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JCM
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Female Infertility: Clinical Diagnosis and Treatment—Second Edition
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Female Infertility: Clinical Diagnosis and Treatment—Second Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 April 2026 | Viewed by 932

Special Issue Editor

Prof. Dr. Laurie Henry

E-Mail Website
Guest Editor
Assisted Reproductive Technologies Center (CPMA-ULiège), Department of Obstetrics and Gynecology, CHU of Liège—Citadelle Site, University of Liège, Liège, Belgium
Interests: oncofertility; fertility preservation; implantation failure; ovulatory disorders; endometriosis; infertility; IVF
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The advancements in the diagnosis and treatment of female infertility over the last several decades have been truly remarkable. Innovations such as exploring the endometrial microbiome, genetic screening, and diagnosing conditions such as endometriosis via micro-RNA are transforming the field. Additionally, emerging techniques for the prediction of the embryo with the best implantation potential, regardless of its morphological development, and the improvement of sperm selection are enhancing pregnancy success rates. Cutting-edge approaches such as preimplantation genetic testing and advanced sperm selection methods promise significant clinical improvements. Integrating these new technologies and methods into treatment protocols can open up unprecedented opportunities for couples facing reproductive challenges. For this Special Issue, we invite authors to submit articles on these revolutionary clinical advances and contribute to the future of reproductive medicine by helping to develop new strategies to continually improve infertility care.

This second edition follows the successful first edition of this Special Issue, which can be accessed here: https://www.mdpi.com/journal/jcm/special_issues/2W17WO3P16.

Prof. Dr. Laurie Henry
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infertility
  • assisted reproductive techniques
  • diagnosis
  • implantation
  • gametes

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Published Papers (1 paper)

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Research

17 pages, 747 KB  
Article
Minimal Dose Paradigm in IUI Stimulation for Unexplained Infertility: Letrozole-Initiated Late Gonadotropin Protocol
by Evren Yeşildağer, Ufuk Yeşildağer and Sefa Arlıer
J. Clin. Med. 2026, 15(3), 1050; https://doi.org/10.3390/jcm15031050 - 28 Jan 2026
Viewed by 690
Abstract
Background: Optimizing pregnancy outcomes while minimizing gonadotropin exposure and treatment burden remains a major goal in ovulation induction for intrauterine insemination (IUI), particularly for patients with polycystic ovary syndrome (PCOS) or high ovarian reserve. Sequential protocols combining early letrozole with late-onset recombinant FSH [...] Read more.
Background: Optimizing pregnancy outcomes while minimizing gonadotropin exposure and treatment burden remains a major goal in ovulation induction for intrauterine insemination (IUI), particularly for patients with polycystic ovary syndrome (PCOS) or high ovarian reserve. Sequential protocols combining early letrozole with late-onset recombinant FSH (rFSH) have been proposed to enhance efficiency while reducing medication requirements. However, real-world comparative data adjusting for baseline differences are limited. Methods: This retrospective comparative cohort study included 764 IUI cycles performed between January 2022 and October 2025. Cycles were stimulated either with conventional rFSH (n = 372) or letrozole plus late-onset rFSH (n = 392). The primary outcome was pregnancy per cycle, defined by a positive serum β-hCG. Secondary outcomes included clinical pregnancy, total gonadotropin dose, endometrial thickness, cycle cancelation, and obstetric outcomes. Confounding was addressed using multivariable logistic regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and doubly robust estimation. Results: The crude pregnancy rate was higher in the letrozole plus late rFSH group compared with conventional rFSH (14.8% vs. 9.9%, p = 0.042). Women in the sequential stimulation group had higher AMH levels, higher antral follicle counts, and a higher prevalence of PCOS (32.4% vs. 16.3%, p = 0.001). After adjustment for age, ovarian reserve, and other baseline characteristics using regression, PSM, and IPTW, the stimulation protocol was not independently associated with pregnancy (adjusted OR 1.09, 95% CI 0.68–1.74; p = 0.657). Female age remained the strongest predictor of pregnancy (adjusted OR 0.70 per year increase; p < 0.001). The sequential protocol required a significantly lower total gonadotropin dose (median 375 IU vs. 750 IU; p < 0.001) while maintaining comparable cycle cancellation and safety outcomes. Conclusions: Sequential stimulation with letrozole plus late-onset rFSH achieves pregnancy outcomes comparable to conventional rFSH stimulation while significantly reducing gonadotropin requirements. After adjustment for PCOS status and ovarian reserve, the protocol itself did not independently influence pregnancy, suggesting that crude differences reflected baseline imbalances rather than true treatment effects. This approach represents a clinically efficient, gonadotropin-sparing option for IUI, particularly in patients at risk for excessive ovarian response. Full article
(This article belongs to the Special Issue Female Infertility: Clinical Diagnosis and Treatment—Second Edition)
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