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Treff NR, Savulescu J, de Melo-Martín I, Shulman LP, Feinberg EC. Should preimplantation genetic testing for polygenic disease be offered to all - or none? Fertil Steril 2022; 117:1162-1167. [PMID: 35513906 DOI: 10.1016/j.fertnstert.2022.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
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Stewart EA, Archer DF, Owens CD, Barnhart KT, Bradley LD, Feinberg EC, Gillispie-Bell V, Imudia AN, Liu R, Kim JH, Al-Hendy A. Reduction of Heavy Menstrual Bleeding in Women Not Designated as Responders to Elagolix Plus Add Back Therapy for Uterine Fibroids. J Womens Health (Larchmt) 2022; 31:698-705. [PMID: 34582715 PMCID: PMC9133968 DOI: 10.1089/jwh.2021.0152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To assess outcomes of women with uterine fibroids (UFs) and heavy menstrual bleeding (HMB) treated with 300 mg elagolix twice daily plus add-back therapy (E2 1 mg/NETA 0.5 mg once daily) or placebo who were not considered responders in pooled analysis of two phase 3, 6-month randomized clinical trials (Elaris UF-1 and UF-2). Methods: Responders were defined as women who met both primary end point bleeding criteria (<80 mL menstrual blood loss [MBL] during the final month and ≥50% reduction in MBL from baseline to the final month) and either completed the study or discontinued due to predefined reasons. Thus, women termed nonresponders who were analyzed in this study who met neither or one bleeding end point or met both criteria but prematurely discontinued treatment because of adverse events, perceived lack of efficacy, or required surgical or interventional treatment for UFs were analyzed in this study. This post hoc analysis assessed mean changes from baseline in MBL, as well as adverse events. Results: Among 367 women receiving elagolix with add-back with observed data, 89 (24%) were not considered responders. Within this subset, 17 (19%) women met both bleeding criteria but prematurely discontinued treatment for the reasons mentioned above, while 23 (26%) met one bleeding criterion and 49 (55%) met neither bleeding criteria, regardless of discontinuation status. Among all nonresponders, a numerical trend toward greater mean reductions in MBL was observed in those receiving elagolix with add-back, compared with placebo group nonresponders. No differences in adverse events were observed between responders and nonresponders. Conclusion: Forty of 89 (45%) women with HMB and UFs who were classified as nonresponders in the UF-1 or UF-2 trials may have had a clinically meaningful response to elagolix with add-back therapy because they met at least one of the objective bleeding criteria. Clinical Trial Registration: Clinicaltrials.gov, NCT02654054 and NCT02691494. (NEJM 2020; 382:328-340) DOI: 10.1056/NEJMoa1904351.
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Feinberg EC, Kawwass JF, Penzias AS, Klipstein S, Schlegel PN, Tipton S, Racowsky C. Coronavirus disease 2019, reproductive health, and public policy: lessons learned after two years of the ongoing pandemic—the American Society for Reproductive Medicine’s Center for Policy and Leadership. Fertil Steril 2022; 117:708-712. [PMID: 35287940 PMCID: PMC8916611 DOI: 10.1016/j.fertnstert.2022.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/21/2022]
Abstract
Objective To describe the experience of the ASRM COVID-19 Task Force over the past 2 years and to discuss lessons learned during the pandemic that can be applied to future public health crises. Design Descriptive narrative. Subjects None. Intervention Creation of the ASRM COVID-19 Task Force in March 2020. Main Outcome Measures None. Results Effective pandemic management requires a joint effort on the part of physicians, scientists, government agencies, subject area experts and funders. Conclusion Reproduction is a fundamental human right that should be protected at all times. Advanced preparation for future pandemics should include appointment of a standing group of experts so that a response is both informed and immediate when a public health crisis arises. This approach will help ensure that the ultimate objective – preserving the safety and well-being of patients and health care workers – is fulfilled. The recommendations put forth in this paper from the ASRM’s Center for Policy and Leadership can be used as a template to prepare for future public health threats.
