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Editorial Board
Available online 3 December 2024, Version of Record 3 December 2024.
doi : 10.1016/S0015-0282(24)02347-1
Volume 122, Issue 6, December 2024, Pages A1-A3
Available online 3 December 2024, Version of Record 3 December 2024.
Table of Contents
doi : 10.1016/S0015-0282(24)02348-3
Volume 122, Issue 6, December 2024, Pages A4-A9
Available online 3 December 2024, Version of Record 3 December 2024
Trustworthiness criteria for meta-analyses of randomized controlled studies: OBGYN journal guidelines
The OBGYN Editors’ Integrity Group (OGEIG)
doi : 10.1016/j.fertnstert.2024.08.351
Volume 122, Issue 6, December 2024, Pages 965-969
Editors of a number of OBGYN journals have formed an OBGYN Editors’ Integrity Group (OGEIG), with the aim of collaborating to improve trustworthiness in published papers.1 These Editors have already jointly agreed and published quality criteria for randomized controlled trials (RCTs), incorporating the guidance in their instructions to authors.2 The requirements for RCTs include
Playing the long game for reproductive rights
Nanette Santoro M.D
doi : 10.1016/j.fertnstert.2024.10.009
Volume 122, Issue 6, December 2024, Pages 970-971
Before the Dobbs v. Women’s Health Organization decision in 2022, reproductive endocrinologists had little direct contact with the burgeoning antichoice movement and its mounting political power. After Dobbs, there were a series of concerns raised that a strict interpretation of personhood beginning with conception could lead to future legislation or judicial rulings that would threaten in vitro fertilization and other assisted reproductive technology procedures (1, 2), despite language in the original decision implying that the opinion was not intended to cast doubt on precedents that did not concern abortion. At least one justice signaled that reproductive behaviors such as contraception could also be future targets for restriction
The Supreme Court and reproductive medicine, 2024
Steven R. Smith J.D., M.S. a, Joseph S. Sanfilippo M.D., M.B.A. b
doi : 10.1016/j.fertnstert.2024.09.046
Volume 122, Issue 6, December 2024, Pages 972-976
The US Supreme Court’s most recent Term illustrates the considerable influence the Court has on the practice of reproductive health providers and their patients. Cases included the availability of mifepristone and emergency-care abortions. In addition, the Court substantially changed its deference to administrative agencies (e.g., Food and Drug Administration, Centres for Medicare & Medicaid Services, and United States Department of Homeland Security) which will affect medical practice. National organizations of physicians and reproductive health providers (e.g., American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine, and the Pro-Life Obstetricians and Gynecologists) now play an active role in communicating with the Court to affect the outcome of cases
In defense of in vitro fertilization: time to get involved in state-level advocacy
Albert L. Hsu M.D., M.S. a, Elizabeth J. Carr B.A., Jessie Losch M.P.H., Susan Crockin J.D. b, J. Preston Parry M.D., M.P.H. c d e
doi : 10.1016/j.fertnstert.2024.10.018
Volume 122, Issue 6, December 2024, Pages 977-982
We share experiences in advocating to defend in vitro fertilization (IVF) in Virginia, Missouri, and Mississippi; provide historical context on the “Personhood” anti-IVF movement; and discuss why “embryo donation” is a more accurate term than “embryo
Donor incentives revisited
Eric A. Widra M.D.
