{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:12:28Z","timestamp":1793056348299,"version":"4.5.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009376","name":"Harokopio University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009376","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hormones"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The follicular microenvironment strongly influences oocyte and embryo quality and therefore plays a critical role in assisted reproduction therapy outcomes. This study prospectively evaluated the association between follicular fluid (FF) concentrations of activin-A, follistatin, and inhibin-B and in vitro fertilization (IVF) outcome parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Couples with primary infertility attending an Assisted Conception Unit in Athens, Greece, were recruited as part of an ongoing prospective cohort study evaluating the impact of dietary and lifestyle patterns on fertility. FF levels of activin-A, follistatin, and inhibin-B were measured in 86 women undergoing IVF\/ICSI cycles, along with assessments of oocyte yield and quality, embryo number and quality, implantation success, clinical pregnancy, and live birth rates. FF samples were collected at oocyte retrieval from follicles\u2009\u2265\u200918\u00a0mm in diameter and analyzed using the enzyme-linked immunosorbent assay. Associations between FF biomarkers and IVF outcomes were assessed using correlation analyses and multivariable-adjusted regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      FF activin-A concentrations were positively correlated with both follistatin and inhibin-B levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while FF follistatin and inhibin-B levels were significantly associated with oocyte and embryo number and quality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Multivariable-adjusted relative risk analyses demonstrated that FF activin-A levels were independently and inversely associated with primary clinical endpoints. Specifically, each 10 pg\/mg increase in protein-normalized FF activin-A was independently and inversely associated with successful implantation [RR (95% CI)\u2009=\u20090.82 (0.69\u20130.96),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016], clinical pregnancy [RR (95% CI)\u2009=\u20090.76 (0.66\u20130.86),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001], and live birth [RR (95% CI)\u2009=\u20090.79 (0.64\u20130.97),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023]; however, none of these associations met the Benjamini-Hochberg adjusted significance threshold and all attenuated to marginal non-significance upon adjustment for family subfertility history.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Follicular fluid follistatin and inhibin-B were associated with favorable intermediate IVF outcomes, whereas activin-A showed an exploratory inverse association with implantation, clinical pregnancy, and live birth. These findings warrant prospective validation in larger, independent cohorts before any clinical translation can be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s42000-026-00818-8","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:56:05Z","timestamp":1785423365000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intrafollicular activin-A, inhibin-B, and follistatin are associated with in vitro fertilization outcomes in subfertile women"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4142-2392","authenticated-orcid":false,"given":"Dimitrios","family":"Karayiannis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4867-6945","authenticated-orcid":false,"given":"Roxane","family":"Tenta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3168-8867","authenticated-orcid":false,"given":"Meropi D.","family":"Kontogianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minas","family":"Mastrominas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3269-4919","authenticated-orcid":false,"given":"Nikos","family":"Yiannakouris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"818_CR1","doi-asserted-by":"publisher","first-page":"e0143632","DOI":"10.1371\/journal.pone.0143632","volume":"10","author":"E Lazzaroni-Tealdi","year":"2015","unstructured":"Lazzaroni-Tealdi E, Barad DH, Albertini DF et al (2015) Oocyte scoring enhances embryo-scoring in predicting pregnancy chances with IVF where it counts most. 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Biochemical analyses were performed in the Laboratory of Biology, Biochemistry and Physiology, in the Department of Nutrition & Dietetics at Harokopio University of Athens. All procedures adhered to the Declaration of Helsinki with written informed consent obtained from the participants. The study protocol was approved by the Institutional Ethics Committee of Harokopio University (12\/13-01-2013).","order":1,"name":"Ethics","label":"Research involving human participants and\/or animals","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures adhered to the Declaration of Helsinki, with written informed consent obtained from the participants.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None declared.","order":3,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"NCT03050944.","order":4,"name":"Ethics","label":"Trial registration number","group":{"name":"EthicsHeading","label":"Declarations"}}]}}