in the gnomAD database. ACMG classification suggested this mutation to be likely pathogenic.

Our study identified a homozygous likely pathogenic mutation (c.4511A > G, Asn1504Ser) in the SPAG17 gene that explains oligoasthenoteratozoospermic infertility in the present case.

To examine whether the rate of HLA similarity among 609 primarily infertile couples is higher than would be expected by chance.

Clinical Trial.

609 primary infertile couples (mean age women: 34.35 years, men: 37.59 years) were recruited before undergoing IVF or ICSI therapy. Couples with former pregnancies, tubal factor, azoospermia or donor therapies were excluded.

For each of the partners, exons encoding the corresponding antigen recognition sites of HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 were sequenced by using next-generation sequencing. HLA similarity between partners was determined based on the probability of homozygous offspring and the observed probability of heterozygous offspring in the sample of primary infertile couples was comparted to the probability for random pairing using bootstrapping.

HLA similarity of infertile couples compared to randomly assigned couples.

In each of the loci, infertile pairs shared more alleles than expected by chance. This result was significant for all HLA class 2 loci (-DRB1, -DQB1, -DPB1), as well as for the HLA class I locus -C, while HLA-A and -B showed a nonsignificant trend towards higher similarity.

These data suggest that HLA similarity between couples relates to primary infertility.

Expanding in vitro fertilization (IVF) access requires improved patient counseling and affordability via cost-success transparency. Clinicians ask how two types of live birth prediction (LBP) models perform: machine learning, center-specific (MLCS) models and the multicenter, US national registry-based model produced by Society for Assisted Reproductive Technology (SART). In a retrospective model validation study, we tested whether MLCS performs better than SART using 4635 patients' first-IVF cycle data from 6 centers. MLCS significantly improved minimization of false positives and negatives overall (precision recall area-under-the-curve) and at the 50% LBP threshold (F1 score) compared to SART (p < 0.05). To contextualize, MLCS more appropriately assigned 23% and 11% of all patients to LBP ≥ 50% and LBP ≥ 75% whereas SART gave lower LBPs. Here, we show MLCS improves model metrics relevant for clinical utility - personalizing prognostic counseling and cost-success transparency - and is externally validated. We recommend evaluating MLCS in a larger sample of fertility centers.

Atorvastatin is a statin group of medicine that inhibits biosynthesis of cholesterol and mainly prescribed for treating cardiovascular diseases. Black pepper is a one of the mostly used spices that contains an alkaloid called piperine in its fruits which is known to cause male reproductive toxicity. Both atorvastatin and black pepper (piperine) are randomly consumed by the patients of chronic hyperlipidemia and it is important to know the synergistic effects of atorvastatin and piperine on male fertility parameters. Twenty rats were taken for the study and divided into four groups each containing five rats. Group I served as a control, group II animals are treated with atorvastatin (ATR) (8mg/kg BW), group III animals received piperine (PIP) (10mg/kg BW) and group IV animals were co-administered with piperine (10mg/kg BW) and atorvastatin (8mg/kg BW). All treatments were done by using water suspension of atorvastatin and piperine and using oral gavage for consecutive 28 days and thereafter assessed for gravimetric and histomorphometry analysis, sperm motility and morphology, ROS generation, anti-oxidant enzymes, serum testosterone quantification, qRTPCR (StAR, CYP11a1, 3βHSD and 17βHSD genes) and toluidine blue staining for analyzing chromatin integrity of spermatozoa. The results showed that co-administration of ATR+PIP significantly reduced body weight, changed in GSI also found. Activities of major two antioxidant enzymes (SOD and Catalase) were found to reduce whereas levels of TBARS and ROS in testicular tissues increased significantly. The study found that combined administration of atorvastatin and piperine negatively impacted male fertility potential, causing reproductive toxicity.

Introduction Infertility affects most of the women of reproductive age, with uterine and tubal factors contributing significantly. Hysterosalpingography (HSG) and diagnostic hysteroscopy are widely used modalities in infertility evaluation. This study compares the findings of HSG and hysteroscopy to assess their diagnostic accuracy and utility in clinical management. Materials and methods A retrospective comparative observational study was conducted at Adichunchungiri Hospital, Karnataka, over six months (April-September 2024). Thirty-nine women aged 23-36 years with primary or secondary infertility underwent both HSG and diagnostic hysteroscopy. HSG assessed tubal patency and gross uterine abnormalities, while hysteroscopy provided direct visualization of intrauterine pathologies. Statistical analysis included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), with hysteroscopy considered the gold standard for intrauterine pathology. Results Bilateral tubal patency was observed in 59% of cases on both HSG and hysteroscopy. HSG demonstrated a sensitivity of 95.83% and specificity of 92.31% for tubal patency. However, hysteroscopy detected additional findings like hydrosalpinx (10.26%), fimbrial cysts (5.13%), and uterine adhesions (7.69%), which were missed by HSG. For uterine abnormalities, HSG had a sensitivity of 70% and specificity of 85.71%, while hysteroscopy provided superior detection of fibroids and septate uterus. Notably, hysteroscopy influenced management decisions, guiding surgical interventions or assisted reproductive techniques in selected cases. Conclusion While HSG remains effective for screening tubal patency, diagnostic hysteroscopy offers superior detection of intrauterine pathologies, impacting treatment strategies. Combining both modalities enhances diagnostic accuracy in infertility evaluation.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs. Male SLE patients often face reproductive health challenges, but research on male sexual and reproductive health in SLE remains limited. This systematic review and meta-analysis aimed to explore the effects of SLE and its related factors on male sexual function and reproductive health.

