BACKGROUND: Functional syncope and vasovagal syncope (VVS) in children both present with transient loss of consciousness (TLOC) and are clinically challenging to differentiate. This study aims to delineate the distinguishing features among factors associated with TLOC induction in these two conditions. METHODS: A total of 31 children presenting with syncope and diagnosed as functional syncope were enrolled in the functional syncope group; concurrently, 40 children presenting with syncope and diagnosed with VVS were enrolled in the VVS group. Clinical manifestations— including demographic characteristics, precipitating factors, prodromal symptoms, syncope episode characteristics, family history, and psychosocial stressors—were systematically compared between the two groups. RESULTS: Body weight was significantly higher in the functional syncope group than in the VVS group (P < 0.05). No statistically significant differences were observed between the groups in terms of sex distribution, age, body height, or baseline resting heart rate (P > 0.05). Compared with the VVS group, the functional syncope group exhibited significantly fewer identifiable triggers, fewer presyncope symptoms, and a lower prevalence of familial syncope history (all P < 0.05). Conversely, the functional syncope group demonstrated significantly longer syncope duration, higher syncope frequency, and greater exposure to emotional stress events (all P < 0.05). Disease duration did not differ significantly between the two groups (P > 0.05). CONCLUSIONS: Children with functional syncope exhibit distinct clinical profiles relative to those with VVS, characterized by fewer precipitating factors and prodromal symptoms, longer duration and higher frequency of syncope episodes, reduced familial syncope history, and increased association with emotional stress events.

Spermatogenesis is precisely regulated by an intricate genetic network, but the biological roles of numerous testis-enriched genes remain unelucidated. This study aimed to systematically investigate the expression pattern, subcellular localization and functional significance of Testis-Expressed Gene 29 (Tex29) in mice and male fertility. Integrated molecular, cellular, and animal model approaches were employed. Tex29 mRNA and protein expression were analyzed by molecular and immunofluorescence staining techniques. CRISPR/Cas9-mediated genome editing was used to generate Tex29-knockout (KO) mice. Fertility assessment, histological examination of testes, sperm quality analysis, and transmission/scanning electron microscopy were performed on Tex29-KO mice. Additionally, whole-exome sequencing was conducted in 165 infertile men to identify Tex29 variants. Tex29 mRNA was specifically expressed in testes, first detectable on postnatal day 18 and gradually upregulated during testicular maturation. TEX29 protein was specifically localized to the acrosome of spermatids and mature sperm throughout spermiogenesis. Tex29-KO males exhibited normal fertility with litter sizes comparable to wild-type (WT) controls, and their seminiferous tubules retained intact structure with all spermatogenic stages. No significant differences in sperm concentration, viability, or motility were observed between Tex29-KO and WT mice. Although Tex29-KO sperm maintained normal overall morphology and canonical "9 + 2" axonemal structure in the flagellum, a subset showed acrosomal membrane abnormalities in the apical region. In vitro fertilization (IVF) rates and blastocyst development were uncompromised in Tex29-KO mice. Two synonymous TEX29 variants (c.66C > T, p.Asp22Asp; c.207C > A, p.Ile69Ile) were identified in 7 of 165 infertile men, and four couples carrying these variants achieved live births. TEX29 is a novel testis-specific acrosomal marker protein essential for maintaining normal acrosomal membrane integrity during murine spermiogenesis. Notably, Tex29 is dispensable for spermatogenesis and male fertility in mice. The functional role of TEX29 in human spermatogenesis and fertility remains to be fully determined due to limited clinical evidence. These findings provide valuable insights for basic research on acrosome biogenesis and male infertility associated with acrosomal abnormalities.

