Pregnancy Rate Research Articles

Disparities in Diabetes in Pregnancy and the Role of Social Determinants of Health.

The rates of diabetes in pregnancy (type 1, type 2, and gestational diabetes) are increasing. Diabetes in pregnancy is associated with increased risk for maternal and neonatal complications. Certain groups are disproportionately affected by these complications and this paper reviews the data about disparities in diabetes in pregnancy and explores the social determinants of health (SDoH) underlying these disparities. Rates of diagnosis of gestational diabetes and pregestational diabetes are higher in racial and ethnic minority groups and people with socioeconomic disadvantage. There is higher all cause maternal mortality for Black people compared to White people. Emerging data suggests higher risk for adverse pregnancy outcomes for Black, American Indian, and Hispanic/Latina subjects with diabetes compared to White subjects. Individuals living in neighborhoods with higher poverty and less educational attainment also have higher rates of pregnancy and neonatal complications with diabetes. Diabetes in pregnancy is a complex condition which requires specialty care that can be time-consuming and costly. Individuals with disadvantages in income and employment, food security, social protection and support, and access to affordable and quality health services may be particularly susceptible to adverse outcomes of diabetes in pregnancy. Providers can reduce disparities by recognizing individuals with vulnerabilities in SDoH and tailoring treatment to social context. Equitable access to diabetes technology and postpartum care can also reduce disparities in outcomes.

Effects of levonorgestrel-releasing intrauterine system on recurrence and fertility outcomes during assisted reproduction after complete remission of early endometrioid endometrial cancer and precancerous lesions: A retrospective cohort study.

To investigate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) on recurrence and fertility outcomes during controlled ovarian stimulation (COS) in patients with early stage endometrioid endometrial carcinoma (EEC) and endometrial atypical hyperplasia (EAH) following successful fertility-preserving treatment. We reviewed the patients with Grade 1 presumed Stage IA EEC or EAH who underwent in vitro fertilization and embryo transfer after successful fertility-sparing treatment. A total of 176 women were enrolled in this study, undergoing 318 cycles of COS and 290 cycles of embryo transfer (ET). Twenty-one percent (37/176) patients have an LNG-IUS insertion during the initial ovarian stimulation, and the median follow-up time for this cohort was 61.3 months (interquartile range [IQR], 39.0-76.6 months), while it was 60.5 months for the other cohort (IQR, 44.9-80.3 months). Disease recurrence was experienced by 34.7% (61/176) of the patients. Compared to the non-LNG-IUS group, the LNG-IUS group had a lower recurrence rate 1 year after COS (5.4% (2/37) versus 20.9% (29/139), p = .034). The use of LNG-IUS was associated with a reduced recurrence rate 1 year after COS (hazard ratio = 0.203, 95% confidence interval [0.042-0.984], p = .048). The overall clinical pregnancy rate reached as high as 65.3% (115/176), while the cumulative live birth rates were up to 46.6% (85/176). We found that LNG-IUS during COS did not impact oocyte yield, ET, or pregnancy outcomes. The placement of LNG-IUS during COS in EEC/EAH patients is worth considering, as it is likely to reduce the recurrence of endometrial lesions without affecting fertility outcomes.

Comparison of the euploidy rate in preimplantation genetic testing for aneuploidy cycles following progestin-primed versus gonadotropin-releasing hormone antagonist protocol: a randomized controlled study

BackgroundProgestins can block endogenous luteinizing hormone secretion from the pituitary gland and have shown similar efficacy in terms of collecting competent oocytes and embryos; however, some inconsistencies have been proposed by the previous papers regarding the quality of oocytes and embryos obtained with the use of progestins. This study aimed to compare the euploidy rate between women treated with progestin-primed ovarian stimulation (PPOS) and the gonadotropin-releasing hormone (GnRH) antagonist protocol.MethodsThis is a prospective randomized study of 240 infertile women undergoing PGT-A between August 2021 and July 2023. Infertile women with advanced maternal age (38–45 years), recurrent pregnancy loss (≥ 2 or 3 consecutive miscarriages), and repeated implantation failure (≥ 4 embryos replaced or ≥ 2 blastocysts replaced without success) undergoing PGT-A cycles were included. Women were randomly assigned into the PPOS group (n = 120) or the antagonist group (n = 120) according to a computer-generated randomization list. Dydrogesterone 20 mg per day was given from the start of ovarian stimulation until the trigger day in the PPOS group. In the antagonist group, an antagonist 0.25 mg was given daily from the sixth day of ovarian stimulation until the trigger day. The primary outcome measure was the euploidy rate, defined as the number of euploid blastocysts per injected oocyte.ResultsNo significant differences were observed in the demographic and ovarian stimulation characteristics between the two groups. The euploidy rate was comparable between the PPOS and antagonist group (12.5% vs. 16.0% respectively, P > 0.05). No significant differences were observed between the two groups in positive pregnancy test, clinical pregnancy, miscarriage, ectopic pregnancy, or live birth rates per transfer in the first frozen embryo transfer cycles.ConclusionBoth PPOS and antagonist protocols had similar euploidy rates in PGT-A cycles.Trial registrationClinicaltrials. gov identifier: NCT04989348 (https://www.clinicaltrials.gov/). Trial registration date: Clinicaltrials. gov: 30 July 2021.

