Search Results (587)

Background: The aim of this study was to evaluate the diagnostic performance of combined testicular function indices in patients with non-obstructive azoospermia and to investigate the clinical value of these indices in predicting the diagnosis of non-obstructive azoospermia and the success of testicular sperm extraction. Methods: This retrospective observational study included 224 male patients who underwent infertility assessment. The patients were classified into a normospermic group (n = 165) and a non-obstructive azoospermia group (n = 59). Serum anti-Müllerian hormone, follicle-stimulating hormone, luteinising hormone and total testosterone levels were assessed. The Testicular Function Index, the modified Testicular Function Index and the logarithmically transformed index were calculated. Patients in the non-obstructive azoospermia group underwent micro-TESE and were classified according to sperm retrieval status. Diagnostic performance was assessed using ROC analysis. Results: Among the 59 patients with non-obstructive azoospermia who underwent micro-TESE, sperm retrieval was successful in 26 patients and unsuccessful in 33 patients. In the non-obstructive azoospermia group, anti-Müllerian hormone and testosterone levels were lower, whilst follicle-stimulating hormone and luteinising hormone levels were higher (all p < 0.001). All combined indices were found to be significantly lower in the non-obstructive azoospermia group (all p < 0.001). In the ROC analysis, follicle-stimulating hormone demonstrated the highest discriminatory performance (AUC = 0.978). In the testicular sperm extraction analysis, anti-Müllerian hormone was found to be the marker with the highest performance (AUC = 0.930). Conclusions: (Follicle-stimulating hormone demonstrated the highest diagnostic performance for distinguishing non-obstructive azoospermia, whereas anti-Müllerian hormone was the strongest predictor of TESE success. Although the combined testicular function indices showed good diagnostic performance, they did not outperform these established hormonal markers and should therefore be regarded as complementary tools for the integrated assessment of testicular function. These findings should be considered exploratory and require further validation. Full article

We explored the potential functions of differentially expressed miRNAs, mRNAs, lncRNAs, and circRNAs identified in the ovaries of gilts with normal estrus (NE) and follicular cyst-associated anestrus (AE), as well as their putative competing endogenous RNA (ceRNA) regulatory networks. Ovarian morphology was assessed via ultrasonography, and serum concentrations of Follicle-stimulating hormone (FSH), (Estradiol) E2, and Progesterone(P4) were measured. Ovarian tissues were harvested after slaughter for whole-transcriptome sequencing. Bioinformatic tools were used to screen differentially expressed RNAs(DERNAs) between NE and AE gilts. We further predicted target interactions among these transcripts, conducted functional enrichment analysis on target genes, and constructed candidate ceRNA regulatory networks potentially associated with gilt estrus. Phenotypic verification confirmed that ovarian ultrasonographic characteristics, histological morphology, and serum reproductive hormone levels were consistent with the physiological status of NE and AE gilts. Under the screening thresholds of p < 0.05 and |log₂FC| ≥ 1, we identified 22 lncRNAs that may interact with 21 mRNAs via 50 miRNAs, alongside 39 circRNAs predicted to regulate 26 mRNAs through 72 miRNAs. Functional enrichment analysis indicated that target genes of these differentially expressed transcripts were predominantly enriched in the lysosome pathway, PPAR signaling pathway, chemokine signaling pathway, cholesterol metabolism and NOD-like receptor signaling pathway. Hub molecules including FGF1, GHR, TLR2, ssc-miR-370, and miR-21-5p were shared in lncRNA/circRNA-miRNA-mRNA regulatory networks; these molecules have been reported to participate in progesterone synthesis, estrus modulation, and endocrine homeostasis. Of particular interest, two non-coding RNAs, MSTRG.1285.1 and novel_circ_056113, were predicted to act as candidate ceRNAs that may sponge ssc-miR-370 and miR-21-5p, which could in turn modulate the expression of estrus-associated mRNAs including FGF1, GHR, and TLR2. The expression trends of MSTRG.1285.1, novel_circ_056113, miR-370, miR-21-5p, GHR, TLR2, and FGF1 were validated by qRT-PCR, and the quantification results agreed with transcriptome sequencing data. Collectively, this study constructed a predicted ceRNA regulatory network of ovarian transcripts comparing NE and AE gilts and uncovered multiple RNA molecules potentially involved in estrus regulation. These findings offer preliminary theoretical clues for exploring the onset of puberty in gilts. Full article