BACKGROUND:Microdissection testicular sperm extraction is the preferred method for sperm retrieval in men with non-obstructive azoospermia. However, the effects of sperm retrieval quantity and freezing on intracytoplasmic sperm injection outcomes remain incompletely understood. OBJECTIVES:To evaluate the impact of sperm quantity and freezing status on fertilization and cumulative live birth rate following intracytoplasmic sperm injection using microdissection testicular sperm extraction spermatozoa in non-obstructive azoospermia patients. MATERIALS AND METHODS:We retrospectively analyzed 1394 microdissection testicular sperm extraction-intracytoplasmic sperm injection cycles performed between 2017 and 2022 at a single tertiary center. Sperm retrieval yield was stratified into three groups: sufficient sperm count (> 10 spermatozoa/100 fields), low sperm count (6-10/100), and extremely low sperm count (1-5/100). Fertilization rate (two pronuclei) and cumulative live birth rate were compared across sperm retrieval yield and freezing subgroups. Multivariable regression and interaction models assessed the independent and combined effects of sperm quantity and freezing status. RESULTS:Fertilization and cumulative live birth rate declined significantly with reduced sperm counts (two pronuclei: 53.6%→32.2%; cumulative live birth rate: 49.8%→21.8%; p < 0.001). Frozen spermatozoa yielded comparable outcomes to fresh spermatozoa overall, but in the extremely low sperm count group, frozen spermatozoa were associated with a significantly lower cumulative live birth rate than fresh spermatozoa (12.3% vs. 29.3%; p = 0.015). Interaction analysis confirmed this adverse effect (OR = 0.39; 95% CI 0.16-0.95; p = 0.038). No significant freezing effect was observed in the other groups. CONCLUSION:Sperm retrieval quantity is an important predictor of intracytoplasmic sperm injection success in men with non-obstructive azoospermia. Freezing generally does not affect outcomes, but may significantly reduce live birth rates when sperm availability is extremely limited. Prioritizing the use of fresh spermatozoa in such cases may improve clinical outcomes.

To evaluate the incidence of new-onset Hypertensive Disorders of Pregnancy (HDP) in donor sperm IVF (DS-IVF) compared with partner sperm IVF (PS-IVF) pregnancies. We retrospectively analyzed a total of 855 DS-IVF cycles and 4,816 PS-IVF cycles of pregnancies delivering after 20 weeks’ gestation achieved live birth between January 2010 and December 2022. All patients underwent fresh embryo transfer after oocyte retrieval. The incidence of new-onset HDP was compared between the two groups. The overall incidence of new-onset HDP was 1.7

Asthenoteratozoospermia represents a leading cause of idiopathic male infertility, characterized by diminished sperm motility and aberrant morphology. Testis-expressed protein 44 (Tex44) is essential for sperm flagellar development in mice, yet its pathogenic contribution to human asthenoteratozoospermia and clinical translational relevance remain largely undefined. This study aimed to characterize the role of TEX44 in sperm structure and function, identify pathogenic TEX44 variants in infertile men, and evaluate intracytoplasmic sperm injection (ICSI) as a fertility-rescue strategy. A Tex44-knockout (Tex44⁻/⁻) mouse model was generated using CRISPR/Cas9. Sperm parameters were analyzed by computer-assisted sperm analysis (CASA), coupled with ultrastructural, transcriptomic, and functional fertility assays (in vivo fertilization, IVF, ICSI). Whole-exome sequencing (WES) was performed in 535 well-phenotyped infertile men, and candidate TEX44 variants were verified by Sanger sequencing. Protein structure prediction and clinical ICSI outcome analysis were also performed. Tex44⁻/⁻ mice displayed asthenoteratozoospermia, marked by disrupted axonemal 9 + 2 microtubule organization, defective mitochondrial sheath assembly, and compromised fertility, all of which were effectively rescued by ICSI. Transcriptomic profiling demonstrated dysregulation of pathways governing flagellar structure and mitochondrial function. In humans, three pathogenic TEX44 variants were identified in seven affected individuals. All patients presented with severe semen abnormalities. ICSI resulted in favorable reproductive outcomes, including healthy live births. Tex44 deficiency causes asthenoteratozoospermia by impairing sperm axonemal integrity and mitochondrial sheath assembly. Pathogenic TEX44 variants are associated with human asthenoteratozoospermia, and ICSI serves as an effective therapeutic intervention for affected patients. These findings establish TEX44 as a novel diagnostic biomarker, broaden the genetic architecture of male infertility, and strengthen the translational bridge between basic science and clinical reproductive care.