Sexual Health of US Transgender Boys, Nonbinary Youth, and Cisgender Girls.

Research documenting the pregnancy experiences of transgender boys and nonbinary youth assigned female at birth (AFAB) in the US is lacking. To examine AFAB youth sexual health indicators by gender. Self-reported data were collected cross-sectionally from 2018 through 2020. Initial analyses were conducted in 2023 and analyses were finalized in September 2024. The study took place online, across the 50 US states and Washington, DC. Eligible participants were 14 to 16 years old, read English, and had internet access. Sexual health (ie, self-reported pregnancy and sexually transmitted infections [STIs] lifetime prevalence, condom use, and use of other forms of birth control at last penile-vaginal or penile-anal sex). Based on weighted data (sample sizes are unweighted), 2109 cisgender girls, 348 transgender boys, and 458 nonbinary AFAB youth were included in analyses. There were 44 transgender boys (14%; 95% CI, 9.4-20.1; P = .24), 67 AFAB nonbinary youth (14%; 95% CI, 10.8-18.8; P = .18), and 397 cisgender girls (18%; 95% CI, 16.0-19.7) who reported ever having penile-vaginal sex. Rates for penile-anal sex were also similar by gender (4% to 6%). Lifetime pregnancy rates were higher for transgender boys (5 [9%]; 95% CI, 2.7-27.1; P = .23) than cisgender (18 [4%]; 95% CI, 2.5-7.1) girls, although not statistically significantly so. Pregnancy rates were similar for AFAB nonbinary youth (5 [5%]; 95% CI, 1.9-13.3; P = .73) compared with cisgender girls. Lifetime STI rates were universally low for all AFAB youth (0.5% to 2.0%). Mean age at first penile-vaginal sex was lower for AFAB nonbinary youth (mean age, 13.6 years; SE, 0.4; P = .003) and transgender boys (mean age, 13.9 years; SE, 0.3; P = .06) compared with cisgender girls (mean age, 14.4 years; SE, 0.1). Condom use at last penile-anal or penile-vaginal sex for transgender boys (24 [16%]; 95% CI, 9.5-27.0; P < .001) and AFAB nonbinary youth (33 [24%]; 95% CI, 16.4-34.2; P < .001) was half that of cisgender girls (245 [49%]; 95% CI, 44.1-54.2). Use of birth control other than condoms at last sex was lower for AFAB nonbinary youth (18 [28%]; 95% CI, 16.2-44.5; P = .14), but similar for transgender boys (20 [42%]; 95% CI, 23.4-62.4; P = .69) compared with cisgender girls (167 [44%]; 95% CI, 38.6-50.0). In this cross-sectional study of sexual health among AFAB youth with a diversity of gender identities, transgender boys were more likely, and nonbinary youth, similarly likely, as cisgender girls to be pregnant during adolescence. Even though overall rates of penile-vaginal sex were similar for transgender boys and AFAB nonbinary youth compared with cisgender girls, half as many transgender boys and AFAB nonbinary youth who had this type of sex used a condom at last sex compared with cisgender girls. As with cisgender girls, transgender boys and AFAB nonbinary youth need to be engaged in affirming and inclusive sexual health education.

Impact of GnRH agonist trigger on subsequent follicular phase length in ART cycles.

