Recurrent implantation failure: reality or a statistical mirage?

Fertility and Sterility, Journal Year: 2023, Volume and Issue: 120(1), P. 45 - 59

Published: Feb. 22, 2023

ImportanceTo date, recurrent implantation failure (RIF) has no clear definition and clearly identified impaired function. Hence, the term RIF is currently used somewhat haphazardly, on basis of clinicians’ judgment.ObjectiveInternational experts in reproductive medicine met July 1, 2022, Lugano, Switzerland, to review different facets define diagnosis its appropriate management.Evidence ReviewA systematic without meta-analysis studies published English from January 2015 May 2022.FindingsData indicated that been largely overevaluated, overdiagnosed, overtreated sufficient critical assessment true nature. Our analyses show extremely uncommon—occurring <5% couples with infertility—and reassurance continued conventional therapies are warranted most cases assisted technology (ART) failure. Although biologic determinants may exist a small subset people infertility, they elude available tools for assessment. Without identification underlying etiology(ies), it reasonable not assign this patient until she failed at least 3 euploid blastocyst transfers (or equivalent number unscreened embryo transfers, adjusted patient’s age corresponding euploidy rate). In addition, other factors should be ruled out contribute her reduced odds sustained implantation. such cases, only issue considered case ART because result multiple necessarily repetitive or persistent. reality, impacting probability further success very rare occurrence.ConclusionTrue uncommon, occurring infertility. Reassurance cases. It would seem embryos, age).RelevanceGiven internationally recognized field present Lugano meeting our publication constitutes consensus statement. To judgment. International management. A 2022. Data occurrence. True age).

Language: Английский

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Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Reproductive Outcomes

Cancers, Journal Year: 2022, Volume and Issue: 14(21), P. 5187 - 5187

Published: Oct. 22, 2022

Endometrial cancer is the most common gynecologic malignancy in developed countries and approximately 7% of women with endometrial are below age 45. Management young who desire to maintain fertility presents a unique set challenges since standard surgical treatment based on hysterectomy salpingo-oophorectomy often not compatible patient’s goals. A fertility-preserving approach can be considered selected patients early stage low-grade cancer. An increasing amount data suggest that oncologic outcomes compromised if conservative utilized close monitoring until childbearing completed. If possible, assisted reproductive technologies assist achieving their

Language: Английский

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Obesity and female infertility

Best Practice & Research Clinical Obstetrics & Gynaecology, Journal Year: 2023, Volume and Issue: 89, P. 102336 - 102336

Published: April 8, 2023

Infertility is a significant global health issue, with negative impact on people's wellbeing and human rights. Despite the longstanding association between obesity infertility, there remains uncertainty, about precise mechanisms underpinning this best management strategies. In article, we aimed to address these uncertainties by reviewing recent literature, focusing studies which evaluated live birth rates. We found that just over half of studies, investigating relationship preconception maternal weight rates an inverse correlation. There was, however, insufficient evidence, lifestyle or pharmacological interventions in obese women resulted improved The implications for clinical practice future research are highlighted. For example, need consider some flexibility applying strict body mass index targets, limiting access fertility treatment, large trials new options bariatric surgery.

Language: Английский

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Comparative efficacy of exercise, diet and/or pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity: a systematic review and network meta-analysis

Human Reproduction Update, Journal Year: 2024, Volume and Issue: 30(4), P. 472 - 487

Published: April 16, 2024

Abstract BACKGROUND The increasing prevalence of obesity worldwide poses a significant threat to reproductive function owing, in part, hormonal disturbances caused by negative feedback between excess adiposity and the hypothalamic–pituitary–ovarian axis. Consequently, finding most appropriate strategies lose weight improve ovulation women with overweight or is clinically relevant matter that needs be investigated. A comprehensive comparison independent combined efficacy lifestyle and/or pharmacological interventions on BMI, ovulation, profile at risk anovulatory infertility would facilitate improving fertility this population. OBJECTIVE AND RATIONALE This study aimed evaluate comparative exercise, diet, reproductive-aged obesity. SEARCH METHODS systematic review was performed searching PubMed, Scopus, Web Science, PsycINFO, Cochrane Library up 14 December 2023, for randomized controlled trials assessing effects diet (i.e. weight-lowering drugs inducers) We frequentist random-effect network meta-analyses rated certainty evidence. primary outcomes were BMI rate, secondary serum hormone levels (gonadotrophins, androgens, oestrogens). sensitivity analyses, including studies only involved PCOS. OUTCOMES Among 1190 records screened, 148 full texts assessed eligibility resulting 95 (9910 women), which 53% presented high unclear bias. revealed that, compared control: (mean difference (MD) −2.61 kg/m2; 95% CI −3.04 −2.19; τ2 = 0.22) adding exercise (MD −2.35 −2.81 −1.89; led greatest decrease BMI; inducers (risk ratio (RR) 7.15; 1.94–26.40; 0.07) (RR 4.80; 1.67–13.84; produced highest increase rate; effective strategy reducing testosterone (standardized mean (SMD) −2.91; −4.07 −1.74; 2.25), third sex hormone-binding globulin (SMD 2.37; 0.99–3.76; 2.48), it coupled being ranked first terms free androgen index reduction −1.59; −3.18 0.01; 1.91). surface under cumulative ranking curve scores suggested that: likely (94%) produce reduction; (89%) rate improvement. exclusively included involving diagnosed PCOS, consistent results above. WIDER IMPLICATIONS Overall, findings meta-analysis indicate combination loss, normalizing Although higher quality are needed, these support optimal treatment wishing conceive must consider during shared decision-making process.

