Romanski PA, Bortoletto P, Pfeifer SM. Cervical agenesis: surgical preservation of reproductive potential in spite of anatomic variation. Fertil Steril. 2022 Sep;118(3):596-597. doi: 10.1016/j.fertnstert.2022.07.004. PMID: 36116805.

Cervical agenesis is a rare anomaly that occurs in 0.001% of the general population, granting even experienced reproductive physicians limited exposure to this congenital disorder. This editorial touches on the historical management, and poor associated outcomes, of the condition. Recent developments have determined that uterovaginal/vestibular anastomosis are the recommended treatment for this condition, but each case should be treated on a case-by-case basis, leading to variable surgical techniques per surgeon. The editorial continues a discussion of a recently developed surgical technique by Fedele et al. (Fertil Steril 2021) utilizing laparoscopically assisted uterovaginal/vestibular anastomosis for patients with cervical agenesis with complete or partial vaginal agenesis.

Hewitt SC, Wu SP, Wang T, Ray M, Brolinson M, Young SL, Spencer TE, DeCherney A, DeMayo FJ. The Estrogen Receptor α Cistrome in Human Endometrium and Epithelial Organoids. Endocrinology. 2022 Sep 1;163(9):bqac116. doi: 10.1210/endocr/bqac116. PMID: 35895287; PMCID: PMC9368022.

Women aged 19 to 34 years old, with regular intermenstrual interval between 25 and 35 days, and no history of infertility or pelvic disease were included in the study. Endometrial biopsies were collected and processed for ESR1 ChIPseq and isolation of epithelial cells for culture of organoids. Study findings include a preferential enrichment of HOX motifs in the mid-secretory ESR1 peaks, and bHLH motifs are enriched in proliferative and mid-secretory ESR1 peaks. Data presented in this study elucidates details of estrogen-mediated response in uterine tissue.

Siegel DR, Sheeder J, Kramer W, Roeca C. Are donor-conceived people willing to use donors themselves? Insights from individuals conceived via donor-assisted reproduction. Hum Reprod. 2022 Aug 25;37(9):2087-2094. doi: 10.1093/humrep/deac169. PMID: 35906918.

Utilizing a web-based survey that was distributed to users of the Sibling Donor Registry, this study found that 40.2% of people who were conceived using donor gametes would consider using donor gametes themselves and 24.6% were undecided. Those who were undecided or had already used donor gametes tended to be younger, and less likely to be married or identify as female than those who would not consider donor gametes.

Martin S, Deng J, Searl T, Ohlander S, Harrington DA, Stupp SI, Dynda D, McVary KT, Podlasek CA. Sonic Hedgehog Signaling in Primary Culture of Human Corpora Cavernosal Tissue From Prostatectomy, Diabetic, and Peyronie’s Patients. J Sex Med. 2022 Aug;19(8):1228-1242. doi: 10.1016/j.jsxm.2022.04.010. Epub 2022 Jun 23. PMID: 35752559; PMCID: PMC9329230.

Akers A, New EP, Plosker S, Silva CP, Sprague R, Imudia AN. Oocyte Retrieval in Asymptomatic Patients Positive for SARS-CoV-2. Case Rep Obstet Gynecol. 2022 Aug 12;2022:3107747. doi: 10.1155/2022/3107747. PMID: 35990707; PMCID: PMC9391171.

COVID-19 has created an additional barrier for women who wish to or are currently undergoing fertility treatment. Fertility centers should address asymptomatic, COVID-19 positive patients on a case-by-case basis in order to ensure safety to center staff and the patient, while also mitigating the dangers associated with cycle cancellation. This study is a discussion of two case studies where women underwent oocyte retrievals and were asymptomatic but tested positive for COVID-19. In both special cases, the risks of canceling the cycles were heavily considered by practice physicians and risk management, and extra precautions were taken to ensure no medical staff were also infected.

Peters BA, Santoro N, Kaplan RC, Qi Q. Spotlight on the Gut Microbiome in Menopause: Current Insights. Int J Womens Health. 2022 Aug 10;14:1059-1072. doi: 10.2147/IJWH.S340491. PMID: 35983178; PMCID: PMC9379122.

This review emphasizes the need to further study the gut microbiome, a key contributor to women’s health, in relation to a woman’s shift into a menopause. Authors include a discussion on the gut microbiome and hormonal transition through pregnancy, pre-menopause, and post-menopause. Particular attention is drawn to the influence of hormones on microbial translocation in the gut barrier, and the role of hormones, specifically estrogens and progesterone, as regulators of the immune system. Additionally, current studies of menopause and the gut microbiome are summarized, as well as the findings. This discussion prompts the need for further research on the influence of the gut microbiome’s ability to recycle sex hormones post-menopause.