The PubMed, Cochrane library, Embase, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) databases were examined from January 2000 to December 2024. Data extraction and quality assessment were performed by two reviewers. Meta-analysis was carried out using Review Manager 5.3 software, and the risk of bias was assessed using the AHRQ checklist. The following outcomes were evaluated: sexual function, reproductive hormones and fertility.

In the literature search, 5002 articles were identified, of which 9 studies met the inclusion criteria. Meta-analysis showed a significantly higher incidence of erectile dysfunction (ED) in SLE patients (OR = 7.44; 95 % CI = 5.00 to 11.06, p < 0.001). SLE patients also had higher levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) compared to controls (FSH: MD = 4.02; 95 % CI = 1.47 to 6.57; p = 0.002; LH: MD = 2.21; 95 % CI = 1.10 to 3.32; p < 0.001). Semen analysis showed a significant decrease in sperm count in SLE patients (MD = -0.54; 95 % CI = -0.86 to -0.22; p < 0.001).

Male SLE patients are more likely to have problems with sexual function, reproductive hormones and sperm quality. These findings emphasize the need for increased clinical awareness and interventions focused on male sexual and reproductive health in SLE patients.

Recessive genetic conditions impose a significant burden, often leading to severe childhood disorders, many of which remain untreatable. It is estimated that 1-2 % of couples are at risk of having an affected child in the general population, with the risk being significantly higher in consanguineous couples. Understanding the increased risk of having a child with a recessive disorder empowers prospective parents to make informed reproductive choices. With technological advancements, genetic screening has evolved beyond identifying only a few common conditions. Expanded carrier screening (ESC) now offers a single test that covers a comprehensive list of recessive disorders, addressing those that contribute most significantly to the burden of these conditions within specific populations. ESC is recommended for all couples planning a pregnancy, with particular emphasis on consanguineous couples or those who are subfertile. To ensure responsible use of ESC, clinical service delivery should adopt a multidisciplinary approach, providing couples with the information they need to make voluntary, informed decisions. This includes access to high-quality genetic testing, genetic counseling, and psychosocial support. National professional societies and governments play a crucial role in shaping guidelines, policies, oversight, and funding to guarantee equitable access to high-quality ESC services.

Infertility affects more than 50 million couples worldwide, resulting in a significant burden on individuals and society. Its prevalence ranges from 8-12% among developed countries. The growing number of patients poses an increasing challenge to the healthcare system and its funding. Our quantitative, descriptive, and cross-sectional study aimed to analyze the prevalence and annual nationwide health insurance treatment cost of female infertility in Hungary in 2019.

We used claims data obtained from the Hungarian National Health Insurance Fund Administration (NHFIA). The number of patients, total and age-specific prevalence, annual health insurance expenditure, and the distribution of costs by age group were evaluated. Infertility was determined according to the World Health Organization International Classification of Diseases codes (N.97.0, N97.1, N97.2, N97.3, N97.4, N97.8, and N97.9) and the utilization of each healthcare service type. During the study descriptive statistics, correlation analysis and t-test were used.

In 2019, the NHIFA spent a total of 7.2 billion HUF (22.2 million EUR) on female infertility treatment in Hungary (33,151 women in outpatient care). The most significant costs were related to inpatient care (4.1 billion HUF, 12.7 million EUR). The highest number of patients and prevalence (650.4 per 100,000 women) were found in outpatient care. In inpatient care, the prevalence is substantially lower (206.7 per 100,000 women). Regardless of its type, female infertility mainly affects patients in the 30-39 years age group (number of patients: 18,156 women). The average annual health insurance expenditure per capita was 1,083 EUR.

Reproductive health education, prevention, and medical screening play inevitable roles in the early stages of reproductive life to reduce the risk of infertility and decrease treatment costs.

This study aimed to explore the ambiguous link between dietary inflammatory indices and sperm parameters. Specifically, it investigated the associations between the dietary inflammatory index (DII) and the energy-adjusted dietary inflammatory index (E-DII) with sperm motility, morphology, and count in men undergoing routine semen analysis.

