Reproductive Medicine

A few millimetres can change the way an IUI cycle is timed, interpreted, and counselled. In intrauterine insemination, the decision to give an ovulation trigger is often made when the leading follicle reaches a size that suggests the oocyte is mature enough, but not so late that ovulation may already be underway. That makes follicle size more than an ultrasound measurement. It is a practical marker of oocyte readiness, hormonal environment, endometrial timing, and the best wi

Gestational diabetes prevention remains a clinical priority, especially in populations with rising rates of insulin resistance, obesity, polycystic ovary syndrome, and type 2 diabetes. Diet, physical activity, early risk identification, and appropriate screening still form the backbone of care. Yet many clinicians are also being asked about supplements, particularly myo-inositol, for preventing gestational diabetes mellitus. The interest is understandable. Myo-inositol is inv

A diagnosis of cancer linked to a BRCA or Lynch syndrome mutation can change family planning overnight. Treatment may need to start soon. Surgery may affect the ovaries, uterus, testes, or hormones. Risk-reducing procedures may be recommended years earlier than expected. In the middle of all this, many people are asked to make fertility decisions while still trying to absorb the diagnosis itself. Good fertility counselling does not promise an easy path. It gives people time-s

A fertility journey rarely begins at a specialist clinic. It often starts quietly, with months of uncertainty, private worry, family pressure, and repeated questions: Is this normal? When should we seek help? Who should we see first? Can we afford it? The article on fertility care pathways brings attention to a difficult truth. For many people, getting fertility care is not a clear medical route from concern to diagnosis to treatment. It is often delayed, fragmented, and ineq

Ovarian ageing is often described as a story of dwindling eggs. That is true, but incomplete. The ovary is not a quiet storage site. It is a living tissue where eggs, hormone-producing cells, blood vessels, nerves, and immune cells talk to one another every day. That conversation changes with age. Immune cells become more inflammatory. Tissue repair slows down. Scar-like fibrosis builds up. Mitochondria become less efficient. Together, these shifts can affect ovulation, egg q

PCOS is often discussed through the lens of periods, acne, hair growth, or fertility. Those symptoms matter. Yet the condition also has a quieter side that deserves equal attention: cardiometabolic health. Many women with PCOS have a higher chance of insulin resistance, unhealthy cholesterol patterns, raised blood pressure, fatty liver, excess abdominal fat, and a higher lifetime risk of type 2 diabetes. That does not mean poor health is inevitable. It means the daily basics,

A diagnosis of an adult granulosa cell tumour can feel confusing because it is rare, slow-growing, and very different from the ovarian cancers most people have heard about. For someone with an early-stage tumour, one of the most sensitive treatment questions is this: can surgery remove the cancer while preserving fertility and hormonal function? For selected patients, the answer may be yes. OVARIAN-SPARING SURGERY can be a reasonable option in early-stage adult granulosa cell

A bicornuate uterus can turn an otherwise standard IVF pathway into a high-risk reproductive case. The condition affects uterine shape, implantation space, pregnancy surveillance, and delivery planning. That is why the first reported successful IVF case in a patient with a bicornuate uterus in Uzbekistan is clinically important, not only as an individual outcome but as a marker of progress in reproductive medicine. For specialists in fertility care, maternal-foetal medicine,

Leiomyomas are common, but their effects are rarely simple. One patient may have a small submucosal fibroid and severe bleeding. Another may have a large intramural fibroid and only mild pressure symptoms. A third may have no symptoms until infertility work-up reveals distortion of the uterine cavity. This variation is why modern leiomyoma care is moving away from a single diagnosis and towards a more precise clinical model. The best treatment plan connects four factors: fibr

A follicle that looks “not quite ready” on scan day is not always a lost opportunity. In IVF, the middle group of follicles, neither clearly small nor confidently mature, often carries much of the uncertainty in a stimulation cycle. The key clinical question is simple: should the team wait, trigger, adjust medication, or accept that some follicles may not yield usable eggs? The answer is rarely based on size alone. Follicle diameter matters, but it sits alongside hormone tren

