INTRODUCTION:Despite well-established contraceptive care services in Sweden, there remains an unmet need for contraception. Emergency contraceptive pills are provided over the counter in pharmacies without subsequent contraceptive counselling. Use is widespread, yet research on Swedish emergency contraceptive users is limited. Understanding their experiences is important for tailoring contraceptive care to their needs. OBJECTIVE:To explore young emergency contraceptive pill users' experiences and perceptions on contraceptive decision-making and contraceptive use. MATERIALS AND METHODS:We performed a qualitative content analysis with an inductive approach on semi-structured interviews in 10 participants between 17 and 26 years old, who purchased emergency contraceptive pills in community pharmacies in Stockholm, Sweden. RESULTS:The theme 'Navigating reproductive autonomy through perceptions, information and norms' was identified, supported by three categories: i) Emergency contraception at pharmacies facilitates reproductive autonomy, where participants shared their appreciation of easy access, ii) Internal perceptions and external information sources affect contraceptive use, considering factors such as one's personal situation and social media, and iii) Perceived social norms and their role in contraceptive experiences, where influences from social context and perceived stigma were mentioned. CONCLUSION:To support informed decision-making and reproductive autonomy, providers need to ensure easy access to contraception, while sustaining non-judgemental environments and actively countering myths and misconceptions with accurate, evidence-based information both offline and online. LAY SUMMARY:This is a qualitative study of 10 interviews with participants aged 17-26 years, who purchased emergency contraceptive pills in community pharmacies in Stockholm, Sweden. We explored experiences and perceptions of these young women on contraceptive decision-making and contraceptive use. Our findings show that community pharmacies play a role in facilitating reproductive autonomy and providing emergency contraceptive pills with minimal barriers to access. Contraceptive decision-making is shaped by internal perceptions, external information sources and different perspectives through friends, family and societal norms. Young women's views on contraception emphasise the wish for a personal approach suitable to their bodies and situational needs. They are navigating new information channels, in which social media plays a prominent role. Healthcare providers can play a role in creating a safe, supportive and non-judgemental environment, offline and online.
LAY SUMMARY:Infertility is a concern for cancer patients who wish to conceive after completing chemotherapy treatment. Puncturing the ovary is part of the IVF procedure, aimed at collecting eggs to fertilize and transferring them to the uterus. We decided to study whether the inflammation and tissue damage caused by puncturing the ovaries could stimulate the collection of healthy eggs in patients who have gone through chemotherapy. To this end, we used female mice that were treated with a frequently used treatment for breast cancer, along with ovarian puncture. We discovered the alterations did not affect follicle growth or egg retrieval. With these findings, we demonstrated, for the first time, the ability of ovarian puncture to bring about healthy egg retrieval, improving quality of life after cancer.
GRAPHICAL ABSTRACT: ABSTRACT:To explore the relationship between endometrium, quality of transferred embryo, and their effects on the live birth outcome of IVF/ICSI-ET using different downregulation protocols, we conducted a retrospective cohort study in an academic reproductive medical center. A total of 13,585 participant's first fresh embryo transfer cycles, comprising 10,951 cycles using the GnRH-agonist regimen and 2,634 cycles using the GnRH-antagonist regimen, were included in this study. We found that the first fresh embryo transfer cycles using the GnRH-agonist downregulation regimen achieved a significantly improved live birth rate (41.9%) compared with the fresh cycles using the GnRH-antagonist regimen (30.4%). This was accompanied by a significantly thicker endometrium on the day of hCG administration. In the general population, increased endometrial thickness in the agonist group demonstrated a protective effect on the live birth. The cutoff value of endometrial thickness for live birth increased with the addition of poor-quality embryos in the double cleavage-stage embryo transfer cycles and the single blastocyst transfer cycles. Different choices of downregulation strategy affect the endometrium and the treatment outcome of IVF/ICSI-ET. LAY SUMMARY:The union of an embryo and the uterine lining is much like that of a seed and soil. The process of nurturing life resembles a seed taking root, sprouting, and bearing fruit. Different seeds require different conditions and soils. In assisted reproductive technology, the downregulation protocol used can affect the state of the uterine lining. Embryos of varying quality also have different chances of successful implantation. Just as fertile soil supports a seed's growth, an endometrium of suitable thickness favors embryo implantation. When seed quality is less than ideal, a richer soil may improve its chance to take root. Similarly, when the available embryos are of lower quality, a thicker endometrial lining is associated with a higher live birth rate.
