Reply: Spermatogonia stem cell technology: a new avenue for all age Klinefelter patients
Sir, As the authors for the manuscript, ‘Age-related presence of spermatogonia in patients with Klinefelter syndrome: a systematic review and meta-analysis’, we would like to address the comments, from Winge and Almstrup’s letter (Winge and Almstrup, 2021). (Source: Human Reproduction Update)
Source: Human Reproduction Update - July 29, 2021 Category: OBGYN Source Type: research

False hope for patients with Klinefelter syndrome on cryopreservation of spermatogonia at younger ages
Sir, (Source: Human Reproduction Update)
Source: Human Reproduction Update - July 29, 2021 Category: OBGYN Source Type: research

Plasticity of the human preimplantation embryo: developmental dogmas, variations on themes and self-correction
AbstractBACKGROUNDIVF for the treatment of infertility offers unique opportunities to observe human preimplantation development. Progress in time-lapse technology (TLT) and preimplantation genetic testing (PGT) has greatly expanded our knowledge of developmental patterns leading to a healthy pregnancy or developmental failure. These technologies have also revealed unsuspected plastic properties of the preimplantation embryo, at macromolecular, cellular and multicellular levels.OBJECTIVE AND RATIONALEThis review focuses on the emerging concept of plasticity of the human embryo as revealed by recent evidence derived from TLT...
Source: Human Reproduction Update - June 15, 2021 Category: OBGYN Source Type: research

Cell dynamics in human villous trophoblast
AbstractBACKGROUNDVillous cytotrophoblast (vCTB) is a precursor cell population that supports the development of syncytiotrophoblast (vSTB), the high surface area barrier epithelium of the placental villus, and the primary interface between maternal and fetal  tissue. In light of increasing evidence that the placenta can adapt to changing maternal environments or, under stress, can trigger maternal disease, we consider what properties of these cells empower them to exert a controlling influence on pregnancy progression and outcome.OBJECTIVE AND RATIONALEHow are cytotrophoblast proliferation and differentiation regulat...
Source: Human Reproduction Update - June 14, 2021 Category: OBGYN Source Type: research

Should women receive luteal support following natural cycle frozen embryo transfer? A systematic review and meta-analysis. Critical assessment of a review and meta-analysis
Dear Sir, (Source: Human Reproduction Update)
Source: Human Reproduction Update - June 4, 2021 Category: OBGYN Source Type: research

Reply: Should women receive luteal support following natural cycle frozen embryo transfer? A systematic review and meta-analysis. Critical assessment of a review and meta-analysis
Dear Sir, (Source: Human Reproduction Update)
Source: Human Reproduction Update - June 4, 2021 Category: OBGYN Source Type: research

Confined placental mosaicism and the association with pregnancy outcome and fetal growth: a review of the literature
The objective of this review is to evaluate the association between CPM and prenatal growth and adverse pregnancy outcomes. All relevant literature has been reviewed in order to achieve an overview on merged results exploring the relation between CPM and FGR and other adverse pregnancy outcomes.SEARCH METHODSThe following Medical Subject Headings (MESH) terms and all their synonyms were used: placental, trophoblast, cytotrophoblast, mosaicism, trisomy, fetal growth, birth weight, small for gestational age and fetal development. A search in Embase, PubMed, Medline Ovid, Web of Science, Cochrane Central Register of Controlle...
Source: Human Reproduction Update - May 13, 2021 Category: OBGYN Source Type: research

A review on the motivations, decision-making factors, attitudes and experiences of couples using pre-implantation genetic testing for inherited conditions
We report that couples find it difficult to consider all of the benefits and costs of PGT, resulting in ambivalence and prolonged indecision. After deciding on PGT use, we found that patients find the process extremely impract ical and psychologically demanding.WIDER IMPLICATIONSThis review aimed to summarize the current knowledge on how patients decide to use and experience PGT and to make suggestions to incorporate the findings into clinical practice. We cannot stress enough the importance of holistic evaluation of patients and thorough counselling prior to and during PGT use from a multidisciplinary team that includes g...
Source: Human Reproduction Update - May 10, 2021 Category: OBGYN Source Type: research