The reproductive and developmental toxicity of diquat (DQ), a widely used herbicide, during pregnancy remains insufficiently characterized. This study investigated the effects of repeated DQ exposure on fetal development and maternal metabolism in pregnant Sprague–Dawley rats. The rats were administered sublethal doses of DQ (28.88 and 57.57 mg/kg), and maternal serum sex hormones, fetal skeletal development, and serum metabolomic profiles were evaluated. Compared with controls, serum estradiol levels were significantly decreased in the high-dose exposure group, whereas luteinizing hormone and follicle-stimulating hormone levels remained unchanged. Significant alterations in malondialdehyde, superoxide dismutase, and glutathione levels indicated oxidative stress in exposed rats. Severe fetal skeletal ossification deficits and developmental delays were observed, with incomplete or failed ossification of the occipital bone, sternum, caudal vertebrae, and pelvis, with litter-level incidences reaching 100%. Metabolomic analysis identified distinct serum metabolic profiles between DQ-exposed and control groups, suggesting ovarian steroidogenesis, phenylalanine metabolism, and aldosterone synthesis and secretion as key pathways affected by DQ toxicity. These findings suggest that repeated maternal exposure to DQ induces oxidative stress, disrupts metabolic and hormonal homeostasis, and causes delayed fetal skeletal development. This study provides novel evidence for understanding the reproductive and developmental toxicity of DQ and its potential metabolic mechanisms. Full article

Non-obstructive azoospermia (NOA) is the most severe phenotype of male-factor infertility and reflects impaired spermatogenesis rather than ductal obstruction. Microdissection testicular sperm extraction (micro-TESE) is the primary sperm retrieval method, but sperm retrieval rates remain at approximately 40–60% and vary with etiology, genetics, histopathology, surgical expertise, and endocrine phenotype. This narrative review synthesizes major international and regional guidelines and contemporary evidence on preoperative hormonal optimization, with particular emphasis on endogenous testosterone dynamics. Exogenous testosterone is contraindicated in fertility-seeking men because it suppresses gonadotropins and intratesticular testosterone. By contrast, selective estrogen receptor modulators, aromatase inhibitors, human chorionic gonadotropin, and follicle-stimulating hormone aim to preserve or augment endogenous Leydig- and Sertoli-cell function. Low-certainty, predominantly observational evidence suggests an association between hormonal pretreatment and higher sperm retrieval in selected normogonadotropic or hypogonadal men, but not consistently in hypergonadotropic NOA. A larger testosterone rise during stimulation has been positively associated with retrieval and may reflect residual Leydig-cell reserve, although causality and transferable thresholds remain unproven. Preoperative endocrine therapy should therefore remain individualized, phenotype-guided, off-label, closely monitored, and preferably investigated within clinical trials; the testosterone response is best regarded as a candidate prognostic biomarker rather than a validated therapeutic target or decision rule. Full article