A cross-sectional study was conducted with 144 men enrolled, where semen samples were collected and evaluated according to the 2010 World Health Organization guidelines. Dietary data were gathered using a 147-item semi-quantitative food frequency questionnaire developed by the researchers. Pearson correlation analysis was employed to assess the relationships of the DII and E-DII with sperm parameters.

The mean DII and E-DII scores were 1.23±1.1 and 0.49±0.43, respectively. The mean values for sperm motility, morphology, and count were 43.08%±19.30%, 78.03%±26.99%, and 48.12±44.41 million, respectively. Both motility (r=-0.353) and count (r=-0.348) were found to be inversely and significantly correlated with DII. Similarly, Pearson correlation tests revealed strong and significant inverse correlations of motility (r=-0.389) and count (r=-0.372) with E-DII.

The findings suggest that a diet with a higher anti-inflammatory potential may be associated with increased sperm count and motility, but not with changes in morphology. Further research is necessary to confirm these findings, elucidate the underlying mechanisms, and identify dietary modifications that could improve male fertility.

Oligoasthenoteratozoospermia (OAT) is a frequent but severe type of male infertility. As one of the most multifaceted male infertility resulting from sperm problems, its genetic etiology remains unknown in most cases. In this review, we systematically sort out the latest literature on clinical reports and animal models leading to OAT, summarise the expression profiles of causative genes for OAT, and highlight the important role of the protein transport system during spermiogenesis, spermatid cell-specific genes, Golgi and acrosome-related genes, manchette-related genes, HTCA-related genes, and axoneme-related genes in OAT development. These causative genes would be instrumental in genetic etiological screening, genetic counseling, and pre-implantation genetic testing of patients with clinical OAT.

More than one million sexually transmitted infections (STIs) are acquired every day worldwide. They are commonly caused by Chlamydia trachomatis (CT), herpes simplex virus (HSV), or human papillomavirus (HPV) and are suggested to contribute to female infertility. This scoping review aims to map and summarize existing literature on the association between a pre-pregnancy infection with CT, genital HSV, or HPV and female fertility. We searched two databases (PubMed, Embase) to identify published literature on the association between CT, genital HSV, or HPV infection and female fertility. We included full-text articles, published from 2002 to 2022, on pre-pregnancy infection with either CT, genital HSV, or HPV within a population of women of reproductive age. The study endpoint was either pregnancy, time-to-pregnancy, or infertility. The included studies were evaluated according to the Critical Appraisal Tool by Joanna Briggs Institute. Eight studies were eligible for the review. All of them investigated the association between a CT infection and fertility, while none of them investigated infections with genital HSV or HPV. Three studies found that a CT infection was associated with poorer female fertility, and one study found a similar association in a subgroup analysis of women with a pregnancy intention. Four studies indicated no association, although methodological differences between the studies preclude firm conclusions. This review revealed sparse literature investigating the association between CT, HPV, and HSV and subsequent female fertility. Prospective cohort studies with preconception assessments of these STIs are needed to determine the relation between STIs and subsequent fertility.

The need for assisted reproductive technology (ART) has increased worldwide, leaving a negative impact on both physical and emotional health of the individual as well as on society depending on child births, thus biomarkers that can increase the success of ART are warranted. The luteinizing hormone/choriogonadotropin receptor (LHCGR) is released into blood and follicular fluid, and the level of soluble LHCGR (sLHCGR) in serum has previously been suggested to predict chances of pregnancy and live birth rate after ART. We aimed to investigate whether sLHCGR originates from the ovary and if serum or follicular fluid sLHCGR can predict the likelihood of pregnancy or live birth. A total of 133 women referred to a fertility clinic were included in the study, in total 203 trials of ART were performed. sLHCGR was analyzed in 170 follicular fluid samples and 75 serum samples. Interestingly, serum levels of sLHCGR were higher than follicular fluid levels (0.51 vs. 0.31 pmol/mL, p = 0.020) and a positive correlation in the two compartments was identified (r2 0.770, p < 0.0001), suggesting an extragonadal origin of sLHCGR. Follicular levels of sLHCGR were associated with follicular SHBG and free testosterone. Follicular/serum-ratio of sLHCGR was inversely associated with both serum- and follicular AMH. However, no association was found between sLHCGR and antral follicle count, which questions a link with folliculogenesis. Neither serum nor follicular fluid sLHCGR levels could predict pregnancy or live births in this cohort. Further studies are needed to clarify the role of sLHCGR in the ovaries.

The Composite Dietary Antioxidant Index (CDAI) measures the antioxidant capacity of the diet, which is believed to provide protection against various diseases, including depression, osteoporosis, and papillomavirus infection, by neutralizing harmful oxidative stress. However, the relationship between CDAI and infertility is not well understood. This research aims to explore the potential correlations between CDAI and the risk of infertility.