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Montoya MN, Feinberg EC. My body, whose choice? Fertil Steril 2022; 117:485-486. [PMID: 35101254 PMCID: PMC8802074 DOI: 10.1016/j.fertnstert.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
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Feinberg EC. Planting the seed of doubt: the diagnosis and management of mosaic embryos. Fertil Steril 2021; 116:1203-1204. [PMID: 34756325 DOI: 10.1016/j.fertnstert.2021.07.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
This month's Views and Reviews focuses on different aspects of the diagnosis of mosaicism. The first piece was written by Treff and Marin, who discuss the methodologic challenges of preimplantation genetic testing for aneuploidies and how the diagnosis of "mosaic" has led to a significant reduction in the accuracy of such testing. The second article by Viotti et al. provides an excellent overview of outcome data from >1,000 mosaic embryo transfers. The investigators make a strong case for three categorizations of embryos: euploid, aneuploid, and mosaic, and that use of mosaic embryos will prevent the discard of embryos that may lead to live birth. The final piece in this series was written by Besser et al., who discussed the various society recommendations for genetic counseling and prenatal diagnostic testing after mosaic embryo transfer and question whether these are truly data-driven. This collection of pieces will give the reader a deeper understanding of the controversy and management of mosaic embryo transfer.
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Bonus ML, Pothast R, Lamb JD, Feinberg EC, Bernardi LA. Planned oocyte cryopreservation in women with blepharophimosis-ptosis-epicanthus inversus syndrome: a case series. F S Rep 2021; 2:332-337. [PMID: 34553160 PMCID: PMC8441554 DOI: 10.1016/j.xfre.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023] Open
Abstract
Objective To describe the experiences of three women with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) who desired to pursue planned oocyte cryopreservation. Design Case series. Setting An academic institution and a private clinic. Patient(s) Three nulligravid women aged 23, 25, and 34 years who desired to pursue planned oocyte cryopreservation. Two women had BPES diagnosed when they were infants and one had BPES diagnosed after presenting to discuss oocyte cryopreservation. Intervention(s) All three women underwent ovarian stimulation. One woman underwent three oocyte retrievals. Main Outcomes Measure(s) Vitrification of metaphase II oocytes. Result(s) One woman had a total of eight metaphase II oocytes vitrified. In addition, she underwent genetic testing that confirmed type 1 BPES. The other two women, who had BPES diagnosed when they were newborns, each underwent two cycles of ovarian stimulation. Neither of these two women responded to ovarian stimulation and both cycles were cancelled before oocyte retrieval. Conclusion(s) BPES is a rare condition that can lead to primary ovarian insufficiency. Early identification of this condition is important to allow for timely reproductive counseling so that oocyte cryopreservation can be offered at a young age before oocyte depletion. Careful counseling is critical for these patients, because this case series demonstrated that not all women with BPES will respond to stimulation. Further, outcomes with cryopreserved oocytes have not yet been described in women with BPES.
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Okine, Pending RA, Smith DG, Bonus ML, Feinberg EC, Bernardi LA. THE TIME IS NOW: ASSESSING FERTILITY KNOWLEDGE, REPRODUCTIVE CONCERNS, AND DESIRE FOR FERTILITY EDUCATION IN UNDERGRADUATES. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kassi LA, Shah S, Lawson AK, Feinberg EC, Swanson A, Pavone ME. VACCINE HESITANCY AND MEDICAL MISTRUST IN WOMEN CONSIDERING OR UNDERGOING FERTILITY TREATMENTS. Fertil Steril 2021. [PMCID: PMC8446879 DOI: 10.1016/j.fertnstert.2021.07.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bakkensen JB, Flannagan KS, Mumford SL, Hutchinson AP, Smith K, Thomas JL, Grote VE, Omurtag K, Moreno PI, Cheung EO, Jordan N, Goldman KN, Feinberg EC. FREEZE NOW, SAVE LATER: A SART DATA COST-EFFECTIVENESS ANALYSIS OF PLANNED OOCYTE CRYOPRESERVATION CONSIDERING IDEAL FAMILY SIZE. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bonus ML, Bernardi LA, Feinberg EC. THE UNINTENDED CONSEQUENCE OF MEDICAL TRAINING: DELAYED CHILDBEARING. A SURVEY OF REPRODUCTIVE GOALS AND FERTILITY KNOWLEDGE IN MEDICAL RESIDENTS. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Feinberg EC, Cedars M, Chaudhari G, DeCherney A, Falcone T, Scott RT, Rosenwaks Z. Reproductive Endocrinology and Infertility fellowship programs: Does one size fit all? Fertil Steril 2021; 115:569-575. [PMID: 33712101 DOI: 10.1016/j.fertnstert.2021.01.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