doi : 10.1016/j.fertnstert.2024.10.002
Volume 122, Issue 6, December 2024, Page 983
This issue’s Fertile Battle revisits a conundrum that has existed since the advent of gamete donation. How do we balance the needs of potential recipients against a limited resource and the well-being of all parties: donors; recipients; and offspring. The history of gamete donation suggests that in the absence of incentives for donors, purely altruistic donation will never meet the needs of recipients. Unlike organ donation, our situation is unique in the need to balance multipartite interests and the relative ease in accessing these gametes. The American Society for Reproductive Medicine has found it ethical to incent egg and sperm donation; this issue’s debate addresses the question of whether offering a portion of eggs for future autologous use as such an incentive crosses an ethical boundary. The two sides articulate strong cases in both directions, as we have seen throughout our history of managing donated gametes
The ethics of egg sharing
Meera Shah M.D. a, Samuel Pang M.D. b, Lydia Hughes M.D. c, Katie Watson J.D. d, Eve C. Feinberg M.D. c, Eric A. Widra M.D. e
doi : 10.1016/j.fertnstert.2024.10.003
Volume 122, Issue 6, December 2024, Pages 984-990
The American Society for Reproductive Medicine has long deemed financial compensation for egg donation ethically permissible on the grounds of respecting women’s autonomy and ability to make informed choices (1). We believe that a form of egg donation called egg sharing—when an egg donor freezes her eggs for reduced or no cost when donating a portion of them—is also ethical, and is a preferable model for some donors
Expectant management? How to communicate realistic outcomes and the possibility of failure
Kiley Hunkler M.D., M.St., M.Sc. a b, Eric Widra M.D. c
doi : 10.1016/j.fertnstert.2024.06.008
Volume 122, Issue 6, December 2024, Pages 991-992
The pursuit of having a child through assisted reproductive technology (ART) therapies is a long road for many patients and often demands a recalibration of expectations as treatment evolves. Failing to set or manage patients’ expectations can contribute to patients discontinuing their pursuit of ART therapy; psychological burden and emotional distress are frequently cited reasons that patients stop their in vitro fertilization (IVF) treatments (1). Physicians play a crucial role in setting and managing patients’ expectations because patients have historically held their physicians’ opinions in high regard. To set up our patients for success, it behooves the reproductive endocrinology and infertility specialists to recognize what is currently known about patient expectations, to understand current metrics regarding these expectations, as well as to implement validated solutions into their practices
Aneuploidy rates and likelihood of obtaining a usable embryo for transfer among in vitro fertilization cycles using preimplantation genetic testing for monogenic disorders and aneuploidy compared with in vitro fertilization cycles using preimplantation genetic testing for aneuploidy alone
Rachel A. Martel M.D. a, Mabel B. Lee M.D. a, Alessia Schadwell M.Sc. b c, Mehrnaz Siavoshi M.S., M.P.H. d, Lorna Kwan M.P.H. d, Jenna Miller M.S. b, Chelsea Leonard M.M.Sc. b, Robert A. Roman M.D. a, Abigail Armstrong M.D. e, Lindsay Kroener M.D. a
doi : 10.1016/j.fertnstert.2024.07.030
Volume 122, Issue 6, December 2024, Pages 993-1001
To compare aneuploidy rates among in vitro fertilization (IVF) cycles using preimplantation genetic testing for monogenic disorders (PGT-M) and aneuploidy (PGT-A) compared with IVF cycles using PGT-A alone, and to determine the likelihood of obtaining at least one usable embryo in cycles using PGT-M+PGT-A compared with cycles using PGT-A alone
Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion
Ethics Committee of the American Society for Reproductive Medicine
doi : 10.1016/j.fertnstert.2024.09.034
Volume 122, Issue 6, December 2024, Pages 1002-1007
The Ethics Committee recommends that in vitro fertilization centers develop patient-centered policies regarding requests for futile treatment. In most cases, clear communication can avoid a direct confiict, but clinicians ethically may refuse to provide treatment believed to be futile or to carry a very poor prognosis. In certain instances, clinicians may provide limited treatment, which they judge likely to be futile, but must be vigilant in their presentation of risks, benefits, and alternatives. This version replaces the previously published draft of this name last published in 2019.
Fair expectations for patients undergoing preimplantation genetic testing for monogenic disorders: aneuploidy no less of an obstacle
Stephanie Willson M.D. a, Emily Mounts M.S. b, Marie Werner M.D., H.C.L.D. a
doi : 10.1016/j.fertnstert.2024.09.033
Volume 122, Issue 6, December 2024, Pages 1008-1009
Preimplantation genetic testing for monogenic disorders (PGT-M) represents a significant advancement within our field, offering a powerful risk reduction strategy for families facing possible transmission of genetic disease. The process provides patients with a valuable tool for embryo selection, and use has been increasing steadily with wider recognition of genetic diagnoses and carrier status. However, as with preimplantation genetic testing for aneuploidy (PGT-A), the caveat to enhanced selection opportunities is the concomitant reduction in usable embryos for transfer
Race, ethnicity, and assisted reproductive technology outcomes: where do we go from here?
doi : 10.1016/j.fertnstert.2024.09.020
Volume 122, Issue 6, December 2024, Pages 1010-1011
Racial and ethnic disparities are a pervasive healthcare issue that reflects deep-rooted systemic inequalities. These inequities impact women’s access to healthcare and their healthcare outcomes, including those related to assisted reproductive technology (ART) (1). Specifically, Black, Hispanic, and Asian individuals are less likely to access fertility care compared with their White counterparts. This may be due to several factors, including, but not limited to, economic barriers, language barriers, cultural differences, concerns about privacy, or distrust of the medical system (1). However, disparities persist even when individuals can access care. Racial and ethnic minority individuals experience lower success rates with ART, including lower clinic pregnancy rates and lower live birth rates, compared with their White counterparts (1). The reason for these differences is poorly understood but has been demonstrated consistently in prior research (2).
