{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:54:35Z","timestamp":1785506075710,"version":"3.56.0"},"reference-count":55,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This multicenter retrospective cohort study assesses the effect of high paternal DNA fragmentation on the well-being of the woman during pregnancy and the health of the newborn delivered. It was performed with clinical data from 488 couples who had a delivery of at least one newborn between January 2000 and March 2019 (243 used autologous oocytes and 245 utilized donated oocytes). Couples were categorized according to sperm DNA fragmentation (SDF) level as \u226415% or &gt;15%, measured by TUNEL assay. Pregnancy, delivery, and neonatal outcomes were assessed. In singleton pregnancies from autologous cycles, a higher but non-significant incidence of pre-eclampsia, threatened preterm labor, and premature rupture of membranes was found in pregnant women from the &gt;15%SDF group. Additionally, a higher proportion of children were born with low birth weight, although the difference was not statistically significant. After adjusting for potential confounders, these couples had lower odds of having a female neonate (AOR = 0.35 (0.1\u20130.9), p = 0.04). Regarding couples using donor\u2019s oocytes, pregnancy and neonatal outcomes were comparable between groups, although the incidence of induced vaginal labor was significantly higher in the &gt;15% SDF group (OR = 7.4 (1.2\u201346.7), p = 0.02). Adjusted analysis revealed no significant association of elevated SDF with adverse events. In multiple deliveries from cycles using both types of oocytes, the obstetric and neonatal outcomes were found to be similar between groups. In conclusion, the presence of an elevated SDF does not contribute to the occurrence of clinically relevant adverse maternal events during pregnancies, nor does it increase the risk of worse neonatal outcomes in newborns. Nevertheless, a higher SDF seems to be related to a higher ratio of male livebirths.<\/jats:p>","DOI":"10.3390\/jcm12216802","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T11:50:18Z","timestamp":1698407418000},"page":"6802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Elevated Sperm DNA Damage in IVF\u2013ICSI Treatments Is Not Related to Pregnancy Complications and Adverse Neonatal Outcomes"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-9245","authenticated-orcid":false,"given":"Irene","family":"Herv\u00e1s","sequence":"first","affiliation":[{"name":"IVIRMA Global Research Alliance, IVIRMA Rome, Via Federico Calabresi, 11, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Rivera-Egea","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, IVIRMA Valencia, Andrology Laboratory and Sperm Bank, Plaza de la Polic\u00eda Local 3, 46015 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Pacheco","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, IVIRMA Madrid, Andrology Laboratory and Sperm Bank, Av. del Talgo 68-70, 28023 Madrid, Spain"},{"name":"Faculty of Health Sciences, Alfonso X el Sabio University, Avda. de la Universidad, 1, Villanueva de la Ca\u00f1ada, 28691 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6863-8981","authenticated-orcid":false,"given":"Maria","family":"Gil Julia","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigaci\u00f3n Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106\u2014Torre A, Planta 1\u00aa, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1687-1279","authenticated-orcid":false,"given":"Ana","family":"Navarro-Gomezlechon","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigaci\u00f3n Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106\u2014Torre A, Planta 1\u00aa, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mossetti","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, IVIRMA Rome, Via Federico Calabresi, 11, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00e1s","family":"Garrido","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigaci\u00f3n Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106\u2014Torre A, Planta 1\u00aa, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.clinbiochem.2018.03.012","article-title":"Fertility and Infertility: Definition and Epidemiology","volume":"62","author":"Christine","year":"2018","journal-title":"Clin. Biochem."},{"key":"ref_2","first-page":"hoac022","article-title":"ART in Europe, 2018: Results Generated from European Registries by ESHRE","volume":"2020","author":"Kupka","year":"2020","journal-title":"Hum. Reprod. Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.fertnstert.2016.05.026","article-title":"Van Society for Assisted Reproductive Technology and Assisted Reproductive Technology in the United States: A 2016 Update","volume":"106","author":"Toner","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.rbmo.2016.10.002","article-title":"Does Oocyte Donation Compared with Autologous Oocyte IVF Pregnancies Have a Higher Risk of Preeclampsia?","volume":"34","author":"Tarlatzi","year":"2017","journal-title":"Reprod. Biomed. Online"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1093\/humrep\/dev090","article-title":"Risk of Hypertensive Disorders in Pregnancies Following Assisted Reproductive Technology: A Cohort Study from the CoNARTaS Group","volume":"30","author":"Opdahl","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1093\/humupd\/dms018","article-title":"Obstetric and Perinatal Outcomes in Singleton Pregnancies Resulting from Ivf\/Icsi: A Systematic Review and Meta-Analysis","volume":"18","author":"Pandey","year":"2012","journal-title":"Hum. Reprod. Update"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/uog.18930","article-title":"Risk of Spontaneous Preterm Birth in Singleton Pregnancies Conceived after IVF\/ICSI Treatment: Meta-Analysis of Cohort Studies","volume":"51","author":"Cavoretto","year":"2018","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.fertnstert.2015.01.015","article-title":"Assisted Reproductive Technology and the Risk of Preterm Birth among Primiparas","volume":"103","author":"Dunietz","year":"2015","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00404-017-4291-2","article-title":"Worldwide Prevalence of Adverse Pregnancy Outcomes Associated with in Vitro Fertilization\/Intracytoplasmic Sperm Injection among Multiple Births: A Systematic Review and Meta-Analysis Based on Cohort Studies","volume":"295","author":"Qin","year":"2017","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s00404-016-4250-3","article-title":"Worldwide Prevalence of Adverse Pregnancy Outcomes among Singleton Pregnancies after in Vitro Fertilization\/Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis","volume":"295","author":"Qin","year":"2017","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/humrep\/deaa272","article-title":"The Risk of Birth Defects with Conception by ART","volume":"36","author":"Luke","year":"2021","journal-title":"Hum. Reprod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1016\/j.fertnstert.2015.08.013","article-title":"Difference in Birth Weight of Consecutive Sibling Singletons Is Not Found in Oocyte Donation When Comparing Fresh versus Frozen Embryo Replacements","volume":"104","author":"Galliano","year":"2015","journal-title":"Fertil. Steril."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1093\/humrep\/deac074","article-title":"Perinatal Outcomes in Children Born after Fresh or Frozen Embryo Transfer Using Donated Oocytes","volume":"37","author":"Rafael","year":"2022","journal-title":"Hum. Reprod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.fertnstert.2017.06.031","article-title":"Obstetric and Perinatal Outcomes of Pregnancies Conceived with Embryos Cultured in a Time-Lapse Monitoring System","volume":"108","author":"Insua","year":"2017","journal-title":"Fertil. Steril."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1093\/humrep\/dey394","article-title":"Risk of Cancer in Children and Young Adults Conceived by Assisted Reproductive Technology","volume":"34","author":"Spaan","year":"2019","journal-title":"Hum. Reprod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.fertnstert.2015.11.015","article-title":"Effects of In Vitro Fertilization and Maternal Characteristics on Perinatal Outcomes: A Population-Based Study Using Siblings","volume":"105","author":"Seggers","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.fertnstert.2015.02.027","article-title":"Adverse Pregnancy and Birth Outcomes Associated with Underlying Diagnosis with and without Assisted Reproductive Technology Treatment","volume":"103","author":"Stern","year":"2015","journal-title":"Fertil. Steril."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.fertnstert.2009.10.046","article-title":"Sperm DNA Fragmentation: Mechanisms of Origin, Impact on Reproductive Outcome, and Analysis","volume":"93","author":"Sakkas","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s10815-016-0763-8","article-title":"Novel Concepts in Male Factor Infertility: Clinical and Laboratory Perspectives","volume":"33","author":"Esteves","year":"2016","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"205","DOI":"10.4103\/1008-682X.172642","article-title":"Specialized Sperm Function Tests in Varicocele and the Future of Andrology Laboratory","volume":"18","author":"Majzoub","year":"2016","journal-title":"Asian J. Androl."