Beyond Conventional Mating: Reviewing the Possibility of Second Pregnancies in Albino Rats Without Male Access

Review Article | DOI: https://doi.org/10.31579/2690-8808/277

Beyond Conventional Mating: Reviewing the Possibility of Second Pregnancies in Albino Rats Without Male Access

  • Samira R. Mansour 1*
  • Mostafa A. Moustafa 2
  • Mardies A. Moustafa 3
  • Amaal M. Elshazly 1
  • AbdelRaouf A. Moustafa 1

1Botany and Microbiology Department, Faculty of Science, Suez Canal University, Ismailia.

2Neurology Department, Faculty of Medicine, 6 October University.

3Endodentric Department, Faculty of Dentistry, Saini University.

*Corresponding Author: Samira R. Mansour, Botany and Microbiology Department, Faculty of Science, Suez Canal University, Ismailia.

Citation: Samira R. Mansour, Mostafa A. Moustafa, Mardies A. Moustafa, Amaal M. Elshazly and AbdelRaouf A. Moustafa, (2025), Beyond Conventional Mating: Reviewing the Possibility of Second Pregnancies in Albino Rats Without Male Access, J, Clinical Case Reports and Studies, 6(8); DOI:10.31579/2690-8808/277

Copyright: ©, 2025, Samira R. Mansour. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 19 September 2025 | Accepted: 03 November 2025 | Published: 14 November 2025

Keywords: second pregnancy; albino rate; pseudopregnancy; parthenogenesis

Abstract

Background: Albino rats are extensively utilized in reproductive and biomedical research owing to their well-characterized physiology. Under normal physiological conditions, successful pregnancy necessitates copulation with a fertile male. However, atypical cases have been documented wherein females appear to undergo a subsequent pregnancy in the absence of male contact following an initial mating event.

Objective: This review aims to clarify potential biological mechanisms underlying this rare and interesting phenomenon, synthesize evidence from rodent studies and comparative biology, and discuss the implications for reproductive science in future.

Methods: A narrative review of the literature was performed, focusing on the reproductive physiology of albino rats, pseudopregnancy, sperm storage, superfetation, and parthenogenesis. Additional insights were combined from studies involving other species exhibiting similar reproductive phenomena.

Results: Several mechanisms may explain the occurrence of second pregnancies in the absence of male contact: (a) sperm storage within the female reproductive tract allowing delayed fertilization; (b) hormonally induced pseudopregnancy without fertilization; (c) superfetation, defined as conception during an ongoing pregnancy; (d) accidental parthenogenesis, although this phenomenon is extraordinarily rare in mammals; and (e) experimental or housing artifacts, including overlooked male access. Evidence from rodent models predominantly supports pseudopregnancy and sperm storage as the most reasonable explanations, whereas parthenogenesis remains highly improbable in mammals.

Conclusion: The observation of second pregnancies in albino rats without male presence challenges the traditional paradigm of mammalian reproduction. Although definitive evidence is currently lacking, consideration of these potential mechanisms exposes significant gaps in reproductive biology knowledge. Future studies employing genetic, hormonal, and histological approaches are in need to clarify this phenomenon and its implications for reproductive biology, laboratory animal management, and the reliability of experimental outcomes.

Introduction

The phenomenon of pregnancy in the absence of male participation has long fascinated reproductive biologists, challenging traditional understandings of fertilization and pregnancy. True parthenogenesis, can simply defined as a form of asexual reproduction where an egg develops into an embryo without fertilization, this phenomenon has been documented in various species, predominantly in invertebrates and some reptiles (Moreira et al., 2021; Booth et al., 2023). Recent studies have confirmed facultative and obligate parthenogenesis in diverse taxa, including sharks (Esposito et al., 2024), lizards and snakes (Booth et al., 2023), and even in some amphibians (Davis et al., 2023). These findings reveal that parthenogenesis serves as an adaptive reproductive strategy in species facing environmental or demographic challenges, facilitating reproduction in the absence of males while contributing to their evolutionary flexibility and biodiversity. A confirmed case of true parthenogenesis in mammals would revolutionize our understanding of genetics, embryonic development, and evolutionary biology. 

