Associations of urinary N, N-dimethylformamide metabolite concentrations with ovarian reserve and in vitro fertilization outcomes based on a prospective cohort study in China.

Heavy metals and human reproductive toxicity: Mechanisms, pregnancy outcomes, and mitigation strategies.

Bisphenol A and di-(2-ethylhexyl) phthalate are among the most widespread endocrine-disrupting chemicals (EDCs), widely present in consumer products and the environment. Preclinical studies have shown that these compounds and their metabolites may interfere with key reproductive processes, including folliculogenesis and steroidogenesis. However, translating these findings into clinical relevance remains challenging. Human studies have yielded conflicting results, with some suggesting associations between EDC levels and reduced ovarian reserve or poorer in vitro fertilisation outcomes, while others report no significant correlations. Differences in study design, population characteristics and exposure assessment contribute to this heterogeneity. Despite the current limitations, the topic warrants attention within reproductive medicine, particularly from a preventive perspective. While evidence remains inconclusive, raising awareness and considering lifestyle factors potentially linked to environmental exposures may be a reasonable step in clinical practice. Further studies are needed to clarify their clinical impact and to guide evidence-based reproductive care.

This study aimed to identify economically optimal nitrogen and phosphorus rates along with examining their synergistic effects and climate variables in Eastern Anatolia’s natural rangelands. Using data from a prior fertilisation trial, pooled regression models, descriptive statistics, and partial budget analysis were employed. Results indicated that nitrogen had a limited standalone impact but showed synergistic benefits when combined with phosphorus in moderate-to-good condition rangelands. While moderate-condition rangeland exhibited notable improvements, these were not statistically significant compared to poor-condition rangeland. Good-condition rangelands responded weakly to fertilisation, suggesting inherent productivity limits marginal gains. Economic analysis confirmed diminishing returns at higher input levels, supporting lower fertiliser rates in moderate rangeland. Optimal doses were determined as 90 kg·ha⁻¹ nitrogen and 40 kg·ha⁻¹ phosphorus for poor-condition rangelands, and 30 kg·ha⁻¹ nitrogen with 40 kg·ha⁻¹ phosphorus for moderate and good rangeland sites. Results also revealed that seasonal humidity, although only marginally significant, had a more pronounced effect than temperature or precipitation, highlighting its potential role as a moderating climatic variable in fertilisation outcomes. The study concludes that rangeland fertilisation strategies should be site-specific, balancing ecological context with economic feasibility. Prioritising poor-condition degraded rangelands may offer long-term restoration benefits, not necessarily for immediate economic returns, but for their potential in enhancing productivity recovery and ecological restoration towards historical benchmarks. Achieving resilient agricultural landscapes and sustainable outcomes requires adaptive fertilisation practices and continuous monitoring.

Objective: To characterize oocyte maturation status and investigate clinical factors influencing oocyte maturity in controlled ovarian stimulation cycles for in vitro fertilization (IVF). Materials and Methods: This retrospective descriptive study analyzed 139 IVF cycles utilizing a GnRH antagonist protocol at the Center of IVF and Tissue Engineering, Hanoi Medical University Hospital, between January 2023 and June 2024. Data regarding oocyte developmental stage, ovarian stimulation parameters, and fertilization outcomes were systematically collected and evaluated. Results: Mature oocytes at the metaphase II (MII) stage constituted 65.81 ± 17.92% of the total oocytes retrieved, whereas immature oocytes at the metaphase I (MI) and germinal vesicle (GV) stages accounted for 9.2 ± 11.18% and 6.88 ± 10.55%, respectively. The intracytoplasmic sperm injection (ICSI) rate was 69.36 ± 17.64%, with a corresponding fertilization rate of 88.29 ± 18.03%. Prolonged duration of infertility and lower initial doses of recombinant FSH were significantly associated with an increased proportion of immature oocytes (p = 0,001 and p = 0,022, respectively). In contrast, a longer duration of ovarian stimulation was positively correlated with higher oocyte maturation rates (p = 0,031). No statistically significant associations were observed between oocyte maturity and patient age, anti-Müllerian hormone (AMH) levels, body mass index (BMI), or serum concentrations of LH, estradiol, and progesterone at the time of trigger. Conclusion: The degree of oocyte maturation in IVF cycles appears to be influenced by modifiable clinical variables, particularly the duration of infertility, the initial FSH dosage, and the length of ovarian stimulation. Further large-scale studies are needed to elucidate the role of these factors in optimizing oocyte quality and enhancing clinical outcomes.