Does the use of GnRH agonist trigger versus hCG trigger affect the length of the subsequent follicular phase in women? A retrospective cohort study analyzing 196 women undergoing controlled ovarian stimulation with freeze-all for PGT-M at a university-affiliated fertility center; 132 received GnRH agonist trigger, and 64 received hCG trigger. The GnRH agonist group demonstrated a significantly longer subsequent follicular phase compared to the hCG group (18.98 ± 3.54 vs. 16.06 ± 3.13days, P < .001), with extended follicular phase occurring in 90.2% versus 60.9% of cycles (P < .001). Both groups had comparable antral follicle counts (14.52 ± 7.71 vs. 13.00 ± 15.36, P = .748). Multiple regression analysis identified GnRH agonist trigger as a significant independent predictor of subsequent follicular phase length (coefficient = 4.552, 95% CI: 3.058-6.045, P < .001), along with BMI (coefficient = 0.188, 95% CI: 0.019-0.357, P = .030). The model explained 31.4% of the variance in follicular phase length (F = 7.516, P < .001). After adjusting for confounding variables, pregnancy rates were comparable between groups (OR = 1.763, 95% CI: 0.798-3.505, P = .173). The GnRH agonist trigger prolongs the subsequent follicular phase compared to the hCG trigger without compromising pregnancy rates. BMI showed a statistically significant but modest association with follicular phase length that requires further validation. These findings have important implications for optimizing the timing of frozen embryo transfer in subsequent cycles and may facilitate more personalized monitoring protocols.

The Relationship Between Obesity, Bariatric Surgery, and Infertility: A Systematic Review

Background: Obesity is a complicated, chronic condition that has a major impact on reproductive health, leading to infertility, anovulation, and poor pregnancy outcomes. It alters the hypothalamic–pituitary–ovarian (HPO) axis, promotes insulin resistance, and causes persistent low-grade inflammation, all of which result in hormonal abnormalities that compromise normal ovarian function. Because standard weight loss procedures frequently fail to provide significant and long-term reproductive benefits, bariatric surgery is becoming increasingly popular as a therapeutic option for obese women trying to conceive. However, continuous research is being conducted to determine the degree of its advantages and potential hazards to fertility and pregnancy outcomes. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and entered into the PROSPERO database. Comprehensive searches in the PubMed, Scopus, and Web of Science databases turned up relevant studies. Studies that examined the effects of bariatric surgery on female fertility, ovulatory function, pregnancy rates, and neonatal outcomes were considered. Methodological quality and risk of bias were evaluated using the Newcastle–Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias Tool for randomized controlled trials. Results: This review comprised 34 studies. More than 75% of the studies analyzed showed improvements in ovulatory function, monthly regularity, or spontaneous pregnancy after bariatric surgery. Post-surgical pregnancies are related to a lower incidence of gestational diabetes, hypertension, and macrosomia. However, several studies raised concerns about nutritional inadequacies and the possibility of small-for-gestational-age newborns, particularly following Roux-en-Y gastric bypass. Studies suggest delaying conception for 12 to 18 months after surgery to reduce nutritional hazards and improve pregnancy outcomes. Variability in study design, follow-up duration, and surgical methods reduces the generalizability of findings, emphasizing the importance of uniform research protocols. Conclusions: Bariatric surgery is a highly effective treatment for increasing fertility and pregnancy outcomes in obese women, particularly those with PCOS. However, rigorous preconception planning, postoperative nutritional monitoring, and multidisciplinary follow-up are required to reduce the related hazards. Future research should concentrate on long-term reproductive outcomes, standardizing fertility assessment criteria, and improving clinical guidelines for managing post-bariatric pregnancies. These findings support the incorporation of bariatric surgery into fertility treatment regimens for obese women, and they may shape future revisions to clinical guidelines on reproductive care following weight loss surgery.

Unlocking the potential of embryos: insight of systematic review and meta-analysis into laser-assisted hatching’s role in conquering recurrent implantation failure

IntroductionThe journey of assisted reproductive technology (ART) for couples facing recurrent implantation failure (RIF) is fraught with emotional and physical challenges. RIF, often characterized by the failure of high-quality embryos to implant after multiple ART cycles, has directed attention towards interventions like laser-assisted hatching (LAH). However, discrepancies in the literature necessitate a comprehensive review of LAH's efficacy and safety.Materials and methodsFollowing a thorough search of PubMed, Embase, Cochrane, and Web of Science databases up to November 2023, retrospective studies or RCT were considered for inclusion. Summary effect sizes [odds ratio (OR) or risk ratio (RR) with 95% confidence interval (CI)] were calculated for each outcome.Results and conclusionEight studies comprising 2,634 patients were included. LAH significantly improved implantation rates (OR: 1.26, 95% CI: 1.05–1.51). Clinical pregnancy rates increased in patients who had fresh embryos transferred (OR: 1.29, 95% CI: 1.05–1.58). Notably, LAH was associated with higher miscarriage rates in frozen embryo transfers (OR: 1.45, 95% CI: 1.04–2.02). No significant increase in ectopic or multiple pregnancy rates was observed. For patients with RIF, especially older women, LAH presents a potential avenue to improve implantation. Its impact on clinical pregnancy rates is less substantial. However, its impact on final live birth rates and the increased miscarriage risk in frozen transfers necessitate a cautious and individualized approach. The technique's safety, while generally upheld, requires careful application and consideration of the specific challenges RIF patients face. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD42024497329, PROSPERO (CRD42024497329).