STUDY QUESTION:Can preimplantation genetic testing for monogenic defects (PGT-M) be achieved by performing third-generation sequencing (TGS) only on the proband for families with de novo variants or incomplete pedigrees? SUMMARY ANSWER:Whole-genome TGS facilitates a simplified PGT-M workflow by establishing reliable haplotypes solely from proband sequencing involving de novo variants or incomplete pedigrees. WHAT IS KNOWN ALREADY:PGT-M enables the accurate exclusion of embryos carrying pathogenic variants. However, its application to de novo variants or incomplete pedigrees is hindered by haplotype phasing. Moreover, direct variant detection suffers from detection failure and erroneous genotyping due to uneven coverage and allele dropout caused by whole-genome amplification. Current solutions, such as gamete or embryo analysis and targeted TGS, remain constrained by procedural complexity and lack of universality across different genes and mutation types. STUDY DESIGN, SIZE, DURATION:This prospective study enrolled 16 families requiring PGT-M with de novo variants or incomplete pedigrees at the Reproductive Medicine Center of Peking University Third Hospital from July 2023 to August 2025. PARTICIPANTS/MATERIALS, SETTING, METHODS:This study included 9 families with incomplete pedigrees and 7 families with de novo variants, covering 10 distinct disease-causing genes or regions. To assess the capability of TGS for haplotype phasing, we evaluated its performance regarding genomic coverage and the retrieval of informative single-nucleotide polymorphisms (SNPs). Haplotypes were constructed using proband TGS data, and linkage analysis was performed by integrating linked heterozygous SNPs with next-generation sequencing data from the couple and embryos to determine pathogenic status. Subsequently, we developed a simplified strategy that inferred inheritance by comparing heterozygous SNPs from the proband's haplotype directly against corresponding homozygous sites in the embryos. The diagnostic outcomes of this simplified workflow were statistically evaluated and compared with those of the standard TGS strategy to assess concordance. MAIN RESULTS AND THE ROLE OF CHANCE:Phase blocks generated by TGS achieved >75% coverage for the vast majority of OMIM genes, most of which contained more than 100 heterozygous informative SNPs located in the gene body and their 1 Mb flanking regions, indicating a wide range of applicability in a variety of gene variants. Haplotypes were successfully constructed for all 16 enrolled families using TGS data, with 14 families having completed embryo testing, while the 2 families withdrew due to personal reasons. To date, prenatal diagnosis via amniocentesis in three families has confirmed the fetuses to be free of pathogenic variants. A simplified strategy was further applied to 14 families that completed the embryo testing process. This approach achieved applicability rates of 91.9% and 80.0% in embryos from non-D4Z4 and D4Z4 families, respectively. While diagnosis was precluded in a subset of embryos due to aneuploidy or insufficient SNP retrieval, the diagnostic outcomes for all remaining embryos were fully concordant with those of the standard TGS strategy. LIMITATIONS, REASONS FOR CAUTION:The applicability of this approach is primarily contingent upon embryo chromosomal euploidy and sufficient retrieval of informative SNPs. Additionally, the relatively high cost of whole-genome TGS remains a barrier to widespread adoption. Given the limited cohort size (n = 16) of this study, the applicability of this method necessitates further validation in larger clinical populations. WIDER IMPLICATIONS OF THE FINDINGS:Direct haplotype construction via proband whole-genome TGS provides an effective clinical strategy to expand the applicability of PGT-M, particularly for families with de novo variants or incomplete pedigrees. Furthermore, the simplified TGS workflow demonstrates the potential to improve clinical efficiency and reduce costs relative to the standard TGS protocol within its applicable scope. STUDY FUNDING/COMPETING INTEREST(S):This work was supported by the National Natural Science Foundation of China (82125013, 82288102, 825B2046). The authors declare no competing interests. TRIAL REGISTRATION NUMBER:N/A.

