Background: Despite advances in assisted reproductive technology, predicting in vitro fertilization (IVF) success remains challenging. Objectives: This study aimed to investigate the relationship between endometrial receptivity biomarkers and Ovarian Sensitivity Index (OSI) as predictors of IVF outcomes. Materials and methods: A total of 72 women undergoing IVF treatment, between December 2023 and July 2024, participated in this study. Serum levels of MUC1, GDF-9, and HLA were measured, OSI was calculated, and pregnancy outcomes (β-hCG) were recorded. Participants were divided into two groups based on OSI (≤4 and >4), and biomarker levels were compared. Correlation analysis, ROC curves, and logistic regression models were used to assess predictive capabilities. Results: OSI showed strong predictive value (AUC=0.751, 95% CI: 0.613-0.859, p<0.05) with a threshold of >8 (sensitivity=52.63%, specificity=94.12%). Endometrial biomarkers showed limited individual predictive capacity (AUCs: MUC1=0.625, GDF-9=0.507, HLA=0.589). OSI retained significant association with pregnancy outcomes across all regression models (OR=1.19-1.38, p<0.05). Combining hormonal parameters with OSI significantly improved model performance (AUC=0.867, R²=0.509). Significant correlations were observed between OSI and hormonal parameters, particularly AMH (r=0.66, p<0.05) and E2 (r=0.49, p<0.05). Conclusion: While endometrial receptivity biomarkers showed limited individual predictive value, the incorporation of OSI with hormonal parameters provides better predictive value of IVF outcomes, suggesting the importance of a comprehensive assessment in assisted reproduction.

Maternal cortisol may influence pregnancy outcomes, including preterm birth (PTB), though evidence remains inconsistent. To investigate the association between early pregnancy cortisol, perceived stress, and adverse pregnancy outcomes. A prospective cohort study. Of 432 multigravida women categorized by prior PTB history (high-risk vs. low-risk), 202 were analyzed who were at 11-13 gestational weeks with standardized afternoon saliva collection (14:00-18:00). Saliva samples and stress questionnaires were collected. Pregnancy outcomes were compared between women with high and low salivary cortisol levels. Mean salivary cortisol levels were compared between high- and low-risk groups, as well as between women with and without selected pregnancy complications. High-risk women had significantly higher mean cortisol (0.193 μg/dL vs. 0.144 μg/dL, p-value = 0.004). and 3.29-fold higher odds of elevated cortisol (aOR = 3.29, 95% CI: 1.55-6.96, p-value = 0.002). PTB rates were 21.4% in high-risk vs. 3.5%in low-risk women (p-value<0.001), high cortisol levels were not significantly predictive of current PTB in multivariable models (p-value = 0.099), despite high odds ratios (3.14). However, high cortisol levels were significantly associated with gestational hypertension (GHTN) (100% vs. 23.5%, p-value = 0.014) and fetal malformations (62.5% vs. 23.1%, p-value = 0.024). No association was found between perceived stress and cortisol levels. Early pregnancy cortisol is significantly elevated in women with a history of PTB, reflecting HPA axis dysregulation. While not a reliable predictor for recurrent PTB at 11-13 gestational weeks, high cortisol is associated with GHTN and malformations, suggesting it may serve as a marker for specific adverse outcomes.

Women with pre-existing diabetes remain at increased risks of adverse pregnancy complications. Optimising glycaemic control before and during pregnancy could reduce risk but data from Asian countries are limited. This study evaluates maternal glycaemia, management strategies and pregnancy outcomes in women with diabetes in a multiethnic cohort. We retrospectively studied pregnancies with pre-existing diabetes or prediabetes at a Singapore tertiary hospital from 01/01/2022 to 31/12/2024. Maternal data and pregnancy outcomes were analysed by diabetes subtype. Multivariate logistic regression identified factors linked to adverse outcomes, including fetal overgrowth (macrosomia and large-for-gestational-age [LGA]) using local birthweight standards. Of 289 pregnancies (75.8% Type 2 diabetes mellitus [T2DM], 19.0% prediabetes, 5.2% Type 1 diabetes mellitus [T1DM]), median maternal age was 33 years and pre-pregnancy body mass index (BMI) was 29.3 kg/m2. HbA1c improved from 7.0% to 6.1% across trimesters (p < 0.00). Macrosomia (≥ 4 kg) occurred in 4.2% of infants, while preterm birth was more frequent in T1DM (33.3%) than in T2DM (5.0%) or prediabetes (1.8%). Retinopathy screening was completed in 67.6% of patients and continuous glucose monitoring (CGM) or pump devices were not utilised. Using Singapore LGA reference, third trimester HbA1c < 6.5% was associated with lower odds of LGA. Multidisciplinary care enhanced glycaemic control and reduced macrosomia, but women with T1DM remain at increased risk of preterm delivery and neonatal morbidity. Enhanced preconception care, retinopathy screening and adoption of real-time CGM may improve outcomes in Asian women with pre-existing diabetes in pregnancy.