Effects of acupuncture-related therapies on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer: a Bayesian network meta-analysis.

This network meta-analysis aimed to assess the efficacy of different acupuncture-related therapies in improving pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET). Randomized controlled trials (RCTs) examining acupuncture-related therapies as adjuncts to IVF-ET were systematically searched in eight databases from inception until January 15, 2025. Dichotomous outcomes concerning efficacy were evaluated as odds risk (OR) and continuous data as mean difference (MD) and 95% credible intervals (CrI) utilizing R 4.1.2 and Stata 16.1. Through a comprehensive literature search, we ultimately identified 96 RCTs that involved 14,736 participants and 15 interventions in this systematic analysis. Based on the clinical pregnancy rate outcome, warm acupuncture for three menstrual cycles before oocyte retrieval (WA-TTP, OR 3.56, 95% CrI 2.05 to 6.25, low certainty, SUCRA = 89.54%), acupuncture combined with moxibustion for three menstrual cycles before oocyte retrieval (AC + M-TTP, OR 3.31, 95% CrI 1.05 to 11.77, low certainty, SUCRA = 78.70%), and acupuncture for one menstrual cycle before oocyte retrieval (AC-OTP, OR 2.69, 95% CrI 1.76 to 4.09, moderate certainty, SUCRA = 77.98%) demonstrated potential superiority compared to false acupuncture or no treatment (F/N). Significant subgroup differences between clinical pregnancy rates were observed by subgroup analysis. Acupuncture-related therapies can potentially enhance clinical pregnancy rates among women undergoing IVF-ET, with WA-TTP, AC + M-TTP, and AC-OTP demonstrating potential superiority. AC-TTP demonstrated a greater efficacy in improving live birth rates, increasing endometrial thickness, and reducing pulsation index. Our findings emphasize that acupuncture-related therapies with a limited number of sessions before or after embryo transfer show minimal clinical benefit except auricular acupressure.

Resilience Amidst Adversity: Demystifying the Lived Experiences of Batang Inatay

Young single parents frequently face substantial financial and emotional hardships. A comparison between France and the UK illustrates these disparities: while a mother in France received €683 monthly in child benefits for three children, her sister in the UK received none due to a means-tested welfare system and higher childcare costs. In the U.S., 41% of parents reported debilitating stress, with similar figures observed in the UK. Despite these challenges, many young single parents display resilience, developing time management skills and relying on support systems to cope. In the Philippines, the issue of teenage pregnancy remains pressing, with one of the highest adolescent pregnancy rates in Southeast Asia, often resulting in adverse health, educational, and socioeconomic outcomes. This study employs qualitative transcendental phenomenology to explore the lived experiences of Junior and Senior High School students in the Philippines who assume the dual parental roles of Batang Inatay—a term denoting young single parents acting as both mother (Nanay) and father (Tatay). Through in-depth interviews, the study reveals that economic pressure often forces participants to prioritize income over education, leading to mental and emotional fatigue. While some derive motivation from their hardships, others feel trapped in a cycle of poverty and limited opportunity. Coping mechanisms include time management, emotional resilience, social support, and, in some cases, avoidance strategies. While caregiving fosters maturity and responsibility, it also restricts personal freedom and hinders academic and professional aspirations. The findings highlight the urgent need for comprehensive policy interventions to support the well-being and development of young single parents.

Letrozole-stimulated cycles versus hormone replacement treatment cycles for frozen embryo transfer in women with polycystic ovary syndrome: a prospective randomized controlled trial.