The mutational landscape of PATL2 and corresponding genotype–phenotype correlations remain incompletely defined in patients presenting unexplained oocyte maturation defect (OOMD) and repeated assisted reproductive technology (ART) failure. This study aimed to identify pathogenic biallelic PATL2 variants, characterize their molecular structural defects, and delineate consistent reproductive phenotypes to support standardized genetic testing and reproductive counseling for affected infertile individuals. Single-center retrospective observational cohort study including six unrelated infertile women with refractory, idiopathic OOMD and ≥ 2 consecutive failed ART cycles. Whole-exome sequencing (WES) followed by Sanger sequencing validation was performed for pathogenic variant screening. A panel of bioinformatic pipelines was applied to assess variant deleteriousness, including cross-species evolutionary conservation analysis, 3D protein modeling, and molecular dynamics simulations. Clinical reproductive data from a total of 16 independent ART treatment cycles were systematically analyzed. Ten distinct pathogenic PATL2 variants were identified, consisting of eight previously unreported novel alleles and two known disease-causing variants. The eight novel variants included four protein-truncating variants and four deleterious missense substitutions; all novel variants carried extremely low minor allele frequencies (MAF < 0.01

Non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) can detect embryo chromosomal aneuploidy by analyzing the cell-free DNA in embryo culture media. However, evidence for its clinical efficacy is insufficient. In this investigator-initiated, multicenter, double-blind, randomised controlled trial, women aged 35-42 who agreed to single frozen-thawed blastocyst transfer with at least two blastocysts were enrolled from 13 fertility centers in China. Eligible participants were randomly assigned (1:1) to the niPGT-A(n = 594) or morphology group(n = 595) using a computer-generated block randomization list, stratified by participating center. In the niPGT-A group, embryos were selected for the first transfer cycle based on niPGT-A results, whereas in the morphology group, embryos were selected according to standard morphological criteria. The primary outcome was the ongoing pregnancy rate (OPR) (pregnancy beyond 12 weeks). Secondary outcomes included clinical pregnancy, miscarriage (pregnancy loss before the 28th week, with those before the 12th week as early miscarriages), and live birth rates. The trial has been completed. The modified intention-to-treat population(mITT) contained 581 couples in the morphology group and 571 in the niPGT-A group. Among 1152 randomised patients, OPR was 38.7% (221/571) in the niPGT-A group and 36.8% (214/581) in the morphology group (adjusted p = 0.49). There were no statistically significant between group differences in the rates of clinical pregnancy (47.6% vs 49.9%, adjusted p = 0.49), miscarriage (21.0% vs 27.6%, adjusted p = 0.06) and live birth (37.0% vs 35.5%, adjusted p = 0.59). Early miscarriage was significantly lower in the niPGT-A group compared with that of the morphology group (18.0% vs 25.2%, adjusted p = 0.03). Maternal and neonatal outcomes did not differ significantly between groups. No serious adverse events were reported in either group. The results indicated that there was insufficient evidence to establish a statistically significant difference in OPR between the two treatment arms. The results of this trial do not provide a basis for recommending routine use of niPGT-A in this good-prognosis population (NCT04339166). Non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) can detect embryo chromosomal aneuploidy by analyzing the cell-free DNA in embryo culture media, but evidence for clinical efficacy is insufficient. Here the authors report a randomised controlled trial involving 1,152 women aged 35–42 years that shows no difference in the primary outcome of ongoing pregnancy rate between the intervention group with niPGT-A and the control group with morphological selection.

Trends toward earlier age at menarche, the starting point in women’s reproductive lifespan, have been observed globally. Whether an earlier age at menarche influences Anti-Müllerian hormone (AMH), a clinical indicator of ovarian reserve, remains unclear due to a lack of community-based data. This nationwide cross-sectional survey was carried out in China’s 15 provinces from May 2019 to April 2021, utilizing a multistage stratified sampling method to ensure sample representativeness and containing a total of 8 278 women aged 21–49 years. Self-reported age at menarche acts as exposure. Participants were categorized as age at menarche < 14 years group (N = 4 022) and age at menarche ≥ 14 years group (N = 4 256). AMH and AMH subgroups act as primary outcomes. A total of 8 278 participants were enrolled in this study. Mean (SD) age at menarche of the participants was 13.74 (1.58) years. Age at menarche decreased nearly 1 year from 14.31 years in women aged 45–49 to 13.38 years in women aged 21–24. For every one-year increase in age at menarche, AMH increases by 0.04 ng/ml. Compared with women with age at menarche < 14 years, women with age at menarche ≥ 14 years tend to have higher AMH level no matter in Middle AMH Group (OR, 1.28; 95