Environmentally relevant low-dose bisphenol A enhances invasion of human extravillous trophoblasts with associated increases in MMP activity.

Unexplained recurrent spontaneous abortion (URSA) remains a prevalent obstetric issue, the underlying causes of which are still not fully understood. MicroRNAs (miRNAs) have the potential to influence URSA through their regulation of gene expression. This study aimed to screen key miRNAs and to verify their regulatory roles and potential molecular mechanisms in URSA. Differentially expressed miRNAs and mRNAs in URSA were identified using GEO datasets (GSE178619 and GSE113790). Weighted gene co-expression network analysis (WGCNA) was performed to identify hub miRNAs and mRNAs, followed by construction of a miRNA-mRNA interaction network. Functional enrichment was analyzed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. An oxidized low-density lipoprotein (OX-LDL)-induced trophoblast cell model was established after concentration screening, and gain- and loss-of-function experiments involving miR-146a/b-5p and IRAK1 were conducted to evaluate cellular functions. The targeting relationship between miR-146a/b-5p and IRAK1 was examined using dual-luciferase reporter assays. Invivo, a URSA mouse model was constructed, and lentiviral overexpression of miR-146a/b-5p was applied to assess pregnancy outcomes and NF-κB pathway-related molecular changes. Results showed that GSE178619 identified 34 differentially expressed miRNAs, while GSE113790 revealed 1056 differentially expressed mRNAs. WGCNA highlighted the MEbrown module (112 hub miRNAs) and the MEdarkorange module (673 hub mRNAs) as closely associated with URSA. Eighteen core miRNAs, including miR-146a/b-5p, and 21 core genes, including IRAK1, were identified, with IRAK1 upregulated in URSA and linked to the NF-κB signaling pathway. Invitro, OX-LDL treatment impaired trophoblast cell proliferation and invasion, promoted apoptosis and oxidative stress, reduced miR-146a/b-5p expression, and activated NF-κB signaling through IRAK1. Overexpression of miR-146a/b-5p alleviated these alterations, whereas inhibition of miR-146a/b-5p produced opposite effects that were partially reversed by IRAK1 knockdown. In URSA mice, miR-146a/b-5p overexpression improved pregnancy outcomes, alleviated placental pathological changes, reduced IRAK1 expression, and attenuated NF-κB pathway activation. Together, miR-146a/b-5p regulates URSA progression by targeting IRAK1 and modulating the NF-κB signaling pathway, suggesting its potential as a therapeutic target for URSA.

Navigating Pregnancy With Primary Glomerular Disease: Experience From a Lower-Middle-Income Country.

Integrating Reproductive and Clinical Variables to Predict Postpartum Disability Outcomes in Multiple Sclerosis Using Machine Learning.

The relationship between maternal glucose concentrations, gestational diabetes mellitus, and adverse fetal growth and gestational age outcomes: a retrospective cohort study.

(i) To evaluate longitudinal changes in urine nephrin to creatinine ratio (NCR) throughout gestation in women with pre-existing diabetes; (ii) To evaluate the association of NCR with diabetic nephropathy and pregnancy outcomes including preeclampsia. A prospective cohort study of 158 pregnant women with pre-existing diabetes was conducted. Changes in urinary nephrin, protein, albumin and creatinine were assessed serially during pregnancy at four time points. The association with diabetic nephropathy and pregnancy outcomes was investigated by linear mixed effects models. Spearman's rank correlation was used to assess the correlation of NCR with protein/albumin to creatinine ratio (PCR/ACR). NCR increased from early to late pregnancy (p < 0.05); however, there was no significant difference in NCR between those with and without preeclampsia irrespective of gestational age. Women with diabetic nephropathy had 3.48 times greater [1.38-8.77] NCR at 14 weeks compared to those without (p < 0.01), although this was not sustained in late pregnancy. NCR was positively associated with PCR through pregnancy (p < 0.01) and with ACR at 14 and 30 weeks (p < 0.05); however, the associations were weak. While all women with diabetes show a gradual increase in NCR during pregnancy, it was not a useful marker in predicting preeclampsia. However, higher NCR was indicative of kidney damage in the first trimester and could potentially be useful for monitoring diabetic nephropathy.