This study aimed to compare the pregnancy outcomes of letrozole (LE)-induced ovulation and hormone replacement treatment (HRT) in endometrial preparation for frozen embryo transfer (FET) in women with polycystic ovary syndrome (PCOS). A randomized controlled trial involved 200 patients with PCOS from December 2017 to December 2022. Participants, who underwentFET with one or twogood-quality blastocysts or cleavage-stage embryos, were randomly assigned to the LE group or HRT group in a 1:1 ratio. The primary outcome was the clinical pregnancy rate. Secondary outcomes included biochemical pregnancy, implantation, ectopic pregnancy, miscarriage, multiple pregnancy, and live birth rates. The clinical pregnancy rate was 66.0% in the LE group compared to 53.0% in the HRT group (absolute difference, 13.0% [95% CI, - 0.5 to 26.5%]; RR, 1.25 [95% CI, 0.98 to 1.57]; P = 0.061). The biochemical pregnancy rate was higher in the LE group (71.0% vs 57.0%; absolute difference, 14.0% [95% CI, 0.8 to 27.2%]; RR, 1.25 [95% CI, 1.01 to 1.54]; P = 0.039). No significant differences were observed for the other secondary outcomes. The LE group showedhigher biochemical pregnancy and live birth rates in the normal weight and normal androgen subgroups. Pregnancy outcomes were similar in the overweight and hyperandrogenic subgroups. There were no statistically significant differences in clinical pregnancy rates between the LE and HRT cycles for FET in women with PCOS. However, the LE protocol may be a preferableoption to HRT for womenwith normal weight or normal androgen levels. This study was registered at Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ; ChiCTR-IOR-17014124).

Pilot study MOVENDOP protocol - impact on quality of life following postoperative osteopathic abdominal mobilizations in patients operated for endometriosis.

Surgery remains the gold standard for management of endometriosis, offering significant improvement in patient pelvic pain and quality of life (QoL). Postoperative tissue adhesions can however diminish these benefits, limiting the long-term effectiveness of the intervention. Despite the development of strategies and devices to reduce adhesion formation, their efficacy remains inconclusive. This study aims to propose and evaluate a novel approach involving early visceral mobilization and training of patients in abdominal self-mobilization as a means to improve QoL following surgery. This pilot study is a prospective, randomized, phase II superiority trial. Patients undergoing surgery for infiltrating endometriosis will be randomized, with a 2:1 ratio, into two groups. The intervention group (n = 42) will receive six sessions of osteopathic visceral mobilization with training in abdominal self-mobilization techniques, one preoperative, and five postoperative during the first month post-surgery. The control group (n = 21) will receive no osteopathic visceral mobilizations but will be offered an osteopathic session after one year. The primary endpoint is a minimum increase of 20 points (on a 100-point scale) in the Endometriosis Health Profile-30 (EHP-30) global score, at one year. Secondary endpoints include assessment of gastrointestinal quality of life (GIQLI), sexual function (FSFI), urinary symptoms (ICIQ-FLUTS), pain catastrophizing (PCS), as well as scar examination, pelvic pain, abdominal flexibility, use of medical and non-medical care, analgesic and hormonal treatments, pregnancy rate, physical activity, sedentary lifestyle and patient compliance. Statistical analyses will be based on a one-sided α=0.05 and β=0.15, assuming a standard deviation of 25 points in the EHP-30 global score. A total of 42 participants in the intervention group and 21 in the control group are required. This trial aims to demonstrate that early and repeated osteopathic sessions following surgery for endometriosis may significantly improve patient QoL.

Oral Dydrogesterone Versus Vaginal Progesterone for Luteal Phase Support in Frozen-Thawed Embryo Transfer Cycles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background/Objectives: Until recently, oral dydrogesterone has only been established in fresh in vitro fertilization (IVF) cycles, whereas its role in luteal phase support (LPS) for frozen embryo transfer (FET) cycles remains unclear. The aim of this study is to determine whether oral dydrogesterone as LPS in FET cycles results in pregnancy rates comparable to vaginal progesterone, focusing primarily on ongoing pregnancy rates, but also on clinical pregnancy, miscarriage, and live birth rates. Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five databases (Embase, MEDLINE®, APA PsycInfo, Global Health, and HMIC) and two additional sources were searched from inception to November 28, 2024. Only randomized controlled trials (RCTs) were included. A common effects model combined risk estimates, and heterogeneity was assessed using I2. Study quality was evaluated with Risk of Bias 2 (RoB2), and evidence certainty was graded using GRADE. Results: Overall, five RCTs with a total of 636 women were included in the meta-analysis. The comparison between oral dydrogesterone and vaginal progesterone for LPS did not yield significant differences for any of the outcomes studied. For ongoing pregnancies, the pooled odds ratio (OR) was 0.90 (95% CI: 0.59-1.35), with no heterogeneity (I2 = 8.7%). For miscarriage events, the OR was 1.41 (95% CI: 0.63-3.13, I2 = 0). For clinical pregnancies, the OR was 0.94 (95% CI: 0.62-1.42, I2 = 49.2%), with heterogeneity attributed to dosage. For live births, the pooled OR was 1.08 (95% CI: 0.67-1.75, I2 = 0%). Two studies were assessed as high risk of bias, two as low risk, and one as moderate. The GRADE assessment indicated low to moderate certainty of evidence. Conclusions: Oral dydrogesterone and vaginal progesterone yield comparable reproductive outcomes for LPS in FET cycles. Given its ease of administration, dydrogesterone may serve as a viable alternative in future FET protocols. However, further RCTs are needed to assess its efficacy against other progesterone administration routes.