Testis-specific TEX family genes are critical for spermatogenesis, but TEX43’s function and subcellular localization remain uncharacterized. This study aimed to delineate TEX43’s localization, molecular function and role in spermatogenesis and fertility using murine models and clinical data. Tex43 expression was analyzed via quantitative reverse transcription-polymerase chain reaction (Q-PCR), immunohistochemistry (IHC), and western blotting. A Tex43 knockout (KO) mouse model was generated using CRISPR/Cas9 (targeting exons 1–3). Testicular histology (hematoxylin–eosin [H E] staining), sperm parameters (morphology via H E smears, density via hemocytometer, motility via computer-assisted sperm analysis [CASA]), and fertility (in vivo breeding assays, in vitro fertilization [IVF]) were evaluated. Sperm ultrastructure was assessed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Whole-exome sequencing (WES) identified TEX43 variants in 146 infertile men with asthenoteratozoospermia. Variant characterization was performed via Sanger sequencing and pedigree analysis. Structural modeling of WT/mutant TEX43 was performed via SWISS-MODEL. Tex43 is testis-enriched: mRNA expression initiated at postnatal day 18 (round spermatid stage) and peaked in elongating spermatids; TEX43 localized to sperm flagellar microtubules. Tex43-KO mice showed modestly reduced sperm density (28.6 ± 3.2 vs. 41.2 ± 2.9 × 10⁶ sperm/ml in WT; P < 0.01) but normal testicular architecture, sperm motility, and fertility (litter size: KO 6.8 ± 0.7 vs. WT 7.2 ± 0.5 pups/litter; P > 0.05). TEM revealed increased flagellar end piece "9 + 2" microtubule disorganization in KO sperm ( 30

BACKGROUND:Acupuncture is increasingly used during in vitro fertilization and embryo transfer (IVF-ET), but its therapeutic benefits for women with polycystic ovary syndrome (PCOS) remain uncertain. METHODS:Eight databases were investigated from the inception until April 1, 2024. We screened randomized controlled trials (RCTs) using acupuncture undergoing IVF-ET, the population was patients with PCOS. RESULTS:We analyzed 13 RCTs with 1,203 patients. Acupuncture significantly improved clinical pregnancy rate (P < 0.01), high-quality embryo rate (P < 0.01), and live birth rate (P < 0.01). It also reduced gonadotropin (Gn) dose (P = 0.0002), Gn duration (P = 0.005), and OHSS incidence (P < 0.01). No significant differences were seen in fertilization rate, oocyte yield, endometrial thickness, progesterone, LH, E2, miscarriage rate, or cycle cancellation rate. CONCLUSIONS:Our results showed that acupuncture therapy could increase the high-quality embryo rate, live birth rate and also the clinical pregnancy rate in PCOS patients undergoing IVF. Acupuncture could reduce the dose and duration of Gn. It also decreased the incidence of OHSS. Based on the result of this meta-analysis, acupuncture therapy is suggested in the IVF process for PCOS patients.

BACKGROUND:Previous studies have found no significant difference in birth weight between donor sperm and partner sperm, and some studies have found that donor sperm is more likely to lead to small for gestational age (SGA). OBJECTIVE:Does the use of donor sperm affect the birth weight of the offspring? MATERIALS AND METHODS:This study was a retrospective cohort study, including patients who achieved a singleton using in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in fresh embryo transfer cycles in Peking University Third Hospital from January 2012 to December 2022. Birth weight and complete maternal baseline data were collected. A total of 3360 cycles were included in the study, of which 611 cycles used donor sperm and 2749 cycles used partner sperm from males with oligoasthenozoospermia. Multiple linear regression analysis and logistic regression analysis were performed to evaluate the possible relationship between donor sperm use and the birth weight of the offspring and the occurrence rates of large for gestational age (LGA), SGA, high birth weight (HBW), and low birth weight (LBW) in offspring. RESULTS:Comparing 611 cycles in which donor sperm was used with 2749 cycles in which partner sperm was used, baseline data did not differ significantly between the two groups in terms of female age, BMI, parity, and cause of infertility. Offspring born in the donor group had higher birth weight (p < 0.01) and Z score (p < 0.01) than those in the partner sperm. There were no differences in the incidence of LGA, SGA, HBW, LBW, preterm birth, and the proportion of offspring gender between the two groups. CONCLUSION:This study found that the babies born in the donor sperm cycles have higher birth weights than the use of partner sperm from males with oligoasthenozoospermia in fresh embryo transfer cycles, but there were no significant differences in LGA, SGA, HBW, and LBW. The research results suggest that we should pay attention to the safety issues of donor sperm. It is necessary to conduct further research to determine whether the cause of the increased birth weight is the sperm freezing technology or the factors of the male donors who provided the sperm.

