Both polycystic ovary syndrome and Hashimoto thyroiditis are commonly associated with female infertility. Each condition may impair reproductive function through distinct but sometimes overlapping mechanisms, and their co-occurrence has been associated with an even higher risk of infertility. In this single-case report, we describe a 33-year-old female with established polycystic ovary syndrome (anti-Müllerian hormone [AMH] 20 ng/mL) and autoimmune thyroiditis (anti-thyroid peroxidase [anti-TPO] antibodies 917 IU/mL) with infertility persisting since 2020. After multiple unsuccessful cycles of ovarian stimulation, advanced fertility treatment with in vitro fertilization and repeated embryo transfers was initiated in 2023, initially without success. Extracorporeal therapeutic apheresis was applied as an adjunctive intervention with the aim of modulating markers of oxidative stress (baseline nitrotyrosine level 883 ng/mL). It was also intended to reduce potential environmental contaminants, including elemental mercury and anesthetic gases, which the patient, a dentist, may have been exposed to in her occupational setting. These exposures have been associated with adverse reproductive outcomes. Pregnancy was successfully documented in December 2024, followed by the birth of a healthy girl in September 2025. This case demonstrates a temporal association between targeted interventions and successful pregnancy, highlighting the importance of considering both immunological and environmental factors in the management of complex infertility. The findings underscore the need for individualized strategies to address multifactorial infertility challenges.

White adipose tissue is now recognized as an active endocrine organ that secretes numerous bioactive molecules known as adipokines. These proteins regulate essential physiological processes, including energy metabolism, inflammation, and reproduction, while disturbances in their secretion are linked to conditions such as infertility, obesity, and diabetes. Omentin-1, also termed intelectin-1, is a secreted trimeric lectin conserved across mammals. In addition to systemic actions that improve insulin sensitivity, enhance glucose uptake, and suppress oxidative stress and inflammation, omentin-1 exerts important functions within the female reproductive system. It is expressed in the hypothalamus, pituitary gland, ovary, oocyte, and placenta, where it influences cell proliferation, apoptosis, and hormone production. Through these actions, omentin-1 contributes to hormonal homeostasis, follicular development, oocyte maturation, luteal function - integrating energy balance with female fertility. Altered circulating or local levels of omentin-1 have been observed in polycystic ovary syndrome, endometriosis, ovarian and endometrial cancers, preeclampsia, and gestational diabetes. This review aims to summarize current knowledge on omentin-1 expression and function in the female reproductive system within hypothalamus - pituitary - ovary axis and its role in reproductive pathologies.

Seasonal infertility as a phenotypic consequence of heat stress has been recognized in production animals for decades and more recently in women. Systemic impacts of heat stress include compromised intestinal integrity, and elevated prolactin and insulin. These effects alone can compromise female fertility. There are also ovarian endocrine changes and molecular sequelae that have been identified. This review summarizes the current literature with a focus on the pig as a model. In addition to direct thermal effects on fecundity, the influence of heat on the ovarian capacity to respond to chemical exposures that are also fertotoxic is discussed. The toxicants of focus are zearalenone and perfluorooctanoic acid, both of which are risks to porcine fertility. Reduced fertility is detrimental to animal welfare, economic sustainability and food security and identification of mechanisms is requisite for development of mitigation strategies.

Gamete plasticity enables fertilization and embryo development under laboratory conditions through procedures commonly known as in vitro production (IVP). While this technology is primarily used in humans to treat infertility, it also enables the propagation of high-quality genetic material at relatively low cost in cattle, supporting sustainable animal production. However, IVP has inherent limitations. The artificial environment in which gamete maturation, fertilization, and embryo development occur may induce permanent epigenomic modifications, thereby altering the individual's transcriptome. This review synthesizes studies describing recurrent phenotypes observed across life stages in IVP-derived cattle compared with in vivo counterparts, from embryonic development through postnatal life, and outlines associated transcriptomic alterations and their potential prediction based on transcriptomic data. Collectively, the evidence indicates that increased pregnancy losses following the transfer of IVP embryos, predominantly after implantation, represent the principal limitation of the technology. When IVP embryos survive, early molecular perturbations may manifest as fetal overgrowth, increased birth weight, stillbirth, and a greater predisposition to reproductive disorders later in life. At the molecular level, transcriptomic alterations are already detectable in the 16-cell IVP embryo if embryonic genome activation occurs in vitro; IVP blastocysts exhibit dysregulated expression of genes involved in energy homeostasis; key developmental genes are deregulated in the embryonic disc of elongated IVP embryos prior to implantation; and transcriptomic alterations due to IVP persist in metabolically relevant organs during fetal and postnatal stages. These findings, together with future research, may enhance understanding of how IVP influences developmental outcomes in cattle and other species, including humans.

Humanity will eventually inhabit extraterrestrial environments, yet crucial questions remain regarding the feasibility of reproduction and long-term survival away from the Earth. Exposure to space radiation might induce DNA damage, potentially resulting in harmful mutations in future generations. Altered gravity on other planets or within space colonies could also interfere with embryonic and fetal development. For sustainable colonization beyond Earth, humans and essential animal species, e.g., livestock and companion animals, must be transported. To prevent inbreeding and genetic deterioration, hundreds of individuals per strain would need to be transferred between planets; however, moving live animals, particularly large species, might be impossible. To address this challenge, technological innovations are required for long-term preservation and secure transport of genetic resources. In addition, maintaining genetic diversity will depend on collecting genetic resources from as many individuals as possible, including those who are infertile or elderly. Although interplanetary migration is not yet practical, the technologies discussed herein are highly relevant to current challenges on Earth, including infertility treatment. This review summarizes our ongoing research on mammalian reproduction under space conditions.