Maternal germline factors associated with aneuploid pregnancy loss: a systematic review
The objective of this review was to appraise critically the existing evidence relating to maternal germline factors associated with pregnancy loss secondary to embryo aneuploidy, identify limitations in the current evidence base and establish areas requiring further research.SEARCH METHODSThe initial literature search was performed in September 2019 and updated in January 2021 using the electronic databases OVID MEDLINE, EMBASE and the Cochrane Library. No time or language restrictions were applied to the searches and only primary research was included. Participants were women who had suffered pregnancy loss secondary to n...
Source: Human Reproduction Update - May 9, 2021 Category: OBGYN Source Type: research

A systematic review and meta-analysis on the association between ICSI and chromosome abnormalities
The objective of this systematic review and meta-analysis was to assess the prevalence of chromosome abnormalities in ICSI pregnancies and children and to examine any potentially increased risk compared to standard IVF and NC.SEARCH METHODSPubmed, Embase, Cochrane Libraries and Web of Science up to October 2020 were searched. Primary outcome measures were overall chromosome abnormalities andde novo abnormalities (including sex chromosome abnormalities and autosomal abnormalities). The secondary outcome was inherited abnormalities. We followed the PRISMA guidelines and relevant meta-analyses were performed.OUTCOMESThe searc...
Source: Human Reproduction Update - May 6, 2021 Category: OBGYN Source Type: research

Novel therapeutic targets to improve IVF outcomes in endometriosis patients: a review and future prospects
AbstractBACKGROUNDPatients with endometriosis often experience infertility and have poor IVF outcomes, with low fertilization and pregnancy rates. Although many theories have tried to explain the mechanisms underlying infertility in these patients, none of them is conclusive.OBJECTIVE AND RATIONALEIn this review, we discuss the pathologic mechanisms through which endometriosis likely leads to infertility along with the therapeutic options used to date to treat endometriosis-related infertility and, thereby, to improve IVF outcomes in patients with endometriosis.SEARCH METHODSWe performed a comprehensive literature search o...
Source: Human Reproduction Update - April 30, 2021 Category: OBGYN Source Type: research

Thank you to our reviewers – 2020
While firmly established as one of the leading journals in the field of reproductive biology and medicine,Human Reproduction Update is not complacent and continually strives for improvement. The journal is acutely aware of the importance of high-quality peer review and its role in maintaining and enhancing the scientific quality and clinical relevance of the articles that we publish. For this reason, the Editorial Team ofHuman Reproduction Update would like to thank all those who have taken the time to review for us in 2020. We greatly appreciate this contribution to the ongoing success of the journal. Thank you. (Source: ...
Source: Human Reproduction Update - April 20, 2021 Category: OBGYN Source Type: research

Should women receive luteal support following natural cycle frozen embryo transfer? A systematic review and meta-analysis
AbstractBACKGROUNDSpontaneous ovulation during a natural menstrual cycle is frequently used for timing frozen embryo transfer (FET). Nevertheless, it remains unclear whether or not women should receive luteal phase support (LPS) following natural cycle frozen embryo transfer (NC-FET).OBJECTIVE AND RATIONALEThe aim of this systematic review and meta-analysis was to study whether the administration of LPS improves the reproductive outcome following NC-FET.SEARCH METHODSWe conducted a systematic search of the literature published in Medline/PubMed, Embase and the Cochrane Library, from January 2000 until December 2020. We inc...
Source: Human Reproduction Update - April 8, 2021 Category: OBGYN Source Type: research

