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Review Article
Conventional Versus Frozen Embryo Transfer in IVF/ICSI Cycles: A Systematic Review of Pregnancy Outcome
Issue:
Volume 14, Issue 1, February 2026
Pages:
1-12
Received:
15 December 2025
Accepted:
25 December 2025
Published:
19 January 2026
Abstract: Although numerous studies have explored differences between conventional (fresh) and frozen embryo transfer in IVF/ICSI cycles, inconsistencies remain regarding their impact on neonatal outcomes. The objective of this systematic review was to comprehensively evaluate and compare pregnancy and neonatal outcomes—such as preterm birth, low birth weight, and growth parameters—between conventional embryo transfer (ET) and frozen embryo transfer (FET). A systematic literature search was conducted across major databases, including PubMed, Cochrane Library, Scopus, Web of Science, Wiley, Ovid, and ScienceDirect, covering publications from January 1980 to February 2025. Studies were included if they compared fresh and frozen embryo transfers in IVF/ICSI cycles and reported at least one neonatal or pregnancy outcome. Data extraction and quality assessment were performed independently by two reviewers using the Newcastle–Ottawa Scale (NOS) for cohort studies and the revised Cochrane Risk of Bias Tool for randomized controlled trials. Twenty-three eligible studies were identified, encompassing over 165,000 embryo transfer cycles from diverse geographic regions. The findings indicated that singleton pregnancies conceived after FET were associated with lower risks of preterm birth, low birth weight, and small-for-gestational-age infants compared to those conceived via fresh ET. Conversely, FET was linked with a higher likelihood of large-for-gestational-age and macrosomic births. RCTs and meta-analytic data further demonstrated higher clinical pregnancy and live birth rates and lower miscarriage and OHSS rates with FET. No significant differences were observed between the two groups in rates of congenital anomalies or neonatal mortality. This systematic review demonstrates that frozen embryo transfer is generally associated with more favorable neonatal outcomes than conventional fresh embryo transfer, particularly regarding fetal growth and gestational maturity. While FET offers distinct advantages, individualized treatment planning remains essential, and the decision to use fresh or frozen transfer should be based on patient characteristics and clinical context. Further prospective studies are encouraged to explore the long-term implications of both transfer methods on child health and maternal outcomes.
Abstract: Although numerous studies have explored differences between conventional (fresh) and frozen embryo transfer in IVF/ICSI cycles, inconsistencies remain regarding their impact on neonatal outcomes. The objective of this systematic review was to comprehensively evaluate and compare pregnancy and neonatal outcomes—such as preterm birth, low birth weigh...
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Review Article
The Potential Role of Vaping in the Increasing Burden of Endometriosis Among Women of Reproductive Age in Sub-Saharan Africa: A Public Health Concern
Kalala Elisee Kabuya*
,
Mukasa Charline Sangany
Issue:
Volume 14, Issue 1, February 2026
Pages:
13-29
Received:
27 November 2025
Accepted:
18 December 2025
Published:
20 January 2026
Abstract: The use of electronic nicotine delivery systems (ENDS) is increasing rapidly across Sub-Saharan Africa (SSA), particularly among young women, while endometriosis remains substantially underdiagnosed in the region. Emerging evidence suggests that vaping may influence hormonal, inflammatory, and oxidative pathways relevant to endometriosis. This scoping review followed PRISMA guidelines and searched PubMed, Web of Science, Scopus, African regional databases, and grey literature to identify studies examining vaping exposure in relation to reproductive or hormonal outcomes and gynecologic pathology. Eligible studies were appraised using the Newcastle–Ottawa Scale and STROBE criteria, and findings were narratively synthesized due to methodological heterogeneity. Across epidemiologic and mechanistic domains, the evidence indicates that nicotine-product use is associated with higher odds of dysmenorrhea and suspected endometriosis; disrupts the hypothalamic–pituitary–gonadal axis and estrogen–progesterone signaling; induces oxidative stress, mitochondrial dysfunction, and NF-κB activation; and may drive epigenetic and immune alterations that promote endometrial adhesion, angiogenesis, and impaired fertility. Contextual vulnerabilities in SSA including environmental co-exposures, infectious disease burden, limited diagnostic capacity, and dual use of vaping with alcohol may further amplify these risks. Although direct causal data from SSA remain limited, the convergence of biological plausibility and emerging epidemiologic signals highlights vaping as a potential reproductive health concern, underscoring the need to integrate vaping into sexual and reproductive health guidelines and to prioritize region-specific research.
Abstract: The use of electronic nicotine delivery systems (ENDS) is increasing rapidly across Sub-Saharan Africa (SSA), particularly among young women, while endometriosis remains substantially underdiagnosed in the region. Emerging evidence suggests that vaping may influence hormonal, inflammatory, and oxidative pathways relevant to endometriosis. This scop...
