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rhLH (LHadi / rhLH, Serono / Luveris)

✓ Approved

Merck KGaA · LHCGR · 重组蛋白

什么是 rhLH？

rhLH 是一种重组蛋白，由Merck KGaA研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Subcutaneous Injection。

药物档案

商品名LHadi, rhLH, Serono, Luveris
公司Merck KGaA
药物类别重组蛋白
分子靶点LHCGR
给药途径Injectable (Others), Subcutaneous Injection
状态Approved
来源： ClinicalTrials.gov, Merck KGaA

作用机制

分子靶点

rhLH 作用于 1 个分子靶点：

LHCGRluteinizing hormone/choriogonadotropin receptor (ULG5, LH/CGR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

rhLH 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Reproductive system and breast disordersInfertility female✓ Approved

相关研究文献

PubMedHuman reproduction (Oxford, England)2026-05-24

Fertility treatment and risk of cerebral palsy: has the association changed in Australia?

Hansen Michele M, Kemp-Casey Anna A, McIntyre Sarah S, Badawi Nadia N et al.

What is the association between treated (ART, ovulation induction (OI)) and untreated subfertility and risk of cerebral palsy (CP)? There is no increased risk of CP in births to subfertile untreated women; the risk of CP has declined in ART conceptions (IVF, ICSI) and is greatest in births conceived using OI medications as a sole therapy. Nordic data suggest a decline in risk of CP for ART births over time with the shift to single embryo transfer (SET), but there are no recent data from other countries and no Australian data for births after 2002. Few studies have examined the risk of CP in births conceived after OI or untreated subfertility; these comparison groups may assist in separating ART treatment effects from potential effects of subfertility itself. Retrospective cohort study using linked population-based data for women with a live birth (LB) in Western Australia from 2003 to 2014, corresponding to 10 126 ART births (3.1%), 4102 births after OI (1.2%), 11 554 births to subfertile untreated women (3.5%), and 305 508 (92.2%) births to fertile women conceiving naturally. Statutory ART, birth, hospital, CP, and pharmacy data were linked to identify four 'conception groups' (ART, OI, subfertile untreated, and fertile natural conceptions), outcome data, and potential confounders. CP descriptions were verified at 5 years of age. Birth prevalence of CP was calculated for each conception group per 1000 LB. Poisson regression with robust standard errors was used to estimate adjusted risk ratios (aRR) for CP with adjustment for maternal demographic characteristics, pre-existing conditions, and adverse obstetric history (with 95% CI). Births to fertile women were the reference group. Analyses included all children and singletons and twins separately. Weinberg's differential rule was used to estimate the rate of monozygotic twinning across our four conception groups and, for ART births, by length of embryo culture. CP was diagnosed in 29 ART children (2.9/1000 LB; 95% CI 1.92-4.11), 16 children born after OI (3.9/1000 LB; 95% CI 2.23-6.33), 23 children in the subfertile untreated group (2.0/1000 LB; 95% CI 1.26-2.99), and 610 in the fertile group (2.0/1000 LB; 95% CI 1.84-2.16). When stratified by plurality and prematurity, risk was increased only for ART twins (aRR 2.8, 95% CI 1.42-5.39) born preterm (<37 weeks) and OI singletons (aRR 2.9, 95% CI 1.41-5.84) born preterm. Twins after SET comprised an increasing proportion of all ART twins over time, and of all ART twins with CP. Most twins after SET were same-sex twins (90.7%) and we estimated that 81% were monozygous, with the majority conceived after the transfer of a single blastocyst. The monozygotic twinning rate was higher after blastocyst-SET compared with cleavage-SET (prevalence ratio 1.7 (95% CI 1.07-2.73)). Small numbers of children with CP in subfertile groups prevented more detailed analyses of pregnancy complications and ART cycle characteristics. More recent data from larger populations are required to confirm whether risk of CP is increased following blastocyst transfer, in twins after SET, and following OI as a sole therapy. As zygosity data were not available, Weinberg's differential rule was used to estimate the rate of monozygotic twinning and may have led to some misclassification. Prevalence of CP following ART has declined in Western Australia, as in the Nordic countries. Avoiding multiple embryo transfer remains important. Monozygotic twinning after SET may increase the risk of CP for ART twins and is more common after blastocyst compared with cleavage-stage transfer. Embryo culture, manipulation, and freezing strategies to reduce monozygotic twinning should be explored. Data about OI (as a sole therapy) are not routinely collected in most countries, but OI-conceived births had the highest risk of CP and may warrant closer scrutiny. Pre-treatment counselling should continue to promote SET while incorporating the small risk of embryo splitting; risk of multiple birth should be discussed with those planning to use OI. This work was supported by the Australian National Health and Medical Research Council, grant number 1086530 (to M.H.) and The Research Foundation of Cerebral Palsy Alliance, grant number 06221 (to M.H.). The sponsors had no role in the design or conduct of the study, or the decision to submit for publication.Professor Hart is the Medical Director of Fertility Specialists of Western Australia and National Medical Director of City Fertility Clinic, a shareholder in CHA SMG; he has received accommodation support from Merck to attend ESHRE and has received travel and accommodation support, as well as educational sponsorship from MSD, Merck-Serono, Origio, Igenomix, and Ferring Pharmaceuticals. He has also received personal fees for presenting a Merck webinar. There are no other conflicts of interest to declare. N/A.