Background: Congenital kidney anomalies, such as horseshoe kidney and unilateral renal agenesis, are rare, occurring in 0.2% and 0.1% of live births, respectively. Vesicoureteral reflux, affecting 1-3% of children, is more common and often associated with recurrent urinary tract infections. Methods: During routine dissection of a whole-body donor, a rare case of a right-sided renal ectopia with suspected scrotal herniation was observed. The donor, a 108-year-old white male with a history of arrhythmia, lacked a left kidney with no evidence of nephrectomy. Results: The remaining kidney was ectopically located in the right iliac fossa, with its inferior pole terminating at the inguinal ligament. The parenchyma was embedded superiorly within the psoas major muscle and extended inferiorly into the scrotal sac. Fascial attachments to perinephric fat were observed, with the fat herniating into the scrotum. Within the scrotum, the perinephric fat and its fascial connections were fused with the right testicle, which had an elongated vas deferens. The kidney appeared to be fused, with evidence of a shared blood supply and ureter configuration consistent with a crossed fused renal ectopia. Conclusion: This study identifies a unique case of a pelvic kidney with perinephric fat herniation into the scrotum, immobilizing the kidney. It highlights the complex interplay between urinary and reproductive anatomy and underscores the importance of recognizing such variations. These can impact renal function, fertility and surgical outcomes. Greater awareness of these anomalies can improve diagnostic accuracy and inform clinical decision making.

Oral Intervention with Eurycoma longifolia and L-arginine to Male Rabbits Boosts Semen Characteristics, Metabolic Attributes, Reproductive Hormones, and Fertility Outcomes

(134) Clinical Outcomes of Pathologist-Guided Ex-Vivo Onco-TESE

Cryopreservation is a crucial technique for the long-term preservation of swine genetic resources. However, its efficiency remains limited by cryo-induced oxidative stress, which compromises sperm membrane integrity, mitochondrial function, and fertilizing capacity. Methyl gallate (MG), a naturally occurring polyphenolic antioxidant, has demonstrated strong free radical scavenging and lipid peroxidation inhibitory properties. This study aimed to evaluate the effects of MG supplementation on sperm quality and fertilization capacity during boar semen cryopreservation. Semen samples were cryopreserved in extenders containing different concentrations of MG (0, 10, 20, 30, and 50 µM). Post-thaw sperm quality, oxidative status, mitochondrial activity, apoptosis-related markers, and in vitro fertilization (IVF) outcomes were comprehensively assessed. The results showed that supplementation with 20 µM MG significantly improved post-thaw motility, viability, membrane and acrosome integrity, mitochondrial membrane potential, ATP content, and antioxidant capacity, while decreasing reactive oxygen species (ROS) and malondialdehyde (MDA) levels and reducing apoptosis (p < 0.05). Moreover, the expression of the anti-apoptotic protein BCL-2 was upregulated, whereas that of the pro-apoptotic protein BAX was downregulated. Sperm cryopreserved with 20 µM MG also exhibited a significantly higher IVF cleavage rate compared with the control group (p < 0.05). In conclusion, MG supplementation effectively enhanced boar sperm cryosurvival by maintaining membrane stability, improving mitochondrial function, and mitigating oxidative stress during freezing and thawing. These findings suggest that MG is a promising antioxidant additive for improving the efficiency of boar semen cryopreservation systems.