Adipocyte and steroidogenic cell cross-talk in polycystic ovary syndrome
AbstractBACKGROUNDMetabolic and endocrine alterations in women with polycystic ovary syndrome (PCOS) affect adipose tissue mass and distribution. PCOS is characterised by hyperandrogenism, obesity and adipocyte dysfunction. Hyperandrogenism in PCOS drives dysfunctional adipocyte secretion of potentially harmful adipocytokines. Glucocorticoids and sex-steroids modulate adipocyte development and function. For their part, adipocyte products interact with adrenal and ovarian steroidogenic cells. Currently, the relationship between adipocyte and steroidogenic cells is not clear, and for these reasons, it is important to elucida...
Source: Human Reproduction Update - March 25, 2021 Category: OBGYN Source Type: research

Secretory products of the corpus luteum and preeclampsia
AbstractBACKGROUNDDespite significant advances in our understanding of the pathophysiology of preeclampsia (PE), there are still many unknowns and controversies in the field. Women undergoing frozen-thawed embryo transfer (FET) to a hormonally prepared endometrium have been found to have an unexpected increased risk of PE compared to women who receive embryos in a natural FET cycle. The differences in risk have been hypothesized to be related to the absence or presence of a functioning corpus luteum (CL).OBJECTIVE AND RATIONALETo evaluate the literature on secretory products of the CL that could be essential for a healthy ...
Source: Human Reproduction Update - March 22, 2021 Category: OBGYN Source Type: research

Ovarian stimulation for oocyte donation: a systematic review and meta-analysis
AbstractBACKGROUNDSince its introduction in the 1980s, oocyte donation (OD) has been largely integrated into ART. Lately, both demand and the indications for OD have increased greatly. Oocyte donors are healthy and potentially fertile women undergoing voluntarily ovarian stimulation (OS). Selection of the optimal type of stimulation is of paramount importance in order to achieve the most favourable outcomes for the oocyte recipients, but most importantly for the safety of the oocyte donors.OBJECTIVE AND RATIONALEThis is the first systematic review (SR) with the objective to summarize the current evidence on OS in oocyte do...
Source: Human Reproduction Update - March 20, 2021 Category: OBGYN Source Type: research

First trimester mechanisms of gestational sac placental and foetal teratogenicity: a framework for birth cohort studies
AbstractBACKGROUNDThe function of the gestational sac (GS) and the placenta in the closely related processes of embryogenesis and teratogenicity in the first trimester has been minimally described. The prevailing assumption is that direct teratogenic effects are mediated by the critical extraembryonic organ, the placenta, which either blocks or transfers exposures to the foetus. Placental transfer is a dominant mechanism, but there are other paradigms by which the placenta can mediate teratogenic effects. Knowledge of these paradigms and first trimester human developmental biology can be useful to the epidemiologist in the...
Source: Human Reproduction Update - March 1, 2021 Category: OBGYN Source Type: research

Reply: Fertility restoration in azoospermic cancer survivors from testicular VSELs that survive oncotherapy upon transplanting MSCs
Sir, (Source: Human Reproduction Update)
Source: Human Reproduction Update - February 22, 2021 Category: OBGYN Source Type: research

Fertility restoration in azoospermic cancer survivors from testicular VSELs that survive oncotherapy upon transplanting MSCs
Sir (Source: Human Reproduction Update)
Source: Human Reproduction Update - February 22, 2021 Category: OBGYN Source Type: research

Immediate versus postponed frozen embryo transfer after IVF/ICSI: a systematic review and meta-analysis
AbstractBACKGROUNDIn Europe, the number of frozen embryo transfer (FET) cycles is steadily increasing, now accounting for more than 190  000 cycles per year. It is standard clinical practice to postpone FET for at least one menstrual cycle following a failed fresh transfer or after a freeze-all cycle. The purpose of this practice is to minimise the possible residual negative effect of ovarian stimulation on the resumption of a norm al ovulatory cycle and receptivity of the endometrium. Although elective deferral of FET may unnecessarily delay time to pregnancy, immediate FET may be inefficient in a clinical setting, f...
Source: Human Reproduction Update - February 16, 2021 Category: OBGYN Source Type: research