PMID 42177772
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PubMedHuman reproduction (Oxford, England)2026-03-29

Double-stranded sperm DNA fragmentation measured with neutral comet assay as a predictor of IVF outcomes: evidence from three European clinics in a multi-centred prospective study.

Humaidan Peter P, Povlsen Betina B BB, Drakeley Andrew J AJ, Jensen Mette B MB et al.

Can measurement of double-stranded sperm DNA fragmentation (dsSDF) via a neutral comet assay predict the probability of live birth following IVF? In a multicentre IVF cohort, dsSDF measured by a neutral comet assay was a strong, independent predictor of live birth. While much of the focus has traditionally been on female factors, emerging research highlights sperm DNA fragmentation as a significant contributor to reproductive outcomes. Over the past decade, studies have shown that different types of sperm DNA damage can affect reproduction differently, with single-stranded breaks being closely linked to reduced spontaneous conception rates, while double-stranded breaks are linked to higher miscarriage rates. Prospective cohort study including a total of 302 males from three European IVF clinics, over a 3-year study period (March 2021-October 2024), with 126 healthy sperm donors with confirmed live birth serving as controls. dsSDF was quantified with a neutral comet assay, expressed as Average Comet Score (ACS) and Incidence of Damage (IOD). The primary outcome was live birth per initiated cycle. Associations were evaluated using multivariable logistic regression, adjusting for female and male age (and centre in sensitivity analyses). Across the cohort, 30% of couples achieved a live birth. Higher dsSDF was associated with reduced odds of live birth, and this association remained statistically significant after adjustment for female age, male age, and recruitment site. Both ACS and IOD were independently predictive of live birth in adjusted models. For ACS, each 1-point increase was associated with 16% lower odds of live birth (OR = 0.84, 95% CI 0.72-0.97; P = 0.026). For IOD, each 1-point increase corresponded to 5% lower odds of live birth (OR = 0.95, 95% CI 0.90-0.99; P = 0.025). As expected, female age remained a strong inverse predictor of live birth across models (OR = 0.86, 95% CI 0.78-0.94; P < 0.001). Using a pragmatic threshold of IOD ≥ 6%, couples were identified with approximately half the odds of achieving a live birth compared to those with IOD < 6% at similar female ages (OR = 0.51, 95% CI 0.28-0.94; P = 0.029). The adverse association between dsSDF and live birth was stronger at higher female ages. This study examined couples undergoing their first or only IVF cycle and did not include couples with repeat IVF failures. Limitations include potential centre-level confounding, which may benefit from mixed-effects modelling. We did not collect or adjust for several cycle-level covariates that influence live birth (e.g. IVF vs ICSI, number of oocytes retrieved, embryo transfer strategy, use of preimplantation genetic testing for aneuploidy, stimulation protocol), so residual confounding is possible. These results support dsSDF as a clinically relevant biomarker that complements conventional semen parameters. The study was part-funded using an unrestricted medical educational grant provided by Merck Serono Limited (0111897641) to the Liverpool Women's Hospital. T.C.B.M., S.H.M., and E.B. were funded in part by UKRI SIP FMI and Peace Plus HF-TIC grants with Ulster University. L.R., A.S., M.L., C.J.L., L.P., and T.C.B.M. are employed at Examen Lab LTD. A.J.D. is a recipient of Merck Serono Limited (0111897641) grant to the Liverpool Women's Hospital. P.H. has received unrestricted research grants from Merck and Gedeon Richter Nordics and honoraria for lectures from Merck, Gedeon Richter, and IBSA. The remaining authors have nothing to disclose. N/A.