Does frozen embryo transfer improve pregnancy outcomes in patients with ovarian endometriosis? A retrospective cohort study.

Preeclampsia is a pregnancy-specific condition affecting 2%-8% of pregnant females and a leading cause of maternal and perinatal morbimortality. High ultraprocessed food (UPF) consumption has been associated with the development of noncommunicable chronic diseases, but evidence on pregnancy outcomes is scarce. To study the association of maternal UPF consumption and the risk of preeclampsia. This study is a secondary analysis of the IMPACT BCN, a randomized clinical trial including 1221 pregnant females at high risk for small for gestational age newborns, conducted in Barcelona, Spain. Among these, 812 participants with complete dietary data at 2 timepoints during pregnancy (between weeks 19-23 of gestation and weeks 34-36 of gestation) were included in this analysis and classified into tertiles of change in UPF consumption during pregnancy. Dietary UPF consumption was assessed using NOVA classification with a validated 151-item food frequency questionnaire. Preeclampsia was defined as high blood pressure plus targeted organ involvement. Analyses were performed using logistic regression models adjusted for potential confounding factors. Associations between change of UFP consumption during pregnancy and overall preeclampsia were observed across tertiles [odds ratio (OR)T3 compared with T1: 2.29; 95% confidence interval (CI): 1.06, 4.97, P-trend 0.026], but not when UPF change was modeled as a continuous variable [OR: 1.04; 95% CI: 0.95, 1.14]. Among UPF subclasses, pre-prepared dishes were significantly associated with preeclampsia risk [ORT3 compared with T1: 2.36; 95% CI: 1.09, 5.12]. In a high-risk population, a higher change in dietary intake of UPF consumption from the second to third trimester of pregnancy was associated with a higher risk of preeclampsia. This trial was registered at clinicaltrials.gov as NCT03166332.

Prenatal phenotypes and pregnancy outcomes of fetuses with 17p12 microdeletions and microduplications.

Given the persistently high rates of adverse pregnancy outcomes (APOs) in women with antiphospholipid syndrome (APS) despite standard therapy, updated guidance is needed to support individualized care. This review summarizes current understanding of the obstetric management of APS, including pathogenic mechanisms, preconception evaluation, pregnancy management, and emerging therapeutic approaches. Recent studies reinforce the central role of inflammation, rather than thrombosis alone, in APS-related pregnancy morbidity. This evolving paradigm has prompted interest in immune-modulating strategies alongside conventional treatment. Early prospective data suggest that TNF-α inhibition may significantly reduce APOs in pregnant women with APS. Animal studies demonstrate immunomodulatory effects of statins at the maternal-fetal interface, although human evidence regarding statins remains limited. Updated clinical recommendations also clarify management surrounding assisted reproductive technology, emphasizing the importance of preconception antiphospholipid antibody screening and risk-based thromboprophylaxis to mitigate complications during ovarian stimulation and early pregnancy. Obstetric APS remains a major cause of maternal-fetal morbidity. Advances in understanding placental inflammation have expanded potential therapeutic targets, but standardized treatment remains limited. Optimal care requires risk-stratified, multidisciplinary management and further research to improve pregnancy outcomes.

Pregnancy after bariatric surgery: persistent obesity and longer time to conception influences peripartum outcomes more than the type of operation.

To explore the ultrasound findings, treatment strategies, and reproductive outcomes in patients with recurrent cesarean scar pregnancy (CSP), providing evidence for clinical management. We identified 1371 confirmed CSP from 1517 initially screened cases (2012-2022) through blinded image review. From 159 subsequent live births in this cohort, 27 recurrent CSP cases were matched 1:1 with CSP patients having normal subsequent pregnancies. Baseline characteristics and reproductive outcomes were collected via medical records and structured interviews. This study revealed the recurrent CSP group showed significantly higher rates of exogenous implantation pattern (33.3% versus 7.4%, OR = 1.96), rich vascularity on color Doppler (81.5% versus 40.7%, OR = 2.80), and embryonic cardiac activity detection (51.9% versus 18.5%, OR = 1.98) than the normal intrauterine pregnancy group after CSP (p < .05) during initial diagnosis. The most commonly used treatment at our hospital is trans-abdominal ultrasound-guided suction curettage, which effectively controls the condition and preserves fertility. However, during long-term follow-up, some patients still face the risks of recurrence infertility. Recurrent CSP presents characteristic sonographic features at initial diagnosis, among which an exogenous implantation pattern, rich vascular flow signals, and embryonic cardiac activity serve as relevant and significant indicators. Although transabdominal ultrasound-guided suction curettage is effective in managing the condition and preserving fertility, some patients still face long-term risks of recurrence and infertility.