Mitochondria: their role in spermatozoa and in male infertility
AbstractBACKGROUNDThe best-known role of spermatozoa is to fertilize the oocyte and to transmit the paternal genome to offspring. These highly specialized cells have a unique structure consisting of all the elements absolutely necessary to each stage of fertilization and to embryonic development. Mature spermatozoa are made up of a head with the nucleus, a neck, and a flagellum that allows motility and that contains a midpiece with a mitochondrial helix. Mitochondria are central to cellular energy production but they also have various other functions. Although mitochondria are recognized as essential to spermatozoa, their ...
Source: Human Reproduction Update - February 8, 2021 Category: OBGYN Source Type: research

Uterine natural killer cells: from foe to friend in reproduction
AbstractBACKGROUNDRecurrent miscarriage and pre-eclampsia are common reproductive disorders, but their causes are often unknown. Recent evidence has provided new insight into immune system influences in reproductive disorders. A subset of lymphocytes of the innate immune system known as uterine natural killer (uNK) cells are now recognized as fundamental to achieving embryo implantation and successful pregnancy, but were initially attributed a bad reputation. Indeed, immune therapies have been developed to treat the ‘exaggerated’ immune response from uNK cells. These treatments have been based on studies of per...
Source: Human Reproduction Update - February 2, 2021 Category: OBGYN Source Type: research

Corrigendum. IUI for unexplained infertility —a network meta-analysis
Hum Reprod Update, 2020:26:1-15. (Source: Human Reproduction Update)
Source: Human Reproduction Update - January 27, 2021 Category: OBGYN Source Type: research

FoxO1 is a cell-specific core transcription factor for endometrial remodeling and homeostasis during menstrual cycle and early pregnancy
AbstractBACKGROUNDEndometrium is a vital multicellular tissue for progression of pregnancy. Forkhead box O1 (FoxO1) transcription factor plays an important role in the endometrium as it regulates various cellular processes with its unique expression in different cell types.OBJECTIVE AND RATIONALEThis review focuses on the role of FoxO1 in endometrium with a particular emphasis on FoxO1 signaling in individual endometrial cell types during the menstrual cycle and early pregnancy.SEARCH METHODSA literature search was conducted in PubMed, Web of Science and Scopus to select studies reporting the role of FoxO1 in endometrium u...
Source: Human Reproduction Update - January 12, 2021 Category: OBGYN Source Type: research

Embryo implantation in the laboratory: an update on current techniques
AbstractBACKGROUNDThe embryo implantation process is crucial for the correct establishment and progress of pregnancy. During implantation, the blastocyst trophectoderm cells attach to the epithelium of the endometrium, triggering intense cell-to-cell crosstalk that leads to trophoblast outgrowth, invasion of the endometrial tissue, and formation of the placenta. However, this process, which is vital for embryo and foetal developmentin utero, is still elusive to experimentation because of its inaccessibility. Experimental implantation is cumbersome and impractical in adult animal models and is inconceivable in humans.OBJECT...
Source: Human Reproduction Update - January 7, 2021 Category: OBGYN Source Type: research

Maternal and neonatal outcome and children ’s development after medically assisted reproduction with in-vitro matured oocytes—a systematic review and meta-analysis
AbstractBACKGROUNDIVM was implemented in medically assisted reproduction 25  years ago. IVM does not involve controlled ovarian stimulation (COS) and is mainly indicated in patients with a high risk of ovarian hyperstimulation syndrome, in particular in patients with polycystic ovary syndrome (PCOS); it is also an acknowledged option in fertility protection. However, thein-vitro culture of immature oocytes raises concerns over their developmental potential and the putative impact on children ’s health. Although an increasing number of studies on obstetric and neonatal outcomes of IVM children and their develop...
Source: Human Reproduction Update - December 30, 2020 Category: OBGYN Source Type: research