PMID 41903517
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PubMedHuman reproduction (Oxford, England)2026-02-24

ESHRE guideline: ovarian stimulation for IVF/ICSI: an update in 2025†.

ESHRE Guideline Group on Ovarian Stimulation, Ata B B, Bosch E E, Broer S S et al.

What is the recommended management of ovarian stimulation, based on the best available evidence in the literature? This updated ESHRE guideline on ovarian stimulation for IVF/ICSI provides 121 recommendations, answering 21 key questions on ovarian stimulation for IVF/ICSI. Before the ESHRE guideline on ovarian stimulation for IVF/ICSI was published in 2019, ovarian stimulation for IVF/ICSI had only been discussed briefly in the National Institute for Health and Care Excellence guideline on fertility problems and in a statement by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. The guideline was developed according to the structured methodology for ESHRE guidelines. The 18 key questions from the 2019 version of the guideline were revised by the Guideline Development Group (GDG). This resulted in the addition of one new key question, the splitting of the key question on fertility preservation in three separate key questions (fertility preservation for women facing gonadotoxic treatment, elective oocyte cryopreservation, and oocyte donation) and several new interventions being added to the existing key questions. Papers published between 31 October 2018 and 2 February 2025 and written in English were included. The critical outcomes for this guideline were efficacy in terms of cumulative live birth rate per started cycle or live birth rate per started cycle, as well as safety in terms of the rate of occurrence of moderate and/or severe ovarian hyperstimulation syndrome (OHSS). Based on the available evidence, recommendations were formulated and discussed until consensus was reached within the GDG. Following stakeholder review of the initial draft, the final version was approved by the GDG and ultimately by the ESHRE Executive Committee. The guideline provides a total of 121 recommendations: 42 recommendations remained unchanged in 2019, 4 recommendations were reworded for better understanding, 29 recommendations were updated in view of new evidence, and 46 new recommendations for 2025 have been formulated. The guideline provides 4 recommendations on pre-stimulation evaluation, 7 recommendations on pre-treatment therapies, 50 recommendations on pituitary suppression and ovarian stimulation, 17 recommendations on monitoring, 18 recommendations on triggering of final oocyte maturation and luteal support, and 8 recommendations on the prevention of OHSS. In addition, the guideline provides 17 recommendations on fertility preservation, both oncologic and elective, and oocyte donation. These include 90 evidence-based recommendations, of which only 42 were formulated as strong recommendations and 48 as conditional, as well as 29 good practice points and 2 research-only recommendations. Of the evidence-based recommendations, none were supported by high-quality evidence, 6 by moderate-quality evidence, 36 by low-quality evidence, and 148 by very low-quality evidence. To support future research on ovarian stimulation for IVF/ICSI, a list of research recommendations was provided. Several newer interventions are not well studied yet. For most of these interventions, a recommendation against the intervention or a research-only recommendation was formulated based on insufficient evidence. Future studies may require these recommendations to be revised. The guideline provides clinicians with clear advice on best practice in ovarian stimulation, based on the best evidence available. In addition, a list of research recommendations is provided to promote further studies in ovarian stimulation. The guideline was developed by ESHRE, who funded the guideline meetings, literature searches, and dissemination of the guideline. The guideline group members did not receive any financial incentives; all work was provided voluntarily. BA reports speaker's fees from Gedeon-Richter, Ferring, IBSA, Intas, Merck, Organon, consulting fees from Merck, Organon, Oxolife, stock options from Global Fertility Solutions LLC (employee co-investment), and was chair of the Turkish Society of