This research harnessed data from the National Health and Nutrition Examination Survey (NHANES) to execute a cross-sectional analysis involving 8263 US women aged 20-45. Each participant was subjected to two distinct 24-h dietary recall interviews. We calculated the CDAI using average daily antioxidant intake. Infertility was assessed using a standardized questionnaire. The association between CDAI and infertility was examined using weighted multiple logistic regression models, while nonlinear correlations were explored through restricted cubic splines. To affirm the robustness of our findings, sensitivity and subgroup analyses were performed using unweighted logistic regression. Additionally, to ascertain the causal influence of circulating antioxidant levels on infertility, a two-sample univariable Mendelian randomization (MR) analysis was conducted, using the inverse variance weighted (IVW) method as the primary analytic approach.

Participants who were infertile exhibited lower CDAI levels compared to their fertile counterparts. When confounding variables were accounted for in the multivariate weighted logistic regression model, an inverse relationship was observed between CDAI and infertility, with the odds ratio for the highest versus lowest quartile being 0.55 (0.33-0.90, P = 0.02). However, the IVW method indicated that genetically predicted elevated levels of CDAI did not significantly correlate with infertility.

Cross-sectional observational studies indicate that antioxidants from diets might diminish infertility risks. However, findings from MR studies do not confirm a causal connection. Additional prospective research is required to elucidate this association further.

Background This study aims to assess the global burden of female infertility from 1990 to 2040. Methods Data on disability-adjusted life years associated with female infertility were sourced from the Global Burden of Disease 2021 study. Generalized additive models were utilized to predict trends for the period spanning from 2022 to 2040. Results The global burden of female infertility is expected to increase significantly, with the age-standardized disability-adjusted life year rate projected to reach 19.92 (95% uncertainty interval (UI): 18.52, 21.33) by 2040. The projected estimated annual percentage change (EAPC) for the age-standardized disability-adjusted life year rate from 2022 to 2040 is expected to be 1.42, with a 95% confidence interval (CI) of 1.3951-1.4418. This is in contrast to the EAPC of 0.71 (95% CI: 0.5391-0.8789) observed from 1990 to 2021. Central sub-Saharan Africa is projected to have the highest age-standardized rate at 29.37 (95% UI: 24.58-34.16), whereas Australasia is expected to have the lowest at 0.78 (95% UI: 0.72-0.84). Age-specific projections show a consistent decline in infertility rates across all age groups. Countries such as Kenya, Chad and Peru exhibit EAPCs exceeding 9.00, whereas Mali and South Africa show significant negative EAPCs. Correlation analysis indicates that regions with a higher sociodemographic index generally have lower female infertility burdens, with notable trends observed in Europe and Asia. Conclusion The projected global burden of female infertility is expected to increase significantly from 2021 to 2040, with notable regional disparities. Central sub-Saharan Africa and south Asia are anticipated to experience higher burdens, whereas overall rates are projected to decrease across different age groups.

Both early and late age at menarche have been associated with various health issues and may influence the risk of infertility. This present study investigated the relationship between age at menarche and infertility risk.

This study follows PRISMA guidelines. Databases including PubMed, Scopus, Web of Science, Embase, and Cochrane were searched in December 2024. Odds ratios with 95% confidence intervals were estimated using a random-effects model. Heterogeneity was assessed with the I2 index and chi-square, and publication bias was evaluated using Egger's test and a funnel plot. Sensitivity analysis and meta-regression examined study impact and variable influence on heterogeneity.

Out of 7,267 articles screened, 18 primary studies were included, yielding 21 pieces of evidence. The odds ratio (OR) for infertility in the late menarche group compared to the normal menarche group was 1.44 (95% CI: 0.98-2.10), while the OR for the early menarche group versus the normal menarche group was 0.98 (95% CI: 0.68-1.42). Additionally, the OR for infertility in the early menarche group compared to the late menarche group was 0.77 (95% CI: 0.55-1.06). For primary infertility, the OR for the late menarche group relative to the normal menarche group was 1.98 (95% CI: 1.02-3.85), whereas the OR for the early menarche group compared to the late menarche group was 0.59 (95% CI: 0.36-0.97).

Although the overall meta-analysis lacked statistical significance, subgroup analysis revealed a notable association between late menarche and primary infertility. Women with late menarche had higher odds of infertility, supporting a dose-responsive relationship. The observed 44% increase in infertility odds highlights late menarche as a potential risk factor, warranting further investigation into its implications for reproductive health.

