Assisted reproduction depends on concise labels to translate complex gamete and embryo phenotypes into clinically useful information. Yet such labels do not remain purely descriptive. Morphology-based classifications can influence whether an embryo is biopsied, cryopreserved, transferred or discarded; shape patient understanding; define research variables; and become training targets for artificial-intelligence models. The issue is therefore not simply semantic, but how observations acquire inference as they move into decisions, datasets and algorithms. A deviation from an expected phenotype does not necessarily indicate dysfunction, a lower morphological rank does not establish non-viability, and a reference limit is not an individual diagnosis. We argue that terminology in assisted reproduction should be proportional to biological certainty and preserve the distinction between observation, phenotype, ranking, prognosis and demonstrated abnormality. We further propose a pragmatic semantic framework for maintaining those distinctions across clinical communication, research and data-driven applications.
To characterize the morphokinetic profile of blastocyst-stage embryos derived from biphasic capacitation in vitro maturation (CAPA-IVM), using a contemporaneous cohort of controlled ovarian stimulation with intracytoplasmic sperm injection (COS-ICSI) embryos as the reference, with standardized time-lapse imaging. This retrospective cohort study was conducted at an assisted reproduction center from March 2021 to December 2024. Eligible women were aged < 40 years and had no prior fertilization failure, gamete donation, planned preimplantation genetic testing, or significant male factor infertility. CAPA-IVM and COS-ICSI cycles were matched 1:1 on a propensity score built from female age and the number of analyzable embryos in the cycle. Embryos were cultured to the blastocyst stage with time-lapse monitoring. Morphokinetic timings were compared using crude, adjusted mixed-effects, and trajectory analyses, with a crude subgroup analysis of good-quality G1/G2 embryos. Overall, 232 couples contributed 876 embryos (421 CAPA-IVM and 455 COS-ICSI). In crude analyses, CAPA-IVM versus COS-ICSI embryos showed later pronuclear appearance (+ 0.71 h; p < 0.001), earlier pronuclear fading (− 0.92 h; p < 0.001), earlier t3 (− 1.42 h; p < 0.001), and earlier t5 (− 1.40 h; p = 0.017), but later compaction (+ 2.00 h; p < 0.01) and blastulation (+ 1.67 h; p < 0.01). Later pronuclear appearance, earlier pronuclear fading, earlier t3, and earlier t5 with CAPA-IVM versus COS-ICSI remained statistically significant after adjustment. There was a lower proportion of good-quality G1/G2 embryos after CAPA-IVM versus COS-ICSI (29
Random-start controlled ovarian hyperstimulation (COH) is an established strategy for fertility preservation (FP) in cancer patients. Although previous studies have demonstrated its efficacy using a binary classification of menstrual cycle phases (follicular vs. luteal), this approach might not fully reflect dynamic endocrine changes throughout the cycle. This study used a subdivided phase classification to evaluate the ovarian response according to the menstrual cycle phase at random-start COH initiation and further assessed the outcomes according to the ovarian reserve. This retrospective study included 255 cancer patients who underwent random-start COH. Patients were categorized into five menstrual cycle phases at the time of stimulation initiation: early follicular (EF), late follicular (LF), early luteal (EL), mid-luteal (ML), and late luteal (LL). Oocyte yield, total gonadotropin dose, and stimulation duration were compared among groups. A subgroup analysis was conducted in patients with low ovarian reserve (anti-Müllerian hormone [AMH] < 1.2 ng/mL). Total oocyte yield was significantly higher in the LL group than in the EF group, though with a greater total gonadotropin dose and longer stimulation duration. Among patients with low ovarian reserve, luteal phase initiation was associated with significantly higher total and mature metaphase II (MII) oocyte counts compared with follicular phase initiation. The menstrual cycle phase at stimulation initiation influences ovarian response during random-start COH. The LL phase represents an effective window for stimulation initiation, and luteal phase initiation is particularly advantageous for maximizing oocyte yield in patients with low ovarian reserve who require urgent FP.
To investigate the associations of anti-Müllerian hormone (AMH) and antral follicle count (AFC) concordance/discordance patterns with embryological and pregnancy outcomes among patients undergoing their first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle. This retrospective cohort study included 6456 patients undergoing their first IVF/ICSI cycle between January 2018 and January 2024. Patients were classified into the concordant normal group (AMH ≥ 1.2 ng/mL and AFC ≥ 5), the concordant reduced group (AMH < 1.2 ng/mL and AFC < 5), and the discordant group (AMH-normal/AFC-reduced: AMH ≥ 1.2 ng/mL with AFC < 5 or AMH-reduced/AFC-normal: AMH < 1.2 ng/mL with AFC ≥ 5). Regression models were used to evaluate their embryological and pregnancy outcomes. Among 6456 patients, 816 (12.64
To evaluate the clinical phenotype and interpretability of TEX15 gene variants in a real-world cohort of patients with primary testicular disease. We conducted a retrospective single-center study including patients with primary testicular dysfunction. Patients carrying isolated TEX15 gene variants (n = 7) were compared with a pathological control group (n = 145) from a cohort of infertile patients with primary testicular failure without identifiable genetic alterations. Clinical, hormonal, and seminal parameters were analyzed using non-parametric tests. Effect size was estimated using Cliff’s delta. TEX15 gene variants were identified in 0.9
