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The Changing Landscape of Fertility Diagnosis and Treatment
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The Changing Landscape of Fertility Diagnosis and Treatment

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

Deadline for manuscript submissions: closed (20 January 2025) | Viewed by 4686

Special Issue Editors

Dr. Amanda N. Kallen

E-Mail Website
Guest Editor
1. Division of Reproductive Endocrinology & Infertility, University of Vermont Larner College of Medicine, 89 Beaumont Ave, Burlington, VT 05405, USA
2. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
Interests: granulosa cell function; ovarian biology; infertility; steroid pathway; long noncoding RNAs; microRNAs
Special Issues, Collections and Topics in MDPI journals
Dr. David B. Seifer

E-Mail Website
Guest Editor
Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
Interests: reproductive aging; AMH; racial disparities in IVF; fertility preservation; in vitro fertilization; assisted reproductive technology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, the field of reproductive medicine has witnessed a profound transformation, propelled by a convergence of scientific breakthroughs, societal shifts, and evolving cultural norms. This dynamic landscape has ushered in an era of unprecedented possibilities and challenges in the realm of fertility diagnosis and treatment. This Special Issue seeks to unravel the multifaceted perspectives of this evolving landscape, illuminating key trends and critical issues that are reshaping the way we perceive, diagnose, and address fertility concerns. We will bring together a diverse array of perspectives encompassing the latest research, clinical insights, and delve into the scientific advancements aimed at preserving reproductive potential and ensuring healthier outcomes for women and couples navigating the complex terrain of infertility.

Dr. Amanda N. Kallen
Dr. David B. Seifer
Guest Editors

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 100 words) can be sent to the Editorial Office for announcement on this website.

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
  • reproductive aging
  • in vitro fertilization
  • fertility
  • ovarian aging
  • ovary
  • uterus
  • sperm
  • tubal factor infertility
  • male factor infertility
  • biomarkers

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Published Papers (3 papers)