Reproductive Medicine. EB reports research grants from Roche Diagnostics and IBSA, consulting fees from MSD, Abbot, Gedeon-Richter, Roche, speaker's fees from IBSA, MSD, Ferring Pharmaceuticals, Abbot, Gedeon-Richter, Merck, Roche, participation in the advisory board of Ferring Pharmaceuticals, IBSA and Merck, and ownership interest from IVI-RMS Valencia. GG was part of the ESHRE working group on Recurrent Implantation Failure and the ESHRE working group on clinical KPISs, reports travel support from Merck, Organon, Ferring, Theramex, Gedeon-Richter, Abbott, consulting fees from Organon, Ferring, Merck, Gedeon-Richter, Theramex, Abbott, ReproNovo, Igyxos, OxoLife, Philipps, ReprodWissen, PregLem, Guerbet, Roche, IBSA, and Besins, speaker's fees from Organon, Ferring, Merck, Gedeon-Richter, Theramex, Abbott, ReproNovo, Igyxos, OxoLife, Philipps, ReprodWissen, PregLem, Guerbet, Roche, IBSA, and Besins, and research grants from Besin, Merck, Abbott, Ferring, Theramex. MG reports speaker's fees from Merck Serono, Ferring, and Gedeon Richter. EK reports travel/hotel expenses from Ferring, Merck SERONO, Vianex, speaker's fees from Ferring, Merck SERONO, Vianex, and is chair of the Greek Society of Fertility and Sterility. MK reports travel support and speaker's fees from Ferring. ALM reports research grants from Merck, Ferring, IBSA, Roche, Organon, Theramex, Beckman Coulter, and Gedeon-Richter, consulting fees from Merck, Ferring, IBSA, Roche, Organon, Theramex, Beckman Coulter, and Gedeon-Richter, speaker's fees from Merck, Ferring, IBSA, Roche, Organon, Theramex, Beckman Coulter, Gedeon-Richter, and participation on an advisory board of Merck, Organon, Ferring, Theramex, Gedeon Richter, and IBSA. GL reports consulting fees from Ferring and Merck, speaker's fees from Ferring, Merck, Gedeon-Richter, Organon, and Vianex, expert testimony fees from Cook, travel support from ESHRE, Ferring, Merck, Gedeon-Richter, Organon, and Vianex, is on the advisory board of Merck and Ferring, and participated in an ESHRE committee and on the Greek Fertility and Sterility Committee. NM reports research grants from IBSA, Organon, consulting fees from Organon, Merck, GE, Ferring, Abbott, and Cooper, and speaker's fees from Ferring, GE, Organon, IBSA, Merck, Theramex. NPP reports research grants from Besins Healthcare, Ferring Pharmaceutical, Merck Serono, Organon, Roche Diagnostics, and Theramex, consulting fees from Besins Healthcare, Alife, Ferring, IBSA, Merck Serono, Organon, Abbott, FertilAI, and speaker's fees from Besins Healthcare, Roche Diagnostics, Ferring Pharmaceuticals, Gedeon-Richter, IBSA, Merck Serono, Organon, and Theramex. SKS reports a research grant from Ferring, travel support from Merck and INTAS, consulting fees from Merck, and speaker's fees from Merck, MSD, INTAS, and Ferring. TT reports travel support from Merck, speaker's fees from Merck, Organon, MSD and is editor-in-chief of a Bulgarian journal, Reproductive Health. MT reports travel support from IBSA, Ferring, and Merck, consulting fees from Abbott and is a member of the board of the Finnish Endocrine Society. JU is a member of the Steering Committee of Richter Reproduction Network and received travel support from IBSA. FB reports a research grant from Besins, is on the advisory board of Merck and Abbott, reports speaker's fees from Ferring, Merck, Besins, Intas Fermaceuticals, PREIS School; he is the owner of FRANKSCHOOL RforL. The other authors have nothing to disclose. N/A. This guideline represents the views of ESHRE, which were achieved after careful consideration of the scientific evidence available at the time of preparation. In the absence of scientific evidence on certain aspects, a consensus between the relevant ESHRE stakeholders has been obtained.Adherence to these clinical practice guidelines does not guarantee a successful or specific outcome, nor does it establish a standard of care. Clinical practice guidelines do not replace the need for application of clinical judgment to each individual presentation, nor variations based on locality and facility type.ESHRE makes no warranty, express or implied, regarding the clinical practice guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose. (The full disclaimer is available at www.eshre.eu/guidelines.).

