Journal of Assisted Reproduction and Genetics

Albertini, David F.

doi: 10.1007/s10815-025-03535-0pmid: 40482002

Nakamura, Kentaro; Iwahata, Hideyuki; Sugishita, Yodo; Suzuki, Yuki; Furuya, Natsuki; Yoshida, Takashi; Morita, Akari; Igalada, Arby Jane Rouque; Ahmad, Mohd Faizal F.; Horage-Okutsu, Yuki; Takae, Seido; Patrizio, Pasquale; Suzuki, Nao

doi: 10.1007/s10815-025-03478-6pmid: 40266419

The 8 th International Congress of the ISFP was held in Tokyo, Japan, from November 15 to 17, 2024. The theme of this year’s Congress was “Rethinking Personalized Fertility Preservation and Cancer Survivors-Opening a New Frontier”. The congress featured special lectures, keynote addresses, and 25 sessions—including a dedicated session on nursing and oral presentations by young doctors and researchers—making it one of the largest and most comprehensive events in the ISFP’s history. Additionally, the program incorporated sessions featuring the Japanese, Korean, and Chinese Societies for Fertility Preservation, providing a convenient platform for international participants from across the globe to showcase their work and discuss the unique characteristics and challenges of these areas within Asia. Participants also had the opportunity to attend workshops on ovarian tissue cryopreservation and oocyte cryopreservation, conducted by leaders in their respective fields exploring the latest technological and clinical advances and translational prospects for the future.Graphical Abstract[graphic not available: see fulltext]

Bakkensen, Jennifer B.; Almgren-Bell, Jessica; Smith, Kristin; Lawson, Angela K.; Goldman, Kara N.

doi: 10.1007/s10815-025-03466-wpmid: 40167956

PurposeTo assess the extent to which patients pursuing medically-indicated fertility preservation (FP) prioritize reproductive certainty vs. hope, and to correlate specific FP strategies with post-cycle satisfaction, anxiety, and optimism.MethodsProspective survey of patients with ovaries 18-45y requiring fertility-compromising therapy having completed a FP consult at an academic fertility center from 10/2021–2/2023.ResultsAmong 136 eligible patients, 70 completed the survey. Of those planning FP, 35 planned egg freezing (57.4%), 16 embryo freezing (26.2%), and 10 both (16.4%). Those freezing eggs were younger (29.7 ± 6.5y) vs. those freezing embryos (35.8 ± 4.5y) or both (30.9 ± 6.1y) (p = 0.01). While those freezing embryos were more likely to be married (12/16, 75%), 33% of married individuals froze at least some eggs. Of those freezing embryos, 88.5% said they would want to know if their embryos were abnormal; however, only 46.2% planned pre-implantation genetic testing (PGT). Fifty-three patients ultimately completed ≥ 1 cycle: 64.1% eggs, 30.2% embryos, and 5.7% both. Among those completing the post-cycle survey (n = 42), cycle satisfaction varied by FP strategy, from 62% for embryos to 96% for eggs and 100% for both (p = 0.013). Anxiety measure scores were higher pre- vs. post-cycle (median [IQR] = 8 [6–12] vs. 6 [0–8], p < 0.001), whereas optimism measure scores were similar throughout.ConclusionsFP decisions are nuanced and individualized. Notably, patients freezing eggs who therefore had less concrete information about reproductive potential endorsed higher cycle satisfaction. More thorough understanding of this complex decision-making may help optimize counseling and support.

Sbaity, Eman; Ramadan, Nagham; Slim, Ali; Diab, Tasnim; Kazarian, Houry; Tarhini, Ali; Charafeddine, Maya; Ghazeeri, Ghina; Bazarbachi, Ali; El Cheikh, Jean; El Saghir, Nagi S.; Assi, Hazem I.