Background: Opportunistic salpingectomy is widely used in gynecological surgery as a preventive measure against ovarian carcinoma. Questions have been raised about the potential impact of salpingectomy on ovarian function, given the possibility of ovarian vascularity disruption through the utero-ovarian arch located in the mesosalpinx. The aim of this study was to evaluate the short-term effects of bilateral salpingectomy on ovarian reserve. Methods: This prospective cohort study included forty premenopausal women, aged 34–50 years, who underwent hysterectomy with bilateral salpingectomy and ovarian preservation for benign uterine conditions. Ovarian reserve was evaluated before surgery and three months postoperatively, using serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and antral follicle count (AFC). Health-related quality of life was assessed using the Women’s Health Questionnaire (WHQ). Results: Serum FSH levels increased significantly after surgery, while AMH levels decreased significantly (both p < 0.05). No significant postoperative changes were observed in AFC. The overall WHQ score increased significantly, indicating a mild deterioration in health-related quality of life. The greatest postoperative changes were observed in the depressive, somatic and sexual domains, where menstrual symptoms improved following surgery. No significant correlation was found between WHQ scores and hormonal or ultrasonographic markers of ovarian reserve. Conclusions: Bilateral salpingectomy performed during hysterectomy was associated with significant short-term hormonal changes, while AFC remained stable. Although patient-reported quality of life slightly worsened after surgery, these changes were not correlated with hormonal or ultrasonographic markers of ovarian reserve. Larger controlled studies with longer follow-up are required to determine the long-term clinical significance of these findings. Full article

Zearalenone is a common mycotoxin that impairs reproductive function, particularly by damaging ovarian granulosa cells. This study investigated the protective effect and underlying mechanism of scutellarin against zearalenone-induced injury in porcine ovarian granulosa cells. Cells were isolated and identified by follicle-stimulating hormone receptor immunofluorescence. Cell viability, cell-cycle distribution, and related molecular changes were evaluated using the MTT assay, flow cytometry, qRT-PCR, and Western blot. Scutellarin showed no obvious cytotoxicity within the tested range and attenuated the zearalenone-induced reduction in cell viability. Flow cytometry analysis demonstrated that scutellarin alleviated zearalenone-induced cell-cycle disturbance. At the molecular level, scutellarin upregulated the expression of cell-cycle-related factors, including CDK1, CDK2, CDK4, and PCNA, and increased the expression of Wnt/β-catenin signaling-related proteins, including WNT5A, β-catenin, c-MYC, and CCND1. WNT5A knockdown further indicated that scutellarin-mediated regulation of PCNA, CDK1, and CDK4 is WNT5A-dependent, whereas its effect on CDK2 may involve a WNT5A-independent mechanism. These findings indicate that scutellarin alleviates zearalenone-induced granulosa cell injury partly through WNT5A-associated modulation of cell-cycle-related proteins, providing mechanistic insights for its protective effects. Full article

Background: Buffaloes have a significant share in the agricultural economies of many developing countries; however, the industry is not well-established because of the low reproductive efficiency of buffaloes. In this study, we designed a novel strategy to enhance buffalo reproductive efficiency and examined the significance of intramuscular AMH-INH-RFRP DNA vaccine immunization on reproductive performance. Methods: Allocated into four groups (n = 30/group), female buffaloes (aged 5–8 years, n = 120) were randomly enrolled in the study. Treatment groups received 10 mL of AMH-INH-RFRP DNA vaccine intramuscularly, once daily for three consecutive days, at the following concentrations: T1—3 × 10⁸ CFU/mL, T2—3 × 10⁹ CFU/mL, and T3—3 × 10¹⁰ CFU/mL. All vaccinated groups received a booster vaccination two weeks later, while the control group received 10 mL of phosphate-buffered saline (PBS) intramuscularly on the same schedule. Serum antibody titers against anti-Müllerian hormone (AMH), inhibin (INH), and RF-amide-related peptide (RFRP) were quantified using indirect ELISA on days 14 (post-primary immunization) and 28 (post-booster immunization). Results: Following primary immunization, antibody titers against AMH, INH, and RFRP were significantly higher in the T3 group than in the T1 group (p < 0.05), and booster immunization further increased antibody positivity rates. Serum concentrations of IL-4, IFN-γ, and E₂ were significantly elevated in the T2 and T3 groups compared to the control group (p < 0.05), while P₄ levels showed no significant differences among groups. Ultrasonography revealed that the ovulatory follicle diameter and dominant follicle growth rate were significantly increased in the T2 and T3 groups compared to the control and T1 groups (p < 0.05). The estrus rate was significantly higher in the T3 group than in the control group (76.67% vs. 40.00%, p < 0.05), and ovulation rates were significantly higher in the T2 (83.33%) and T3 (86.67%) groups compared to the control group (56.67%) (p < 0.05). However, conception rates did not differ significantly between vaccinated and control groups in the primary dose comparison (p > 0.05). In exploratory post hoc analyses, antibody-positive (Ab+) buffaloes exhibited higher E₂ concentrations, larger ovulatory follicle diameters, accelerated dominant follicle growth rates, and higher estrus and ovulation rates compared to antibody-negative (Ab−) buffaloes. Furthermore, gestating buffaloes were monitored until calving, revealing no significant effect of the vaccine on newborn calf weight or body size. Conclusions: In total, intramuscular immunization with the AMH-INH-RFRP DNA vaccine, particularly at the highest dose, enhances reproductive performance in buffaloes by stimulating E₂ secretion and follicular development. Full article