An acorn is not an oak tree…
Louisa Drake D.O., Kelly A. Lynch M.D., Daniel R. Grow M.D.
doi : 10.1016/j.fertnstert.2024.09.045
Volume 122, Issue 6, December 2024, Pages 1012-1013
We appreciate the opportunity to review and comment on this manuscript from the Cornell Group. This manuscript focuses on an important issue, the ethical quandary for some, surrounding the disposition of supernumerary embryos. The Dobbs decision and the Alabama Supreme Court have raised international attention to this issue. This attention is unfortunate but highlights the struggles that a minority of patients experience because they try to reconcile maximizing success rates using in vitro fertilization (IVF) with the position taken by some faith-based groups that an embryo is due the same respect as an independently living human.
The dilemma of polycystic ovary syndrome and pregnancy complications
Mohamed Aboulghar M.D., Mona Aboulghar M.D
doi : 10.1016/j.fertnstert.2024.09.030
Volume 122, Issue 6, December 2024, Pages 1014-1015
Polycystic ovary syndrome (PCOS) is the most common endocrinologic disorder in women during their reproductive life. Infertility is a common problem associated with PCOS. The primary line of treatment is a change of lifestyle and ovulation induction. When these measures fail, in vitro fertilization (IVF) is the next option of treatment. One problem during ovarian stimulation for IVF in women with PCOS is the possibility of a strong ovarian response and the risk of ovarian hyperstimulation syndrome (OHSS). Cryopreservation of all embryos and embryo transfer (ET) in a future cycle is a very effective procedure for prevention of severe forms of OHSS. Subsequently, the number of ETs of thawed embryos in women with PCOS became very high. For this reason, the topic was extensively investigated by several retrospective studies.
Endometriosis, adenomyosis, and nonpregnant uterine contractility
Demetrios A. Arvanitis Ph.D.
doi : 10.1016/j.fertnstert.2024.09.032
Volume 122, Issue 6, December 2024, Page 1016
Endometriosis and adenomyosis affect millions of women worldwide, suffering from their symptomologies, including infertility, chronic pelvic pain, and discomfort during sex. Almost a century after the terms endometriosis and adenomyosis were coined, the multifaceted etiologies of these conditions remain obscure. Anatomically, the lack of a separating basement membrane between the endometrium and myometrium, the endometrial-myometrial interface, suggests a critical interplay between these tissues with essential physiologic functions and possible pathophysiologic disruptions. The rhythmic wave-like endometrial movements of the nonpregnant uterus are due to the contractions of the myometrium and show different contractility patterns throughout the phases of the menstrual cycle (1). Abnormal myometrial contractility has been proposed for the etiology of endometriosis through the correlation of uterine contractions with retrograde bleeding and the presence of viable endometrial cells in the abdomen (2). Dysfunctions of the uterine peristaltic activity also have been suggested for the etiology of adenomyosis through tissue injury and repairs (3), and hypertrophic inner myometrium with intermediate filaments aggregates and endoplasmic reticulum enlargements have been described in uteri with adenomyosis cases (4).
Postoperative recurrence of ovarian endometrioma and hormone phobia: can physicians successfully overcome patient “pill fatigue”?
Paolo Vercellini M.D. a b, Paola Viganò Ph.D. a b, Edgardo Somigliana M.D., Ph.D. a b
doi : 10.1016/j.fertnstert.2024.09.050
Volume 122, Issue 6, December 2024, Pages 1017-1019
Veth et al. (1) conducted a systematic review to define the likelihood of postoperative endometrioma recurrence in patients who did not use hormonal treatments to suppress ovulation after first-line surgery. The investigators should be commended for their appreciable methodological approach, for having screened the available evidence for retracted articles, and for having adopted a novel checklist to assess the trustworthiness of randomized controlled trials. This should have resulted in a reliable overall estimate of the effect of exposure to uninterrupted postoperative ovulation.