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Case Report
Low-dose Methotrexate Toxicity in Ectopic Pregnancy:
A Case Report and Literature Review
Issue:
Volume 14, Issue 1, February 2026
Pages:
30-36
Received:
11 December 2025
Accepted:
22 December 2025
Published:
30 January 2026
Abstract: Low-dose methotrexate (LD‑MTX) is widely regarded as a safe and effective fertility‑preserving treatment for selected ectopic pregnancies; however, rare cases of severe, life‑threatening toxicity have been reported. We describe a previously healthy 24‑year‑old woman who developed fulminant systemic toxicity following a single intramuscular dose of 60 mg methotrexate administered for persistent tubal ectopic pregnancy after laparoscopic salpingostomy. Within 72 hours, she presented with progressive mucocutaneous manifestations, including diffuse rash, facial oedema and severe oral ulceration, followed by pancytopenia and acute kidney injury by day 4. Concomitant treatment with long‑acting benzathine penicillin G and subsequent pharmacogenetic testing revealing heterozygous MTHFR C677T and MTRR A66G variants were considered contributory risk factors. Prompt initiation of high‑dose intravenous leucovorin rescue, alkalinised hydration and granulocyte colony‑stimulating factor led to complete haematological recovery by day 14 and normalisation of renal function without the need for glucarpidase or extracorporeal clearance. A review of the literature identified fewer than a dozen similar cases, highlighting consistent early mucocutaneous warning signs and rapid progression to severe myelosuppression. This case underscores that even a single LD‑MTX dose can precipitate severe toxicity when renal clearance is impaired, interacting medications are present and folate‑pathway polymorphisms coexist, and emphasises the critical importance of early symptom recognition, close laboratory monitoring between days 4 and 7, and timely leucovorin rescue.
Abstract: Low-dose methotrexate (LD‑MTX) is widely regarded as a safe and effective fertility‑preserving treatment for selected ectopic pregnancies; however, rare cases of severe, life‑threatening toxicity have been reported. We describe a previously healthy 24‑year‑old woman who developed fulminant systemic toxicity following a single intramuscular dose of ...
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Research Article
Comparison of Ciprofol-nalbuphine and
Propofol-nalbuphine Sedation During Painless Abortion:
A Randomized Controlled Trial
Issue:
Volume 14, Issue 1, February 2026
Pages:
37-44
Received:
13 January 2026
Accepted:
23 January 2026
Published:
6 February 2026
DOI:
10.11648/j.jgo.20261401.14
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Abstract: Objective: Despite the widespread use of propofol for painless abortion, it is frequently associated with cardiopulmonary adverse events. Ciprofol, a novel intravenous anesthetic agent, demonstrates a more favorable respiratory and hemodynamic stability profile. The aims of this study were to evaluate the efficacy and safety of ciprofol-nalbuphine combination in mitigating cardiopulmonary complications and enhancing recovery following painless abortion procedures. Methods: A total of 120 patients scheduled for elective painless abortion, aged 18-39 years, ASA physical status I or II, were selected. They were randomly divided into a Propofol-Nalbuphine group (PN group, n = 60) and a Ciprofol-Nalbuphine group (CN group, n = 60) using a random number table. Anesthesia was induced by intravenous injection of nalbuphine 0.1 mg/kg, followed 3 minutes later by intravenous injection of propofol (2 mg/kg, PN group) or ciprofol (0.4 mg/kg, CN group). Anesthesia was maintained by continuous intravenous infusion of propofol or ciprofol. The incidence of cardiopulmonary adverse reactions (respiratory depression, hypotension, bradycardia), changes in heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) at different time points were observed. Additionally, drug dosage, induction time, operative time, recovery time, injection pain, postoperative uterine contraction pain, and surgeon satisfaction were compared between the two groups. Results: Compared with PN, CN demonstrated a lower incidence of cardiopulmonary adverse reactions (15% vs. 40%, P < 0.05) and shorter recovery time (2.8 ± 1.8 vs. 1.9 ± 0.8 min, P < 0.05). The CN group also had reduced injection pain (3.3% vs. 16.6%) and intraoperative body movement (10% vs. 20%) (both P < 0.05). Surgeons reported higher satisfaction scores with CN (8.9 ± 1.0 vs. 8.0 ± 1.0, P < 0.001). MAP decreased after induction in both groups, with no intergroup difference (P > 0.05). Anesthesia induction time, operative time, and postoperative uterine contraction pain did not differ significantly between groups (P > 0.05). Conclusion: Intravenous anesthesia using ciprofol 0.4 mg/kg combined with nalbuphine 0.1 mg/kg is safe and effective for painless abortion. It offers advantages such as fewer cardiopulmonary adverse events, faster recovery, and less injection pain, making it worthy of clinical application and promotion.
Abstract: Objective: Despite the widespread use of propofol for painless abortion, it is frequently associated with cardiopulmonary adverse events. Ciprofol, a novel intravenous anesthetic agent, demonstrates a more favorable respiratory and hemodynamic stability profile. The aims of this study were to evaluate the efficacy and safety of ciprofol-nalbuphine ...
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