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Feinberg EC, Rosenwaks Z. Training the next generation of reproductive endocrinology and infertility subspecialists. Fertil Steril 2021; 115:567-568. [PMID: 33712100 DOI: 10.1016/j.fertnstert.2021.01.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
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Feinberg EC, Tozour J. Time to revisit the adage: relax and you will get pregnant. Fertil Steril 2021; 116:695. [PMID: 33972084 DOI: 10.1016/j.fertnstert.2021.03.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 11/19/2022]
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Lawson AK, McQueen DB, Swanson AC, Confino R, Feinberg EC, Pavone ME. Psychological distress and postponed fertility care during the COVID-19 pandemic. J Assist Reprod Genet 2021; 38:333-341. [PMID: 33400078 PMCID: PMC7783482 DOI: 10.1007/s10815-020-02023-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/24/2020] [Indexed: 02/02/2023] Open
Abstract
Purpose To evaluate perceptions of delayed fertility care secondary to the COVID-19 pandemic. Methods This was a cross-sectional anonymous survey of N = 787/2,287 patients (response rate = 42.6%) from a single academic fertility center. Participants were randomized 1:1 to receive supplemental educational explaining the rationale behind recommendations to delay fertility treatments due to the COVID-19 pandemic. Assessment of well-being was conducted via the Personal Health Questionnaire Depression Scale, the Generalized Anxiety Disorder-7, the Ways of Coping-Revised, the Appraisal of Life Events Scale, and influence of supplemental education on agreement with ASRM COVID-19 Taskforce recommendations and associated distress. Results Participants in the education v. no education groups were 35.51 (SD = 4.06) and 37.24 (SD = 5.34) years old, married (90.8% v. 89.8%), had a graduate degree (53.9% v. 55.4%), > 1 year of infertility (73.4% v. 74.4%), and were nulliparous (69.0% v. 72.6%), with moderate to high distress (64.9% v. 64.2%) (ns). Distress was related to age, duration of infertility, and engagement in social support seeking and avoidant coping strategies (P < 0.001). Agreement with recommendations was related to receipt of supplemental education, history of pregnancy loss, and use of cognitive coping (P = 0.001). Conclusion Most participants were distressed by the delay of treatments. Supplemental education increased acceptance of recommendations but did not decrease distress. Future treatment delays should include education related to and assessment of understanding of recommendations, and inclusion of mental health professionals in patient care. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-020-02023-x.
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Ruderman RS, McQueen DB, Robins JC, Barnhart KT, Maisenbacher MK, Feinberg EC. Novel ploidy analysis in ectopic pregnancy. F S Rep 2020; 2:67-71. [PMID: 34223275 PMCID: PMC8244258 DOI: 10.1016/j.xfre.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/24/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
Objective To study whether a single-nucleotide polymorphism (SNP) array could be used to test tissue from ectopic pregnancy to distinguish whether ectopic pregnancies were aneuploid. Design Case series report. Setting Academic medical center. Patients One hundred seventy-eight women who underwent surgery for ectopic pregnancy at Northwestern Memorial Hospital between 2015 and 2018 were eligible for participation; written consent was obtained from 33 patients. Eight subjects had sufficient DNA samples and were included in the analysis. Maternal and paternal DNA samples were self-collected by buccal swab. Archived paraffin tissue containing chorionic villi from each surgically removed ectopic specimen was analyzed using SNP microarray technology to determine chromosome number and evaluate for maternal cell contamination. Interventions None. Main Outcome Measures Prevalence of aneuploidy in ectopic pregnancy specimens as well as success of SNP array technology in formalin-fixed and paraffin-embedded specimens. Results Subjects had a mean (±SD) age of 33.4 ± 5.4 years, body mass index of 23.4 ± 5.7 kg/m2, 3.3 ± 1.8 prior pregnancies, and 1.5 ± 1.4 live births. Genetic testing revealed that all eight tested samples were euploid, 6 female and 2 male (two arr(1-22)x2, (X,Y)x1 and 6 arr(1-22, X)x2); maternal cell contamination was ruled out in all cases. Conclusions This study showed proof of concept for the use of routinely stored formalin-fixed, paraffin-embedded tissue blocks with DNA extraction for SNP array to detect ploidy status of ectopic pregnancy. Although all tested samples were euploid, further research is needed to gain a definitive answer to this question and better understand the mechanism that leads to ectopic implantation.