Background/Objectives: Recurrent pregnancy loss (RPL) is one of the most challenging conditions in reproductive medicine, particularly when no identifiable cause can be determined after diagnostic evaluation. Although the role of immunological dysregulation has been hypothesized, the implementation of immunotherapies in clinical practice is controversial due to inconsistent findings and methodological heterogeneity across studies. This systematic review aims to provide an overview of the main characteristics of existing research on the role of immunological interventions in relation to In Vitro Fertilization (IVF) outcomes in women with RPL. Given the marked inter-individual variability in immunological mechanisms among affected women, evaluating these treatments may help identify future directions for personalized reproductive medicine. Methods: A comprehensive bibliographic search was systematically conducted from inception to October 2025 across databases, including Medline, Embase, Scopus, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov. Studies were included if they evaluated the efficacy of immunological treatments in women with unexplained RPL, comparing IVF outcomes between case and control groups. Results: Six cohort studies were included, four retrospective and two prospective. The immunological treatments investigated were granulocyte colony-stimulating factor (G-CSF), intravenous intralipid (with or without prednisolone), and lymphocyte immunization therapy (LIT). Despite some promising results, particularly for G-CSF and LIT, the studies were limited by small sample sizes, heterogeneous diagnostic criteria for RPL, and inconsistent treatment protocols. Furthermore, not all IVF outcomes, such as implantation and biochemical pregnancy rates, were reported. Conclusions: Current evidence is insufficient to support the use of immunotherapy in clinical practice for improving IVF outcomes in women with unexplained RPL. The variability in study design, patient selection, and immunotherapy regimens hinders the ability to draw firm conclusions. Well-designed randomized controlled trials with standardized definitions and outcome measures are needed to determine whether and for whom immunological treatments may offer clinical benefit.

Endometriosis (EMs) is a common gynecological disorder frequently associated with infertility, yet the underlying immune mechanisms remain poorly understood. Sun's Bushen Huayu Formula (BSHYF) has been clinically applied to improve fertility in patients with EMs, but its immunological mechanism remains unclear. This study investigated whether BSHYF alleviates EMs-related infertility by modulating the Th1/Th2 cytokine balance. A total of 80 serum samples from women with or without EMs were analyzed and further stratified into pregnancy and infertility groups (n = 20 each). Levels of IFN-γ and IL-4 were measured by ELISA, and the IFN-γ/IL-4 ratio was calculated. In parallel, an EMs rat model was established and divided into four groups: control, EMs, EMs + BSHYF, and EMs + aspirin. After treatment, fertility outcomes were evaluated, and flow cytometry was performed to assess Th1 (IFN-γ+) and Th2 (IL-4+) lymphocyte proportions. Clinically, EM patients-particularly those with infertility-showed a significantly elevated IFN-γ/IL-4 ratio compared with controls. In the animal model, BSHYF treatment improved the pregnancy rate from 20% to 50% and effectively corrected the Th1/Th2 imbalance. Notably, BSHYF demonstrated a stronger immunoregulatory effect on Th1/Th2 cytokine balance than aspirin, accompanied by improved reproductive performance. These findings indicate that BSHYF may alleviate infertility associated with EMs by restoring Th1/Th2 cytokine homeostasis, providing new mechanistic insights into immunomodulation and supporting its therapeutic potential as a complementary approach for EMs-related infertility.

The uterine microbiome of in vitro fertilization (IVF) patients was analyzed using next-generation sequencing (NGS) targeting 16S rRNA. Lactobacillus spp. were examined, with a special focus on Lactobacillus iners. The effects of antibiotic therapy on pregnancy outcomes were investigated. A total of 257 IVF patients underwent endometrial microbiome testing. Patients were initially classified based on the percentage of Lactobacillus spp. into the Lactobacillus-dominant microbiome (LDM) group and the non-LDM group using a cutoff of 90%. Treatment was provided to non-LDM patients. Treated patients who improved on the second test were included in the Post-treatment group, and their pretreatment status was also examined. Lactobacillus was dominant in many IVF patients, but some patients showed Gardnerella or other bacteria associated with bacterial vaginosis. The treatment improvement rate for the non-LDM group was 81.4%, with an equivalent or better pregnancy success rate compared with the LDM group. The effect on pregnancy outcomes of Lactobacillus may differ by species, with L. crispatus and L. gasseri tending to act positively, whereas L. iners at ≥ 74.2% acts negatively. This study shows that the recovery of an LDM in non-LDM IVF patients improves the composition of the endometrial microbiome, and pregnancy outcomes approach those of patients initially having an LDM. Furthermore, in LDM cases, L. iners species were also associated with lower pregnancy rates. These findings suggest that both the presence and type of Lactobacillus species are important for IVF success and that targeted microbiome treatment may improve reproductive outcomes.