Adaptations of the human placenta to hypoxia: opportunities for interventions in fetal growth restriction
AbstractBACKGROUNDThe placenta is the functional interface between the mother and the fetus during pregnancy, and a critical determinant of fetal growth and life-long health. In the first trimester, it develops under a low-oxygen environment, which is essential for the conceptus who has little defense against reactive oxygen species produced during oxidative metabolism. However, failure of invasive trophoblasts to sufficiently remodel uterine arteries toward dilated vessels by the end of the first trimester can lead to reduced/intermittent blood flow, persistent hypoxia and oxidative stress in the placenta with consequence...
Source: Human Reproduction Update - December 30, 2020 Category: OBGYN Source Type: research

Risk of foetal harm with letrozole use in fertility treatment: a systematic review and meta-analysis
AbstractBACKGROUNDThe aromatase inhibitor letrozole is increasingly recommended for ovulation induction, as it is more effective with fewer side-effects than other agents. But many clinicians are reluctant to use the drug for fertility treatment due to a strong-label warning against its use, which warns about congenital malformation risk to the foetus in women seeking pregnancy.OBJECTIVE AND RATIONALEThe aim of this study was to determine the risks of congenital malformations and pregnancy loss with letrozole compared with clomiphene primarily, and with other fertility drugs and natural conception.SEARCH METHODSA systemati...
Source: Human Reproduction Update - December 29, 2020 Category: OBGYN Source Type: research

Will Single-Cell RNAseq decipher stem cells biology in normal and cancerous tissues?
Sir, (Source: Human Reproduction Update)
Source: Human Reproduction Update - December 26, 2020 Category: OBGYN Source Type: research

Reply: Will Single-Cell RNAseq decipher stem cells biology in normal and cancerous tissues?
Sir, (Source: Human Reproduction Update)
Source: Human Reproduction Update - December 26, 2020 Category: OBGYN Source Type: research

Is there an association between paternal age and aneuploidy? Evidence from young donor oocyte-derived embryos: a systematic review and individual patient data meta-analysis
The objective of this systematic review and individual patient data (IPD) meta-analysis is to evaluate existing evidence regarding an association between PA and chromosomal aberrations in an OD model.SEARCH METHODSThis review was conducted according to PRISMA guidelines for systematic reviews and meta-analyses. Medline, Embase and Cochrane databases were searched from inception through March 2020 using the (MeSH) terms: chromosome aberrations, preimplantation genetic screening and IVF. Original research articles, reporting on the types and/or frequency of chromosomal aberrations in embryos derived from donor oocytes, inclu...
Source: Human Reproduction Update - December 23, 2020 Category: OBGYN Source Type: research

Fertility preservation for prepubertal boys: lessons learned from the past and update on remaining challenges towards clinical translation
AbstractBACKGROUNDChildhood cancer incidence and survivorship are both on the rise. However, many lifesaving treatments threaten the prepubertal testis. Cryopreservation of immature testicular tissue (ITT), containing spermatogonial stem cells (SSCs), as a fertility preservation (FP) option for this population is increasingly proposed worldwide. Recent achievements notably the birth of non-human primate (NHP) progeny using sperm developed in frozen-thawed ITT autografts has given proof of principle of the reproductive potential of banked ITT. Outlining the current state of the art on FP for prepubertal boys is crucial as s...
Source: Human Reproduction Update - December 16, 2020 Category: OBGYN Source Type: research

Endometrial function in women with polycystic ovary syndrome: a comprehensive review
AbstractBACKGROUNDPolycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. An endometrial component has been suggested to contribute to subfertility and poor reproductive outcomes in affected women.OBJECTIVE AND RATIONALEThe aim of this review was to determine whether there is sufficient evidence to support that endometrial function is altered in women with PCOS, whether clinical features of PCOS affect the endometrium, and whether there are evidence-based interventions to improve endometrial dysfunction in PCOS women.SEARCH METHODSAn extensive literature search was performed from 1970 up to Ju...
Source: Human Reproduction Update - December 10, 2020 Category: OBGYN Source Type: research

