Sperm motility and structural integrity are essential for successful fertilization in vivo, and any hindrance of the correct assembly of the axoneme and peri-axonemal structures in the sperm flagellum can lead to fertility problems. While there has been considerable advancement in studying diseases related to the flagellum, the underlying mechanisms that control sperm movement are not yet fully understood. In this study, we reveal that the tetratricopeptide repeat protein 6 (Ttc6) gene, expressed mainly in the testes, plays a crucial role in maintaining male fertility in mice. We further demonstrate that the knockout of Ttc6 in mice results in decreased sperm motility and induces an abnormal circular swimming pattern, consequently leading to male subfertility. Morphological analysis showed an atypical hairpin-like appearance of the spermatozoa, and ultrastructural studies showed unsheathed flagella at the juncture between the midpiece and principal piece. Collectively, these findings suggest that TTC6 plays an essential role in maintaining the stability of the annulus region of the sperm flagellum, thus ensuring the swift and directed motion of sperm.

Background and Objectives: Fertility preservation in young patients with hematological malignancies is often constrained by the need for urgent life-saving chemotherapy, leaving limited evidence to guide counseling once treatment has already begun. Reliable predictors of ovarian response after chemotherapy are therefore clinically important. Materials and Methods: This retrospective single-center study included 37 hematological patients aged ≤35 years who underwent urgent controlled ovarian stimulation after initial chemotherapy. Only the first cycle per patient was analyzed. Patients were grouped by metaphase II oocyte yield as high-yield group (≥8 metaphase II oocytes) or low-yield group (<8). Post-chemotherapy ovarian reserve markers and chemotherapy-related variables were assessed. Parsimoniously adjusted logistic regression and ROC analyses were performed, and LOESS regression was used to explore relationships with mature oocyte number. Results: The median number of chemotherapy cycles before stimulation was three (IQR: 2–4), and the median interval from last chemotherapy to retrieval was 33 days (IQR: 27–39). The high-yield group had higher post-chemotherapy anti-Müllerian hormone (AMH) and antral follicle count (AFC) than the low-yield group (both p < 0.05). In adjusted analyses, AMH (OR 2.58, 95% CI 1.17–5.70) and AFC (OR 1.24, 95% CI 1.04–1.48) were associated with achieving ≥8 mature oocytes. No association was detected between oocyte yield and chemotherapy cycle number, chemotherapy-free interval, alkylating agent exposure, or stimulation-related factors. LOESS showed positive, non-linear associations for AMH and AFC with mature oocyte number. In this exploratory analysis, ROC curves suggested moderate discrimination for predicting high oocyte yield, with areas under the curve of 0.78 for AMH, 0.73 for AFC, and 0.80 for the combined model. Conclusions: Post-chemotherapy AMH and AFC were associated with ovarian response in urgent fertility preservation after initial chemotherapy for young hematological malignancies. Larger studies are needed to validate these exploratory findings.

Hematological patients constitute a key group for fertility preservation, but the surgical risk of emergency ovarian tissue cryopreservation (OTC) before hematopoietic stem cell transplantation (HSCT) is unclear. This study investigates the perioperative safety of emergency OTC management in hematological patients prior to HSCT, and explores the correlation between perioperative treatment, surgical complications, and disease type. Design a single-center retrospective study. A single-center retrospective analysis was conducted on 67 hematologic patients (non-neoplastic: aplastic anemia, Fanconi anemia, thalassemia; neoplastic: myelodysplastic syndromes, acute lymphocytic leukemia, acute mixed leukemia, acute myeloid leukemia, lymphoma) who underwent emergency OTC before HSCT (January 2023-December 2025). Perioperative management and complications were analyzed, with logistic regression employed to assess the correlation between hematological disease type and perioperative complication occurrence. Compared with the neoplastic group, the non-neoplastic group had a significantly higher incidence of mild infections (21.43% vs. 0%; p < 0.05). No significant differences were observed in perioperative bleeding (5 vs. 10, p = 0.319) or prolonged hospitalization (5 vs. 6, p = 0.925), both of which were infrequent. The non-neoplastic group also showed significantly lower perioperative blood counts (p < 0.05). Accordingly, these patients required more hematologic support during the perioperative period, with higher rates of red blood cell transfusion (80.95% vs. 28.00%; p < 0.01) and platelet transfusion (90.48% vs. 12.00%; p < 0.01). Logistic regression confirmed a strong association between non-neoplastic hematologic disorders and the need for perioperative red blood cell and platelet transfusion but showed no link with hospitalization duration (p = 0.296). With active perioperative management, patients undergoing emergency OTC prior to HSCT had a low incidence of adverse outcomes. Nevertheless, perioperative care for non-neoplastic patients warrants increased attention.