ABSTRACT:In women with uterine adenomyosis, bleeding and pain can have a major impact on quality of life. There is clearly a widespread demand for effective long-term medical therapies. The objective of this narrative review was to investigate the efficacy of oral gonadotropin-releasing hormone (GnRH) antagonists in the management of uterine adenomyosis by analyzing data from two post hoc analyses of two prospective randomized trials (elagolix and relugolix), one retrospective study (relugolix) and one prospective study (linzagolix). All three GnRH oral antagonists were able to control the disease and uterine fibroid-related heavy menstrual bleeding, enhancing quality of life. When administered without add-back therapy, high doses of GnRH antagonists were found to significantly and rapidly reduce uterine volume and the severity of adenomyotic lesions. Nevertheless, some limitations should be addressed. The post hoc analyses were a retrospective look at two prospective randomized clinical trials. In the elagolix study, most women underwent both transvaginal ultrasound and magnetic resonance imaging (MRI). Some who opted out of MRI may have had concurrent adenomyosis that was undetected by ultrasound, so they were not included in the adenomyosis subset. In the relugolix study, baseline ultrasounds were not specifically performed to spot adenomyosis that may have been overlooked in case of large fibroids, as shadowing can partially or completely obscure the disease. While the linzagolix study is prospective and evaluates data from women with proven adenomyosis documented by MRI, the number of cases is limited and randomized controlled trials are needed to confirm and validate this concept. LAY SUMMARY:Uterine adenomyosis is characterized by the presence of endometrial glands inside the myometrium, the muscular layer of the uterus. Transvaginal ultrasound and magnetic resonance imaging now facilitate its diagnosis. The estimated prevalence of adenomyosis among patients of reproductive age is 20-30%. Rising rates in younger patients combined with a growing trend to postpone first pregnancy underscore the importance of understanding the mechanisms behind its development. We need novel strategies for the treatment of typical but distressing symptoms of adenomyosis, which include pelvic pain, abnormal uterine bleeding, menstrual cramps, painful sex and infertility. There is a lack of approved pharmacological agents specifically indicated for the treatment of adenomyosis, presenting a clear unmet need in this population. Oral gonadotropin-releasing hormone (GnRH) antagonists have recently emerged as a promising new therapeutic option. Their advantages over GnRH agonist depot formulations include an absence of the flare-up effect, hence avoiding initially worsening symptoms and rapid reversibility.
ABSTRACT:Gender-affirming hormone therapy (GAHT) facilitates the desired phenotypic changes consistent with an individual's gender identity. However, inter-individual variability in treatment effects has been reported at the endocrine and testicular tissue levels. To address the hypothesis that treatment effects are not homogeneous, we selected 24 persons from a cohort of 453 persons assigned male at birth, based on a similar dose of cyproterone acetate (Androcur®, 10 or 12.5 mg/day). Principal component analysis and hierarchical clustering on principal components were performed considering clinical parameters and identified four distinct clusters. Cluster 1 (n = 3) was characterized by the presence of tubules with round or elongated spermatids, the highest numbers of reserve spermatogonia (Adark) and cells positive for UTF1, PIWIL4, NANOS3 and KIT. Persons in Cluster 2 (n = 4) showed a high percentage of tubules with spermatogonia as the most advanced germ cell type and high testosterone levels that were not suppressed to the desired female values. Persons in Cluster 3 (n = 10) had low testosterone but elevated AMH levels and suppressed spermatogenesis to the spermatogonial level. Finally, persons in Cluster 4 (n = 7) had the highest number of Sertoli cell-only tubules and tubular shadows, as well as the highest person age. Despite homogeneous inclusion criteria, we observed heterogeneous treatment effects. Consultation regarding contraceptives, as well as fertility preservation, therefore has to be considered in counselling, ideally prior to initiation of GAHT. LAY SUMMARY:Hormonal therapy can help to align one's physical appearance with gender identity. However, hormonal therapy does not work the same way for everyone. The effects on testis function, including hormone and sperm production, can vary considerably. In this study, we characterized persons who received comparable therapies to transition to their desired female gender. We found four subgroups: in Group 1, sperm was still produced by testicular tissues. In Group 2, only precursors of sperm were present, but male, rather than the desired female, hormone levels were observed. In Group 3, only precursors of sperm were present, and desired hormone levels were reached. Finally, Group 4 largely showed loss of germ cells and included the oldest people in the study. These results are relevant for counselling, as individuals need to be informed about the different effects that hormonal therapy can have with regard to sperm production and thereby fertility.