Language: Английский

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Low-dose polystyrene microplastics exposure impairs fertility in male mice with high-fat diet-induced obesity by affecting prostate function

Environmental Pollution, Journal Year: 2024, Volume and Issue: 346, P. 123567 - 123567

Published: Feb. 15, 2024

Language: Английский

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Effectiveness of preconception weight loss interventions on fertility in women: a systematic review and meta-analysis

Fertility and Sterility, Journal Year: 2024, Volume and Issue: 122(2), P. 326 - 340

Published: Feb. 24, 2024

Language: Английский

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What is known about the use of weight loss medication in women with overweight/obesity on fertility and reproductive health outcomes? A scoping review

Clinical Obesity, Journal Year: 2024, Volume and Issue: 14(6)

Published: July 1, 2024

Summary Pregnancy during or soon after treatment with weight loss medication, particularly glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), is contraindicated due to potential teratogenicity. The aim of this scoping review investigate what known about the use medication in women childbearing age relation reproductive health outcomes, focusing on three medications licenced United Kingdom at time search. A systematic search studies that assessed outcomes taking either orlistat, liraglutide semaglutide was undertaken July 2023 and updated January 2024 across MEDLINE, Embase, CINAHL, Scopus, ClinicalTrials.gov , PROSPERO, Epistemonikos OpenGrey. Studies focused polycystic ovarian syndrome, diabetes animals were excluded. Titles abstracts screened, data from included articles extracted. After removal duplicates, 341 titles remained, which 318 Of final 18 included, there five interventional trials, one retrospective case‐control study, six narrative reviews, two protocols registry protocol yet start recruitment. All trials involved orlistat given preconceptionally, showing no improvement live birth rate, despite hormone levels. There primary GLP‐1 RAs. qualitative studies. an absence role RAs without syndrome. Future research should explore short‐ long‐term effects health, pregnancy experiences.

Language: Английский

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Role of Glucagon-Like Peptide-1 Receptor Agonists in People With Infertility and Pregnancy

Obstetrics and Gynecology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 23, 2025

Obesity is a chronic condition that causes significant morbidity and mortality in people the United States around world. Traditional means of weight loss include diet, exercise, behavioral modifications, surgery. New medications, glucagon-like peptide-1 receptor agonists, are revolutionizing management but have implications for fertility pregnancy. associated with infertility may affect response to ovulation induction medications. In pregnancy, obesity increases risks spontaneous abortion, birth defects, gestational diabetes, hypertensive disorders cesarean delivery, stillbirth. Lifestyle changes alone not improved outcomes. Glucagon-like agonists new medications targeting gut hormones can help achieve their goals contraindicated Obstetrician-gynecologists should work patients manage these before they become pregnant, between pregnancies, after delivery.

Language: Английский

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The Impact of Ketogenic Nutrition on Obesity and Metabolic Health: Mechanisms and Clinical Implications

Nutrition Reviews, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 26, 2025

The ketogenic diet (KD) has recently gained increasing popularity. This high-fat, adequate-protein, and carbohydrate-poor eating pattern leads to nutritional ketosis. KD long been known for its antidiabetic antiepileptic effects used therapeutically in these contexts. Recently, the KD, due effectiveness inducing weight loss, also proposed as a possible approach treat obesity. Likewise, is currently explored supporting element treatment of obesity-associated metabolic disorders certain forms cancer. Here, we discuss biochemical mechanisms at play during shift metabolism fatty acids acid-derived ketone bodies main fuel molecules, substitution carbohydrates, nutrition. Different sources KDs alternatives glucose carbohydrates energy substrates are discussed, together with an attempt weigh benefits risks posed by chronic use context considering molecular that exert on endocrine system.

Language: Английский

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Effects of preconception weight loss after lifestyle intervention on fertility outcomes and pregnancy complications

Fertility and Sterility, Journal Year: 2022, Volume and Issue: 118(3), P. 456 - 462

Published: Sept. 1, 2022

Language: Английский

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