Congenital anomalies are a critical public health concern and warrant prioritization in research. However, the teratogenic potential of dydrogesterone (DYG) remains uncertain and a subject of ongoing debate. This retrospective cohort study included patients undergoing embryo transfer between January 2010 and December 2018. It analyzed 124,815 embryo transfer cycles (80,103 [64.2

RESEARCH QUESTION:Do endometrial preparation protocols affect pregnancy outcomes in overweight and obese women with a normal ovulatory cycle undergoing their first frozen-thawed embryo transfer (FET)? DESIGN:In this retrospective cohort study, we analyzed 3713 overweight and obese women (body mass index ≥ 24 kg/m2) with a normal ovulatory cycle who underwent their first FET between January 2018 and October 2023. Patients were divided into two groups based on endometrial preparation protocol: natural cycle and artificial cycle. Propensity score matching (PSM) was used to match baseline characteristics between the two groups at a 1:1 ratio. RESULTS:After PSM, 1238 overweight and obese patients were included in natural and artificial cycle groups. Compared with the artificial cycle cohort, the natural cycle group had higher biochemical pregnancy (53.6% [664/1238] versus 49.5% [613/1238]; P = 0.04), clinical pregnancy (44.7% [554/1238] versus 40.3% [499/1238], P = 0.025), ongoing pregnancy (35.7% [439/1229] versus 31.6% [389/1230], P = 0.032) and live birth (34.7% [427/1229] versus 30.6% [376/1230], P = 0.027) rates. No significant differences were identified in the incidence of perinatal complications or neonatal outcomes. After adjusting for confounders using multivariate logistic regression analysis, natural cycle remained an independent protective factor for live birth in FET cycles (OR 1.298, 95% CI 1.004 to 1.678, P = 0.046). Further subgroup analyses of women in the overweight or obese ranges revealed similar findings among overweight women, but no statistically significant association between endometrial preparation regimen and the live birth rate in obese women. CONCLUSION:For the combined group of overweight and obese women (BMI >24 kg/m2) with a normal ovulatory cycle, natural cycle FET results in better pregnancy outcomes compared with artificial cycle FET without increasing the incidence of obstetric complications.

BACKGROUND:Oocyte vitrification, a widely utilized assisted reproductive technology for fertility preservation, can address emergencies arising from the unavailability of sperm from the male partner on the day of oocyte retrieval. However, the infrequent and unpredictable nature of emergency oocyte cryopreservation leads to a scarcity of literature on its reproductive outcomes, complicating the provision of informed patient counseling. METHODS:This study, conducted between January 2017 and December 2022, included 137 emergency oocyte cryopreservation cycles involving 136 patients and their respective thawed cycles. Descriptive statistics were used to analyze cycle characteristics and oocyte thaw and transfer outcomes, grouped by indication of oocyte vitrification. Univariate and multivariate analyses were performed to identify predictors associated with reproductive outcomes by indication of oocyte vitrification. RESULTS:A total of 137 emergency oocyte cryopreservation-thaw cycles were analyzed, with a median oocyte survival rate of 84.2%, fertilization rate of 57.7%, and high-quality Day-3 embryo formation rate of 33.3%. Of all cycles, 15.3% resulted in no transferable embryos. The cumulative live birth rate (CLBR) for the entire cohort was 29.2%, with 40 live births achieved through both fresh and frozen embryo transfers. Stratified analysis revealed that cycles due to absolute male factor infertility had higher reproductive efficiency, including more oocytes retrieved, a greater number of high-quality embryos, higher implantation rates, and a CLBR of 39.5%, compared to 11.8% in the relative male factor group. Multivariate analysis identified female age, infertility duration, sperm source, number of mature oocytes retrieved and the presence of male infertility factors as key determinants of live birth outcomes. CONCLUSIONS:Emergency oocyte vitrification yielded a cumulative live birth rate of 29.2%, with rates differing by clinical indication: 39.5% in the absolute male factor group and 11.8% in the relative male factor group. Moreover, the factors associated with reduced live birth rates differed depending on the underlying indication for vitrification. These findings support the clinical utility of emergency oocyte vitrification and underscore the significant contributions of both female and male factors to reproductive outcomes of oocyte cryopreservation.