ABSTRACT:Psychological resilience is an adaptive capacity that enables individuals to maintain or regain equilibrium following stress. Infertility treatment represents a significant psychological stressor for many couples. Although higher resilience has been associated with better psychological well-being in patients undergoing medically assisted reproduction, its relationship with embryological outcomes remains unknown. This study aimed to determine whether psychological resilience in couples undergoing infertility treatment is associated with blastocyst quality. In this prospective observational study, a total of 126 infertile couples who underwent intracytoplasmic sperm injection using fresh autologous gametes were included. Psychological resilience in both partners was assessed using the 10-item Connor-Davidson Resilience Scale. The numbers of mature oocytes retrieved, semen parameters, and sperm histone retention were evaluated. The primary outcome was the day 5 good-quality blastocyst development rate. Higher psychological resilience in men, but not in women, was independently associated with a higher good-quality blastocyst development rate (B = 0.06, 95% CI: 0.01-0.11, P = 0.02) and remained significant in sensitivity analyses. Male resilience was also positively correlated with sperm morphology (ρ = 0.28, P = 0.001) and inversely correlated with sperm histone retention (ρ = -0.26, P = 0.02). Psychological resilience in men, but not in women, was associated with sperm characteristics and blastocyst quality in couples undergoing infertility treatment. These findings suggest that psychological factors may be reflected in biological parameters relevant to reproduction. Further studies are needed to investigate the underlying mechanisms and reproductive outcomes beyond embryo development. LAY SUMMARY:Psychological resilience is the ability to adapt to and recover from stressful situations. Infertility treatment can be emotionally challenging for couples, but it is not known whether resilience is related to laboratory outcomes during treatment. In this study, we assessed psychological resilience in 126 couples undergoing intracytoplasmic sperm injection, a fertility treatment in which one sperm is injected into each mature egg. We found that higher resilience in men was associated with better sperm characteristics and a higher rate of good-quality embryos reaching the blastocyst stage on day 5. This association was not observed in women. These findings suggest that psychological factors in men may be linked to biological features relevant to reproduction. However, this was an observational study and cannot establish cause and effect. Larger studies are needed to confirm these findings and to understand the biological mechanisms involved.