Nanoparticles in pregnancy: the next frontier in reproductive therapeutics
AbstractBACKGROUNDNanotechnology involves the engineering of structures on a molecular level. Nanomedicine and nano-delivery systems have been designed to deliver therapeutic agents to a target site or organ in a controlled manner, maximizing efficacy while minimizing off-target effects of the therapeutic agent administered. In both reproductive medicine and obstetrics, developing innovative therapeutics is often tempered by fears of damage to the gamete, embryo or developing foetus or of negatively impacting a woman ’s reproductive potential. Thus, nanomedicine delivery systems may provide alternative targeted inter...
Source: Human Reproduction Update - December 6, 2020 Category: OBGYN Source Type: research

IVF and other ART in low- and middle-income countries: a systematic landscape analysis
AbstractBACKGROUNDInfertility affects 48.5 million couples worldwide with a prevalence estimated at 3.5 –16.7% in low- and middle-income countries (LMIC), and as high as 30–40% in Sub-Saharan Africa. ART services are not accessible to the majority of these infertile couples due to the high cost of treatments in addition to cultural, religious and legal barriers. Infertility and childlessness, part icularly in LMIC, have devastating consequences, which has resulted in considerable interest in developing affordable IVF procedures. However, there is a paucity of evidence on the safety, efficiency and ability to re...
Source: Human Reproduction Update - November 25, 2020 Category: OBGYN Source Type: research

Neurophysiology of cognitive behavioural therapy, deep breathing and progressive muscle relaxation used in conjunction with ART treatments: a narrative review
AbstractBACKGROUNDInfertility is defined as the failure to achieve clinical pregnancy after 12  months of regular unprotected intercourse. It could be due to male or female factors, each requiring different treatment options. ART treatment exposes couples to numerous psychological stressors. Therefore, it has been recommended by the ESHRE Psychology and Counselling Guideline Development Gro up recently that psychosocial support should be offered as a complementary therapy during infertility treatments. In this context, the efficiency of different psychological interventions, such as cognitive behaviour therapy (CBT)...
Source: Human Reproduction Update - November 25, 2020 Category: OBGYN Source Type: research

The other face of advanced paternal age: a scoping review of its terminological, social, public health, psychological, ethical and regulatory aspects
AbstractBACKGROUNDThere is a global tendency for parents to conceive children later in life. The maternal dimension of the postponement transition has been thoroughly studied, but interest in the paternal side is more recent. For the moment, most literature reviews on the topic have focused on the consequences of advanced paternal age (APA) on fertility, pregnancy and the health of the child.OBJECTIVE AND RATIONALEThe present review seeks to move the focus away from the biological and medical dimensions of APA and synthesise the knowledge of the other face of APA.SEARCH METHODSWe used the scoping review methodology. Search...
Source: Human Reproduction Update - November 17, 2020 Category: OBGYN Source Type: research

Endometriosis and cancer: a systematic review and meta-analysis
AbstractBACKGROUNDEndometriosis is an often chronic, inflammatory gynaecologic condition affecting 190 million women worldwide. Studies have reported an elevated cancer risk among patients with endometriosis. However, prior research has included methodologic issues that impede valid and robust interpretation.OBJECTIVE AND RATIONALEWe conducted a meta-analysis of studies investigating the association between endometriosis and cancer risk and analysed the results by methodologic characteristics. We discuss the implications of cancer screening in patients and management challenges faced by clinicians.SEARCH METHODSWe searched...
Source: Human Reproduction Update - November 17, 2020 Category: OBGYN Source Type: research

Preconception genome medicine: current state and future perspectives to improve infertility diagnosis and reproductive and health outcomes based on individual genomic data
AbstractBACKGROUNDOur genetic code is now readable, writable and hackable. The recent escalation of genome-wide sequencing (GS) applications in population diagnostics will not only enable the assessment of risks of transmitting well-defined monogenic disorders at preconceptional stages (i.e. carrier screening), but also facilitate identification of multifactorial genetic predispositions to sub-lethal pathologies, including those affecting reproductive fitness. Through GS, the acquisition and curation of reproductive-related findings will warrant the expansion of genetic assessment to new areas of genomic prediction of repr...
Source: Human Reproduction Update - November 16, 2020 Category: OBGYN Source Type: research