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.ejogrb.2015.02.026","article-title":"Conventional Semen Parameters and DNA Fragmentation in Relation to Fertility Status in a Greek Population","volume":"188","author":"Evgeni","year":"2015","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12958-015-0035-y","article-title":"The Relationship between Sperm Viability and DNA Fragmentation Rates","volume":"13","author":"Samplaski","year":"2015","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1590\/S1677-55382012000500002","article-title":"Unexplained Male Infertility: Diagnosis and Management","volume":"38","author":"Hamada","year":"2012","journal-title":"Int. Braz. J. Urol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0015-0282(02)03219-3","article-title":"Increased Sperm Nuclear DNA Damage in Normozoospermic Infertile Men: A Prospective Study","volume":"78","author":"Saleh","year":"2002","journal-title":"Fertil. Steril."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s00404-019-05133-9","article-title":"The Impact of Sperm DNA Fragmentation on ICSI Outcome in Cases of Donated Oocytes","volume":"300","author":"Antonouli","year":"2019","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.fertnstert.2003.12.039","article-title":"Extent of Nuclear DNA Damage in Ejaculated Spermatozoa Impacts on Blastocyst Development after In Vitro Fertilization","volume":"82","author":"Seli","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.fertnstert.2019.03.003","article-title":"Sperm DNA Fragmentation and Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis","volume":"112","author":"McQueen","year":"2019","journal-title":"Fertil. Steril."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2908","DOI":"10.1093\/humrep\/des261","article-title":"The Effect of Sperm DNA Fragmentation on Miscarriage Rates: A Systematic Review and Meta-Analysis","volume":"27","author":"Robinson","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.rbmo.2012.09.019","article-title":"Sperm DNA Damage Has a Negative Association with Live-Birth Rates after IVF","volume":"26","author":"Simon","year":"2013","journal-title":"Reprod. Biomed. Online"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2663","DOI":"10.1093\/humrep\/den321","article-title":"Sperm DNA Damage Is Associated with an Increased Risk of Pregnancy Loss after IVF and ICSI: Systematic Review and Meta-Analysis","volume":"23","author":"Zini","year":"2008","journal-title":"Hum. Reprod."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s10815-019-01632-5","article-title":"Sperm DNA Fragmentation on the Day of Fertilization Is Not Associated with Embryologic or Clinical Outcomes after IVF\/ICSI","volume":"37","author":"Green","year":"2020","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.fertnstert.2022.04.002","article-title":"Sperm Deoxyribonucleic Acid Fragmentation (by Terminal Deoxynucleotidyl Transferase Biotin DUTP Nick End Labeling Assay) Does Not Impair Reproductive Success Measured as Cumulative Live Birth Rates per Donor Metaphase II Oocyte Used","volume":"118","author":"Pacheco","year":"2022","journal-title":"Fertil. Steril."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/j.rbmo.2022.02.010","article-title":"IVF\/ICSI Cumulative Live Birth Rates per Consumed Oocyte Remain Comparable Regardless of Sperm DNA Fragmentation by TUNEL","volume":"44","author":"Pacheco","year":"2022","journal-title":"Reprod. Biomed. Online"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.fertnstert.2010.05.055","article-title":"Effect of Sperm DNA Fragmentation on Pregnancy Outcome Depends on Oocyte Quality","volume":"95","author":"Meseguer","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1365-2605.2011.01222.x","article-title":"Spermatozoa DNA Damage Measured by Sperm Chromatin Structure Assay (SCSA) and Birth Characteristics in Children Conceived by IVF and ICSI","volume":"35","author":"Bungum","year":"2012","journal-title":"Int. J. Androl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13048-020-00658-z","article-title":"Effects of the Sperm DNA Fragmentation Index on the Clinical and Neonatal Outcomes of Intracytoplasmic Sperm Injection Cycles","volume":"13","author":"Chen","year":"2020","journal-title":"J. Ovarian Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1095\/biolreprod.107.065623","article-title":"Long-Term Effects of Mouse Intracytoplasmic Sperm Injection with DNA-Fragmented Sperm on Health and Behavior of Adult Offspring","volume":"78","author":"Moreira","year":"2008","journal-title":"Biol. Reprod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/j.fertnstert.2015.11.027","article-title":"Oocyte Vitrification as an Efficient Option for Elective Fertility Preservation","volume":"105","author":"Cobo","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/andr.12551","article-title":"High Sperm DNA Fragmentation Delays Human Embryo Kinetics When Oocytes from Young and Healthy Donors Are Microinjected","volume":"6","author":"Esbert","year":"2018","journal-title":"Andrology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3142","DOI":"10.1093\/humrep\/17.12.3142","article-title":"Sperm and Oocyte Donor Selection and Management: Experience of a 10 Year Follow-up of More than 2100 Candidates","volume":"17","author":"Garrido","year":"2002","journal-title":"Hum. Reprod."