Albino rats serve as one of the most widely utilized model organisms in reproductive and biomedical research due to their well-understood physiology, ease of breeding, and genetic uniformity. Their reproductive biology has been extensively characterized, demonstrating that successful pregnancy generally requires copulation with a fertile male. This initial understanding supports numerous studies related to fertility, endocrinology, and developmental biology. (Quesenberry, 2024; Stramek et al., 2019). However, recent reports have challenged this his conventional view by reporting cases where female albino rats appear to undergo subsequent pregnancies without existence any male contact (Ochiogu, et al., 2006), raising important questions about the complexities and possible alternative mechanisms in mammalian reproduction (Ochiogu et al., 2006).

The phenomenon of second pregnancy also suggests the existence of alternative pathways for reproductive activation, including spontaneous ovulation, pseudo-pregnancy, or overlooked environmental and physiological factors (Figure 1). Such pathways may operate independently of copulation, indicating more complex regulatory mechanisms in female reproductive physiology than previously understood. These findings not only have significant implications for our understanding of reproductive biology but also impact laboratory animal management, breeding programs, and experimental reliability. For instance, unrecognized pregnancies or reproductive states can confound experimental outcomes, leading to variability and challenges in reproducibility. Moreover, these occurrences raise important questions about the triggers and controls of ovulation and implantation, as well as the potential for cryptic fertilization events. Understanding whether these events are due to physiological phenomena, such as sperm storage, hormonal states, or rare reproductive capabilities like parthenogenesis, is crucial to interpreting experimental data accurately. Furthermore, elucidating these mechanisms could inform improvements in animal husbandry protocols, ensuring more precise control over breeding and reducing unintended reproductive events that may affect both scientific studies and animal welfare.

This review aims to explain existing knowledge and explore the potential biological mechanisms that could elucidate such extraordinary reproductive events. By examining data from rodent studies and comparative biology across species, the review seeks to clarify whether known reproductive phenomena, such as sperm storage, pseudopregnancy, superfetation, or parthenogenesis, can account for these observations. Further, it highlights the gaps in current understanding and discusses the implications for reproductive science, laboratory practices, and future research directions.

This hypothetical observation is scientifically extraordinary, as it would challenge the established understanding of obligate sexual reproduction in placental mammals. The main items concerning this study would focus on rigorously investigating the purported event, considering established biological mechanisms that could mimic pregnancy, and exploring more radical, but less likely, biological explanations. Primary hypotheses and probable mechanisms for understanding this rare occurrence could provide new insights into reproductive physiology and potential parthenogenetic or hormonally induced processes.

Explanations for Second Pregnancy mechanisms in Rats

1.Pseudopregnancy Misinterpretation

Most reasonable explanation of the observed “second pregnancy” is actually pseudopregnancy, in which rats, cervical stimulation (from infertile mating, interactions with other females, or environmental factors) activates a neuroendocrine reflex. Environmental factors may play role in regular fertility where any disturbance can delay pregnancy (Abd El-Aziz et al., 2024). The most important effective factor is light. Light exposure significantly influences reproductive physiology in albino rats through its effects on the hypothalamic-pituitary-gonadal (HPG) axis and the circadian regulation of reproductive hormones. Albino rats, which possess amelanotic retinas, are particularly sensitive to light intensity and photoperiod changes. Exposure to abnormal lighting conditions, such as constant light or light at night, disrupts their reproductive cycles by altering the secretion of key hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), and progesterone, ultimately affecting ovulation and fertility (Lawton & Schwartz, 1967; Emmer et al., 2018).

2. Hormonal state: This response for prolongs the life of the corpus luteum, which secretes progesterone. Elevated progesterone causes physiological changes, mammary gland development, nesting behavior, and weight gain, that mimic true pregnancy (Vazakidou et al., 2024; El Hennawi, et al.,2024) Investigative procedure can be done through hormonal profiling (progesterone, prolactin) during the suspected gestation is required to distinguish true pregnancy from pseudopregnancy.

3. Delayed Implantation

A possible explanation for the occurrence of second pregnancy in albino rats is an overlooked mating during the fertile postpartum estrus, which typically occurs within approximately 48 hours after parturition. Mating during this brief fertile window can initiate a new pregnancy; however, the implantation of embryos may be delayed or enter a dormant state (Agrati and Uriarte, 2023). This delay in implantation allows the uterus to temporally pause embryonic development until maternal and conditions become favorable for embryo attachment and further gestation.