GRAPHICAL ABSTRACT: ABSTRACT:The aim of this retrospective study in assisted reproductive technology was to provide new evidence that i) the visibility of the meiotic spindle (MS) in human oocytes with an extruded first polar body predicts not only nuclear maturation but also embryo ploidy and ii) the interval between ovulation triggering and ICSI-mediated fertilization affects the chromosomal status of embryos. MS visibility was assessed using polarized light microscopy, and the trigger-to-fertilization interval was adjusted accordingly to increase the likelihood of complete oocyte nuclear maturation. Extending the trigger-fertilization interval based on MS status significantly increased the proportion of mature oocytes (displaying both MS and polar body) from 79 to 92% (P < 0.05), indicating ongoing spindle assembly. Of 1,879 oocytes examined under polarized light, 462 (24.5%) developed into embryos undergoing PGT-A. Embryos derived from immature oocytes (without visible MS or with a spindle bridge to the polar body) had a euploidy rate of 14%, compared with 42% in embryos from mature (visible MS) oocytes (P < 0.05). Differences in embryo euploidy were also associated with the interval between ovulation trigger and ICSI fertilization. Cycles with a trigger-ICSI interval of 40-44 h had a significantly higher likelihood of euploidy (47%) compared with cycles in which the trigger-ICSI interval was 36-39 h (33%) (P < 0.05). For example, in women of advanced maternal age, who exhibit an increased risk of embryonic aneuploidy, spindle-guided assessment of oocyte maturation and quality may improve the prediction of subsequent embryo ploidy. LAY SUMMARY:This IVF study investigated whether giving human eggs more time to mature before fertilization can improve embryo quality. Eggs showing clear signs of full maturity under the polarization microscope were more likely to develop into embryos with the correct number of chromosomes. Having the correct chromosome number is important for healthy embryo development and a successful pregnancy. Eggs that were given a few extra hours to mature before fertilization were more likely to produce healthy embryos with the correct number of chromosomes. The best results were seen when fertilization took place 40-44 h after the hormone injection, rather than 36-39 h later. Fertilization was carried out using a procedure in which a single sperm is injected directly into an egg. These findings suggest that careful assessment of egg maturity and optimization of fertilization timing may help improve IVF outcomes.
GRAPHICAL ABSTRACT: ABSTRACT:Surrogacy is a form of assisted reproductive technology in which a woman carries a child on behalf of an individual or couple and relinquishes the child following birth. Since its emergence in its contemporary form in the late 1970s, surrogacy has been the subject of ongoing debate and controversy, shaped by developments in scientific research and social discourse. This work proposes a theoretical framework that directly engages with the ethical and practical paradoxes of surrogacy rather than bypassing them. The analysis is grounded in a comprehensive review of 86 scholarly articles drawn from international, cross-disciplinary literature. The aim of this research is to approach surrogacy through a non-binary, socially informed lens, placing surrogates themselves at the center of the inquiry. First, it clarifies the conceptual distinction between reproductive rights and reproductive justice, exploring their respective contributions to surrogacy debates on regulation without oversimplifying the issues or reducing them to binary frameworks. Second, it mobilizes these frameworks to diagnose how surrogates' autonomy, health, and agency are unevenly protected across national and transnational arrangements, focusing on different geographies to illustrate de diversity of surrogacy practices. Third, it critically examines institutional responses - particularly medical, legal, and associational forms of regulation - highlighting both their potential and their limitations in advancing reproductive justice for surrogates. By adopting a cross-disciplinary perspective, this work seeks to reorient the discussion toward the experiences of surrogates and to inform political decision-making concerning assisted reproductive technologies within the context of an expanding global reproductive market. LAY SUMMARY:Surrogacy is when a woman carries a child for someone else and gives the baby to them after birth. While this practice helps people become parents, it also raises complex ethical and social questions. This review looks at 86 studies from different countries and disciplines to better understand these issues. It proposes a new way to think about surrogacy, focusing on the rights and experiences of the women involved, especially surrogates and donors. The study shows that many women, especially in the Global South, face problems such as poor access to healthcare and limited information about the process. It also highlights how medical and legal systems often fail to protect them. By combining ideas from human rights and feminist movements, the review offers a tool to identify these problems and calls for stronger protections. It encourages global rules to ensure that surrogacy respects women's health, rights, and dignity, no matter where they live.