Grimes NP, Bertone-Johnson ER, Whitcomb BW, Sievert LL, Crawford SL, Gold EB, Avis NE, Greendale GA, Santoro N, Habel LA, Reeves KW. Anti-Müllerian hormone levels and breast cancer risk in the study of women’s health across the nation. Cancer Causes Control. 2022 Aug;33(8):1039-1046. doi: 10.1007/s10552-022-01596-5. Epub 2022 Jun 29. PMID: 35768642.

The presented study addresses the current lack of literature addressing the relationship between AMH levels with breast cancer in women who do not identify as non-Hispanic and white, and gathered information from Chinese, Japanese, Black, Hispanic, and white women. This SWAN study measured AMH level by ELISA, and breast cancer history was assessed during a series of interviews. AMH measurements were available for 1,529 SWAN participants, 84 of which reported an incident of a breast cancer diagnosis. Subgroup analysis revealed the hazard ratio for continuous AMH was 1.11 (95% CI 0.92–1.34) for White women, 1.04 (95% CI 0.86–1.27) for Black women and 1.07 (95% CI 0.85–1.33) for Asian women. This study was not able to accurately assess the hazard ratio for Hispanic women due to low incidence of breast cancer in this subgroup. A non-significant, positive association was observed between AMH level and risk of breast cancer in pre- and perimenopausal women.

Pal L, Morgan K, Santoro NF, Manson JE, Taylor HS, Miller VM, Brinton EA, Lobo R, Neal-Perry G, Cedars MI, Harman SM, James TT, Gleason CE. Cardiometabolic measures and cognition in early menopause – Analysis of baseline data from a randomized controlled trial. Maturitas. 2022 Aug;162:58-65. doi: 10.1016/j.maturitas.2022.04.004. Epub 2022 Apr 29. PMID: 35617770.

Data from the KEEPS (Kronos Early Estrogen Prevention Study) clinical trial suggests that recently menopausal women with higher waist circumferences (over 88 cm) and waist-to-hip ratios (over 0.8) were associated with lower cognitive function, assessed by lower Modified Mini Mental Status scores.

Doyle N, Combs JC, Jahandideh S, Wilkinson V, Devine K, O’Brien JE. Live birth after transfer of a single euploid vitrified-warmed blastocyst according to standard timing vs. timing as recommended by endometrial receptivity analysis. Fertil Steril. 2022 Aug;118(2):314-321. doi: 10.1016/j.fertnstert.2022.05.013. Epub 2022 Jun 13. PMID: 35710597; PMCID: PMC9329263.

Endometrial receptivity analysis (ERA) is an add-on tool used in the fertility practice to find the optimal timing of egg implantation into the endometrium during the menstrual cycle. This study found that in a pool of patients with previously unsuccessful frozen embryo transfers, live birth outcomes did not differ when ERA results deemed the endometrium receptive or nonreceptive. Patients who used ERA and those who underwent standard protocol did not have differences in live birth outcomes.

Jonah Bardos, MD, Jacyln Kwal, MD, Wayne Caswell, MS, Samad Jahandideh, PhD, Melissa Stratton, BS, Michael Tucker, PhD, Alan Decherney, MD, Kate Devine, MD, Micah Hill, DO, Jeanne E. O’Brien, MD, MSc. Accepted, Fertil Steril. 2022.

This retrospective study gathered data from embryos of donor oocytes that underwent trophectoderm biopsy and PGT-A from four different laboratories to investigate variation in euploid blastocyst rate and live birth rate across different laboratories when controlling for blastocyst quality. Results from the study suggest that there are differences in euploid blastocyst rate and live birth rates for a young and healthy population between laboratories, suggesting that not all PGT-A laboratories are comparable.

Chung A, Romanski PA, Bortoletto P, Spandorfer SD. Live birth outcomes are not associated with household income and insurance disparities following ART treatment. Reprod Biomed Online. 2022 Aug;45(2):410-416. doi: 10.1016/j.rbmo.2022.04.004. Epub 2022 Apr 20. PMID: 35610155.

Zanolli NC, Bishop KC, Kuller JA, Price TM, Harris BS. Fibroids and Fertility: A Comparison of Myomectomy and Uterine Artery Embolization on Fertility and Reproductive Outcomes. Obstet Gynecol Surv. 2022 Aug;77(8):485-494. doi: 10.1097/OGX.0000000000001052. PMID: 35932289.

Mima M, Huang JB, Andriole GL, Freedland SJ, Ohlander SJ, Moreira DM. The impact of smoking on sexual function. BJU Int. 2022 Aug;130(2):186-192. doi: 10.1111/bju.15711. Epub 2022 Mar 3. PMID: 35166438.

Fanton M, Nutting V, Rothman A, Maeder-York P, Hariton E, Barash O, Weckstein L, Sakkas D, Copperman AB, Loewke K. An interpretable machine learning model for individualized gonadotrophin starting dose selection during ovarian stimulation. Reprod Biomed Online. 2022 Jul 28:S1472-6483(22)00498-9. doi: 10.1016/j.rbmo.2022.07.010. Epub ahead of print. PMID: 36096871.

