Honored and grateful to @aogsjournal.bsky.social for selecting our paper as Article of the Month, and for the wonderful podcast discussing our work. Thank you for this recognition and for helping share the science with a wider community!! Listen to podcast here: www.youtube.com/playlist?lis...

Can natural cycles be effectively utilized in women of advanced maternal age undergoing oocyte donation? 👀 To explore the answer, join the next #ESHREjc 📍May 29th, 17:00 CET 👉Featured paper: academic.oup.com/humrep/advan... Short summary (what we call “skytorial” or “bluettorial”) provided below👇

A new diagnostic framework for #Obesity is sparking debate by moving beyond BMI and distinguishing preclinical from clinical categories. Jennifer Abbasi and Kate Schweitzer discuss the implications for diagnosis, insurance coverage, and access to medication. ja.ma/42DX6XG

🚨🚨Scientific Speed Dating is back at the ESHRE Annual Meeting 2026! ⚡ Whether you’re looking for future collaborators, mentorship, research discussions, or simply to expand your network; this is the place to connect! 📍 London | #ESHRE2026 👉 Save your spot: lnkd.in/eVMhaDCf @eshre.bsky.social

The endometrium sheds and regenerates every month without scarring -- it's one of those gob-smacking miracles of science. But at a cellular level, we really don't know how it pulls off this unique biological feat. (1/x)

Does the age of culture media affect #IVF outcomes? Only one week left to join this #ESHRE Webinar on a question with direct impact on daily lab decisions. Evidence-based insights on shelf life, quality & sustainable practice. 🎤 Dean Morbeck - 12 May|13:00–14:00 CEST www.eshre.eu/Education/We...

Early career looking forward to meet your fav inspiring expert? Join us in London at #ESHRE2026! 👇🏼👇🏼👇🏼

@omarammar.bsky.social @mr-att.bsky.social @juanjo-fraire.bsky.social @noemisalmeri.bsky.social @dkalaitzopoulos.bsky.social Maíra Casalechi Julie LABROSSE #ESHRE

From our February issue, 52.2, this narrative review disentangles the current role of luteinizing hormone activity in ART by bridging foundational biological insights with the emerging paradigm of patient-specific treatment strategies to optimize reproductive outcomes. doi.org/10.1016/j.rb...

3/3 😏 At the same time, many of you raised important doubts about how much of this effect is truly biological versus context-dependent. 💬 A rich, nuanced discussion, thank you all for your contributions! 🙏🏻 Now we look forward to the summary slides, coming in a few hours 👀 #ESHREjc

2/3 🤔 There’s growing agreement that male infertility is not one entity, and that severe phenotypes may impact outcomes more than we previously acknowledged, especially in terms of time and efficiency to live birth.🫨 #ESHREjc

1/3 🚀🚀🚀 As this #ESHREjc discussion comes to a close, a few key themes are emerging 👇 We’ve questioned long-standing assumptions, particularly whether ICSI truly overcomes male factor infertility, and highlighted the gap between improving semen parameters and achieving live birth.

Studies show that patients often don’t retain most of the information they receive after receiving bad news. So summarizing at the end and offering a chance to revisit the topic later (such as in a follow up consultation) may be helpful #ESHREjc

Every couple is different and should be approached individually, with clear expectation management. The focus should be on strategies to improve outcomes, including antioxidant supplementation, which, although still under investigation, may improve semen parameters, particularly in OAT-S #ESHREjc

Agree! Patients may need time to process information before they can ask questions or engage in the next step discussion. Having an easy way to contact their healthcare provider or scheduling a follow up consultation is important #ESHREjc

It’s normal for patients to feel distressed after receiving bad news (sometimes the concern would be if they weren’t), and they find coping mechanisms to deal with it afterward. But for patients with high levels of distress, psychological support may be needed and it should be accessible #ESHREjc

Normalizing emotions is important, but there is often a fine delicate line between normalization and undervaluation. Patients can feel misunderstood and normalization shouldn’t make them feel their experience is being minimized #ESHREjc

YES! Doctor-patient communication is key in fertility care, especially when delivering difficult news. Frameworks like SPIKES help professionals communicate empathetically, set realistic expectations, and support patients’ emotions while respecting their pace #ESHREjc

Agree! Sometimes evidence alone isn’t enough. Information may be processed more through an emotional lens than rational thinking (so a 5% chance can feel like a certainty they’ll be in that 5%). Understanding if patients expectations are adjusted is very important #ESHREjc

You’re absolutely right to shift the focus from a binary success rate to Time to Live Birth. While neonatal outcomes might remain comparable once a pregnancy reaches term, the efficiency of the process is where the impact of severe male factor is most punishing. #ESHREjc

Poorer outcomes in severe OAT-S and NOA are driven by a synergistic failure of both biology and environment.While sperm DNA fragmentation and epigenetic defects provide the intrinsic ceiling often leading to late paternal effect and embryo arrest #ESHREjc

Yes, this could also be! #ESHREjc I think we have to design our clinical studies properly to answer specific questions and test specific hypothesis. Then we interpret the data we obtain objectively, without speculating or extrapolating.