Delayed implantation, also known as embryonic diapause, is a well-documented reproductive strategy observed in numerous mammalian species, allowing synchronization of birth with optimal environmental conditions and maternal physiological readiness. In rodents including albino rats, this facultative delay is regulated by a balance of ovarian hormones, primarily progesterone and estrogen. Studies demonstrate that the preimplantation surge of ovarian estrogen is critical for blastocyst activation and uterine receptivity, and its absence or insufficiency can maintain the blastocyst in a dormant state (Zhang et al., 2021).

During delayed implantation, the blastocyst exhibits reduced metabolic activity and fails to initiate uterine attachment until it receives appropriate hormonal signals (Alabiad et al., 2024; Hiraoka et al., 2025). This dormancy can last from several days to weeks, after which the blastocyst is reactivated, leading to resumed growth and implantation. Thus, in albino rats, embryos conceived during postpartum estrus might remain in a state of delayed implantation, explaining the observation of a delayed or second pregnancy.

4.Lactational delay

The process of lactation and suckling induces a neuroendocrine response that temporarily inhibits uterine receptivity and embryo implantation, resulting in a state of embryo dormancy or diapause. This phenomenon, known as lactational delay, is a form of facultative delayed implantation widely documented in rodents. It involves hormonal regulation primarily through sustained progesterone secretion, which maintains pregnancy, and the suppression of ovarian estrogen surges necessary for blastocyst activation and uterine readiness (Lee et al., 2011; Yomogita et al., 2022). This adaptive reproductive strategy allows rodents, including albino rats, to optimize reproductive success by spacing pregnancies according to physiological and environmental constraints.

Prolactin secretion, stimulated by suckling, acts centrally on the hypothalamic-pituitary-gonadal (HPG) axis to suppress the preimplantation estrogen surge critical for blastocyst activation and subsequent implantation. This hormonal regulation postpones implantation until maternal conditions, such as weaning and adequate energy reserves, are suitable for supporting pregnancy (UW medicine, 2023).

5. Subsequent implantation

When suckling intensity decreases or the first litter is stopped, the inhibitory neuroendocrine signals disappear, permitting blastocysts to transition from a metabolically dormant state to an active state capable of implantation in the uterine lining, thereby initiating a subsequent pregnancy. This process ensures optimal maternal resource allocation and successful establishment of pregnancy under physiologically favorable conditions (Fang et al., 2021).

6. Superfetation and or sequential ovulation

In some mammals can perceive a second fetus while already pregnant, this refers to the rare occurrence in which a female considers a second fetus while already pregnant. Although this phenomenon can explain overlapping pregnancies, it necessitates fertilization by sperm and is distinct from delayed implantation. Superfetation requires a permissive hormonal and physiological environment that allows ovulation and fertilization during an ongoing gestation (Pinto-Pinho P, et al., 2023) 

To investigate these mechanisms, careful monitoring of mating behavior during the postpartum fertile period, controlled litter separation to modulate suckling stimuli, and comparative analysis of gestation length relative to established delays in implantation are essential. Furthermore, hormonal assays measuring progesterone, estrogen, and prolactin, combined with molecular markers of blastocyst activation, can provide robust evidence supporting delayed implantation as the underlying process for observed secondary pregnancies without apparent new mating events (He, et al., 2019). Another potential mechanism involves the retention of viable sperm within the female reproductive tract from prior mating events, allowing fertilization of a new cohort of ova at a later stage. This hypothesis warrants further investigation for anatomical or physiological peculiarities that may enable extended sperm viability (Ahmadkhani et al., 2022).

7. Sperm retention and storage

Sperm viability, explore the less-documented possibility of long-term sperm retention in the female's reproductive tract, considering what research would be needed to test this hypothesis including:  precise timing of male isolation relative to copulation.

Long-term sperm storage, least likely explanation, within the female reproductive tract is not characteristic of rat physiology, where sperm viability typically persists for only several hours to a few days post-copulation. Unlike some vertebrate species, such as certain reptiles and bats, that possess specialized anatomical adaptations enabling extended sperm preservation, rats lack such mechanisms (Levine et al., 2021). In meantime, long-term sperm storage in the female tract is not characteristic of rat physiology, but it remains a theoretical possibility.