Mild versus conventional ovarian stimulation for IVF in poor, normal and hyper-responders: a systematic review and meta-analysis
AbstractBACKGROUNDMild ovarian stimulation has emerged as an alternative to conventional IVF with the advantages of being more patient-friendly and less expensive. Inadequate data on pregnancy outcomes and concerns about the cycle cancellation rate (CCR) have prevented mild, or low-dose, IVF from gaining wide acceptance.OBJECTIVE AND RATIONALETo evaluate parallel-group randomised controlled trials (RCTs) on IVF where comparisons were made between a mild ( ≤150 IU daily dose) and conventional stimulation in terms of clinical outcomes and cost-effectiveness in patients described as poor, normal and non-polycystic ovary sy...
Source: Human Reproduction Update - November 4, 2020 Category: OBGYN Source Type: research

Persistent organic pollutants and couple fecundability: a systematic review
AbstractBACKGROUNDDespite increasing regulation, exposure to persistent organic pollutants (POPs) remains a serious public health concern due to their accumulation in the environment and ability to biomagnify up the food chain. POPs are associated with endocrine-disrupting effects including adverse reproductive outcomes that could affect fecundability, i.e. the capacity to conceive a pregnancy, quantified as time to pregnancy (TTP).OBJECTIVE AND RATIONALEResults of epidemiologic studies that examine the impact of various chemical classes of POPs on TTP have not been synthesised. We undertook a systematic review to summaris...
Source: Human Reproduction Update - November 4, 2020 Category: OBGYN Source Type: research

Plants as source of new therapies for endometriosis: a review of preclinical and clinical studies
AbstractBACKGROUNDGiven the disadvantages and limitations of current endometriosis therapy, there is a progressive increase in studies focusing on plant-derived agents as a natural treatment option with the intention of achieving high efficiency, avoiding adverse effects and preserving the chance for successful pregnancy. The heterogeneity of these studies in terms of evaluated agents, applied approaches and outcomes illustrates the need for an up-to-date summary and critical view on this rapidly growing field in endometriosis research.OBJECTIVE AND RATIONALEThis review provides a comprehensive overview of plant-derived ag...
Source: Human Reproduction Update - October 30, 2020 Category: OBGYN Source Type: research

Over-the-counter analgesics during pregnancy: a comprehensive review of global prevalence and offspring safety
This article examines the evidence of foetal exposure to OTC analgesia, starting from different routes of exposure to evidence, or the lack thereof, linking maternal consumption to offspring ill health. There is a very high prevalence of maternal consumption of OTC analgesics globally, which is increasing sharply. The choice of analgesia selected by pregnant women differs across populations. Location was also observed to have an effect on prevalence of use, with more developed countries reporting the highest consumption rates. Some of the literature focuses on the association ofin utero exposure at different pregnancy trim...
Source: Human Reproduction Update - October 29, 2020 Category: OBGYN Source Type: research

Molecular genetics of infertility: loss-of-function mutations in humans and corresponding knockout/mutated mice
AbstractBACKGROUNDInfertility is a major issue in human reproductive health, affecting an estimated 15% of couples worldwide. Infertility can result from disorders of sex development (DSD) or from reproductive endocrine disorders (REDs) with onset in infancy, early childhood or adolescence. Male infertility, accounting for roughly half of all infertility cases, generally manifests as decreased sperm count (azoospermia or oligozoospermia), attenuated sperm motility (asthenozoospermia) or a higher proportion of morphologically abnormal sperm (teratozoospermia). Female infertility can be divided into several classical types, ...
Source: Human Reproduction Update - October 29, 2020 Category: OBGYN Source Type: research