Abnormal uterine bleeding (AUB) represents a notable sign for benign and malignant uterine pathology. Differentiating adenomyosis from leiomyoma via hysteroscopy aids in selecting appropriate surgical or medical management. Accurate diagnosis is crucial for optimizing fertility outcomes and symptom control. The current study evaluated the diagnostic accuracy of hysteroscopy in differentiating between uterine adenomyosis and leiomymatosis. In addition to; compare between continuous versus intermittent administration of Norethissterone to control both uterine adenomyosis and leiomymatosis. A total of 100 premenopausal women present with AUB. History takin and clinical evaluation was done. All women were subjected to hysteroscopy. Two regimens were used by Norethindrone administration the 1st regimen as continuous manner from day 5 to day 21 46 patients (46%). The 2nd manner was the intermittent type from day 16 and for 10 days 54 patients (54%). Roc-curve of hysteroscopy usage to predict diagnosis; adenomyosis sensitivity was 73.33% and specificity 95.29% and fibroid sensitivity was 73.33% and specificity was 97.65%. Both groups of therapy revealed; highly significant decrease in follow up menorrhagia in continuous Norethindrone group (P < 0.001).By using ROC-curve analysis; Norethindrone administration predicted decreased menorrhagia pain with AUC was 0.973. Hysteroscopy has effective role in differentiating between adenomyosis and fibroids. Yet, long term follows up of abnormal uterine bleeding cases with large sample size in future research are still warranted.

To evaluate the oncological and reproductive outcomes of patients with ovarian sex-cord stromal tumors (SCSTs) treated with fertility sparing surgery (FSS). This retrospective study included patients diagnosed with malignant ovarian SCSTs between February 2007 and June 2020 at Başkent University Hospital, Ankara. All patients underwent FSS, which preserved at least one ovary and the uterus. Data on demographics, surgical and pathological features, adjuvant treatments, follow-up, recurrence, survival, and obstetric outcomes were collected. Follow-up continued until September 2025, with survival analyses performed using Kaplan-Meier and Cox regression methods. The median age of the 35 included patients was 29.0 years, with a median follow-up of 141.0 months. Recurrence occurred in 17.1%, and disease-related mortality was 8.6%. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 85.7% and 97.1%, respectively. No significant factors influenced DFS, while adjuvant therapy impacted OS in univariate analysis. All patients maintained regular menstrual cycles post-treatment. Nine patients conceived (36.0%), resulting in 12 pregnancies and 6 live births (50.0%). Chemotherapy did not significantly affect fertility outcomes. FSS in patients with ovarian SCSTs demonstrated favorable oncologic and reproductive outcomes. Larger, prospective multicenter studies are necessary to optimize management strategies and establish definitive guidelines for fertility preservation in this patient population.

Association of bisphenol A exposure with in vitro fertilization outcomes: A meta-analysis and systematic review.

Individualized strategies and future perspectives of high-intensity focused ultrasound combined with pharmacological treatment for adenomyosis-associated infertility: A narrative review.

A health-based recommended occupational exposure limit for isoflurane and sevoflurane using experimental animal data based on a systematic review and dose-response analysis.

Effect of voluntary waiting period length on milk yield, fertility, and culling in high-yielding, second-parity cows.

Predictors of reproductive outcomes in seasonal-calving, pasture-based lactating dairy cows.

Novel genetic variants of sperm chromatin compaction regulators are associated with non-obstructive azoospermia in Indian men.