Bias and conflict of interest: the Modern Fertility Study
Anne Z. Steiner M.D., M.P.H.
doi : 10.1016/j.fertnstert.2024.09.044
Volume 122, Issue 6, December 2024, Pages 1020-1021
I would like to thank the editors of Fertility and Sterility for the opportunity to write a commentary on the article by Nelson et al. (1) (Modern Fertility Study). The study has some limitations in its design, which will be detailed in the following, that led to inaccurate results and conclusions. As disclosed, there are conflicts of interest. Modern Health (Modern Fertility) provided the data and paid for the work. Five of the six investigators have been employees, founder (and current stockholder), or consultants for Modern Health, which sells antimüllerian hormone (AMH) tests to women as a fertility test.
To see or not to see? That is the miscarriage management question
Salomeh Salari M.D., M.S. a, Steven R. Lindheim M.D., M.M.M. b c
doi : 10.1016/j.fertnstert.2024.09.021
Volume 122, Issue 6, December 2024, Pages 1022-1023
Across various surgical specialties, there has been a consistent trend toward performing targeted interventions under direct visualization. This is most evident in gynecologic surgery because we have increasingly moved from blind dilation and curettage (D&C) to hysteroscopy-guided biopsy and resection. This is reflected in the American Association of Gynecologic Laparoscopists practice guidelines for management of endometrial polyps (1), with growing evidence of an overall ineffectiveness of D&C with respect to diagnosing intrauterine pathology (2). Moreover, when treating patients with infertility who have often spent enormous emotional and financial resources, cost-effectiveness, time to pregnancy, and live birth rate (LBR) are all crucial factors that should be taken into consideration when assessing diagnostic and treatment interventions. In this issue of Fertility and Sterility, Hu et al. (3) report on their retrospective cohort study assessing whether the addition of hysteroscopy to vacuum aspiration for management of early pregnancy loss increases the success of subsequent frozen embryo transfer (FET). The investigators detail that patients who underwent vacuum aspiration and operative hysteroscopy concurrently had a lower LBR than those who underwent vacuum aspiration only, whereas no differences in the secondary outcomes, including biochemical and clinical pregnancy or miscarriage rates, were noted.
It takes a team to achieve success with neovagina creation
Beth W. Rackow M.D.
doi : 10.1016/j.fertnstert.2024.09.049
Volume 122, Issue 6, December 2024, Pages 1024-1025
When an adolescent presents with primary amenorrhea in the setting of typical growth and pubertal development, aged approximately15–16 years, the wide differential diagnosis includes endocrine, genetic, and structural disorders. One of the most challenging diagnoses to give an adolescent is that of vaginal agenesis. Approximately 90% of individuals with vaginal agenesis have müllerian agenesis, otherwise known as Mayer-Rokitansky-Kuster Hauser syndrome; androgen insensitivity syndrome is another etiology of vaginal agenesis. This editorial will focus on individuals with müllerian agenesis; however, some of the comments are applicable to individuals with other etiologies of vaginal agenesis.
Racial disparities in the outcomes of euploid single frozen-thawed embryo transfer cycles – analysis of the Clinical Outcome Reporting System of the Society for Assisted Reproductive Technology 2016–2018 data
Xiomara Brioso M.D. a, Satu Kuokkanen M.D., Ph.D. b, Meredith Akerman M.S. c, Lubna Pal M.B.B.S., M.S., F.R.C.O.G a
doi : 10.1016/j.fertnstert.2024.07.031
Volume 122, Issue 6, December 2024, Pages 1026-1036
To evaluate if in pregnancies conceived with the transfer of single genetically tested embryos, maternal race and ethnicity relate to pregnancy outcome
Undisturbed culture: a clinical examination of this culture strategy on embryo in vitro development and clinical outcomes
María Ángeles Valera M.Sc. a b, Akhil Garg M.Sc. b, Lorena Bori Ph.D. a b, Fernando Meseguer M.Sc. a b, José María de los Santos Ph.D. b, Marcos Meseguer Ph.D. a b
doi : 10.1016/j.fertnstert.2024.07.018
Volume 122, Issue 6, December 2024, Pages 1037-1047
To compare the effect of a fully undisturbed culture strategy over a sequential one on embryo in vitro development and clinical outcomes in intracytoplasmic sperm injection (ICSI) cycles.