GRAPHICAL ABSTRACT: ABSTRACT:This study addresses the limited knowledge of immune cells and their origins in the human fetal testis. By identifying and localising macrophages, T cells, neutrophils, and mast cells, evidence of their potential roles in testicular and epididymal development is provided. Macrophages (CD68+), T cells (CD3+), neutrophils (CD66b+), and mast cells (tryptase+ and chymase+) were identified using immunohistochemistry and immunofluorescence in 20 formalin-fixed fetal testes (and epididymides, when present) collected at autopsy from stillborn fetuses (gestational weeks, GW14-41). Immune cell transcripts were compiled from published scRNA-seq datasets from human embryonic (GW6-8) and fetal (GW12-16) testes. CD68+ macrophages were abundant in interstitial, testis border, and perivascular regions, increasing adjacent to cords from GW23 onward. Interstitial CD3+ T cells were rare in second trimester but more frequent in the third. CD66b+ neutrophils were extremely rare. Chymase+ mast cells were absent, while tryptase+ mast cells were present near the capsule and vessels. scRNA-seq identified CD68-expressing cells as the predominant immune population from GW6-16. This first description of multiple immune cell types in the human fetal testis reveals similarities to murine testes; in both species, early macrophage abundance, preceding bone marrow haematopoiesis, suggests yolk sac and/or liver origins, while later-appearing immune cells are likely bone marrow-derived. The near-complete absence of Ly6G+ neutrophils in the later gestation stages differs from observations in mouse. These findings highlight potential developmental windows vulnerable to immune-related disruption and reinforce the value of mouse models for understanding human testis development. LAY SUMMARY:This study examines how the immune system helps the testicles to form before birth. In animals, immune cells called macrophages are important for early testis development, but their roles and those of other immune cells in humans were unclear. We studied tissues from 20 stillborn babies between 14 and 41 weeks of pregnancy to identify immune cells in developing testes and compared our results with existing genetic data. We found that macrophages were the most common immune cells, appearing early and increasing in number as the testis grew. Other immune cells, including T cells and mast cells, appeared later. Our findings suggest that macrophages come from early sources, such as the yolk sac or fetal liver, and play a key role in building the testis. Understanding these processes could reveal how factors affecting immune cell functions before birth could impair male fertility in men.
GRAPHICAL ABSTRACT: ABSTRACT:Viral infections are associated with early pregnancy loss and later gestational complications, including preeclampsia and fetal growth restriction. While viral components, including viral double-stranded RNA (dsRNA), have been shown to affect placental trophoblast function, how these components may affect maternal endometrial function is less understood. Endometrial stromal cells make up the bulk of the human endometrium, and they undergo a specialized hormone-driven differentiation process termed decidualization, monthly in preparation for pregnancy. We have previously shown that these stromal cells exhibit robust inflammatory responses to bacterial LPS and viral dsRNA. The goals of this study are to determine the effects of prior viral dsRNA exposure on endometrial decidualization and whether this affects subsequent placentation and pregnancy outcomes. Using a combination of 2D endometrial stromal cell cultures, 3D human endometrial assembloids, and mouse models of decidualization and pregnancy, we demonstrated that exposure to viral dsRNA (Poly(I:C)) 48 h prior to hormonal stimulation impaired decidualization in vitro and in vivo. Similarly, preimplantation exposure to Poly(I:C) on GD0.5 in timed-mated dams inhibited decidualization, reduced implantation success, and induced fetal growth restriction. This was associated with altered placentation, in particular, formation of the Syn-TII cells in the labyrinth zone, and dysregulated expression of glucose and amino acid transporters in the placenta. This work emphasizes the importance of preconception endometrial health for successful pregnancy and identifies a novel mechanism by which prior viral infection can lead to implantation failure and later pregnancy complications. LAY SUMMARY:Viral infections increase the risk of early pregnancy loss and later complications, such as poor fetal growth. While viruses are known to affect the placenta, less is understood about their impact on the uterine lining, which must be healthy for pregnancy to begin. The uterine lining is made up of cells that undergo changes each month called decidualization, which is driven by hormones to help with implantation. In this study, we examined how early exposure to viral infection affects decidualization and pregnancy outcomes. Using cell cultures, 3D uterine models, and mouse studies, we found that exposure to viral factors impaired decidualization, reduced embryo implantation, and disrupted fetal growth. These effects were linked to abnormal placental development and altered nutrient transport to the fetus. Overall, our findings show that uterine health before conception is critical for successful pregnancy and identify a mechanism by which early maternal viral infections may lead to pregnancy complications. This provides exciting opportunities to screen and prevent complications much earlier on in pregnancy.