This study aims to explore the causal links between cytokines and four male reproductive disorders, namely abnormal spermatozoa (AS), male infertility, erectile dysfunction (ED), and hyperplasia of prostate (HP), employing a two-sample Mendelian randomization (MR) approach. Genetic associations with male reproductive diseases were derived from the IEU OpenGWAS project, with cytokine data from two GWASs focused on the human proteome and cytokines. Estimations were derived using inverse variance weighting, MR-Egger regression, weighted median, weighted model, and simple mode. Furthermore, the robustness of the findings was evaluated through Cochran's Q-test, MR-Egger regression, and leave-one-out sensitivity analysis. Fifteen unique cytokines were identified as having causal relationships with the risk of four male reproductive disorders. Specifically, for AS, interleukin-22 (IL-22), IL-12, and macrophage migration inhibitory factor were negatively correlated with AS, while tumor necrosis factor β levels were positively correlated with AS. In the context of male infertility, IL-2 receptor antagonist levels, IL-34, and granulocyte-colony stimulating factor levels were positively linked to male infertility, whereas IL-21 showed a negative relationship. Regarding ED, IL-19, IL-1β, and eotaxin levels were negatively associated with ED risk, while macrophage inflammatory protein 1β (MIP-1β) levels and interferon gamma-induced protein 10 levels were positively associated. As for HP, stromal-cell-derived factor 1α levels and MIP-1α levels revealed negative associations with HP. In conclusion, this MR analysis revealed that several cytokines were causally associated with male reproductive diseases and could be valuable in offering new insights for further mechanistic and clinical investigations of cytokines-associated male reproductive diseases.

To investigate the correlation between vitamin D levels and clinical pregnancy rates in infertile women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) procedures and to assess the utility of vitamin D levels in developing a predictive model for assisted reproductive technology (ART) outcomes.

A total of 188 infertile patients receiving their initial IVF or ICSI treatment at our reproductive center between June 2020 and July 2021 were selected for data collection. Vitamin D levels and other relevant ART-related factors were used to construct a predictive model.

The multivariate regression analysis revealed that several independent variables significantly impacted ART pregnancy outcomes, including infertility age, vitamin D level, reproductive anti-Müllerian hormone, antral follicle count, Gn dose, daily endometrial thickness after human chorionic gonadotropin (HCG) administration, and number of retrieved eggs. The area under the receiver operating characteristic curve for this comprehensive model was 75.34%, with a standard error of 0.045 and p-value of 0.003 (95% confidence interval 0.712-0965). Furthermore, the multivariate regression analysis identified specific independent variables that might influence vitamin D levels, such as the number of embryos obtained, daily endometrial thickness after HCG administration, and clinical pregnancy.

The developed predictive model integrating serum 25-Hydroxyvitamin D level and ART-related factors holds significant clinical value in forecasting pregnancy outcomes.

A wealth of evidence indicates that dyslipidemia is associated with endothelial dysfunction, oxidative stress, and inflammation, each of which can impair reproductive function and lead to infertility. The Atherogenic Index of Plasma (AIP) is an innovative lipid biomarker that combines the triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio, providing a more in-depth evaluation of lipid metabolism. This biomarker synthesizes discrete lipid disruptions into a single value, surpassing isolated lipid indicators' diagnostic value. The primary goal of our study was to explore the link between AIP and the incidence of infertility.

Data from the National Health and Nutrition Examination Survey (NHANES) spanning 2013-2018 were subjected to cross-sectional examination. The AIP is determined through the logarithmic transformation (base 10) of the triglyceride-to-HDL-C ratio. To uncover the connection between AIP and infertility, a suite of analytical techniques was employed, encompassing weighted multiple logistic regression, stratified analyses, spline curve modeling, and determination of cutoff values.

Among the 1,191 participants, with a weighted mean age of 31.89 years, 12.09% were diagnosed as infertile. The multivariate-adjusted odds ratios for infertility occurrence across the AIP quartiles were 1.00 (reference), 1.96 (95% CI: 1.10-3.49), 2.62 (95% CI: 1.48-4.63), and 2.38 (95% CI: 1.31-4.32), respectively. Subgroup examinations suggest that the association between AIP and infertility remains robust and is not substantially altered by factors including age, marital status, economic status, tobacco use, alcohol intake, and body mass index. Curve fitting and threshold analyses have indicated a positive nonlinear relationship between AIP and infertility, as well as a relatively stable incidence of infertility within the AIP range from -0.21 to 0.22.

Incorporating an assessment of AIP into the clinical evaluation could potentially refine the accuracy of risk estimation for infertility patients.

Recent studies have shown that disruptions in the nicotinamide adenine dinucleotide (NAD+) de novo synthesis pathway accelerate ovarian aging, yet its role in spermatogenesis remains largely unknown. In this study, we investigated the impact of the NAD+ de novo synthesis pathway on spermatogenesis by generating Qprt-deficient mice using CRISPR-Cas9 to target quinolinate phosphoribosyl transferase (Qprt), a key enzyme predominantly expressed in spermatocytes. Our results revealed that the deletion of Qprt did not affect NAD+ levels or spermatogenesis in the testes of 3-month-old mice. However, from 6 months of age onward, Qprt-deficient mice exhibited significantly reduced NAD+ levels in the testes compared to wild-type (WT) controls, along with a notable decrease in germ cell numbers and increased apoptosis. Additionally, these mice demonstrated mitochondrial dysfunction in spermatocytes, impaired progression through prophase I of meiosis, defective double-strand break (DSB) repair, and abnormal meiotic sex chromosome inactivation. Importantly, supplementation with the NAD+ precursor nicotinamide riboside (NR) in Qprt-deficient mice restored NAD+ levels and rescued the spermatogenic defects. These findings underscore the critical role of NAD+ de novo synthesis in maintaining NAD+ homeostasis and highlight its importance in meiotic recombination and meiotic sex chromosome inactivation in spermatogenesis.