Age-related decline in oocyte quality increases the risk of infertility, miscarriage, and birth defects. Mitochondrial dysfunction is a key contributor to this decline. Here, we report that oocyte-specific deletion of Uba3, which encodes the catalytic subunit of the E1 NEDDylation-activating complex, causes sterility in mice. Fully grown, germinal vesicle-stage Uba3 conditional knockout oocytes exhibit mitochondrial dysfunction, including elevated reactive oxygen species, impaired oxidative phosphorylation, and depletion of mitochondrially encoded RNA transcripts. Proteomic analysis identified alterations in mitochondrial-associated proteins, including enrichment of mitochondrial matrix and respiratory chain components and reduced abundance of electron transport chain complexes. These defects were associated with reduced levels of the mitochondrial RNA polymerase, POLRMT [polymerase (RNA) mitochondrial DNA directed]. We further show that POLRMT is directly modified by NEDDylation, which alters its stability by antagonizing ubiquitylation and degradation. Notably, NEDD8 levels decline with age in both mouse and human oocytes. Together, these findings identify NEDDylation as a regulator of oocyte quality and connect this pathway to mitochondrial transcription in oocytes.

Overweight and obesity are global health concerns linked to impaired female fertility. Weight-lowering drugs are an alternative for achieving weight loss; however, their effect on natural female fertility is unclear. A systematic review and meta-analysis were conducted to summarise the literature on the effects of weight-lowering drugs on ovulation, conception, pregnancy and live birth rates. Inclusion criteria comprised interventional and observational studies involving women with overweight or obesity receiving weight-lowering drugs, compared with non-users, lifestyle modifications or other medications. MEDLINE, Embase, CINAHL, CENTRAL and ClinicalTrials.gov were searched, yielding 2731 records. After screening, seven clinical trials were included (n = 575), six of which were randomised. Sample sizes ranged from 40 to 120 women aged 25.9-29.7 years. Six trials evaluated orlistat, while one assessed semaglutide. In four trials, orlistat was associated with a higher ovulation rate than lifestyle modifications. A meta-analysis of ovulation rates comparing orlistat and metformin showed no significant difference (RR = 0.78, 95% CI: 0.41-1.49; p = 0.45). Two studies reported pregnancy rates: one found a higher rate with orlistat compared to lifestyle modifications (23.3% vs. 6.7%, p = 0.044), and another showed that adding semaglutide to metformin increased the pregnancy rate compared to metformin alone (35% vs. 15%, p < 0.05). Future studies should address current limitations and evaluate the effects of newer weight-lowering drugs on natural pregnancy and live birth rates in adequately powered studies.

Male-perpetrated intimate partner violence (IPV) against women is a global crisis, particularly in low- and middle-income countries (LMICs) due to restrictive gender norms. Stigma against infertility and childlessness could increase women's vulnerability to IPV. This study analyzed data from the Demographic Health Survey, including 93,734 ever-in-union, HIV-negative women aged 20-49 years across 16 LMICs. Logistic regressions, adjusted for survey design and covariates, compared lifetime and past-year IPV exposures (any, physical, sexual, emotional) across infertile women, women without children, and women with children. The prevalence of any lifetime and past-year IPV was 40.6% and 30.4%, respectively. Infertile women showed a non-significant difference in their odds of experiencing any IPV compared to women with children (Lifetime: aOR = 0.93, 95%CI 0.71-1.21; Past-year: aOR = 0.94, 95%CI 0.71-1.25). Women without children had lower odds of lifetime IPV (aOR = 0.71, 95%CI 0.58-0.86), with odds of past-year any IPV non-significant (aOR = 0.81, 95%CI 0.66-1.00). The study found alarmingly high prevalence of male-perpetrated IPV among women in LMICs, irrespective of fertility status. Findings highlight the need for universal IPV prevention and support that are inclusive of all women, including families and communities, emphasizing routine screening and support within primary and community healthcare, regardless of women's reproductive experiences.

The rates of infertility among physicians are nearly twice that of the general population; therefore, we sought to determine whether physicians undergoing planned fertility preservation have similar ovarian reserve markers and number of oocytes retrieved compared with nonphysicians. We performed a retrospective cohort study comparing female physicians and nonphysicians 18-45 years of age who completed planned oocyte or embryo cryopreservation at three geographically spaced academic institutions. We excluded patients with known ovarian insufficiency disorders, undergoing oocyte or embryo cryopreservation before cancer treatment or prior gonadotoxic therapy, BRCA1 and BRCA2 carriers, those with exogenous androgens exposure, and those had a prior oophorectomy. There were 50 physicians and 241 nonphysicians who underwent planned oocyte or embryo cryopreservation. Physicians were significantly younger than nonphysicians at the time of retrieval (average age 33.6 years vs 34.9 years, P=.01). After adjustment for age and race, physicians had significantly lower anti-müllerian hormone levels (average difference -0.38 [95% CI, -0.55 to -0.22]), but the median number of mature oocytes retrieved did not differ significantly. Therefore, planned oocyte or embryo cryopreservation among physicians could be considered for future family building.