Limiting the number of fresh donor oocytes inseminated with sperm as a strategy to minimize supernumerary embryos
Samantha Spring M.D. a, Shelun Tsai M.D. a, Zoe Verzani M.P.H. b, Steven Spandorfer M.D. a
doi : 10.1016/j.fertnstert.2024.07.035
Volume 122, Issue 6, December 2024, Pages 1048-1054
To determine the optimal number of fresh donor oocytes to expose to sperm for patients who want to prioritize reducing surplus embryos while preserving the live birth rate
Pregnancy complications and birth outcomes in women with polycystic ovary syndrome undergoing frozen embryo transfer
Reweiguli Aihaiti M.D. a, Ziyun Shen M.D. b, Xian Wu M.D. a, Zhihong Niu Ph.D. a
doi : 10.1016/j.fertnstert.2024.07.017
Volume 122, Issue 6, December 2024, Pages 1055-1062
To determine whether polycystic ovary syndrome (PCOS) increases adverse pregnancy and birth outcomes in women undergoing frozen embryo transfer (FET).
Functional determinants of uterine contractility in endometriosis and adenomyosis: a systematic review and meta-analysis
Noemi Salmeri M.D. a b c, Giorgia Di Stefano M.Sc. d e, Paola Viganò Ph.D. d e, Pamela Stratton M.D. f, Edgardo Somigliana M.D. d e, Paolo Vercellini M.D. d e
doi : 10.1016/j.fertnstert.2024.07.026
Volume 122, Issue 6, December 2024, Pages 1063-1078
To summarize evidence on uterine contractility across the menstrual cycle phases in women with endometriosis and adenomyosis.
Recurrence after surgery for endometrioma: a systematic review and meta-analyses
Veerle B. Veth M.Sc. a b, Anne Keukens M.Sc. b c, Anouk Reijs M.Sc. c, Marlies Y. Bongers M.D. a b c, Velja Mijatovic M.D. d, Sjors F.P.J. Coppus M.D. c, Jacques W.M. Maas M.D. a b
doi : 10.1016/j.fertnstert.2024.07.033
Volume 122, Issue 6, December 2024, Pages 1079-1093
To determine the recurrence rate for surgically treated endometrioma without postoperative hormonal treatment.
Investigating the influence of oral contraceptive pill use on multiple sclerosis risk using UK Biobank data
Andrea Nova Ph.D., Giovanni Di Caprio, Giulia N. Baldrighi Ph.D., Davide Galdiolo, Luisa Bernardinelli, Teresa Fazia Ph.D.
doi : 10.1016/j.fertnstert.2024.07.999
Volume 122, Issue 6, December 2024, Pages 1094-1104
To investigate the association between oral contraceptive (OC) pill use and the risk of developing multiple sclerosis (MS), attempting to address the limitations present in previous studies that produced conflicting results.
Prenatal cell-free DNA screening for chromosomal aneuploidies after euploid embryo transfer shows high concordance with preimplantation genetic testing for aneuploidy results and low positive predictive values
Mitko Madjunkov M.D. a b, Prati Sharma M.D. a b, Ari Baratz M.D. a b, Karen Glass M.D. a b, Rina Abramov a, Nicole Logan a, Svetlana Madjunkova M.D., Ph.D. a c, Clifford Librach M.D. a b d e f
doi : 10.1016/j.fertnstert.2024.07.029
Volume 122, Issue 6, December 2024, Pages 1105-1113
To evaluate the positive predictive value (PPV) of prenatal cell-free DNA (cfDNA) screening for chromosomal aneuploidies in pregnancies achieved either after single euploid transfer in in vitro fertilization or Preimplantation Genetic Testing for Aneuploidy (PGT-A) cycles or transfer of single untested embryo, and to assess the concordance of prenatal-cfDNA-screening and PGT-A results.
Antimüllerian hormone levels are associated with time to pregnancy in a cohort study of 3,150 women
Scott M. Nelson M.D., Ph.D. a, Martin Shaw Ph.D. b, Benjamin J. Ewing M.S. c, Kate McLean M.D., M.P.H. c, Afton Vechery B.S. c, Sharon F. Briggs Ph.D. c
doi : 10.1016/j.fertnstert.2024.06.024
Volume 122, Issue 6, December 2024, Pages 1114-1123
To study the association between antimüllerian hormone (AMH) levels and time of pregnancy. Although it has been hypothesized that serum AMH levels may indicate the chance of conception, findings have been mixed. Given that any association is expected to be modest, and it is possible that previous studies have been underpowered, we investigated this relationship in the largest prospective cohort to date
Effectiveness of degradable polymer film in the management of severe or moderate intrauterine adhesions (PREG-2): a randomized, double-blind, multicenter, stratified, superiority trial
Hervé Fernandez M.D., Ph.D. a, Laura Miquel M.D. b, Jérémy Sroussi M.D. c, Steven Weyers Ph.D. d, Meritxell Munmany Ph.D. e, Xiping Luo Ph.D. f, Petr Kovar M.D. g, Yue Wang M.D. h, Brunella Zizolfi M.D. i, Anna Surbone M.D. j, Victoire Delporte M.D. k, Enrique Moratalla M.D. l, Marine Sauvan M.D. m, Gaetano Perrini M.D. n, Long Sui Ph.D. o, Michal Mara Ph.D. p
doi : 10.1016/j.fertnstert.2024.07.020
Volume 122, Issue 6, December 2024, Pages 1124-1133
To study the effectiveness of a new intrauterine degradable polymer film (Womed Leaf) in the management of moderate to severe intrauterine adhesions (IUA).