Background: The aim of this study was to investigate the impact of intraovarian platelet-rich plasma (PRP) treatment on ovarian reserve markers, hormonal profiles, oocyte yield, fertilization potential, and pregnancy outcomes in infertile women with diminished ovarian reserve. Methods: This retrospective single-center study was conducted at a tertiary referral center between January 2021 and December 2024 in the Department of Obstetrics and Gynecology, IVF Clinic, Private Diyarlife Hospital, Diyarbakır, Turkey. A total of 78 infertile women with diminished ovarian reserve (DOR) were included. DOR was defined in the present study as an AMH level < 1.1 ng/mL and/or an antral follicle count (AFC) < 5 follicles. Pre-PRP and post-PRP measurements were compared in the same patients. Hormonal and clinical parameters, including prolactin, thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), estradiol, endometrial thickness, gonadotropin dosage, antral follicle count (AFC), mature metaphase II (MII) oocyte count, and two-pronuclear (2PN) zygote count, were evaluated before and after PRP treatment. Results: Significant increases were observed in AMH and prolactin levels, whereas FSH levels significantly decreased following PRP treatment (all p < 0.001). Post-PRP AFC, MII oocyte count, and 2PN zygote count were significantly higher than pre-PRP values (all p < 0.001). A total of 21 pregnancies (26.9%) were achieved, including 17 clinical pregnancies (81.0% of pregnancies; 21.8% of all patients), 4 biochemical pregnancies (19.0% of pregnancies; 5.1% of all patients), 11 miscarriages (52.4% of pregnancies; 14.1% of all patients), and 6 live births (28.6% of pregnancies; 7.7% of all patients). Significant positive correlations were identified between post-PRP AFC and MII oocyte count (r = 0.803, p < 0.001), post-PRP AFC and 2PN zygote count (r = 0.624, p < 0.001), and MII oocyte count and 2PN zygote count (r = 0.728, p < 0.001). Conclusions: Intraovarian PRP administration was associated with improvements in ovarian reserve markers, oocyte maturation, and fertilization-related outcomes in women with DOR. Significant increases in AFC, MII oocyte count, and 2PN zygote count were observed after PRP treatment. However, these improvements in ovarian reserve markers were not associated with significant differences between women who achieved pregnancy and those who did not. Because of the retrospective design and the absence of a control group, these findings should be interpreted as associations rather than evidence of a causal treatment effect. Although clinical pregnancies and live births were observed during follow-up, larger, multicenter randomized controlled trials are required to confirm these findings and to further evaluate the effect of PRP on reproductive outcomes. Full article