Wang, Li; Li, Jianfang; Lu, Tiexia; Shan, Chuyue; Wang, Lixiu; Liu, Chang; Luo, Dan; Yang, Bing Xiang; Zou, Huijing; Zhou, Fuling; Liu, Qian

doi: 10.1007/s10815-024-03380-7pmid:

Cherven, Brooke; Fitch, Kayla D.; Nijeboer, Eline; Klosky, James L.; Lehmann, Vicky

doi: 10.1007/s10815-025-03527-0pmid: 40434704

BackgroundYoung patients may search the Internet and consult online discussion platforms for health-related information. This can be useful and supportive, but also problematic if misinformation is spread. Fertility-related information in the context of cancer is complex and confounded by uncertainty, which can cause misunderstandings and unnecessary burden.MethodsDiscussions on the online platform Reddit were searched and analyzed for questions around cancer and fertility. A mix of structured coding (e.g., number/types of questions) and qualitative analyses of user questions and comments were used to uncover salient content and interactions online.ResultsA total of N = 149 relevant threads were identified, posted on three subreddits related to cancer and fertility. Posted questions aimed at seeking either information (57.7%, n = 86) or advice/support (42.3%, n = 63). Information-related questions focused on medical aspects (e.g., fertility status, assisted reproductive technologies [ART]), financial aspects (e.g., health insurance), or medical decision-making (e.g., ART, fertility assessments). Advice-related questions focused on the emotional impact of (possible) infertility (e.g., coping, burden of unsuccessful pregnancy attempts). Analyses of n = 20 comment sections revealed six themes within answers to information-related questions (e.g., personal experiences/stories to provide advice, offering explanations/ suggestions). These interactions typically occurred in a respectful and supportive tone of voice. While misinformation was infrequent, users sometimes derailed into subdiscussions unrelated to the initially posted question.ConclusionOnline communities like Reddit offer a place where cancer patients/survivors may seek information and exchange ideas regarding their concerns in real time. Frequent topics of discussion can serve as areas of priority for developing educational and communication interventions in clinical care.

Decanter, Christine; Dassonneville, Audrey; D’Orazio, Emmanuelle; Behal, Hélène; Gagez, Anne-Laure; Mailliez, Audrey; Pigny, Pascal

doi: 10.1007/s10815-025-03475-9pmid: 40220108

PurposeThe impact of a germline BRCA1/2 pathogenic variant (gBRCApv) on baseline or late post-treatment AMH concentrations in breast cancer patients has been extensively studied, yielding mixed conclusions. However, whether the AMH decline during neo-adjuvant chemotherapy reflects differences in chemotherapy susceptibility between gBRCApv carriers and non-carriers remains unexplored.MethodsA monocentric, retrospective, longitudinal study was conducted on breast cancer patients carrying a gBRCApv (n = 12) or wild-type (WT) (n = 35) who received a neo-adjuvant sequential chemotherapy (CT) with anthracyclines followed by taxanes. Serum AMH levels were measured at baseline (AMH0) and at three time points during CT by a hypersensitive assay. Tumor size change was assessed via imaging. The impact of genetic status on AMH decline was evaluated using a linear mixed model with post hoc analysis.ResultsThe change of AMH concentrations from baseline to the end of CT tended to be influenced by the genetic status (BRCA * time interaction, p = 0.058). The slope between AMH0 and the end of anthracyclines (after log transformation) was steeper in gBRCApv than in WT patients (mean (SE): − 5.54 (0.63) vs − 3.97 (0.62); p = 0.023). Tumor size change was positively and significantly correlated with the change in AMH levels (AMH MidCT-AMH0) in gBRCApv patients (r = 0.93, p < 0.001) but not in WT patients (r = − 0.05; p = 0.84).ConclusionGermline BRCA1/2 status influences AMH decline during neo-adjuvant CT with drugs inducing DNA lesions. AMH decay is positively related to tumor size change assessed by imaging in gBRCApv patients. However, no conclusions can be drawn regarding the relationship with treatment response assessed by histological criteria.

Mortimer, Roisin M.; Lanes, Andrea; Waldman, Ian; Ginsburg, Elizabeth S.; Srouji, Serene S.