Recent advances in assisted reproductive technologies demonstrate improved in vitro sperm storage capabilities; however, these do not reflect natural physiological processes (Yamaga et al., 2024). Nevertheless, the possibility of passing sperm retention or rare exceptions in rodents cannot be entirely dismissed and warrants further investigation (Miller, 2024). Detailed studies utilizing histological examinations and molecular markers are essential to elucidate whether any cryptic anatomical or physiological phenomena could facilitate prolonged sperm viability in the rat female tract. This line of inquiry may reveal novel reproductive adaptations or anomalies influencing fertility outcomes.

Figure 1: Comparison of reproductive pathways in albino rats, highlighting standard and alternative mechanisms including pseudopregnancy, sperm storage, superfetation, and parthenogenesis. The figure illustrates the physiological adaptability of albino rats to diverse environmental conditions through multiple reproductive strategies.

Future prospective:

This phenomenon can open idea on different levels:

1. Genetics

A. Genetic Diversity

Currently, sexual reproduction promotes genetic diversity through the combination of parental DNA. True parthenogenesis would challenge this paradigm, as offspring would be genetically identical to the mother. This could lead to a reevaluation of the importance of genetic diversity in mammalian populations and the mechanisms that drive evolution.

B. Genetic Engineering and Cloning

The ability of a single female to generate viable offspring has the potential to advance biotechnological applications significantly. This capability could lead to the development of techniques for cloning or producing genetically modified organisms without the requirement for male gametes. Such advancements would streamline research in genetics and developmental biology by simplifying reproduction-related methodologies.

C. Epigenetics

Mammalian embryo development is governed by complex epigenetic regulation involving DNA methylation, histone modifications, and chromatin remodeling. A parthenogenetic embryo offers a unique model to study how epigenetic factors influence development in the absence of paternal genetic contributions. Investigating epigenetic imprinting in such embryos can provide valuable insights that may reshape our understanding of heredity, gene expression regulation, and developmental processes.

2. Embryonic Development

A. Developmental Pathways

True parthenogenesis could unveil new pathways in mammalian embryonic development. The mechanisms by which an egg can develop independently may reveal alternative developmental routes that are not observed in sexually reproducing mammals.

B. Stem Cell Research

Parthenogenetic embryos could serve as a source of pluripotent stem cells, offering a unique avenue for regenerative medicine. If these cells retain the ability to differentiate into various cell types, they could be used for therapeutic purposes without ethical concerns related to embryo destruction. Parthenogenetic embryos have garnered significant interest as a valuable source of pluripotent stem cells. These cells possess the capacity to differentiate into a wide range of specialized cell types, making them particularly promising for regenerative medicine applications. Importantly, stem cells derived from parthenogenetic embryos offer unique ethical advantages, as their derivation does not involve the destruction of viable embryos, thereby bypassing many ethical concerns associated with embryonic stem cell research.

3. Evolutionary Biology

A. Evolutionary Strategies

The occurrence of true parthenogenesis in mammals would prompt a profound reassessment of established evolutionary strategies. Sexual reproduction is traditionally favored due to its ability to generate genetic diversity, which enhances adaptability and resilience in changing environments. However, the emergence of asexual reproductive modes, such as parthenogenesis, challenges this paradigm by allowing for reproduction without males, resulting in offspring genetically identical to the mother. From an evolutionary perspective, parthenogenesis may confer selective advantages under specific ecological conditions, such as low population density, scarcity of mates, or stable environments where rapid population expansion is beneficial. This reproductive strategy enables a lineage to proliferate quickly without the genetic cost or risk associated with sexual reproduction, such as the production of less fit male offspring or the need to find a mate.

Nevertheless, evolutionary trade-offs exist, the lack of genetic recombination in parthenogenetic reproduction can reduce genetic variation, potentially limiting long-term adaptability and increasing vulnerability to environmental changes or diseases. This balance between the benefits of rapid reproduction and the risks of reduced genetic diversity raises critical questions regarding the ecological contexts and evolutionary pressures that could allow mammalian parthenogenesis to evolve and persist. Understanding these dynamics in albino rats or other model organisms can provide insights into the plasticity of reproductive modes and the complex interplay between genetics, environment, and evolutionary fitness.