Immunological changes associated with adenomyosis: a systematic review
The objective was to systematically review the literature regarding the role of the immune system in development of adenomyosis in the inner and the outer myometrium, in humans.SEARCH METHODSA systematic review of published human studies was performed in MEDLINE, EMBASE and Cochrane Library databases from 1970 to February 2019 using the combination of Medical Subject Headings (MeSH): Adenomyosis AND ( ‘Immune System’ OR ‘Gonadal Steroid Hormones’), and free-text terms for the following search terms (and their variants): Adenomyosis AND (immunity OR immune OR macrophage OR ‘natural killer cell&...
Source: Human Reproduction Update - October 25, 2020 Category: OBGYN Source Type: research

Recovery of menses after functional hypothalamic amenorrhoea: if, when and why
AbstractBACKGROUNDProlonged amenorrhoea occurs as a consequence of functional hypothalamic amenorrhoea (FHA) which is most often induced by weight loss, vigorous exercise or emotional stress. Unfortunately, removal of these triggers does not always result in the return of menses. The prevalence and conditions underlying the timing of return of menses vary strongly and some women report amenorrhoea several years after having achieved and maintained normal weight and/or energy balance. A better understanding of these factors would also allow improved counselling in the context of infertility. Although BMI, percentage body fa...
Source: Human Reproduction Update - October 17, 2020 Category: OBGYN Source Type: research

Outcomes of pregnancies using donor sperm compared with those using partner sperm: systematic review and meta-analysis
The objective of this study was to establish whether pregnancies conceived using donor sperm are at higher risk of obstetric and perinatal complications than those conceived with partner sperm. As more treatments are being carried out using donor sperm, attention is being given to obstetric and perinatal outcomes, as eventsin utero and at delivery have implications for long-term health. There is a need to know if there is any difference in the outcomes of pregnancies between those conceived using donor versus partner sperm in order to adequately inform and counsel couples.SEARCH METHODSWe performed a systematic review and ...
Source: Human Reproduction Update - October 15, 2020 Category: OBGYN Source Type: research

Current approaches and developments in transcript profiling of the human placenta
AbstractBACKGROUNDThe placenta is the active interface between mother and foetus, bearing the molecular marks of rapid development and exposuresin utero. The placenta is routinely discarded at delivery, providing a valuable resource to explore maternal-offspring health and disease in pregnancy. Genome-wide profiling of the human placental transcriptome provides an unbiased approach to study normal maternal –placental–foetal physiology and pathologies.OBJECTIVE AND RATIONALETo date, many studies have examined the human placental transcriptome, but often within a narrow focus. This review aims to provide a compre...
Source: Human Reproduction Update - October 12, 2020 Category: OBGYN Source Type: research

Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis
AbstractBACKGROUNDAlthough surgery for endometriosis can improve pain and fertility, the risk of disease recurrence is high. There is little consensus regarding the benefit of medical therapy in preventing recurrence of endometriosis following surgery.OBJECTIVE AND RATIONALEWe performed a review of prospective observational studies and randomised controlled trials (RCTs) to evaluate the risk of endometriosis recurrence in patients undergoing post-operative hormonal suppression, compared to placebo/expectant management.SEARCH METHODSThe following databases were searched from inception to March 2020 for RCTs and prospective ...
Source: Human Reproduction Update - October 6, 2020 Category: OBGYN Source Type: research

The development of the human uterus: morphogenesis to menarche
ABSTRACTThere is emerging evidence that early uterine development in humans is an important determinant of conditions such as ontogenetic progesterone resistance, menstrual preconditioning, defective deep placentation and pre-eclampsia in young adolescents. A key observation is the relative infrequency of neonatal uterine bleeding and hormone withdrawal at birth. The origin of the uterus from the fusion of the two paramesonephric, or M üllerian, ducts was described almost 200 years ago. The uterus forms around the 10th week of foetal life. The uterine corpus and the cervix react differently to the circulating steroid ...
Source: Human Reproduction Update - October 6, 2020 Category: OBGYN Source Type: research