A machine learning model was developed using de-identified, electronic medical record data from three IVF clinics to determine the best starting dose of FSH during ovarian stimulation per individual. This tool uses historical FSH dosing and clinical outcomes as a guideline for new patients starting ovarian stimulation and may help standardize care across fertility practices.

Santoro N. A call to action to reproductive endocrinologists: we cannot avoid the culture wars. Fertil Steril. 2022 Jul;118(1):54-55. doi: 10.1016/j.fertnstert.2022.04.021. Epub 2022 May 21. PMID: 35610092.

Dr. Nanette Santoro shares her story of being raised in a religious household and discusses the damage brought unto women from the culture wars of abortion and the pro-life movement. Dr. Santoro goes on to discuss the need to disassociate a woman’s reproductive potential to her worth and remove religious ties from public policy.

Devine K, Dolitsky S, Ludwin I, Ludwin A. Modern assessment of the uterine cavity and fallopian tubes in the era of high-efficacy assisted reproductive technology. Fertil Steril. 2022 Jul;118(1):19-28. doi: 10.1016/j.fertnstert.2022.05.020. PMID: 35725118; PMCID: PMC9348809.

Prior to embryo transfer, assessment of the fallopian tubes and uterine cavity is vital to determining if a woman’s anatomy is compliant with pregnancy. This article discusses more patient-friendly alternatives to diagnostic imaging, in particular, various modalities of ultrasound, for women who are noninfertile and undergoing embryo transfer.

New EP, Semerci N, Ozmen A, Guo X, Jonnalagadda VA, Kim JW, Anderson ML, Guzeloglu-Kayisli O, Imudia AN, Lockwood CJ, Kayisli UA. FKBP51 Contributes to Uterine Leiomyoma Pathogenesis by Inducing Cell Proliferation and Extracellular Matrix Deposition. Reprod Sci. 2022 Jun;29(6):1939-1949. doi: 10.1007/s43032-022-00921-2. Epub 2022 Apr 14. PMID: 35426036; PMCID: PMC9009985.

This study was able to determine that uterine leiomyoma (fibroid) cells have increased expression of FKBP51 compared to normal myometrial cells. This binding protein may be used to further study fibroid pathogenesis.

Peters BA, Lin J, Qi Q, Usyk M, Isasi CR, Mossavar-Rahmani Y, Derby CA, Santoro N, Perreira KM, Daviglus ML, Kominiarek MA, Cai J, Knight R, Burk RD, Kaplan RC. Menopause Is Associated with an Altered Gut Microbiome and Estrobolome, with Implications for Adverse Cardiometabolic Risk in the Hispanic Community Health Study/Study of Latinos. mSystems. 2022 Jun 28;7(3):e0027322. doi: 10.1128/msystems.00273-22. Epub 2022 Apr 13. PMID: 35675542; PMCID: PMC9239235.

Analysis of the gut microbiome of a large set of Hispanic/Latinos in the United States revealed that post-menopausal Hispanic/Latino women had a gut microbiome more similar to that of men, and changes in gut microbiome due to menopause were associated with adverse cardiometabolic risks. These data suggest that the gut microbiome contributes to cardiometabolic health during menopause.

Combs A, Kimes MJ, Jaslow CR, Hayes H, O’Leary LB, Levy MJ, Kutteh WH. Perception of pain and the oocyte donor experience: a retrospective analysis of commercial US donors. Reprod Biomed Online. 2022 Jun 22:S1472-6483(22)00421-7. doi: 10.1016/j.rbmo.2022.06.013. Epub ahead of print. PMID: 36058796.

A survey that queried pain during egg donation was emailed to women who had undergone egg donation. Results from the survey allowed the study team to conclude that this group of women had been made aware of the risk of pain they would experience beforehand, and that those who had reported being informed of the risk of pain were less likely to report higher levels of pain. They also found that unexpected levels of pain were related to low donor satisfaction.

Taylor H, Li HJ, Carson S, Flores V, Pal L, Robbins J, Santoro NF, Segars JH, Seifer D, Huang H, Young S, Zhang H. Pre-IVF treatment with a GnRH antagonist in women with endometriosis (PREGNANT): study protocol for a prospective, double-blind, placebo-controlled trial. BMJ Open. 2022 Jun 17;12(6):e052043. doi: 10.1136/bmjopen-2021-052043. PMID: 35715184; PMCID: PMC9207753.

Women diagnosed with endometriosis-associated infertility are often successfully treated with IVF. The PREGnant study utilizes an oral GnRH antagonist to treat endometriosis prior to IVF start; the efficacy of the treatment will be assessed using live birth rates. This publication further explains the study protocol.