Arboviral burden among pregnant women with HIV coinfection in sub-Saharan Africa remains inadequately characterised. To assess arboviral seroprevalence using IgG and IgM antibodies to distinguish historical exposure from relatively recent infection among Nigerian women. We conducted a cross-sectional serosurvey (December 2020-November 2023) across three Nigerian regions representing distinct ecological zones, recruiting 619 women: HIV-positive pregnant (n = 207), HIV-negative pregnant (n = 207), and HIV-positive non-pregnant (n = 205). Arboviral IgG and IgM antibodies against chikungunya virus (CHIKV), dengue virus (DENV), Zika virus (ZIKV), and other flaviviruses were detected using immunoblot assays, with plaque reduction neutralisation testing (PRNT) performed on a subset of 150 samples to support virus-specific interpretation. IgG seropositivity was highest for CHIKV (42.2%), followed by DENV (27.1%) and ZIKV (13.6%). IgM seropositivity, indicating relatively recent infection, was observed for CHIKV (14.1%), DENV (9.0%), and ZIKV (4.5%). All IgM-positive individuals were also IgG-positive; overall seroprevalence patterns suggest both endemic transmission and infections occurring at different time points within a previously exposed population. Northern regions showed significantly higher odds of CHIKV IgM (aOR 2.13, 95% CI: 1.18-3.87) and ZIKV IgM (aOR 4.71, 95% CI: 1.53-14.49) seropositivity. Among pregnant women, CHIKV IgM seropositivity was associated with higher odds of preterm birth, while other birth outcome associations should be interpreted cautiously given limited power and the cross-sectional design. PRNT identified samples with predominant virus-specific neutralising patterns, while others showed evidence consistent with multiple flavivirus exposures. Substantial arboviral exposure exists across Nigerian populations, with evidence consistent with ongoing endemic transmission. Dual serology supported by PRNT helped distinguish remote exposure from relatively recent infection, but does not precisely date infection timing. These findings support enhanced surveillance and prospective pregnancy studies incorporating molecular diagnostics (e.g., RT-PCR) to better define the impact of arboviral infection on pregnancy and birth outcomes.

Men's exposure to ambient air pollution and in vitro fertilization outcomes among an infertility treatment population.

Cell migration and adhesion in autophagy-induced damage of human trophoblast cells.

The duration of endometrial edema has been positively correlated with uterine receptivity and likelihood of pregnancy. Therefore, this study aimed to evaluate whether there is a relationship between the duration of endometrial edema (DEdema) and other key parameters of the estrous cycle: maximum edema (MEdema), largest follicle diameter (LPF), corpus luteum and uterine tone on day 5 post ovulation (CLD5 and TD5), progesterone concentration (P4) and fertility. A total of 88 cycles from 36 mares were evaluated and divided into Short Estrus (SE), Long Estrus (LE), Inseminated (AI) and Non-inseminated (N-AI) groups. In addition, AI group was divided into pregnant (P) and non-pregnant (N) mares. From the detection of a dominant follicle and uterine edema ≥1.5, mares were monitored daily until ovulation (D0). Data on dominant follicle diameter and endometrial edema were recorded. On D5, CL size and uterine tone were assessed and blood was collected for P4 measurement. Of all cycles, 30.7% (27/88) were SE and 69.3% (61/88) LE. Correlations were observed between DEdema and the variables: LPF (P = 0.001; r = 0.32), MEdema (P = 0.002; r = 0.31), and TD5 (P = 0.01; r = 0.28). Furthermore, DEdema was associated with a higher probability of a positive pregnancy outcome (OR= 1.45; P= 0.049) and pregnancy rates were higher (P=0.006) in LE group (67.5%) than SE (16.6%). In conclusion, the duration of endometrial edema was positively associated with key estrous cycle parameters, as well as fertility.

Mapping fear of childbirth and the role of family support in pregnant women: A network approach.