PMID 41732035
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PubMedBMJ open2026-02-05

Recombinant human growth hormone (rHGH) for muscle enhancement in knee osteoarthritis: protocol for a pilot, randomised placebo-controlled trial.

Shah Ajay A, Ravi Bheeshma B, Tomescu Sebastian S, Catapano Michael M et al.

The management of active patients with symptomatic knee osteoarthritis (KnOA) who are too young for total knee arthroplasty poses a specific challenge to clinicians. Research studies show that improving quadriceps muscle strength improves pain and function; however, aspects of the disease render it difficult for patients to achieve and maintain improvements. Recombinant human growth hormone (rHGH) is shown to increase the magnitude and duration of muscle growth when combined with exercise treatment in adult populations. Hence, rHGH combined with physical therapy may provide meaningful benefits in the treatment of KnOA. This is a single-centre, double-blind, randomised trial to pilot a future Phase III trial from 2025 to 2028. Participants are aged 18-60 with clinical and radiographic evidence of isolated degenerative arthritis of the knee (patellofemoral or tibiofemoral). The investigational product is rHGH (Saizen (somatropin of rDNA origin, EMD Serono)) and a saline placebo. Participants will deliver the solution via subcutaneous injection area once per day at a dose of 0.5 mg HGH per body surface area (0.5 mg/m2) for 6 weeks, alongside participation in a lower limb strengthening programme developed by rehabilitation specialists. 17 participants will be recruited into each study arm.The primary outcomes are feasibility (compliance with the study drug regimen for the 6-week administration period and enrolment rate) and safety (the proportion of minor and major adverse events between groups). The primary endpoint for these outcomes will be at 6 weeks. The secondary outcomes are knee extension strength, knee flexion strength, radiographic arthritis progression, thigh muscle circumference, MRI-measured quadriceps muscle volume and patient-reported outcome measures (Knee Osteoarthritis Outcome Score (KOOS), SF-20 and Tegner). The primary endpoint for these outcomes will be at 12 weeks, and the final endpoint will be 24 months, where final radiographic (X-ray) assessment will take place.The primary outcome of compliance will be a calculation of mean compliance between groups, which can be analysed as a t-test after the treatment period. A two-sample, two-sided t-test will compare the clinical (secondary) outcome of greatest interest: knee extension strength at baseline versus week 6 compared between treatment groups. Other secondary outcomes will be compared using a simple linear mixed-effects model. The χ2 test will be used to determine whether the number of participants who made meaningful changes was different between groups. The null hypotheses are that the rHGH and placebo groups will have no difference in compliance rates, safety events, knee extension strength at 12 weeks and arthritis grade progression at 24 months. This study has been approved by the Sunnybrook Research Institute Research and Ethics Board (#6427) and received a no-objection letter from Health Canada Clinical Trials. The primary sponsor is the Sunnybrook Centre for Clinical Trial Studies (CCTS). The findings of this study will be published in a peer-reviewed journal and presented at orthopaedic conferences. NCT07036003.