Infertility affects millions worldwide, with a significant proportion of cases remaining unexplained. Recent evidence suggests a potential link between lipid metabolism and reproductive health, prompting investigations into novel biomarkers like the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) for assessing infertility risk.

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) to conduct a cross-sectional analysis of 5,524 women aged 20-45 in the United States. NHHR was calculated from lipid profiles, and infertility was determined via the Reproductive Health Questionnaire. Multivariate logistic regression and restricted cubic spline (RCS) analyses were performed to examine the relationship between NHHR and infertility, adjusting for confounding factors such as age, BMI (body mass index), and lifestyle habits.

The study found a nonlinear association between NHHR and infertility risk, with the risk peaking in the second and third quartiles of NHHR levels. Notably, women in the higher NHHR quartiles exhibited a 2.15 to 2.36 odds ratio for infertility compared to those in the lowest quartile, suggesting a significant increase in risk. Subgroup analyses revealed that this association was particularly strong in younger women and those with a higher BMI. Moreover, the RCS analysis confirmed the nonlinear pattern of the relationship, highlighting a more pronounced risk at moderate NHHR levels, which plateaued or varied at higher levels. The interaction analyses further suggested that the relationship between NHHR and infertility risk could be influenced by age and BMI, pointing to differential effects in various subpopulations.

Elevated NHHR levels are associated with increased infertility risk, especially in specific subgroups, suggesting a complex link between lipid metabolism and reproductive health. Further research is needed to validate these findings and explore the potential of NHHR as a biomarker for infertility risk.

Subtle uterine lesions are abnormal intracavitary conditions that, while not causing significant anatomical changes, can adversely impact fertility. Identifying these "subtle" lesions is challenging due to arbitrary interpretation, varied management strategies, unclear clinical significance, and insufficient clinician training in recognizing them. Hysteroscopy offers direct visualization and the capacity to obtain targeted biopsies, making it an invaluable tool for the diagnosis and treatment of these often overlooked conditions.

The lack of standardized and universally accepted terminology complicates the diagnosis and treatment of subtle uterine pathologies. A thorough understanding of how to identify and effectively manage these lesions is essential for the treatment of infertile patients. This review summarizes the critical and evolving subtle uterine lesions that clinicians frequently overlook during hysteroscopic procedures, highlighting the importance of accurate identification and its potential to improve reproductive outcomes.

This literature review followed the Scale for the Quality Assessment of Narrative Review Articles (SANRA) guidelines. All articles discussing infertility-related issues and subtle lesions diagnosable with hysteroscopy were deemed eligible for inclusion.

We identified several subtle uterine lesions that are often overlooked during routine hysteroscopic evaluations but can adversely impact fertility. These include morphological abnormalities such as the T-shaped uterus, cystic lesions of the uterine wall, adenomyosis, cervicitis, cervical and tubal endometriosis, and endometrial conditions such as chronic endometritis, thin endometrium and endometrial calcifications.

Effective diagnosis and treatment of subtle uterine lesions is essential to fertility care. Knowing which lesions are commonly missed and understanding their endoscopic features and potential clinical implications, is crucial for enhancing the diagnostic capacity of hysteroscopy. This, in turn, may improve reproductive outcomes and the overall quality of care of infertile patients.

To develop a predictive tool in the form of a Nomogram based on the Cox regression model, which incorporates the impact of the length of treatment cycles on the outcome of live birth, to evaluate the probability of infertile couples having a live birth after one or more complete cycles of In Vitro Fertilization (IVF), and to provide patients with a risk assessment that is easy to understand and visualize.

A retrospective study for establishing a prediction model was conducted in the reproductive center of Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital). A total of 4413 patients who completed ovarian stimulation treatment and reached the trigger were involved. 70% of the patients were randomly placed into the training set (n = 3089) and the remaining 30% of the patients were placed into the validation set (n = 1324) randomly. Live birth rate (LBR) and cumulative LBR (CLBR) were calculated for one retrieval cycle and the subsequent five frozen embryo transfer (FET) cycles. Proportional Hazards (PH) Assumption test was used for selecting the parameter in the predictive model. A Cox regression model was built based on the basis of training set, and ROC curves were used to test the specificity and sensitivity of the prediction model. Subsequently, the validation set was applied to verify the validity of the model. Finally, for a more intuitive assessment of the CLBR more intuitively for clinicians and patients, a Nomogram model was established based on predictive model. By calculating the scores of the model, the clinicians could more effectively predict the probability for an individual patient to obtain at least one live birth.

