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Zhang C, Yao N, Lu Y, Ni J, Liu X, Zhou J, Wang W, Zhang T, He Y, Huang J, Sun K, Sun Y. Ambient air pollution on fecundity and live birth in women undergoing assisted reproductive technology in the Yangtze River Delta of China. Environ Int 2022; 162:107181. [PMID: 35303533 DOI: 10.1016/j.envint.2022.107181] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ambient air pollution has adverse effects on the reproductive system. However, inconsistent conclusions were reached from different studies with regard to air pollutants and pregnancy outcomes, especially the livebirth rate in assisted reproductive technology (ART) in different windows of exposure. METHODS A retrospective cohort study was conducted on 12,665 women who underwent first fresh or frozen embryo transfer cycle in the Yangtze River Delta of China. Daily average levels of six air pollutants in four different periods were obtained: Period 1 and 2: 90 days or one year prior to oocyte retrieval; Period 3 and 4: the day of oocyte retrieval or one year prior to oocyte retrieval to the day of serum hCG test or to the end of the pregnancy. A multiple logistic regression model was used to investigate the association between air pollutant exposure and pregnancy outcomes. Stratified analyses were conducted to explore potential modifier effects. RESULTS The one year exposure window (Period 2) before oocyte retrieval had a more evident negative association with pregnancy outcomes. Each IQR increase in ambient PM10 (OR: 0.89, 95% CI: 0.84-0.93), PM2.5 (OR: 0.82, 95% CI: 0.77-0.87), SO2 (OR: 0.87, 95% CI: 0.83-0.91) and CO (OR: 0.91, 95% CI: 0.87-0.96) was associated with a respective 11%, 18%, 13% and 9% decrease in the likelihood of live birth. In entire exposure window of Period 4, all air pollutants except for O3 were associated with a decreased likelihood of live birth. Stratified analyses showed that women undergoing frozen embryo transfer cycles, especially those with two embryos transferred, were more vulnerable to air pollutant exposure. CONCLUSION This study indicates a negative association between air pollutant exposure before oocyte retrieval and livebirth rate in ART. The adverse impact was more evident in one year exposure compared to three-month refresh cycle of the gametes. Additional protection from air pollution should be undertaken at least one year before ART, particularly for those with frozen embryo transfer cycles.
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Affiliation(s)
- Chuyue Zhang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Ning Yao
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Yao Lu
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Jingyi Ni
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Xiaohui Liu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Ji Zhou
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai, PR China; Shanghai Typhoon Institute, CMA, Shanghai, PR China
| | - Wangsheng Wang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Ting Zhang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Yaqiong He
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Jiaan Huang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Kang Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China.
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202
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Zhang Q, Xu Y, Gong Y, Liu X. The impact of assisted reproductive technology in twin pregnancies complicated by intrahepatic cholestasis: a five-year retrospective study. BMC Pregnancy Childbirth 2022; 22:269. [PMID: 35361142 PMCID: PMC8969330 DOI: 10.1186/s12884-022-04610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Intrahepatic cholestasis of pregnancy is one of the common complications during pregnancy, and ursodeoxycholic acid has been recommended as the first-line drug. However, if the assisted reproductive technology may increase adverse perinatal outcomes of twin pregnancies complicated by intrahepatic cholestasis is disputed, we aimed to investigate perinatal outcomes between twin pregnancies by assisted reproductive technology versus spontaneous conception, based on these women accepted ursodeoxycholic acid treatment. Methods From January 2014 to January 2019, we retrospectively analysed the clinical data of twin pregnant women with intrahepatic cholestasis, excluding those who did not receive ursodeoxycholic acid treatment. In total, 864 women were included, among whom 500 conceived by assisted reproductive technology and 364 conceived by spontaneous conception. The primary assessment for perinatal outcomes included premature birth, meconium-stained amniotic fluid, low Apgar score, neonatal intensive care unit and still birth, and secondary indicators were serum bile acid and liver enzymes level during medication, so we also finished subgroup analysis based on different elevated bile acid level and drug usage. The statistical analysis was performed by SPSS 22.0. Results The study demonstrated that compared to spontaneous conception, assisted reproductive technology conceived twin pregnancies diagnosed as intrahepatic cholestasis earlier (p = 0.003), and lower birth weight (p = 0.001), less incidence of preterm delivery (p = 0.000) and neonatal intensive care unit admission (p = 0.001), but the rate of meconium-stained amniotic fluid, low Apgar score and still birth have no statistic differences. Moreover, the subgroup analysis showed no significant difference in elevated bile acid levels and medication between assisted reproductive technology and spontaneous conception groups. Conclusions The assisted reproductive technology may increase the risk of early-onset intrahepatic cholestasis in twin pregnancies, but it does not seem to increase adverse effects on bile acid levels and perinatal outcomes. Regardless of ursodeoxycholic acid used alone or combination, the effect of bile acid reduction and improving perinatal outcomes in twin pregnancies is limited. Our conclusions still need more prospective randomized controlled studies to confirm.