PMID 41638751
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PubMedHuman reproduction (Oxford, England)2025-12-30

The impact of transdermal testosterone treatment on quality of life in women with diminished ovarian reserve: secondary analysis of a randomized controlled trial.

Leathersich Sebastian J SJ, Davis Susan R SR, García Martínez Sandra S, Blockeel Christophe C et al.

Does transdermal testosterone treatment improve fertility-related quality of life (QOL) in women with diminished ovarian reserve (DOR)? Transdermal testosterone for 9 weeks at a dose of 5.5 mg per day did not result in improved fertility-related QOL compared with placebo in women with DOR. Reduced QOL is prevalent in women with infertility, many of whom have DOR. Several studies have shown a correlation between DOR and lower testosterone levels, and testosterone is frequently prescribed to women with DOR undergoing fertility treatment. Some studies have reported that testosterone therapy may improve wellbeing in pre- and post-menopausal women, though others have found no benefit. There are no studies evaluating the effect of testosterone on QOL in women undergoing fertility treatment. Pre-planned secondary analysis of a double-blind placebo-controlled randomized controlled trial that included 288 participants recruited between April 2015 and August 2022. Of these, 213 completed QOL surveys both before and after treatment and were eligible for inclusion in this analysis. Participants were women aged 18-43 years with DOR according to the Bologna criteria and planning to undergo IVF treatment at one of eight fertility clinics in Spain, Belgium, and Denmark. Participants were randomized to 5.5 mg of transdermal testosterone per day as 1% gel (n = 106) or an identical placebo (n = 107), applied for a median of 60 days prior to commencing ovarian stimulation. QOL was assessed using the FertiQoL instrument prior to commencing the intervention, and at the completion of the intervention but prior to commencing ovarian stimulation. QOL scores were compared using a one-way ANCOVA adjusted for age, BMI, parity, history of IVF treatment, and baseline FertiQoL scores. There were no significant differences in baseline characteristics between the testosterone (n = 106) and placebo (n = 107) groups. After adjustment, testosterone showed no benefit over placebo for the Total FertiQoL score (F(1,204)=0.07, P = 0.79), the Core and Treatment scores, nor for any of the included FertiQoL subscales. Total testosterone levels were higher in the testosterone group than the placebo group at the end of the treatment (3.2 ± 2.7 nmol/l vs 0.6 ± 0.4 nmol/l, P < 0.001). QOL was a secondary outcome in this trial, and participants were not recruited based on a low QOL. Considering the available evidence, including the current study, premenopausal women are unlikely to benefit from testosterone treatment with regard to wellbeing and QOL. This study provides further evidence that testosterone should not be seen as a treatment for low wellbeing or QOL. The study was supported by unrestricted grants and support from Besins Healthcare, Roche Diagnostics, and Ferring Pharmaceuticals. The study medication and placebo were provided by Besins Healthcare. Funders had no access to patient data and had no role in the interpretation of the data, nor in the writing or approval of the final manuscript. The researchers were independent of the funders and had full access to all the data in the study. S.J.L. has received honoraria from Merck, Organon, and Hologic, consulting fees from Merck, and travel support from Merck, Organon, Besins Healthcare, and Ferring Pharmaceuticals. S.R.D. has received grants from NHMRC Australia, MS Australia, MRFF Australia, the Australian Heart Foundation, and Lawley Pharmaceuticals, consulting fees from Besins Healthcare, Astellas, and Abbott, honoraria from Theramex, Astellas, and Bayer, travel support from Astellas, and drugs/placebo from Lawley Pharmaceuticals for clinical trials; she is an Executive Board Member of the Australian Academy of Health and Medical Sciences. C.B. has received honoraria from Ferring Pharmaceuticals, IBSA, Organon, Merck A/S, and Abbott. A.G. has received honoraria from Lab Seid and travel support from Merck Serono. P.H. has received honoraria from Merck, IBSA, Gedeon Richter, and Besins Healthcare. L.D.L.F. has received consulting fees from Gedeon Richter, Ferring Pharmaceuticals, and Organon, travel support (personal and to institution) from Gedeon Richter, Ferring Pharmaceuticals, IBSA, Merck, Organon, and Theramex, and educational support (to institution) from Gedeon Richter and Merck. A.P. has received grants from Gedeon Richter, Ferring Pharmaceuticals, and Merck A/S, consulting fees from Gedeon Richter and Ferring Pharmaceuticals, honoraria from Ferring Pharmaceuticals, Gedeon Richter, Merck A/S, Abbott, and Organon, and travel support from Gedeon Richter. D.S. has received grants from Organon, Ferring Pharmaceuticals, Besins Healthcare, Gedeon Richter, and Vitrolife, honoraria from Organon, Ferring Pharmaceuticals, Besins Healthcare, Gedeon Richter, and Merck, travel support from Organon, Ferring Pharmaceuticals, Besins Healthcare, Gedeon Richter, and Merck, and is President of the Belgian Society for Reproductive Medicine. N.P.P. has received grants from Merck Serono, Ferring Pharmaceuticals, Theramex, Organon, Besins Healthcare, and Gedeon Richter, consulting fees from Merck Serono, Besins Healthcare, Organon, IBSA, FertilAI, and Alife, and honoraria from Merck Serono, Theramex, IBSA, Ferring Pharmaceuticals, Organon, Roche Diagnostics, and Besins Healthcare. S.G.M., F.M., and F.F. have no interests to declare. NCT02418572 (ClinicalTrials.gov).