In the fresh embryo transfer cycle, the LBR was 38.7%. In the first to fifth FET cycle, the optimal estimate and conservative estimate CLBRs were 59.95%, 65.41%, 66.35%, 66.58%, 66.61% and 56.81%, 60.84%, 61.50%, 61.66%, 61.68%, respectively. Based on PH test results, the potential predictive factors for live birth were insemination method, infertility factors, serum progesterone level (R = 0.043, p = 0.059), and luteinizing hormone level (R = 0.015, p = 0.499) on the day initiated with gonadotropin, basal follicle-stimulating hormone (R = -0.042, p = 0.069) and BMI (R = -0.035, p = 0.123). We used ROC curve to test the predictive power of the model. The AUC was 0.782 (p < 0.01, 95% CI: 0.764-0.801). Then the model was verified using the validation data. The AUC was 0.801 (p < 0.01, 95% CI: 0.774-0.828). A Nomogram model was built based on potential predictive factors that might influence the event of a live birth.

The Cox regression and Nomogram prediction models effectively predicted the probability of infertile couples having a live birth. Therefore, this model could assist clinicians with making clinical decisions and providing guidance for patients.

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The association between male infertility and health status has yet to be unraveled. Here, by combining multiparameter phenotyping and scRNA-seq, we delineate the immune status of infertile men both at the semen and systemic levels. We first observe that young infertile men have a pro-inflammatory milieu with increased frequency of myeloid cells and inflammatory mediators in the seminal fluid and the peripheral blood, which are immune alterations typically observed in healthy elderly men. Transcriptomic profiling confirms the upregulation of genes associated with the interferon-gamma and -alpha responses in peripheral blood T cells of infertile men with oligo-astheno-teratozoospermia or non-obstructive azoospermia, with distinct T cell signatures of exhaustion and senescence discriminating the two infertile conditions. These findings provide evidence that subtypes of male infertility are characterized by specific immune signatures and unravel the potential link between infertility and the risk of developing secondary diseases.

Nearly 200 million people worldwide suffer from infertility. Disparities exist between developed and developing countries due to differences in the availability of infertility care, different reimbursement policies and socio-cultural differences surrounding procreation. In low- and middle-income countries, specialized infertility centres are either scarce or non-existent, mostly in private settings, and accessible only to the fortunate few who can afford them. The success and sustainability of ARTs will depend on our ability to optimize these techniques in terms of availability, affordability, and effectiveness. A low-cost, simplified IVF system has been developed and shown to be safe, cost-effective, and widely applicable to low-resource settings. Combined with inexpensive mild ovarian stimulation protocols, this could become a truly effective means of treating infertility and performing assisted reproduction at affordable prices, but only if such programmes are sincerely desired and supported by all relevant stakeholders. A receptive political, governmental, and clinical community is essential.

Growing evidence suggests that environmental pollutants exert a detrimental impact on female fertility. Among these pollutants, volatile organic compounds (VOCs), easily encountered in the environment, have garnered significant attention as prevalent airborne contaminants. Nevertheless, a definitive consensus regarding the association between VOCs and the incidence of infertility remains elusive.

Conducted as a cross-sectional study, this research utilized data from three survey cycles of the NHANES program spanning from 2013 to 2018. The objective was to delve into the relationship between volatile organic compounds and the prevalence of infertility. The definition of infertility relied upon information derived from the reproductive health questionnaire. In order to comprehensively explore this relationship, various analytical models, including logistic regression, weighted quantile sum (WQS), and Bayesian kernel-machine regression (BKMR), were employed.

A total of 1098 participants, 120 in the infertility group and 978 in the control group, were included. All 15 volatile organic compounds showed higher concentrations in the infertility group's urine. Multivariate regression revealed that the highest AMCC (N-acetyl-S-(N-methylcarbamoyl)-L-cysteine) and CYMA (2-hydroxyethyl mercapturic acid) quartiles associated with significant infertility increases, approximately 191 % and 128 %, respectively, versus the lowest quartile (OR for AMCC = 2.91; 95%CI: 1.33, 6.37; OR for CYMA = 2.28; 95%CI: 1.01, 5.15). This emphasizes AMCC and CYMA's role in infertility, supported by WQS and BKMR studies. Inflammation mediates AMCC's impact on infertility, enhancing our understanding of volatile organic compounds and reproductive health.

The study highlights the correlation between VOCs exposure, notably AMCC and CYMA, and infertility. It identifies inflammation as a mediating factor connecting AMCC to infertility.