Laparoscopic sclerotherapy for ovarian endometriomas during surgery for deep endometriosis: Outcomes of a 134-patient cohort.

Laparoscopic sclerotherapy for ovarian endometriomas during surgery for deep endometriosis: Outcomes of a 134-patient cohort.

Supplementation of Saccharomyces cerevisiae fermentation product to beef cows grazing fescue-based pastures and its impact on reproductive performance

Abstract The study aimed to evaluate the effects of Saccharomyces cerevisiae fermentation product (SCFP) supplementation during the breeding season on reproductive performance of beef cows grazing fescue-dominated pastures (Festuca arundinacea). A total of 883 multiparous suckled beef cows across eight locations were stratified by age and days postpartum (DPP) and randomly assigned to one of two treatments: 1) CON - mineral supplementation at 90 g/hd/d (n=439 cows; 13 experimental units), or 2) SCFP - mineral with 9 g SCFP (NaturSafe, Diamond V, Cedar Rapids, IA; n=444 cows; 13 experimental units). Supplementation began 21 days pre-breeding and continued through the breeding season (approx. 171 days). Cows grazed tall-fescue pastures and followed a fixed-time artificial insemination (TAI) protocol (7-day CO-Synch+CIDR) with natural service and clean-up bulls for a 70-day breeding season. Pregnancy diagnoses were performed by ultrasonography at 55 days post-TAI and 40 days after the breeding season. Cow body weight (BW) and body condition score (BCS) were recorded at TAI (day 0) and weaning (day 150). Mineral disappearance was measured weekly. Data were analyzed using GLIMMIX for binomial data and MIXED for continuous data. Cow age and DPP did not differ (P&amp;gt;0.10) between treatments (6.0 ± 1.0 yr and 79.7 ± 2.6 days, respectively). Mineral disappearance was similar (P=0.97) between treatments (99.2 and 99.8 ± 8.76 g/hd/d for CON and SCFP, respectively). No differences were observed (P&amp;gt;0.10) in BW and BCS between treatments on days 0 and 150. SCFP supplementation did not affect estrus expression (63.2% vs 63.7% ± 2.6% for CON and SCFP, respectively; P=0.91), but TAI pregnancy rates were higher (P=0.025) in SCFP (65.9 ± 2.5%) compared to CON (57.9 ± 2.5%). Final pregnancy rates tended to be higher (P=0.057) for SCFP (92.9 ± 1.4%) vs CON (89.0 ± 1.4%), with no effect on calf performance (P&amp;gt;0.10). In conclusion, SCFP supplementation during the breeding season did not influence BW or BCS but improved TAI pregnancy rates in beef cows grazing endophyte-infected tall fescue.

Effect of pelvic adhesions on reproductive outcomes following high-intensity focused ultrasound in patients with adenomyosis.

Effect of pelvic adhesions on reproductive outcomes following high-intensity focused ultrasound in patients with adenomyosis.

Pregnancy and neonatal outcomes of borderline blastocysts: a novel evaluation model based on inner cell mass and trophectoderm parameters.

To investigate the applicability and safety of the blastocyst grading system for borderline blastocysts assessed by measurement of the inner cell mass (ICM) and trophectoderm (TE) parameters. A total of 361 borderline blastocysts were classified as B-B-, B-C, and CB/CB-blastocysts based on the parameters of the ICM and TE in frozen-thawed embryo transfer cycles, and these embryos were divided into groups A, B, and C. The primary outcome measures were clinical pregnancy rate (CPR), live birth rate (LBR), gestational age (GA) at birth, birth weight, and malformation rate. Four embryologists independently evaluated 90 embryos, with inter- and intra-observer agreement analyzed using Fleiss' kappa coefficient. The CPR (9.1%) and LBR (5.5%) in group C were lower than those in groups A (34.9% and 25.6%, respectively) and B (25.3% and 19.0%, respectively). There were no differences in GA at birth, birth weight, or malformation rate among groups A, B, and C. Binary regression analysis revealed that embryos with an ICM grade of C (OR 0.158; 95% CI 0.073-0.439; P < 0.001) had a lower likelihood of LBR than those with an ICM grade of B-. The inter- and intra-observer agreement between embryologists in terms of embryo morphological grading and clinical decision-making ranged from good (K > 0.61) to very good (K > 0.81). The modified grading system to assess borderline blastocysts is safe and effective and improves the consistency of embryo assessment.