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Affiliation(s)
- Qianwen Zhang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Yu Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Yunhui Gong
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
| | - Xinghui Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
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203
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De Proost M, Coene G, Nekkebroeck J, Provoost V. 'I feel that injustice is being done to me': a qualitative study of women's viewpoints on the (lack of) reimbursement for social egg freezing. BMC Med Ethics 2022; 23:35. [PMID: 35351108 PMCID: PMC8966350 DOI: 10.1186/s12910-022-00774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background During the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator that there are almost no funding arrangements or reimbursement policies. This is the first qualitative study that specifically explores viewpoints on the (lack of) reimbursement for women who had considered to uptake at least one social egg freezing cycle in Belgium. Methods To understand the moral considerations of these women, drawing from twenty-one interviews, this paper integrates elements of a symbiotic empirical ethics approach and thematic analysis. Results We identify four themes: (1) being confronted with unclear information; (2) financial costs as ongoing concern; (3) necessity of coverage; (4) extent of reimbursement. In the first theme, we found that some women were concerned about the lack of clear information about the cost of social egg freezing. In the second theme, we report moral sentiments of injustice and discrimination which some women attributed to their struggles and needs not being recognised. The third theme illustrates diverse views on reimbursement, ranging from viewing social egg freezing as an elective treatment not appropriate for reimbursement to preferences for greater public responsibility and wider access. Finally, we describe the participants’ varying proposals for partial reimbursement and the idea that it should not be made available for free. Conclusions This research adds important empirical insights to the bioethics debate on social egg freezing, in particular by presenting (potential) users’ views on the lack of reimbursement. While there is much more to say about the ethical and political complexities of the reimbursement of this procedure, our study highlighted the voices of (potential) users and showed that at least some of them would welcome the coverage of SEF through the public healthcare insurance. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00774-z.
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Affiliation(s)
- Michiel De Proost
- RHEA (Research Centre Gender, Diversity and Intersectionality), Vrije Universiteit Brussel, Brussels, Belgium.
| | - Gily Coene
- RHEA (Research Centre Gender, Diversity and Intersectionality), Vrije Universiteit Brussel, Brussels, Belgium
| | - Julie Nekkebroeck
- Centre for Reproductive Medicine and Centre for Medical Genetics, UZ Brussel, Brussels, Belgium
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Di Nisio V, Antonouli S, Damdimopoulou P, Salumets A, Cecconi S. In vivo and in vitro postovulatory aging: when time works against oocyte quality? J Assist Reprod Genet 2022; 39:905-918. [PMID: 35312936 PMCID: PMC9050976 DOI: 10.1007/s10815-022-02418-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/27/2022] [Indexed: 12/26/2022] Open
Abstract
In mammalian species an optimal fertilization window during which successful fertilization occurs. In the majority of mammals estrus marks ovulation time and coincident with mating, thereby allowing the synchronized meeting in the fallopian tubes, between freshly ejaculated sperm and freshly ovulated oocytes. Conversely, women do not show natural visual signs of ovulation such that fertilization can occur hours later involving an aged oocyte and freshly ejaculated spermatozoa. During this time, the oocyte undergoes a rapid degradation known as “postovulatory aging” (POA). POA may become particularly important in the human-assisted reproductive technologies, as the fertilization of retrieved mature oocytes can be delayed due to increased laboratory workload or because of unforeseeable circumstances, like the delayed availability of semen samples. This paper is an updated review of the consequences of POA, either in vivo or in vitro, on oocyte quality with particular attention to modifications caused by POA on oocyte nuclear, cytoplasmic, genomic, and epigenetic maturation, and embryo development.