Addition of operative hysteroscopy to vacuum aspiration for the management of early pregnancy loss after in vitro fertilization
Kai-Lun Hu M.D. a b c d, Jie Zhao M.D. a, Mingmei Lin M.D. a, Xiaoye Wang M.D. e, Linjing Qi M.D. e, Huan Liu M.D. f, Dan Mo M.D. a g, Zhonghong Zeng M.D. a g, Ben W. Mol M.D., Ph.D. h i, Rong Li M.D., Ph.D. a b c d
doi : 10.1016/j.fertnstert.2024.07.027
Volume 122, Issue 6, December 2024, Pages 1134-1143
To investigate whether operative hysteroscopy in addition to vacuum aspiration for the management of early pregnancy loss effectively increases the success rate of subsequent frozen embryo transfer.
No association between celiac disease and female infertility: evidence from Mendelian randomization analysis
Shuai Yuan Ph.D. a, Jie Chen M.D. b, Xue Li Ph.D. b, Daniel A. Leffler M.D., M.S. c, Susanna C. Larsson Ph.D. a d, Jonas F. Ludvigsson M.D., Ph.D. e f g
doi : 10.1016/j.fertnstert.2024.07.001
Volume 122, Issue 6, December 2024, Pages 1144-1146
Several guidelines and reviews recommend screening for celiac disease (CeD) in women with unexplained infertility or suggest an association between CeD and infertility. However, research in this field is contradictory (1). We conducted this Mendelian randomization (MR) study to strengthen the causal assessment of CeD-infertility association
Blastocyst re-expansion 1 hour after biopsy: an independent predictor of live birth
Ibrahim Elkhatib M.Sc. a b, Daniela Nogueira Ph.D. a c, Asina Bayram M.Sc. a, Andrea Abdala M.Sc. a, Riechel Gonzales B.S. a, Raquel Del Gallego Ph.D. a, Baris Ata M.Sc., M.D. a d, Barbara Lawrenz Ph.D. a e, Erkan Kalafat M.Sc., M.D. a d, Human Fatemi M.D., Ph.D. a
doi : 10.1016/j.fertnstert.2024.07.014
Volume 122, Issue 6, December 2024, Pages 1147-1149
In non–preimplantation genetic testing cycles, the recommended practice of blastocyst artificial collapse before vitrification has gained prominence, enhancing the viability of cryopreserved embryos (1). In preimplantation genetic testing for aneuploidy (PGT-A) cycles, artificial collapse is caused by the biopsy procedure itself, and the approach becomes more complex. The European Society of Human Reproduction and Embryology recommends immediate vitrification after biopsy for PGT-A cycles, although a definitive timeframe remains elusive (2). Complicating matters further, existing studies present a spectrum of opinions regarding the timing of blastocyst cryopreservation after biopsy in PGT-A cycles. Some advocate for prolonged culture after biopsy (>3 hours) suggesting improved implantation and pregnancy rates (3), whereas others emphasize the necessity of cryopreservation rapidly after biopsy promoting a more immediate approach, within an hour (4, 5). The objective of this study was to investigate the correlation between blastocyst re-expansion at the time of vitrification (1 hour after biopsy) and blastocyst re-expansion after warming and their association with live birth (LB).