Hysteroscopic adhesiolysis remains the central treatment for intrauterine adhesions, but surgery alone does not solve the whole problem. The endometrium still has to heal, the uterine cavity must stay open, and recurrence needs to be prevented during a biologically vulnerable window. That is where adjunctive strategies matter. Current research is moving beyond a single successful hysteroscopic procedure toward a broader care pathway: careful prevention, cavity maintenance, en

A genetic test can sound like a clean answer to a difficult IVF question: which embryo is most likely to become a healthy baby? In theory, selecting an embryo with the expected number of chromosomes should improve success rates, reduce miscarriage, and shorten the path to pregnancy. In practice, the evidence is more mixed. PGT-A, or preimplantation genetic testing for aneuploidy, sits at the intersection of reproductive medicine, genetics, laboratory skill, cost, and patient

For many people with PCOS-related infertility, clomiphene citrate is the first medication tried to induce ovulation. When it does not work, the next decision can feel much harder: continue with medical ovulation induction using letrozole, or move to a surgical option such as laparoscopic ovarian drilling. The study comparing reproductive outcomes after letrozole versus laparoscopic ovarian drilling adds useful evidence to this decision. Its main message is clinically relevant

For many people with polycystic ovary syndrome, the hardest part of fertility treatment is not starting medication. It is finding out that the first-line medicine has not triggered ovulation as expected. Clomiphene citrate has helped many patients ovulate, but a meaningful group with PCOS remain resistant to it. That is where metformin has drawn attention, especially as a short-term add-on before or during another attempt at ovulation induction. The study on short-term metfor

When fertility treatment begins, the male partner is often reduced to a semen analysis report. That narrow view can miss treatable causes, delay care, and leave patients feeling confused or blamed. ART clinics are in a strong position to change this. Assisted reproductive technology has helped many couples and individuals build families, but better outcomes do not come from lab skill alone. They also come from asking better questions about sperm health, explaining results cle

For many families, assisted reproductive technology offers a long-awaited path to pregnancy. It can also bring a new set of questions, including one that feels especially worrying: does IVF or related treatment raise the chance of a baby being born with a heart defect? A systematic review and meta-analysis can help answer that question because it combines results from many studies instead of relying on one clinic, one country, or one small group of births. The broad message f

Infertility is often treated as a private struggle. The new WHO guidance pushes back on that idea. It frames fertility care as part of essential health care, not a luxury service for those who can pay out of pocket or live near a specialist clinic. That shift matters. WHO has previously estimated that about one in six adults experience infertility during their lifetime. Behind that number are people delaying treatment because of cost, couples facing stigma, men who are never

Endometriosis mapping has moved beyond the question of whether disease is present. For patients with suspected ovarian and deep endometriosis, the clinical value lies in where the lesions are, how extensive they are, and whether they distort pelvic anatomy. Transvaginal ultrasound is well placed to answer these questions, provided the findings are reported in a structured way. The #Enzian system gives that structure. It translates ultrasound observations into a compartment-ba

Obesity care is changing because treatment is no longer limited to “eat less and move more” advice. For many people, weight gain is linked to biology, medicines, sleep, stress, food access, genetics, hormones, and long-term health conditions. NICE guidance reflects this more modern view by placing medicines such as semaglutide within a structured, specialist weight management plan rather than treating them as stand-alone solutions. This article is for information only and sho

Adenomyosis can create a painful conflict between symptom relief and fertility planning. Heavy bleeding, severe cramps, anaemia, pelvic pain, and infertility may push a woman towards treatment, yet many standard options either suppress ovulation or remove the uterus. That is why pregnancy after uterine artery embolisation for adenomyosis draws so much attention. Uterine artery embolisation, often called UAE, is a minimally invasive procedure that blocks selected blood vessels