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Research

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12 pages, 1392 KiB  
Article
A Large Study About Reproductive Factors That Predict Hysterosalpingography-Identified Tubal Pathology: An Insight into the Necessity of Preconception Screening
by Yurie Nako, Kuniaki Ota, Toshio Sujino, Junichiro Mitsui, Hisae Kamo, Shoko Katsumata, Yuko Takayanagi, Makiko Tajima, Tomonori Ishikawa, Akira Komiya and Kiyotaka Kawai
J. Clin. Med. 2025, 14(1), 179; https://doi.org/10.3390/jcm14010179 - 31 Dec 2024
Viewed by 1432
Abstract
Background/Objectives: Hysterosalpingography (HSG) is pivotal in delineating tubal pathology, but is associated with pain and exposure to ionizing radiation. This study investigated which reproductive factors predict HSG-identified tubal pathology. Methods: From May 2016 to August 2023, 3322 infertile females with HSG [...] Read more.
Background/Objectives: Hysterosalpingography (HSG) is pivotal in delineating tubal pathology, but is associated with pain and exposure to ionizing radiation. This study investigated which reproductive factors predict HSG-identified tubal pathology. Methods: From May 2016 to August 2023, 3322 infertile females with HSG (mean age 33.9 ± 4.3 years) were assessed for fallopian tube status. Results: HSG indicated that 2764 had patent tubes while 558 (16.8%) had non-patent tubes. Unilateral and bilateral absence of free contrast spillage occurred in 377 (11.3%) and 181 (5.4%) cases, respectively. Non-spillage, denoted as non-patency, was seen in 148 (4.5%) and 153 (4.6%) right and left cases, respectively. Tubal occlusion was observed in 181 (5.4%) and 159 (5.4%) right and left cases, respectively. Hydrosalpinx was found in 37 (1.2%) right and 58 (1.7%) left cases. Multivariate logistic regression revealed CT-IgG positivity (odds ratio [OR]: 1.57), endometrioma (OR: 1.64), and fibroids (OR: 1.58) as independent factors for increased non-patency. CT-IgG positivity (OR: 1.92) and fibroids (OR: 1.88) were significant risk factors for occlusion. Painful defecation (OR: 2.79), CT-IgA positivity (OR: 2.09), CT-IgG positivity (OR: 2.07), and endometrioma (OR: 3.11) were significant risk factors for hydrosalpinx. Conclusions: In females with painful defecation, CT-IgG positivity, endometrioma, and fibroids, HSG may be used as a second-line investigation, with laparoscopy as the preferred assessment tool. Full article
(This article belongs to the Special Issue The Changing Landscape of Fertility Diagnosis and Treatment)
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7 pages, 219 KiB  
Article
Uterus Transplantation from Deceased Donors: First Italian Experience
by Pierfrancesco Veroux, Paolo Scollo, Alessia Giaquinta, Giuseppe Roscitano, Martina Maria Giambra, Basilio Pecorino, Concetta De Pasquale, Giuseppe Scibilia, Maria Luisa Pistorio and Massimiliano Veroux
J. Clin. Med. 2024, 13(22), 6821; https://doi.org/10.3390/jcm13226821 - 13 Nov 2024
Viewed by 897
Abstract
Background: Uterus transplantation (UTx) is currently the only available treatment for absolute uterine factor infertility. Deceased donors have recently emerged as a valid alternative to living donors for uterus transplantation, with similar results. Methods: We report the first experience in Italy [...] Read more.
Background: Uterus transplantation (UTx) is currently the only available treatment for absolute uterine factor infertility. Deceased donors have recently emerged as a valid alternative to living donors for uterus transplantation, with similar results. Methods: We report the first experience in Italy of uterus transplantation from deceased donors. Three uterus transplantations from deceased donors were performed at the Organ Transplant Unit of the University Hospital of Catania, Italy, between August 2020 and January 2022. Results: Two patients underwent UTx due to Mayer–Rokitansky–Küster–Hauser syndrome, while one patient had a previous hysterectomy due to benign disease. The donors’ ages were between 25 and 43 years and the mean cold ischemia time was 18.3 h. The mean age of the recipients was 31.6 years, and the mean recipient surgery duration was 5.3 h, with a mean blood loss of 766.66 mL. Two recipients developed a post-transplant hematoma, which was treated conservatively. No uterus recipient needed a re-operation during the first 30 days after transplantation. No histological signs of acute rejection were detected at the cervical biopsies performed at 1, 3, and 6 months after transplantation. First menstruation occurred in all recipients after 39 ± 12 days after transplantation. One live birth was reported 15 months after UTx. One graft was lost three months after UTx due to graft thrombosis. Conclusions: Uterus transplantation from deceased donors is emerging as a valid alternative to living donors in order to increase the donor pool. Full article
(This article belongs to the Special Issue The Changing Landscape of Fertility Diagnosis and Treatment)

Review

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11 pages, 608 KiB  
Review
Moving toward Narrowing the United States Gap in Assisted Reproductive Technology (ART) Racial and Ethnic Disparities in the Next Decade
by Jasmin Mahabamunuge and David B. Seifer
J. Clin. Med. 2024, 13(8), 2224; https://doi.org/10.3390/jcm13082224 - 11 Apr 2024
Cited by 4 | Viewed by 1677
Abstract
The Disparities in Assisted Reproductive Technology (DART) hypothesis, initially described in 2013 and further modified in 2022, is a conceptual framework to examine the scope and depth of underlying contributing factors to the differences in access and treatment outcomes for racial and ethnic [...] Read more.
The Disparities in Assisted Reproductive Technology (DART) hypothesis, initially described in 2013 and further modified in 2022, is a conceptual framework to examine the scope and depth of underlying contributing factors to the differences in access and treatment outcomes for racial and ethnic minorities undergoing ART in the United States. In 2009, the World Health Organization defined infertility as a disease of the reproductive system, thus recognizing it as a medical problem warranting treatment. Now, infertility care is largely recognized as a human right. However, disparities in Reproductive Endocrinology and Infertility (REI) care in the US persist today. While several studies and review articles have suggested possible solutions to racial and ethnic disparities in access and outcomes in ART, few have accounted for and addressed the multiple complex factors contributing to these disparities on a systemic level. This review aims to acknowledge and address the myriad of contributing factors through the DART hypothesis which converge in racial/ethnic disparities in ART and considers possible solutions to effect large scale societal change by narrowing these gaps within the next decade. Full article
(This article belongs to the Special Issue The Changing Landscape of Fertility Diagnosis and Treatment)
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