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1016\/j.fertnstert.2015.08.020","article-title":"Six Years\u2019 Experience in Ovum Donation Using Vitrified Oocytes: Report of Cumulative Outcomes, Impact of Storage Time, and Development of a Predictive Model for Oocyte Survival Rate","volume":"104","author":"Cobo","year":"2015","journal-title":"Fertil. Steril."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4399","DOI":"10.1210\/jc.2004-2252","article-title":"Age and Uterine Receptiveness: Predicting the Outcome of Oocyte Donation Cycles","volume":"90","author":"Soares","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_43","unstructured":"World Health Organization (2010). WHO Laboratory Manual for the Examination and Processing of Human Semen, World Health Organization. [5th ed.]."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.fertnstert.2003.09.035","article-title":"Role of Cholesterol, Calcium, and Mitochondrial Activity in the Susceptibility for Cryodamage after a Cycle of Freezing and Thawing","volume":"81","author":"Meseguer","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.fertnstert.2014.09.001","article-title":"Removal of Annexin V-Positive Sperm Cells for Intracytoplasmic Sperm Injection in Ovum Donation Cycles Does Not Improve Reproductive Outcome: A Controlled and Randomized Trial in Unselected Males","volume":"102","author":"Romany","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.rbmo.2011.07.010","article-title":"Impact of Sperm DNA Fragmentation on the Outcome of IVF with Own or Donated Oocytes","volume":"23","author":"Esbert","year":"2011","journal-title":"Reprod. Biomed. Online"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.5534\/wjmh.220283","article-title":"Low Birth Weight Is Associated with Sperm DNA Fragmentation and Assisted Reproductive Technology Outcomes in Primary Infertile Men: Results of a Cross-Sectional Study","volume":"41","author":"Boeri","year":"2023","journal-title":"World J. Men\u2019s Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/humupd\/dmz001","article-title":"The Health of Children Conceived by ART: \u201cThe Chicken or the Egg?\u201d","volume":"25","author":"Berntsen","year":"2019","journal-title":"Hum. Reprod. Update"},{"key":"ref_49","first-page":"123","article-title":"Original Article Ovarian Response to Stimulation and Suboptimal Endometrial Development Are Associated with Adverse Perinatal Outcomes in Intracytoplasmic Sperm Injection Cycles","volume":"23","author":"Borges","year":"2019","journal-title":"JBRA Assist. Reprod."},{"key":"ref_50","first-page":"94","article-title":"Perinatal Outcomes after Stimulated versus Natural Cycle IVF: A Systematic Review and Meta-Analysis","volume":"36","author":"Shashikant","year":"2017","journal-title":"Reprod. Biomed. Online"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.fertnstert.2012.11.023","article-title":"Neonatal and Maternal Outcomes Comparing Women Undergoing Two in Vitro Fertilization (IVF) Singleton Pregnancies and Women Undergoing One IVF Twin Pregnancy","volume":"99","author":"Sazonova","year":"2013","journal-title":"Fertil. Steril."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.fertnstert.2020.12.016","article-title":"Endometrium Preparation and Perinatal Outcomes in Women Undergoing Single-Blastocyst Transfer in Frozen Cycles","volume":"115","author":"Hu","year":"2021","journal-title":"Fertil. Steril."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lee, J.C., Badell, M.L., and Kawwass, J.F. (2022). The Impact of Endometrial Preparation for Frozen Embryo Transfer on Maternal and Neonatal Outcomes: A Review. Reprod. Biol. Endocrinol., 20.","DOI":"10.1186\/s12958-021-00869-z"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s10815-019-01552-4","article-title":"Risk of Adverse Perinatal Outcomes after Oocyte Donation: A Systematic Review and Meta-Analysis","volume":"36","author":"Sepulveda","year":"2019","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1111\/1471-0528.12896","article-title":"Impact of Obstetric History on the Risk of Spontaneous Preterm Birth in Singleton and Multiple Pregnancies: A Systematic Review","volume":"121","author":"Kazemier","year":"2014","journal-title":"BJOG"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/21\/6802\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:12:51Z","timestamp":1760130771000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/21\/6802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,27]]},"references-count":55,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["jcm12216802"],"URL":"https:\/\/doi.org\/10.3390\/jcm12216802","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,27]]}}}