BackgroundTuberculosis can negatively impact both overall health and female reproductive function. This study investigated the relationship between the interferon-gamma release assay (IGRA) status and pregnancy outcomes in infertile women, with untreated “inactive” tuberculosis lesions observed on chest radiography, who are undergoing in vitro fertilization and embryo transfer (IVF-ET).MethodsThis ambispective cohort study, which includes retrospective (2012–2019) and prospective (2020–2024) cohorts, enrolled infertile women with untreated inactive tuberculosis lesions visible on chest imaging who are planning to undergo IVF-ET. All patients underwent IGRA testing. Baseline characteristics, such as age, body mass index (BMI), infertility factors, ultrasound follicle count, and hormone levels, were collected. Pregnancy outcomes, including live birth rates, oocyte retrieval numbers, embryo quality, clinical pregnancy, miscarriage, and preterm birth rates, were followed and compared between the IGRA-positive and IGRA-negative groups.ResultsAmong 836 patients, the IGRA positivity rate was 42.5%. The cumulative miscarriage rate was higher in the IGRA-positive group than in the IGRA-negative group (21.5% vs. 15.0%, p = 0.047). No significant differences were found in clinical pregnancy or live birth rates. Age, BMI, and endometrial thickness were independent risk factors influencing clinical pregnancy and live birth rates, while the IGRA status was not.ConclusionIn infertile women with untreated inactive tuberculosis lesions on chest radiography, IGRA positivity is associated with higher cumulative miscarriage rates following IVF-ET. Early IGRA screening and intervention may help improve pregnancy outcomes.

To investigate if trophectoderm (TE) biopsy on preimplantation genetic testing (PGT) increases the risk of obstetrical and infant outcomes after frozen single blastocyst transfer cycles. This retrospective cohort study included all frozen single blastocyst transfer cycles conducted between January 2012 and December 2017 at Peking University Third Hospital. A total of 1492 patients in the PGT group and 600 patients in the non-PGT group were analyzed. The primary outcomes were clinical pregnancy rate, live birth rate, and early motor development milestones. Secondary outcomes included miscarriage, obstetric complications, and infant outcomes. The PGT group had younger parental ages and higher antral follicle counts, whereas the non-PGT group had lower sperm quality. The clinical pregnancy rate (52.7 vs. 45.2

[This corrects the article DOI: 10.3389/fmed.2025.1605662.].

BACKGROUND:Early spontaneous abortion (ESA) is one of the most common clinically recognized pregnancy complications. While multiple factors such as embryo abnormalities and maternal conditions may contribute to ESA, early identification and screening of maternal risk factors are increasingly important to explore the potential etiologies and improve prevention and treatment strategies for ESA. This study investigates the changes in uterine microbiota and the decidual immune response in ESA patients without embryo abnormalities. METHODS:ESA patients without embryo abnormality and artificial abortion (AA) controls were enrolled for clinical characteristics analysis. The decidual endometrium was subsequently collected for histological evaluation and inflammatory indicator detection. Moreover, 16S rRNA gene sequencing of uterine secretions was performed to investigate the differences in uterine microorganisms between the ESA and AA groups. RESULTS:Clinical analysis showed higher inflammatory response with elevated neutrophil counts in ESA patients. The increase in leukocytes, including neutrophils, was positively correlated with ESA. ESA patients presented significantly increased IL-1β expression in decidual stromal cells. 16S rRNA gene sequencing revealed greater diversity in the uterine microbiota of the ESA group, which presented decreased Lactobacillus abundance and increased abundance of other bacteria at the genus and species levels. CONCLUSIONS:Changes in the uterine microbiome are likely related to inflammatory response and lead to early pregnancy loss.