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Smith K, Hutchinson AP, Cheung EO, Thomas JL, Moreno PI, Grote VE, Goldman KN, Jordan N, Feinberg EC. AGE AND INFERTILITY: AN OPPORTUNITY FOR IMPROVING MEDICAL EDUCATION. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hutchinson AP, Smith K, Cheung EO, Moreno PI, Jordan N, Goldman KN, Thomas JL, Grote VE, Feinberg EC. BARRIERS TO FAMILY BUILDING AND IMPACT ON CAREER TRAJECTORY FOR WOMEN IN MEDICINE. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hairston JC, Kohlmeier A, Feinberg EC. Compassionate embryo transfer: physician practices and perspectives. Fertil Steril 2020; 114:552-557. [DOI: 10.1016/j.fertnstert.2020.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 10/23/2022]
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Bernardi LA, Luck M, Kyweluk MA, Feinberg EC. Knowledge gaps in the understanding of fertility among non-medical graduate students. F S Rep 2020; 1:177-185. [PMID: 34223241 PMCID: PMC8244259 DOI: 10.1016/j.xfre.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/03/2020] [Accepted: 08/01/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To assess knowledge of female and male fertility among students enrolled in a Master of Business Administration (MBA) program. Design Web-based cross-sectional survey. Setting Academic setting. Patient(s) Not applicable. Intervention(s) None. Main Outcome Measure(s) Knowledge of how female and male age impacts reproduction, fecundability, and success rates with in vitro fertilization (IVF). Result(s) A total of 133 female and male MBA students completed the survey. Nearly 10% of participants were not aware that women are born with a fixed number of oocytes and that oocyte quantity and quality decline with age. More than 30% of participants overestimated fecundability in women aged ≥35 years, and >50% overestimated IVF success rates in women older than 40 years. Fifteen percent of participants did not know that men have stem cells in the testes, and >25% were not aware that men experience a decrease in sperm concentration and quality with age. Nearly 30% believed that a man’s age never impacts reproductive outcomes. Less than 30% of participants correctly estimated fecundability and IVF success rates based on male age. Conclusion(s) These data highlight important knowledge gaps in a highly educated group of MBA students, most whom desire future childbearing. Specifically, there is a lack of understanding of both male and female reproductive aging and an overestimation of treatment success. As delayed childbearing continues, particularly among those with high educational attainment, attention should be focused on introducing broad fertility education at a younger age to improve future reproductive success.
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Ruderman R, Feinberg EC. Time for sperm eg(g)alitarianism? Fertil Steril 2020; 114:292. [PMID: 32741471 DOI: 10.1016/j.fertnstert.2020.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 10/23/2022]
Abstract
The demand for certainty is one which is natural to man, but is nevertheless an intellectual vice -Bertrand Russell.
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Zhou X, McQueen DB, Schufreider A, Lee SM, Uhler ML, Feinberg EC. Black recipients of oocyte donation experience lower live birth rates compared with White recipients. Reprod Biomed Online 2020; 40:668-673. [DOI: 10.1016/j.rbmo.2020.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 11/17/2022]
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Segars J, Katler Q, McQueen DB, Kotlyar A, Glenn T, Knight Z, Feinberg EC, Taylor HS, Toner JP, Kawwass JF. Prior and novel coronaviruses, Coronavirus Disease 2019 (COVID-19), and human reproduction: what is known? Fertil Steril 2020; 113:1140-1149. [PMID: 32482250 PMCID: PMC7161522 DOI: 10.1016/j.fertnstert.2020.04.025] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To summarize current understanding of the effects of novel and prior coronaviruses on human reproduction, specifically male and female gametes, and in pregnancy. DESIGN Review of English publications in PubMed and Embase to April 6, 2020. METHOD(S) Articles were screened for reports including coronavirus, reproduction, pathophysiology, and pregnancy. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Reproductive outcomes, effects on gametes, pregnancy outcomes, and neonatal complications. RESULT(S) Seventy-nine reports formed the basis of the review. Coronavirus binding to cells involves the S1 domain of the spike protein to receptors present in reproductive tissues, including angiotensin-converting enzyme-2 (ACE2), CD26, Ezrin, and cyclophilins. Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) may cause severe orchitis leading to germ cell destruction in males. Reports indicate decreased sperm concentration and motility for 72-90 days following Coronavirus Disease 2019 (COVID-19) infection. Gonadotropin-dependent expression of ACE2 was found in human ovaries, but it is unclear whether SARS-Coronavirus 2 (CoV-2) adversely affects female gametogenesis. Evidence suggests that COVID-19 infection has a lower maternal case fatality rate than SARS or Middle East respiratory syndrome (MERS), but anecdotal reports suggest that infected, asymptomatic women may develop respiratory symptoms postpartum. Coronavirus Disease 2019 infections in pregnancy are associated with preterm delivery. Postpartum neonatal transmission from mother to child has been reported. CONCLUSION(S) Coronavirus Disease 2019 infection may affect adversely some pregnant women and their offspring. Additional studies are needed to assess effects of SARS-CoV-2 infection on male and female fertility.