Porcine cumulus–oocyte complexes (COCs) undergo dynamic morphological and molecular changes during maturation; however, cell type- and stage-dependent transcript patterns of Ras-related factors in cumulus cells and oocytes remain unclear. This study investigated changes in Ras-related factors during porcine in vitro maturation (IVM). Porcine COCs were cultured under IVM conditions supplemented with follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), and epidermal growth factor (EGF). Cumulus cells and oocytes were collected at 0, 22, and 44 h of IVM, and cumulus expansion was monitored using time-lapse imaging. Hormone receptor-related factors, CX43, Ras family members, and their RasGAP and RasGEF regulators were analyzed using RT-PCR and qPCR with band-intensity analysis. Progressive cumulus expansion was observed during IVM. In cumulus cells, R-Ras transcript abundance increased at 22 and 44 h, whereas RASA1 transcript abundance was lower at 44 h. In oocytes, R-Ras and H-Ras transcript abundance decreased during maturation. These findings indicate that selected Ras family members and their regulators exhibit distinct cell type- and stage-dependent transcript patterns during porcine COC maturation. These transcript-level findings provide a basis for future protein-level and functional analyses. Full article

Long COVID affects multiple organ systems and disproportionately affects women, raising concerns about reproductive health. This updated narrative review summarizes evidence from PubMed, Scopus, and Web of Science through March 2026 and extends previous reviews by distinguishing Long COVID-specific findings from acute and early post-infection observations and integrating newer evidence on ovarian reserve, follicular-fluid biology, assisted reproduction, and endometrial function. Reported menstrual changes include irregular cycles, heavy or prolonged bleeding, intermenstrual bleeding, and amenorrhea. Evidence regarding ovarian reserve remains inconsistent: some studies reported lower anti-Müllerian hormone (AMH) levels and/or antral follicle count (AFC), whereas others found no significant changes. Case reports describe premature ovarian insufficiency (POI) and possible autoimmune oophoritis but do not establish causality. Proposed mechanisms include immune dysregulation, inflammation, oxidative stress, endothelial dysfunction, and hypothalamic–pituitary–ovarian axis disturbance. Available evidence does not indicate adverse effects of COVID-19 vaccination on ovarian reserve or fertility outcomes. Most studies suggest transient changes. Direct Long COVID-specific evidence for persistent ovarian or endometrial injury remains limited. However, short follow-up precludes conclusions regarding ovarian aging, menopausal timing, lifetime fertility, or long-term endometrial receptivity. Symptom-guided assessment may include menstrual tracking, AMH, early-follicular-phase follicle-stimulating and luteinizing hormones, and pelvic ultrasonography when clinically indicated. Full article

Purpose: This post-marketing surveillance study evaluated the real-world safety and descriptive outcomes of a fixed 2:1 recombinant human follicle-stimulating hormone (r-hFSH) and recombinant human luteinizing hormone (r-hLH) combination among Korean women undergoing assisted reproductive technology with severe LH and FSH deficiency (baseline endogenous serum LH < 1.2 IU/L). Methods: A prospective, multicenter, observational study was conducted across 24 Korean fertility centers between August 2011 and May 2018. Safety outcomes included adverse events (AEs), adverse drug reactions (ADRs), and ovarian hyperstimulation syndrome (OHSS). Descriptive outcomes included endpoint-specific evaluable sets for follicular response and ultrasound-confirmed clinical pregnancy. Analyses were performed in safety (n = 600), follicular-response evaluable (n = 537), and pregnancy-evaluable (n = 486) sets. Results: Among patients in the safety set (mean age, 34.6 years), AEs occurred in 2.7% (16/600; 95% confidence interval [CI], 1.6–4.3), ADRs in 2.2% (13/600; 95% CI, 1.3–3.7), and OHSS in 1.3% (8/600; 95% CI, 0.7–2.6), including one severe case. In the follicular-response evaluable set, follicular response (≥1 follicle ≥17 mm) occurred in 99.3% (533/537; 95% CI, 98.1–99.7). In the pregnancy-evaluable set, clinical pregnancy occurred in 42.0% (204/486; 95% CI, 37.7–46.4), biochemical-only pregnancies in 3.1% (15/486; 95% CI, 1.9–5.0), and total pregnancies (clinical + biochemical-only, reported descriptively) in 45.1% (219/486; 95% CI, 40.7–49.5). Conclusions: In this historically constrained post-marketing surveillance cohort, the fixed 2:1 r-hFSH and r-hLH combination showed a favorable post-marketing safety profile and provided descriptive outcome information within endpoint-specific evaluable sets in women meeting the severe LH-deficiency criterion. Full article