ABSTRACT:Following semen deposition, the female reproductive tract must balance immune tolerance towards spermatozoa with preservation of antimicrobial defence. To date, much of our understanding of female immune response following insemination has been derived from models of pathogen defence and uterine receptivity in humans, with comparatively little on how these same immune pathways shape successful sperm transport. Here, we summarise the relationship between early sperm transport immediately following semen deposition and acute innate immune activation, characterised by complement engagement and rapid leukocyte recruitment. Polymorphonuclear neutrophils, traditionally viewed as terminal effectors of sperm clearance, are reframed as active mediators of innate surveillance and sperm immune adaptation. Spermatozoa enter the female environment bearing a molecular identity shaped by testicular development, epididymal maturation, and exposure to seminal plasma, yet the link between specific mediators, immunity, and fertility has yet to be explored in livestock. Seminal plasma extracellular vesicles stand out as a promising mediator of complement activity and cytokine signalling. Disruption of this male-derived immune conditioning through processing for cryopreservation is hypothesised to explain impaired sperm transport in sheep. Orchestrating male and female contributions to the maternal immune response reframes reproductive success as coordinated sperm-immune communication. This review identifies knowledge gaps whose resolution will advance our understanding of immune tolerance to spermatozoa, informing strategies to enhance the success of assisted reproductive technologies in livestock. LAY SUMMARY:Successful reproduction requires a highly functional immune response to defend against pathogens while facilitating sperm transport. This review explores how sperm and seminal plasma actively communicate with the female immune system immediately following semen deposition. We highlight how immune cells and complement proteins shape sperm survival, and how alterations to the sperm immune profile during in vitro processing may disrupt this delicate balance of communication within the female.
ABSTRACT:Maternal mortality remains a critical public health challenge in Nigeria, with rates far exceeding global targets. This narrative review correlates findings from peer-reviewed studies published between 2015 and 2025 to assess the burden, causes, and contributing factors of maternal mortality across Nigeria's six geopolitical zones. PubMed and Google Scholar were searched using predefined keywords, and studies reporting maternal mortality ratios (MMRs), causes of death, or contributing factors from Nigerian health facilities or population-based surveys were included. Hypertensive disorders of pregnancy (HDP) and obstetric hemorrhage were consistently identified as the leading direct causes of maternal death, while complications of unsafe abortion and sepsis were also prominent. Most of the non-medical contributing factors identified in this review study were poor utilization of prenatal care (PNC) services, limited access to healthcare facilities, financial constraints, and low educational attainment. Significant regional variation was observed, with facility-based MMRs ranging from 383 to 7,364 per 100,000 live births. This study emphasizes the urgent need for strengthened PNC delivery, improved emergency obstetric services, health workforce development, and targeted community health education to reduce maternal mortality in Nigeria. LAY SUMMARY:Deaths from pregnancy-related causes remain a major public health concern, especially in less developed countries. Nigeria is one of the countries with high pregnancy-related deaths. A substantial number of women who become pregnant in Nigeria never make it through the pregnancy. Our study investigated pregnancy-related deaths and their responsible factors across Nigeria. We found out that most of these deaths are caused by pregnancy-related bleeding, high blood pressure, and their complications. Pregnant women who do not attend prenatal care and those with low socioeconomic status are affected the most. Understanding the causes and contributing factors behind pregnancy-related deaths can help create ways to reduce this serious public health problem.