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MESH Headings
- Betacoronavirus/pathogenicity
- COVID-19
- Coronavirus Infections/complications
- Coronavirus Infections/diagnosis
- Coronavirus Infections/virology
- Female
- Fertility
- Host-Pathogen Interactions
- Humans
- Infertility, Female/diagnosis
- Infertility, Female/physiopathology
- Infertility, Female/virology
- Infertility, Male/diagnosis
- Infertility, Male/physiopathology
- Infertility, Male/virology
- Male
- Orchitis/diagnosis
- Orchitis/physiopathology
- Orchitis/virology
- Pandemics
- Pneumonia, Viral/complications
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/virology
- Pregnancy
- Pregnancy Complications, Infectious/physiopathology
- Pregnancy Complications, Infectious/virology
- Pregnancy Outcome
- Reproduction
- Risk Assessment
- Risk Factors
- SARS-CoV-2
- Sperm Count
- Sperm Motility
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Layman LC, Feinberg EC, Hurst BS, Morin SJ, Morris JL, Pisarska MD, Smith YR, Price TM. Academic pursuits in board-certified reproductive endocrinologists. Fertil Steril 2020; 113:653-660.e1. [DOI: 10.1016/j.fertnstert.2019.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/29/2019] [Accepted: 10/31/2019] [Indexed: 11/17/2022]
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Archer DF, Ng J, Chwalisz K, Chiu YL, Feinberg EC, Miller CE, Feldman RA, Klein CE. Elagolix Suppresses Ovulation in a Dose-Dependent Manner: Results From a 3-Month, Randomized Study in Ovulatory Women. J Clin Endocrinol Metab 2020; 105:5606934. [PMID: 31650182 DOI: 10.1210/clinem/dgz086] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 10/03/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Elagolix is an oral gonadotropin-releasing hormone (GnRH) antagonist recently approved for the treatment of endometriosis-associated pain and being developed for heavy menstrual bleeding associated with uterine fibroids. OBJECTIVE The objective was to evaluate the effects of elagolix on ovulation and ovarian sex hormones. DESIGN AND SETTING This was a randomized, open-label, multicenter study. PARTICIPANTS Participants were healthy ovulatory women aged 18 to 40 years. INTERVENTIONS Elagolix was administered orally for 3 continuous 28-day dosing intervals at 100 to 200 mg once daily (QD), 100 to 300 mg twice daily (BID), and 300 mg BID plus estradiol/norethindrone acetate (E2/NETA) 1/0.5 mg QD. MAIN OUTCOME MEASURES The main outcomes measures were ovulation rates measured by transvaginal ultrasound, progesterone concentrations, and hormone suppression. RESULTS Elagolix suppressed ovulation in a dose-dependent manner. The percentage of women who ovulated was highest at 100 mg QD (78%), intermediate at 150 and 200 mg QD and 100 mg BID (47%-57%), and lowest at 200 and 300 mg BID (32% and 27%, respectively). Addition of E2/NETA to elagolix 300 mg BID further suppressed the ovulation rate to 10%. Elagolix also suppressed luteinizing hormone and follicle stimulating hormone in a dose-dependent manner, leading to dose-dependent suppression of estradiol and progesterone. Elagolix had no effect on serum biomarker of ovarian reserve, and reduced endometrial thickness compared to the screening cycle. CONCLUSION Women being treated with elagolix may ovulate and should use effective methods of contraception. The rate of ovulation was lowest with elagolix 300 mg BID plus E2/NETA 1/0.5 mg QD.
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Babayev E, Feinberg EC. Embryo through the lens: from time-lapse cinematography to artificial intelligence. Fertil Steril 2020; 113:342-343. [PMID: 32106987 DOI: 10.1016/j.fertnstert.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 11/28/2022]
Abstract
"Once a new technology rolls over you, if you're not part of the steamroller, you're part of the road." -Stewart Brand.
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