The pituitary and gonads serve as central regulatory hubs and functional organs for gametogenesis and maturation. In this study, we performed single-cell RNA sequencing (scRNA-seq) of the pituitary and ovary in pre-spawning Pelteobagrus fulvidraco to elucidate the cellular landscape and regulatory pathways governing gonadal development and oocyte maturation. Pituitaries from four female fish (weight: 43.8 ± 3.2 g; length: 14.1 ± 0.7 cm) and four male fish (weight: 78.2 ± 11.2 g; length: 18.9 ± 1.1 cm) were subjected to single-cell transcriptomic analysis. A total of 17 distinct cell types were identified in the female pituitary, whereas 15 cell types were detected in the male pituitary. Both male and female pituitaries comprised multiple hormone-secreting endocrine populations, indicating a largely conserved cellular composition. However, sex-specific differences were observed in thyrotrope subtypes, suggesting potential sexual dimorphism in pituitary endocrine regulation. Examination of receptor gene expression revealed cell-type-specific regulatory capacities, highlighting gonadotropin, steroid, and neuropeptide responsiveness across pituitary populations. In the ovary, 10 cell types were identified, with granulosa cells (~22.9%) and theca cells (~8.6%) showing distinct transcriptional profiles. Follicle-stimulating hormone receptor (fshr) was highly expressed in granulosa cells, whereas luteinizing hormone receptor (lhcgr) and steroidogenic genes (hsd3b1, pgr) were predominantly localized in theca cells, indicating functional compartmentalization of gonadotropin and steroid signaling. Prostaglandin (PG) and melatonin (MT) pathways were implicated in paracrine regulation: the prostaglandin synthase ptgs2a was expressed in theca, germ, and immune cells, while ptger2a was expressed in granulosa cells; melatonin synthesis genes (aanat1, aanat2, asmtl) were confined to granulosa cells, with receptors (mtnr1ab) in germ cells. These findings suggest that ovarian paracrine signaling complements systemic endocrine control to modulate oocyte maturation and ovulation. This single-cell atlas provides a high-resolution framework of reproductive cell types and signaling networks in P. fulvidraco, offering insights for improving artificial breeding and reproductive management in aquaculture. Full article

The hallmark feature of empty follicle syndrome (EFS) is failure to retrieve oocytes from apparently mature follicles despite adequate ovarian stimulation and appropriate ovulation triggering. Although considered uncommon, with a reported prevalence ranging from 0.2% to 7%, EFS may have a profound clinical and psychological impact and can recur in assisted reproductive technology (ART) cycles. Modern classification systems divide EFS into genuine and false forms. Genuine EFS is potentially associated with intrinsic abnormalities involving luteinizing hormone/choriogonadotropin receptor (LHCGR) signaling, oocyte competence, and cumulus–oocyte interaction, whereas false EFS is primarily attributed to pharmacokinetic or pharmacodynamic factors resulting in inadequate trigger exposure. Borderline EFS represents a third phenotype characterized by incomplete or partial impairment of final oocyte maturation. This review examines the pharmacodynamics of ovulation-triggering agents, including human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) agonist protocols, and dual-trigger strategies, and their roles in regulating final oocyte maturation. The molecular aspects of periovulatory signal transduction and the mechanisms of LHCGR activation, epidermal growth factor (EGF)-like pathways, and meiotic resumption in relation to EFS etiopathogenesis will be described. The impact of patient-dependent conditions like obesity, poor ovarian reserve, polycystic ovary syndrome (PCOS), and pituitary response on trigger response will be assessed. New approaches like post-trigger monitoring of hormones and rescue treatment with gonadotropins represent a valuable method for avoiding cycle cancellation in patients at risk. Overall, EFS is increasingly regarded not as a single disorder but as a heterogeneous spectrum of periovulatory dysfunction arising from pharmacological, endocrine, and intrinsic ovarian factors that impair completion of final oocyte maturation. Full article