ABSTRACT:Dysmenorrhoea is the most common gynaecological condition in women of reproductive age. Approximately 90% of cases are primary dysmenorrhoea (PDM), which is not associated with an underlying pathology. Dysmenorrhoea can have a substantial impact on quality of life, yet current therapies do not provide adequate relief to everyone. Family history (FHx) is a known risk factor that suggests genetic involvement. We therefore aimed to synthesise the literature describing the genetics of PDM. Three databases (MEDLINE, Embase and Web of Science) were searched for studies published up to November 2025. Key search terms included 'dysmenorrhea', 'polymorphism' and 'SNP'. Articles were screened independently by two researchers, and data were extracted and presented in a narrative format. Quality assessment was conducted using the Newcastle-Ottawa Scale and STREGA guidelines. Fifteen articles were included in the review (n = 7 case-control; n = 4 cross-sectional; and n = 4 genome-wide association studies (GWASs)). Candidate gene studies identified seven polymorphisms and two combined genotypes that were associated with PDM. One significant positive association was replicated in two studies (ESR1 PvuII). GWASs highlighted loci near the NGF, ZMIZ1, IL1A and IL1B genes. The NGF and IL1 loci support what is known about the involvement of inflammatory pathways in PDM pathogenesis. However, they are also known endometriosis loci. The current literature is limited by a lack of adequate secondary dysmenorrhoea case exclusion, limited ethnic populations and low quality. Further research in multiple ancestries is essential to increase generalisability, while thorough diagnostic protocols will reduce misclassification, improve understanding of PDM pathogenesis and thus help inform new treatment development. LAY SUMMARY:Period pain is extremely common in menstruating women and has a major impact on their lives, yet we still do not have a full understanding of its biological causes or how to treat all women effectively. Research shows that period pain can run in families; therefore, we conducted this review to highlight which genes appear to be related to period pain (specifically period pain that is not caused by an existing condition, such as endometriosis or fibroids). After searching three academic databases, we found 15 studies that met our criteria. Three genes were highlighted across two or more studies; these genes are known to be involved in pain processing and how the body deals with immune responses and oestrogen (a female hormone). From this review, we know that we need more research on this topic as there are still likely to be more genes involved in period pain and these might vary in different ethnic populations.
LAY SUMMARY:In the UK, every day about five children receive a diagnosis of cancer. Although the majority (over 80%) will survive, some will become infertile depending on the severity of the treatment received during childhood. Currently, there are no medical treatments available to protect male fertility. This study assessed if rapamycin, a drug currently used to treat other medical conditions, which has been shown in experimental studies to help protect female fertility from cancer treatment, could be used to protect male fertility. Results showed that rapamycin did not prevent overall loss and damage of the cells that will develop into sperm. Further studies are needed to find medical strategies to preserve young boys' fertility.
ABSTRACT:Fluctuations in endogenous sex hormones across the menstrual cycle (MC) have been hypothesised to have physiological changes that could influence athletic performance. Due to the marginal nature of elite sport, even subtle physiological changes can meaningfully influence performance outcomes in elite female athletes. This systematic review and meta-analysis evaluated the effects of the menstrual cycle phase (MCP) on maximal oxygen uptake (VO2 max) in elite female athletes. Bibliographic databases were searched for studies that confirmed the MCP through serum or plasma hormone analysis and that involved elite or well-trained athletes. Meta-analyses compared VO2 max between early follicular (EF) and mid-luteal (ML) phases. Across five studies, no statistically significant differences were found in VO2 max between phases, although small, non-significant decreases in performance were observed in the EF phase. Despite null results, biological plausibility and athlete-reported experiences suggest that minor or individual-specific effects of MCP on performance may exist. Future research should use standardised protocols, larger cohorts and individualised sport-specific outcomes to better understand how MC dynamics influence an elite female athlete's performance. A suggested standardised protocol for conducting future research in this area was developed. LAY SUMMARY:Elite female athletes train and compete at the highest levels of sport, where even small changes in performance can make a difference between winning and losing. One possible under-researched influence on performance is the menstrual cycle (MC). During this monthly cycle, there are natural changes in hormone levels. We looked at all the published research to explore whether different MC stages affect sports performance in elite female athletes. No substantial evidence was found that endurance changes significantly across the cycle. However, a slight trend showed that performance might be negatively impacted during menstruation, when hormone levels are low. While these results suggest that the MC might not have a major impact overall, small changes could still matter in elite sport. More research with larger groups and better testing methods is needed to fully understand how the MC might affect an individual athlete's performance.