Updated etiologies of patients presenting with primary amenorrhea: a cross-sectional study
Rebecca Josephson Amos M.D. a, Rosabella Pitera B.S. b, Paige Reimche M.S. c, Kate O’Flynn O’Brien M.D. d, Kylie Fowler M.D., M.S. d
doi : 10.1016/j.fertnstert.2024.07.019
Volume 122, Issue 6, December 2024, Pages 1150-1151
Primary amenorrhea is defined as absence of menarche by age 15 years or within 3 years of thelarche (1, 2). Identifying the underlying etiology of primary amenorrhea has implications for current and long-term health of adolescent females. The most recent study of primary amenorrhea etiologies from the United States was published in 1981 (3) and reviewed data from 262 patients who presented over a 20-year span from 1960–1980. Leading etiologies of primary amenorrhea at the time included hypergonadotropic hypogonadism (43%), hypogonadotropic hypogonadism (31%), and eugonadal causes (26%). Included in eugonadal causes were anatomic/obstructive (18%) and “inappropriate positive feedback” (7%), which was believed to be a type of polycystic ovary syndrome (PCOS). Our clinical experience is inconsistent with these approximately 50-year-old historical data, in which PCOS is among the most common causes of primary amenorrhea. The objective was to update these data and describe the most common underlying etiologies for patients presenting with primary amenorrhea.
Live birth after transmyometrial embryo transfer in a patient with radical trachelectomy
Claire A. Jones M.D. a b, Justin Tan M.D., M.Phil. a b, Pat Chronis-Brown M.Sc. b, Amy Zhu M.Sc. B.M.C. b, Nigel Pereira M.D. a b
doi : 10.1016/j.fertnstert.2024.08.346
Volume 122, Issue 6, December 2024, Pages 1152-1153
To report the successful utilization of transmyometrial embryo transfer (TMET) in a patient with a history of radical trachelectomy
Laparoscopic Vecchietti procedure: pearls for success
Jensara Clay M.D. a, Cecile Ferrando M.D., M.P.H. a, Thomas Gallant D.O. a, Cara R. King D.O., M.S. a
doi : 10.1016/j.fertnstert.2024.08.349
Volume 122, Issue 6, December 2024, Pages 1154-1156
To present an effective strategy for optimizing the care of patients with Müllerian agenesis who desire surgical management for the creation of a neovagina with the laparoscopic Vecchietti procedure.
Robotic techniques in endometriosis: six steps for excision of rectovaginal nodules – the butterfly method
Nicolas Samartzis M.D. a, Dimitrios Rafail Kalaitzopoulos M.D. a, Laurin Burla M.D. a, Mihai Angheluta M.D. a, Benjamin Merlot M.D. b c, Horace Roman M.D. b c d
doi : 10.1016/j.fertnstert.2024.09.022
Volume 122, Issue 6, December 2024, Pages 1157-1159
To present a standardized and reproducible approach for the surgical excision of deep endometriosis in the rectovaginal septum, represented by #ENZIAN A
Enhancing women’s health management for predicting miscarriage risk: a call for broader inclusivity and holistic approaches
Luyang Su M.D., Weilan Liu M.D., Cuiqiao Meng M.B., B.S.
doi : 10.1016/j.fertnstert.2024.07.038
Volume 122, Issue 6, December 2024, Page 1160
The study by Yland (1) published in Fertility and Sterility, July 2024, demonstrated that models predicting the risk of miscarriage using self-reported preconception data are commendable and contribute significantly to the field of reproductive health. Although the findings are significant, they warrant cautious interpretation and further exploration
Reply of the authors: Enhancing women’s health management for predicting miscarriage risk: a call for broader inclusivity and holistic approaches
Jennifer J. Yland Ph.D. a, Zahra Zad Ph.D. b c, Ioannis Ch. Paschalidis Ph.D. b c d, Lauren A. Wise Sc.D. a
doi : 10.1016/j.fertnstert.2024.08.329
Volume 122, Issue 6, December 2024, Page 1161
We thank Drs. Su, Liu, and Meng (1) for their comments on our study (2). In their letter, the investigators call for the adoption of holistic women’s health management programs to reduce miscarriage risk. These programs would include preconception health assessments and education, with a focus on psychological health assessments, lifestyle modification, and preventative care. We agree that such programs would be greatly beneficial. Several predictors that we identified point to modifiable lifestyle factors that mitigate miscarriage risk.
Is the rarity of recurrent implantation failure real or a mirage?
Ryszard J. Chetkowski M.D.
doi : 10.1016/j.fertnstert.2024.07.039
Volume 122, Issue 6, December 2024, Page 1162
The statement of the Lugano workshop on recurrent implantation failure (RIF) offers useful insights, such as reassurance that a normal saline sonogram suffices for optimal implantation or the calculation of equivalent embryo numbers in different age groups (Table 2), but its main argument appears misguided (1).
Reply of the authors: Unexplained recurrent implantation failure is rare!