Maternal Morbidity in Singleton versus Twin Gestations Undergoing Cesarean Delivery.

As the prevalence of twin pregnancies rises, and because of the high cesarean rate in twin pregnancies, it is imperative to estimate the maternal morbidity in twin pregnancies undergoing cesarean delivery. This study aims to clarify whether twin gestations undergoing cesarean delivery are at increased risk for maternal morbidity compared with singleton pregnancies undergoing cesarean delivery.This study was a retrospective cohort study of all singleton and twin gestations who underwent cesarean delivery in a single maternal fetal medicine and obstetrical practice from 2005 to 2023. All patients who underwent a cesarean delivery with a liveborn were included with the exception of patients with a history of a prior myomectomy, known placenta previa, or known placenta accreta spectrum. An electronic medical record was used to obtain baseline characteristics and maternal outcomes. Our primary outcome was a composite outcome for maternal morbidity. We first compared all patients undergoing primary cesarean delivery and performed subgroup analyses of patients laboring prior to cesarean delivery, scheduled primary cesarean section without labor, and repeat cesarean section. Chi-squared test, Fisher exact test, and student's t-test were utilized for statistical analysis.Of the 2,872 women meeting inclusion criteria, 2,250 had singleton pregnancies while 622 had twin pregnancies. Baseline characteristics were largely similar between groups, except for higher body mass index and incidence of preeclampsia in twin gestations. In patients undergoing primary cesarean delivery, the composite outcome for maternal morbidity did not significantly differ between singleton and twin pregnancies (0.8 vs. 1.4%; p = 0.172). However, secondary outcomes revealed higher blood loss in twin pregnancies, evidenced by both elevated estimated blood loss (EBL) and increased rate of blood transfusion (4.7 vs. 1.8%; p < 0.001). These findings remained consistent across all subgroup analyses.We observed no differences in major maternal morbidities between patients undergoing cesarean delivery for singleton or twin gestations. However, we did find significant differences in EBL and transfusion requirements for women with twin gestations. · There are no differences in major maternal morbidities.. · This is between patients undergoing cesarean delivery for singleton versus twin gestations.. · This includes with the exception of higher EBL and transfusion requirements in twin gestations..

Differences in Abortion Use by Sexual Orientation in 3 National Cohorts.

Sexual minority individuals have less access to high-quality reproductive health care-including contraceptive care-and have higher rates of unintended pregnancies than their heterosexual peers. Little is known about differences in abortion use by sexual orientation. To quantify differences in abortion use by sexual orientation. This study using data from 3 North American cohorts included pregnancies between 1959 and 2024. Nurses' Health Study II (NHS2) is a cohort of female nurses in the US, Growing Up Today Study (GUTS) is a cohort of NHS2's offspring, and Nurses' Health Study 3 (NHS3) is a cohort of nurses and nursing students in the US and Canada. Sexual orientation (completely heterosexual, heterosexual with same-sex experience, mostly heterosexual, bisexual, and lesbian or gay). Participant-reported pregnancy outcome (induced abortion vs any other pregnancy outcome). Of a total of 235 948 pregnancies (with nonmissing pregnancy outcome data) across 85 640 participants, 211 095 pregnancies (89.5%) were to completely heterosexual participants, and 24 853 (10.5%) were to sexual minority participants. In GUTS and NHS3, there were a higher percentage of pregnancies to sexual minority participants (1546 [17.7%] and 7425 [19.7%], respectively) than in NHS2 (15 882 [8.4%]). In the cohorts combined, 20 243 pregnancies (8.6%) ended with an induced abortion. Compared with pregnancies to completely heterosexual participants, those to sexual minority participants were more likely to end with an induced abortion (risk ratio [RR], 1.93 [95% CI, 1.85-2.02]). Among sexual minority subgroups, heterosexual with same-sex experience (RR, 1.56 [95% CI, 1.47-1.66]), mostly heterosexual (RR, 2.15 [95% CI, 2.03-2.29]), bisexual (RR, 2.84 [95% CI, 2.49-3.23]), and lesbian or gay participants (RR, 2.52 [95% CI, 2.14-2.95]) had higher abortion use. In this study using data from retrospectively reported pregnancies from 3 longitudinal cohorts, all sexual minority groups had increased abortion use compared with completely heterosexual participants, and abortion use was heterogeneous; given the higher use of abortion among sexual minority populations, they are more likely to be disproportionately impacted by the narrowing of abortion access in the US after the Supreme Court Dobbs decision. Future research is needed to understand the pathways that contribute to the unique abortion care needs of sexual minority individuals, in order to provide adequate support for abortion seekers.