The objective of this study was to measure the different redox biomarker levels within the follicular fluid (FF) and evaluate correlations with embryo quality using the one follicle-one oocyte/embryo approach. The prospective study included 54 women (average age 34.6 ± 3.0 years). Out of the 235 mature metaphase II cells that underwent intracytoplasmic sperm injection, fertilization was achieved in 177 cells, producing 92 Grade I embryos, 26 Grade II embryos, 39 Grade III embryos, and 20 Grade IV embryos. The activities of antioxidant enzymes, superoxide dismutase, glutathione peroxidase, and glutathione transferase were significantly higher in the group consisting of lower-quality (Grades II-IV) embryos in comparison with top-quality (Grade I) embryos (p = 0.011; p = 0.021; p = 0.008, respectively). The concentration of oxidative stress markers, malondialdehyde, 8-hydroxy-2'-deoxyguanosine, and thiol groups was significantly increased in the group with lower-quality embryos (Grades II-IV) compared to top-quality embryos (0.027; 0.018; 0.021, respectively). Furthermore, a significant positive correlation between each oxidative marker and the activities of antioxidant enzymes was observed (p < 0.001). According to our findings, the best embryos and, consequently, better in vitro fertilization outcomes are linked to low levels of oxidative stress and low antioxidant enzyme activity.

High parental age is associated with adverse birth and genetic outcomes, but little is known about fecundity in male offspring.

We investigated if high parental age at birth was associated with biomarkers of male fecundity in a large population-based sample of young men.

We conducted a study of 1057 men from the Fetal Programming of Semen Quality (FEPOS) cohort, a sub-cohort of sons born 1998-2000 into the Danish National Birth Cohort. Semen characteristics and reproductive hormone concentrations were measured in samples provided by the men 2017-2019. Testis volume was determined by self-measurement. Data on the parental age was drawn from registers. Adjusted relative difference in percentage with 95% confidence intervals were estimated for each outcome according to pre-specified maternal and paternal age groups (< 30 (reference), 30-34 and ≥ 35) as well as for combinations of parental age groups, using multivariable negative binomial regression models.

We did not observe consistent associations between parental age and biomarkers of fecundity, although sons of mothers ≥ 35 years had lower sperm concentration (-15% (95% CI: -30, 3)) and total sperm count (-10% (95% CI: -25, 9)). The analysis with parental age combinations showed lower sperm concentration with high age of the parents (both ≥ 35 years: -27%, 95% CI: -40, -19) when compared to the reference where both parents were below 30 years.

We found no strong association between higher parental age and biomarkers of fecundity in young men. However, we cannot exclude poorer semen characteristics in sons born by older mothers or with high age of both parents.

In recent years, In Vitro fertilization (IVF) science has grown by leaps and bounds in the field of assisted reproduction, helping millions of couples worldwide. The aim of this study is to examine the extent to which infertile women are willing to pay for IVF services in Greece.

Through the distribution of questionnaires, willingness to pay (WTP) is recorded according to IVF success rates, and the relationship between WTP and the respondents' demographic characteristics is analyzed. Subjects were divided into two groups according to age and were given a hypothetical scenario, according to the contingent valuation approach.

The majority of women were reluctant to pay the amount of money corresponding to the average cost of an IVF cycle in Greece. In particular, participants replied that the amount they would be willing to pay is only one-third of the indicative amount of €6000. Moreover, WTP is not influenced by the professional status or educational level of the participating women.

This study highlights the financial barriers many couples face when pursuing assisted reproduction. If the average cost of IVF were lower, infertile women would be willing to undergo more IVF cycles if necessary. This finding has important implications for the valuation of IVF services and the development of pricing policies to enhance affordability and accessibility. Policymakers must consider reforms that balance the cost of IVF with its societal benefits. By incorporating this aspect into pricing and policy decisions, Greece can improve the accessibility of IVF services and ensure equitable treatment opportunities for all concerned individuals.

Women in couples experiencing infertility are at heightened risk for intimate partner violence (IPV) from husbands and domestic violence (DV) from family. Couples experiencing infertility in Jordan, a patriarchal culture with high rates of IPV and DV, are particularly vulnerable. This article explores the gendered similarities and differences in the experiences of mental health, social support, exclusion, and IPV.

The objectives of this study are to understand both men and women's perspectives on their experiences of infertility and to develop intervention strategies to reduce IPV among married couples experiencing infertility.

This study is a descriptive, observational study.

Through quantitative surveys and in-depth qualitative interviews, we examined key themes including: challenges to mental health and well-being; reproductive health and fertility care-seeking; experiences of shame, isolation, and discrimination; coping skills; sources of support; and challenges within spousal and family relationships.

In this article, we analyze primary areas of gender discordance and discuss how gendered experiences can shape implementation of psychosocial support intervention programs to prevent IPV. Our findings provide important insight into facilitators and barriers to prevention of IPV in this vulnerable group.

We conclude that providing both women and men with culturally appropriate support during fertility treatment-seeking can improve psychosocial health and couple functioning and ultimately to reduce the occurrence of IPV in this vulnerable population.