Paul Pirtea M.D. a, Marcelle I. Cedars M.D., Ph.D. b, Kate Devine M.D. c, Baris Ata M.D., M.Sc. d, Jason Franasiak M.D. e, Catherine Racowsky Ph.D. a, Jim Toner M.D., Ph.D. f, Richard T. Scott M.D. e, Dominique de Ziegler M.D., Ph.D. a, Kurt T. Barnhart M.D., M.S.C.E. g
doi : 10.1016/j.fertnstert.2024.08.327
Volume 122, Issue 6, December 2024, Pages 1163-1164
We thank Dr. Chetkowski for his interest in our article “Recurrent implantation failure (RIF) reality or statistical mirage” (1). We appreciate his compliments and are glad to see that he considers our study as offering several valuable insights, such as reassurance that a normal uterine cavity suffices for optimal implantation and the conversion to equivalent embryo number in different age groups (Table 2 in our study) (1). We also noted the two main criticisms emphasized in his letter to the editor, and we will use this opportunity to clarify our message.
Refining insights on celiac disease and female infertility
Qing Zhou Ph.D.
doi : 10.1016/j.fertnstert.2024.08.310
Volume 122, Issue 6, December 2024, Page 1165
The article by Yuan et al. (1) has investigated the potential causal relationship between celiac disease (CeD) and female infertility using Mendelian randomization (MR), which represents a significant contribution to our understanding of the relationship between them. The study is commendable for its use of MR to minimize the influence of confounding variables and reverse causality, where the use of genetic variation addresses how modifiable exposures influence different outcomes. Nevertheless, I would like to present some suggestions to enhance the reliability and validity of the findings.
Reply of the authors: no association between celiac disease and female infertility: evidence from Mendelian randomization analysis
Shuai Yuan Ph.D. a, Jonas F. Ludvigsson Ph.D. b
doi : 10.1016/j.fertnstert.2024.08.320
Volume 122, Issue 6, December 2024, Page 1166
We thank Dr Zhou for reading our study and providing valuable insights. We agree that further Mendelian randomization studies involving participants of diverse ancestries from various locations can enhance the field. Other types of studies, such as cohort analyses to identify high-risk groups and cost-effectiveness analyses, are also valuable for patient management. Here are our responses to other points raised
Assessing the impact of polycystic ovary syndrome on pregnancy complications in frozen embryo transfer cycles: unexplored factors and clinical implications
Wei-Zhen Tang M.D., Tai-Hang Liu Ph.D., Xia Lan M.D.
doi : 10.1016/j.fertnstert.2024.08.313
Volume 122, Issue 6, December 2024, Page 1167
On meticulous review of the research by Aihaiti et al. (1) regarding the increased risk of pregnancy complications and adverse birth outcomes associated with polycystic ovary syndrome (PCOS) in women undergoing frozen embryo transfer (FET), we are encouraged by the conclusion that women with PCOS may require closer monitoring and additional consultation both pre-pregnancy and during gestation. However, we feel compelled to highlight a few other areas that were not addressed that may play impact the study’s findings.
Reply of the authors: Assessing the impact of PCOS on pregnancy complications in FET cycles: unexplored factors and clinical implications
Reweiguli Aihaiti M.D., Zhihong Niu Ph.D.
doi : 10.1016/j.fertnstert.2024.08.343
Volume 122, Issue 6, December 2024, Page 1168
In in vitro fertilization treatment, recurrent implantation failure (RIF) has diverse definitions and complex causes, among which maternal immune factors are just 1 aspect (1). Patients with a history of immune-related diseases and other reproductive diseases such as adenomyosis and multiple uterine fibroids are excluded from our study. It is challenging and expensive to perform comprehensive immunity indicators test for all patients with infertility; therefore, RIF was not included as study metrics in our research. Some treatments for RIF, such as intravenous immunoglobulin and peripheral blood mononuclear cell, are promising strategies for improving pregnancy outcomes in patients with infertility. However, their effectiveness for all patients with RIF is still debated (2). Further research is required to confirm these findings and explore the effects of drug combinations. In fact, very few patients in our study had received such treatments.
Erratum
Available online 24 October 2024, Version of Record 3 December 2024.
doi : 10.1016/j.fertnstert.2024.09.036
Volume 122, Issue 6, December 2024, Page 1169
In the article “A brief overview of pilot studies and their sample size justification” (Fertil Steril 2024;121:899–901), there is an error in the sample size justification section. The last two lines of the second paragraph should read as follows