Adjuvant treatment with Wu-Zi-Yan-Zong formula for abnormal sperm parameters associated with male infertility: a meta-analysis of randomized controlled trials

BackgroundWu-Zi-Yan-Zong (WZYZ) formula is a traditional Chinese botanical drug that has been used to treat male infertility. This meta-analysis aims to evaluate its effectiveness of the WZYZ formula as an adjuvant therapy for treating abnormal sperm parameters associated with male infertility.MethodsA comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, Web of Science, SinoMed, Wanfang, and CNKI databases until December 12, 2024 to identify randomized controlled trials (RCTs) that assessed the effectiveness of the WZYZ formula as an adjuvant therapy for treating abnormal sperm parameters associated in men with infertility. For dichotomous data, the pooled results were summarized as risk ratio (RR) with 95% confidence intervals (CI), while continuous data were expressed as pooled weighted mean difference (WMD) with 95% CI.ResultsA total of 11 RCTs involving 951 men were identified. The pooled results showed that the WZYZ formula, when combined with control treatment, significantly improved the pregnancy rate of female partners (RR 1.68; 95% CI 1.34–2.11), semen volume (WMD 0.58 mL; 95% CI 0.28–0.89), sperm concentration (WMD 6.87 × 106/mL; 95%CI 4.24–9.51), total sperm motility (WMD 15.55%; 95% CI 10.38–20.72), forward grade (a) sperm motility (WMD 5.44%; 95% CI 1.86–9.01), forward grade (a + b) sperm motility (WMD 7.14%; 95% CI 4.04–10.23), abnormal sperm morphology (WMD −10.38%; 95% CI −15.72 to −5.03), and activity of the acrosome enzyme (WMD 8.02 × 106 μIU; 95% CI 3.58–12.46.ConclusionAdjuvant treatment with WZYZ formula significantly improves the pregnancy rate of female partners by improving several semen parameters in infertile men with abnormal sperm parameters. However, further well-designed RCTs with larger sample sizes are necessary to definitively determine the efficacy and safety of the WZYZ formula in treating abnormal sperm parameters associated with male infertility.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024629510.

Impact of relative estradiol changes during ovarian stimulation on blastocyst formation and live birth in assisted reproductive technology

This study aimed to evaluate the predictive value of relative change in E2 levels during controlled ovarian stimulation (COS) on embryo development and pregnancy outcomes in assisted reproductive technology (ART). We retrospectively analyzed 9,376 patients who underwent their first fresh ART cycle from January 1, 2020, to December 31, 2022. Patients were classified into four groups based on relative change in E2 levels: low response group, moderate response group, moderate-high response group, and high response group. The primary outcomes were blastocyst formation rate, clinical pregnancy rate, and live birth rate, while secondary outcomes included miscarriage rate and ectopic pregnancy rate. Most cycles (96.5%) demonstrated an increase in E2 levels during COS. The blastocyst formation rate significantly increased across the groups (low response group: 0.13, moderate response group: 0.21, moderate-high response group: 0.28, high response group: 0.34; P < 0.001). Multivariable logistic regression showed significantly higher blastocyst formation rates in the moderate response group (adjusted OR = 2.012, 95% CI: 1.687–2.399), moderate-high response group (adjusted OR = 4.613, 95% CI: 3.853–5.523), and high response group (adjusted OR = 11.295, 95% CI: 9.192–13.880) compared to the low response group. Both clinical pregnancy rate and live birth rate were significantly higher in the moderate-high response group and high response group compared to the low response group (clinical pregnancy rate: 54.5% and 61.5% vs. 35.5%, adjusted RR = 1.21 [95% CI: 1.03–1.42] and 1.27 [95% CI: 1.08–1.51]; live birth rate: 44.9% and 52.0% vs. 25.7%, adjusted RR = 1.27 [95% CI: 1.06–1.52] and 1.35 [95% CI: 1.11–1.64]). However, no significant differences were observed in either clinical pregnancy rate or live birth rate between the moderate response group and low response group (clinical pregnancy rate: adjusted RR = 1.07 [95% CI: 0.91–1.25]; live birth rate: adjusted RR = 1.11 [95% CI: 0.92–1.33]). No significant differences in miscarriage rate or ectopic pregnancy rate were observed across the groups. Higher E2 responses were associated with improved embryo development and better pregnancy outcomes.