Say controlled model results are underestimating the male factor (due to high-quality oocytes compensating), we may be at risk of under-counselling couples about sperm-related risks, if we are relying strongly on them for our decisions. #ESHREjc

Or, even if the controlled model is compensating and we still see a difference, it means it is an important effect to really consider in decision-making #ESHREjc

Of course the Clinician must aim to do more than deliver the prognosis, but also guide the patients through and beyond it. To have the necessary confidence and skill there should be professional training offered to clinicians by their workplaces on navigating these specific conversations. #ESHREjc

Evidence from donor sperm and oocyte donation models suggests that when gamete quality is normalized, outcomes tend to align more closely supporting a key role of intrinsic sperm factors rather than the couple’s environment(Capelouto et al., 2018). S-OA reflects true biological impairment. #ESHREjc

Be sure to close the conversation with clarity, don’t leave the patients adrift. Reorient them with a summary and of the next steps that are available, and with intentions to continue to support them, a scheduled follow-up call for questions they may have after time to process. #ESHREjc

This suggests that while we can manipulate sperm quality to some extent, improving semen parameters alone is not enough to guarantee better reproductive outcomes. So it becomes crucial to act on these additional points or do you think we should be moving in a different direction? #ESHREjc

Try to use clear, simple language and present the facts along with possible interventions. But above all, normalize emotional reactions! #ESHREjc

Embryo competence and above all, live birth and offspring fitness.

Future progress may depend on identifying which sperm traits and their underlying genetic architecture are linked to embryo competence #ESHREjc

How are you integrating PICSI—hyaluronic acid-based selection for mature, DNA-intact sperm pre-ICSI? Does it boost outcomes in severe cases, and what barriers do you face? RCTs or experiences welcome #ESHREjc

Great question! #ESHREjc Here some insights: www.rbmojournal.com/article/S147... www.rbmojournal.com/article/S147...

So the oocyte can compensate for sperm DNA damage, but only below a threshold that remains unknown. Does protection rely solely on the most competent oocyte? #ESHREjc

In fertility care, it must be a priority to combine medical expertise with psychological support. Also, giving professionals the right knowledge ensures they can communicate with patients empathetically, setting realistic expectations while honoring their emotional journey. #ESHREjc

Maybe by using an evidence-based approach to explain possible outcomes but also by making sure the doctor is using the best evidence to offer the most efficient treatment to the patient based on diagnosis? #ESHREjc

Yes, agree it's important to highlight that outcomes depend on multiple factors. I would also add that we need to understand who is the patient, as they differ in their preferences: some patients want step by step info, others want to know evrything right away (from plan A to Z) #ESHREjc

Q4: Clinicians should present information in stages, and emphasize that outcomes are variable and influenced by multiple factors. Engaging patients in a dialogue and ending with a clear next step may help adjust expectations while minimizing emotional distress. #ESHREjc

Communicating prognosis in severe male infertility requires empathy and support, providing realistic information without creating false expectations #ESHREjc

Q4: How can doctor-patient communication effectively integrate prognosis and expectation adjustment in severe male infertility (OAT-S, cryptozoospermia, NOA) without increasing couples’ emotional distress? #ESHREjc

Also, if we have a sperm selection technique to choose the best sperm, I would love to have a million of “super good sperm” rather than just one. So, once again, pre ART treatment of infertile man is important! #ESHREjc

Do we know the limits of oocyte repair against sperm DNA defects? Is there really a threshold? #ESHREjc

Q4 is now open for discussion! How can we clearly communicate prognosis in severe male infertility while setting realistic expectations—without increasing patients’ emotional burden? #ESHREjc

Residual confounding cannot be completely eliminated. I believe there may also be unknown, unrecorded variants. We cannot be 100% sure that the results are not influenced by hidden factors. #ESHREjc

I’m curious to hear what Prof. Lotti thinks about this… #ESHREjc @prof-lotti.bsky.social

Even when ICSI is ultimately used, earlier male evaluation can still influence management by identifying modifiable factors (e.g. varicocele, endocrine imbalance, lifestyle exposures), informing timing of treatment, and guiding decisions on sperm source (ejaculated vs testicular).

Real-word IVF-ICSI cohorts can be very valuable but one must be careful to address confounders in retrospective studies or to set proper inclusion/exclusion criteria to draw robust conclusions #ESHREjc