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Affiliation(s)
- Valentina Di Nisio
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, 14186, Huddinge, Stockholm, Sweden.
| | - Sevastiani Antonouli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, 14186, Huddinge, Stockholm, Sweden
| | - Andres Salumets
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, 14186, Huddinge, Stockholm, Sweden.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 50406, Tartu, Estonia.,Competence Centre On Health Technologies, 50411, Tartu, Estonia
| | - Sandra Cecconi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy.
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205
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Han EJ, Lyu SW, Kwak IP, Kwon H, Choi DH, Kim JY, Park HM, Kim JW, Chang EM, Lee HJ, Kim MK, Lee HN, Kim JY, Park SL, Lee WS. Efficacy and safety of newly developed ganirelix acetate in infertile women for assisted reproductive technology: a prospective, randomised, controlled study. J OBSTET GYNAECOL 2022; 42:2197-2202. [PMID: 35254199 DOI: 10.1080/01443615.2022.2036955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to investigate the efficacy of Ganilever pre-filled syringe (PFS), a newly developed ganirelix acetate, for the inhibition of premature luteinising hormone (LH) surge in in vitro fertilisation (IVF). A prospective randomised controlled study was conducted (NCT03051087). A total of 236 women (Ganilever group: 114, Orgalutran group: 122) were finally analysed. The patients with LH of >10 mIU/mL on the day of human chorionic gonadotropin (hCG) injection were 0 (0.0%) and 3 (2.5%) in the Ganilever and Orgalutran groups, respectively (p= .25). The number of retrieved oocytes from two groups did not show any significant difference (12.0 ± 6.4 vs. 11.8 ± 6.3, p= .73). Furthermore, the two groups did not show significant differences in the number of good-quality oocytes and embryo, and the rate of fertilisation. Similar safety profiles were also observed. In conclusion, Ganilever PFS showed comparable IVF outcomes and safety profile in IVF, as compared to the Orgalutran. Impact StatementWhat is already known on this subject? Premature LH surge during controlled ovarian stimulation results in the induction of luteinisation of the immature follicles. Thus, gonadotrophin-releasing hormone (GnRH) antagonist protocol was suggested as an option for suppression of premature LH surge. Currently, one of GnRH antagonists being widely used is ganirelix acetate (Orgalutran®; Organon, Oss, The Netherlands). Ganilever pre-filled syringe (PFS) is a newly developed GnRH antagonist containing ganirelix acetate as an active ingredient.What do the results of this study add? Our study demonstrated that Ganilever PFS showed comparable IVF outcomes and patient safety profile in infertile women undergoing in IVF-ET, as compared to the Orgalutran.What are the implications of these findings for clinical practice and/or further research? The results of our study will provide another available GnRH antagonist to be used in patients with IVF.
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Affiliation(s)
- E Jung Han
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Sang Woo Lyu
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - In Pyung Kwak
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Hwang Kwon
- Department of Obstetrics and Gynecology, Fertility Center of CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Dong Hee Choi
- Department of Obstetrics and Gynecology, Fertility Center of CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jin Young Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Han Moie Park
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Ji Won Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Eun Mi Chang
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Hee Jun Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Min Kyung Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Hye Nam Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Jeong Yun Kim
- Clinical Development Department, LG Chem Ltd., Seoul, South Korea
| | - So La Park
- Clinical Development Department, LG Chem Ltd., Seoul, South Korea
| | - Woo Sik Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
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Russell C. Which lives matter in reproductive biomedicine? Reprod Biomed Soc Online 2022; 14:28-31. [PMID: 34703917 PMCID: PMC8526890 DOI: 10.1016/j.rbms.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 04/05/2021] [Accepted: 04/26/2021] [Indexed: 06/13/2023]
Abstract
The most recent Black Lives Matter moment provides an important opportunity for consideration of the interlocking social and political systems that contribute to ongoing racism and racial inequality. What does this mean in the context of reproductive biomedicine? Which lives do reproductive biomedicine devalue and how? In this commentary, I address why reproductive biomedicine is an important site for reflection on race, and how the Reproductive Justice Movement calls on us to shift our thinking. I argue for the need to recognize the deep connections between reproductive biomedicine and eugenics, and then offer some examples of racialization in reproductive biomedicine through assisted reproductive technology. Finally, I consider what steps practitioners might take to be part of the change for which this Black Lives Matter moment calls.