Background/Objectives: Fertility preservation is a key component of cancer care in women of reproductive age, and controlled ovarian stimulation (COS) followed by oocyte/embryo cryopreservation is considered the standard strategy. Although COS protocols are generally standardized, systemic effects related to different malignancies may interfere with ovarian reserve assessment and influence stimulation planning and counselling. This study aimed to evaluate COS outcomes across different malignancy types in women undergoing fertility preservation. Methods: This retrospective study included 331 oncological patients who underwent COS for fertility preservation at a single referral center between May 2008 and May 2025. Patients were stratified into three groups according to malignancy type: breast cancer, hematological malignancies, and other cancers. Ovarian reserve was assessed using serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC). COS outcomes, including stimulation duration, total gonadotropin dose, number of retrieved and mature oocytes, follicular output rate (FORT), and follicle-to-oocyte index (FOI), were compared among groups. Results: Patients with hematological malignancies were significantly younger and showed higher AFC values compared with the other groups, whereas AMH levels did not differ significantly. After adjustment for age and AFC, patients with hematological malignancies showed significantly lower AMH levels compared with breast cancer patients (β = −0.94 ng/mL, 95% CI −1.40 to −0.48, p < 0.001), supporting the presence of a relative AMH–AFC discordance. In unadjusted analyses, gonadotropin requirements were higher in breast cancer patients, whereas the number of retrieved and mature oocytes was higher in patients with hematological malignancies. However, after adjustment for age and AFC, malignancy type was not independently associated with retrieved oocytes, mature oocytes, total gonadotropin dose, or stimulation duration. FORT and FOI were comparable among groups. Conclusions: Malignancy type did not appear to independently impair ovarian responsiveness to stimulation. Patients with hematological malignancies showed preserved stimulation outcomes despite AMH values not being proportionally higher than expected based on their younger age and higher AFC. These findings suggest that AMH should be interpreted with caution in systemic malignancies and that AFC may be particularly useful for tailoring fertility preservation counselling and stimulation strategies when AMH and AFC are discordant. Full article

Background/Objectives: Infertility is an important public health problem. It is the source of considerable psychological load, negatively affecting the quality of life, social relations, and psychological health. Stress in infertility plays the role of both a risk factor and a consequence of reproductive disorders, exerting an effect through hormonal, inflammatory and oxidative mechanisms, which may reduce the effectiveness of treatment. The aim of the study is assessment of the frequency of occurrence of depression, anxiety, and stress in infertile women. Methods: The study included 300 women treated due to infertility, and 50 women in the control group. The evaluation was carried out using an author-constructed socio-demographic questionnaire and the Depression Anxiety Stress Scales-42 (DASS-42) for the measurement of depression, anxiety, and stress. In addition, selected hormones were determined in blood serum. Results: Hormonal analysis showed significantly higher levels of prolactin (PRL) in women treated due to infertility, especially in the group without the use of assisted reproductive technology (non-ART), whereas higher levels of the follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were noted in the control group. The level of anti-mullerian hormone (AMH) was lower in the therapeutic group, with no differences observed between the methods of treatment, and the levels of thyroid-stimulating hormone (TSH) did not differ between groups. Psychological evaluation according to the DASS-42 showed a significantly higher intensity of depression, anxiety, and stress in patients treated due to infertility, this intensity being the highest in the in vitro fertilization (IVF) group. Weak, but significant, correlations were found between PRL, FSH and LH, and the intensity of the symptoms of depression, anxiety, and stress, and the overall result according to the DASS-42. Conclusions: Infertile women experienced higher levels of depression, anxiety, and stress, compared to fertile women. The study suggests a relationship between the level of psychological stress in persons treated for infertility, and their hormonal status. The study demonstrates that integration of psychological support and infertility treatment may bring about important benefits for psychological health and the quality of life of patients. Full article