Recent advances in mammalian biology suggest that although natural parthenogenesis in mammals is generally considered highly unlikely due to genomic imprinting and developmental constraints, experimental evidence demonstrates that parthenogenetic development can be induced under controlled conditions, and in some cases, viable offspring have been produced (Wei et al., 2022). This indicates that while rare and constrained, the possibility of parthenogenesis in mammals should not be dismissed entirely and could have important evolutionary and biomedical implications.

B. Speciation and Adaptation

Parthenogenesis alters established concepts of speciation by introducing evolutionary pathways distinct from those observed in sexual reproduction. This mode of reproduction can drive genetic divergence by enabling populations to become reproductively isolated in the absence of genetic recombination. By allowing organisms to reproduce independently of males, parthenogenesis facilitates rapid population growth and colonization in specific environmental contexts where sexual reproduction may be less efficient or hindered.

Furthermore, parthenogenetic lineages may adapt to their environments differently, often by maintaining advantageous gene combinations that support niche specialization. While parthenogenesis limits genetic diversity and can constrain adaptive potential over long timeframes, it simultaneously promotes biodiversity by fostering ecological differentiation and speciation through alternative evolutionary trajectories. Recent molecular studies suggest that, despite inherent genetic and epigenetic challenges, facultative or rare parthenogenetic events might contribute to the diversification and adaptation of mammalian species (Wei et al., 2022).

Figure 2: Future prospects of true parthenogenesis in mammals.

Conclusion

The possibility of true parthenogenesis would be highlighted as a revolutionary claim that would require irrefutable, replicated evidence before being accepted by the scientific community. Any future study must utilize highly experimental controlled conditions to eliminate confounding variables. Using video monitoring to confirm the absence of male rats or other forms of contact, as well as to precisely document all behavioral and physiological changes. Study should include both truly isolated virgin females and known pseudopregnant females as controls for comparison. A multi-pronged approach is necessary to understand the observed phenomenon for send pergenancy with male contact. Histological and hormonal evaluation could be conducted as hormonal assays and examine reproductive tissues of the affected female to confirm pregnancy and rule out pseudopregnancy or other pathologies. High-resolution genetic testing of offspring is critical to conclusively rule out paternal DNA contribution to the mother's to rule out any paternal contribution. Given the profound implications, the event must be successfully replicated in a controlled setting. The study would involve carefully designed experiments to test each of the proposed mechanisms. If a repeatable, asexually derived pregnancy is observed, it would necessitate a paradigm shift in the field of reproductive biology.

Authors conflict:

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

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Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

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Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

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Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

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Luiz Sellmann

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

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Zhao Jia

Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."

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Thomas Urban

I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.

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Cristina Berriozabal

To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.

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Dr Tewodros Kassahun Tarekegn

"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".

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Dr Shweta Tiwari

I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.

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Dr Farooq Wandroo

Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.

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Dr Anyuta Ivanova

We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.

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Dr David Vinyes

My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.

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Gertraud Teuchert-Noodt

To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina

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Dr Elvira Farina

Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.

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Dr Oleg Golyanovski

Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.

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Dr Farahnaz Fallahian

Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.

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Dr Victor Olagundoye

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD

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Dr Eric S Nussbaum

Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.

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Hala Al Shaikh

Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.

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Dr Rakhi Mishra

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.

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Dr Walter F Riesen

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.

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Dr Jelle Lettinga

Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora

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Dariusz Ziora

Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.

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Dr Ravi Shrivastava

Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.

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Dr Aline Tollet

Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.

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Dr Chiara Giuseppina Beccaluva

Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti

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Dr Claudio Ligresti

Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.

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Dr Matteo Bonori

I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.

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Edouard Kujawski

Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell

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Dr Andriy Sinelnyk

Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.

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Dr Meng-JouLe

Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed

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Mahmoud Kamal Moustafa Ahmed

Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.

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Dr Elena Salvatore

Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal

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Christoph Maurer

Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.

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Baciulescu Laura

Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.

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Dr Mamoun Magzoub