PMID 41461161
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PubMedHuman reproduction (Oxford, England)2025-12-22

Family planning of infertile couples: a systematic review of intentions regarding parenthood and return to ART.

Li Piani Letizia L, Esposito Giovanna G, Reschini Marco M, Donnez Jacques J et al.

What motivations and barriers influence family planning decisions among infertile individuals? In studying the family planning of infertile couples, this review found that a significant gap persists between desired and achieved family size. While ART has traditionally focused on live birth rate (LBR) as a primary success parameter, growing attention has been paid to whether treatments help couples achieve their desired family size. Evidence suggests that many infertile couples do not return to ART for subsequent children, despite having cryopreserved embryos available. This review was conducted as a systematic review following PRISMA guidelines. A comprehensive search strategy was developed and implemented across PubMed and Embase databases, covering studies published in English up to May 2025. The search combined free text terms and MeSH/Emtree terms related to 'infertility' and 'family planning'. We included observational studies reporting outcomes related to family size, return to ART, or intentions for subsequent children. Two reviewers independently performed screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Of 2495 screened records, 9 studies were included. Across contexts, infertile couples consistently reported smaller family sizes compared to fertile ones. Return rates to ART for a second child ranged from 25 to 50%, even among those with cryopreserved embryos. Factors associated with return included younger age, availability of embryos, and previous treatment characteristics. However, emotional, financial, and social burdens often discouraged further ART use. Success rates for second ART pregnancies varied, with cumulative LBRs between 38 and 88%, depending on treatment strategy and prior history. Scarcity of evidence and high heterogeneity across studies, including differences in design, populations, outcomes, and type of ART, may have limited comparability of the studies. The low return rate to ART highlights unmet needs in post-treatment support and counselling. Future research should explore the psychosocial, economic, and systemic barriers that prevent couples from pursuing their reproductive goals, enabling more patient-centred care in reproductive medicine. Open access funding was provided by Università degli Studi di Milano within the CRUI-CARE Agreement. This study was in part supported by the Italian Ministry of Health-Current Research IRCCS. E.S. reports receiving grants from Ferring and honoraria for lectures from Merck-Serono, IBSA, and Gedeon-Richter. J.D. has received consulting fees from ObsEva, Gedeon Richter, and Theramex and was a member of the scientific advisory board of ObsEva and Preglem until 2023. L.L.P. reports participation in a training course sponsored by Gedeon Richter, during which she received medical writing assistance for this paper as part of the training course. The remaining authors declare no competing interests. n/a.

PMID 41428654
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