doi: 10.1007/s10815-025-03517-2pmid: 40402399

ObjectiveTo evaluate the differences in total number of oocytes and MII oocytes retrieved with gonadotropin dosing in adolescent and young adult patients compared to older patients undergoing fertility preservation cycles for cancer diagnosis.DesignRetrospective cohort.SettingSingle academic institution.Patient(s)All patients less than 35 years old undergoing a fertility preservation cycle who have a cancer diagnosis, or a plan to receive gonadotoxic chemotherapy.Intervention(s)Fertility preservation cycles in patients < 22 years old (younger group) compared with those 22– < 35 years old (older group) stratifying by age, AMH, and average daily gonadotropin dosing.Main outcome measure(s)Total oocyte yield, total number of MII oocytes.ResultsThe younger group had 26% more oocytes retrieved and 28% more MII oocytes retrieved compared with the older group, when adjusting for BMI, chemotherapy prior to treatment and myelodysplasia (aRR 1.28, 95% CI 1.01–1.63). Starting, total, and average daily gonadotropin doses were similar between age groups. Cycles in the younger group (10.0%) were more likely to be canceled compared with the older group (2.8%) (RR 3.52, 95% CI 1.35–0.17); 35.9% of the younger group and 11.7% of the older group had chemotherapy prior to cycle start.Conclusion(s)Patients should be encouraged to undergo fertility preservation prior to receiving chemotherapy as this commonly decreases ovarian reserve and leads to a higher likelihood of cycle cancellation.

Zimmermann, Appoline; Perrin, Jeanne; Deveze, Carole; Saias-Magnan, Jacqueline; Guillemain, Catherine; Courbiere, Blandine

doi: 10.1007/s10815-025-03522-5pmid: 40447956

PurposeFertility preservation in women with cancer represents a major medical challenge at the intersection of oncological and reproductive concerns. With therapeutic advancements, the survival rates of cancer patients have significantly improved, offering the possibility of motherhood. Currently, there is a lack of data on the return of cryopreserved oocytes/embryos and pregnancy outcomes following cancer treatment.MethodsWe conducted a retrospective, single-center, descriptive cohort study, including women who underwent fertility preservation through oocyte or embryo cryopreservation before a medium risk of gonadotoxicity chemotherapy for cancer at our Department of Reproductive Medicine and Oncofertility between January 2012 and May 2024.ResultsA total of 327 women were included, with 318 cases of oocyte cryopreservation and nine embryo cryopreservation. The average follow-up duration was 5.1 ± 2.7 years. Among the 49 women who expressed a desire for pregnancy post-cancer treatment, 65.3% of them (n = 32/49) reported at least one live birth. Of the 35 live births recorded, 80% (n = 28/35) resulted from spontaneous pregnancies, five were achieved after thawing vitrified oocytes (11.4%), and three after oocyte donation (8.6%). The return rate of cryopreserved oocytes was 6.92% (22/318), with a live birth rate per woman of 22.7% (5/22) following oocyte warming.ConclusionAlthough fertility preservation (FP) must be proposed systematically in age-reproductive women facing cancer with a medium risk of gonadotoxicity chemotherapy, physicians must be aware of the low rate of oocyte return and the potential for spontaneous pregnancies despite a post-cancer diminished ovarian reserve. Fertility consultations should also be better integrated into oncologic post-treatment care.

Cadenas, Jesús; Adrados, Cristina Subiran; Kumar, Ajay; Kalra, Bhanu; Mamsen, Linn Salto; Andersen, Claus Yding

doi: 10.1007/s10815-025-03483-9pmid: 40261459

PurposeTo characterize the hormonal environment in spent medium and cumulus cell gene expression during human IVM using oocytes from small antral follicles (SAFs) retrieved from surplus medulla tissue after ovarian tissue cryopreservation.MethodsImmature oocytes from surplus medulla tissue underwent 42-h IVM in media with varying FSH and LH concentrations (0, 10, 100 IU/L FSH, and 100 IU/L FSH + 100 IU/L LH). Oocyte maturation was assessed by germinal vesicle (GV), metaphase I (MI), or metaphase II (MII) stages. Gene expression of FSHR, LHCGR, AMH, CYP19 A1, and INHA in cumulus cells was analyzed by RT-qPCR, and GDF9, AMH, inhibin-B, inhibin-A, and total inhibin were measured in the spent media by ELISA.ResultsIncreased FSH concentrations downregulated FSHR expression and upregulated LHCGR, which correlated with MII transition. GDF9 concentrations in the spent medium significantly decreased with higher FSH, as did GDF9, AMH, and inhibin-B in MII oocytes. Inhibin-A levels tended to be higher in the media of MII oocytes. FSHR expression was positively associated with inhibin-B and negatively with inhibin-A, while LHCGR showed the opposite pattern and was also negatively linked to GDF9 concentration.ConclusionFSH-induced LHCGR expression, along with FSHR downregulation, is closely linked to oocyte maturation. Reduced GDF9 secretion from oocytes facilitates LHCGR expression on cumulus cells, while FSH and LH collectively induced hormones like inhibin-A, which likely support oocyte maturation.