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207
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Moll T, Gerrits T, Hammarberg K, Manderson L, Whittaker A. Reproductive travel to, from and within sub-Saharan Africa: A scoping review. Reprod Biomed Soc Online 2022; 14:271-288. [PMID: 35419496 PMCID: PMC8907603 DOI: 10.1016/j.rbms.2021.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Scholarly interest in reproductive travel has increased in recent years, but travel within, to and from the African continent has received much less attention. We reviewed the literature on cross-border reproductive travel to and from countries of sub-Saharan Africa in order to understand the local forms of this trade. Access to fertility care remains deeply stratified, which is an ongoing concern in a region with some of the highest rates of infertility. We found a wide variety of reasons for reproductive travel, including a lack of trusted local clinics. Destinations were chosen for reasons including historical movements for medical treatment broadly, diasporic circulations, pragmatic language reasons, and ties of former colonial relations. We describe the unique tempos of treatment in the region, ranging from some intended parents staying in receiving countries for some years to the short-term contingent support networks that reprotravellers develop during their treatment and travel. Unique to the region is the movement of medical professionals, such as the 'fly-in, fly-out' clinic staff to deliver fertility care. Future research should include practices and movements to presently neglected 'reprohubs', particularly Kenya and Nigeria; the impact of pandemic-related lockdowns and border closures on the movements of intended parents, reproductive assistors and reproductive material; and the impact of low-cost protocols on treatment access within the region. This scoping review provides insight into the relevant work on cross-border reproductive care in sub-Saharan Africa, where a unique combination of access factors, affordability, and sociocultural and geopolitical issues fashion individuals' and couples' cross-border reproductive travel within, to and from Africa.
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Affiliation(s)
- Tessa Moll
- School of Public Health, University of the Witwatersrand, Parktown, South Africa
| | - Trudie Gerrits
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Karin Hammarberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Victorian Assisted Reproductive Treatment Authority, Melbourne, VIC, Australia
| | - Lenore Manderson
- School of Public Health, University of the Witwatersrand, Parktown, South Africa
- School of Social Sciences, Faculty of Arts, Monash University, Clayton, Melbourne, VIC, Australia
| | - Andrea Whittaker
- School of Social Sciences, Faculty of Arts, Monash University, Clayton, Melbourne, VIC, Australia
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Roshong A, Pier B. A Comparison of Prostaglandin Profile in Human Follicular Fluid Between White and Black/Hispanic Women. Reprod Sci 2022; 29:2039-2042. [PMID: 35233737 DOI: 10.1007/s43032-022-00893-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
Abstract
The aim of the study is to compare prostaglandin (PG) profiles in human follicular fluid between White and Black/Hispanic women using data from a previously published study. A retrospective cohort study of 5 White and 5 Black/Hispanic women who underwent oocyte retrieval was conducted. Human follicular fluid was obtained from the first follicle entered at time of oocyte retrieval for patients undergoing in vitro fertilization cycles (IVF). PG levels were compared using mass spectroscopy with known standards to quantify PG levels. Five White women were matched with 5 Black/Hispanic women with diagnosis. Both cohorts had similar levels of age, body mass index, and IVF cycle characteristics. There were no statistical differences in PG profiles (PGE2, PGF1α, PGF2α, or 8 iso-PGF1α). In this small repeat analysis of previously studied data, there were no differences noted in PG profiles in follicular fluid. Larger studies are needed to verify this finding. This study further demonstrates the lack of representation of minority patients in studies.
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Affiliation(s)
- Anne Roshong
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Bruce Pier
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA.
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209
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Karavani G, Chill HH, Dick A, Bergman M, Imbar T, Grisaru-Granovsky S, Ben-Meir A. Obstetric outcomes of young women following in-vitro fertilization: a case-control study. BMC Pregnancy Childbirth 2022; 22:164. [PMID: 35227248 PMCID: PMC8887143 DOI: 10.1186/s12884-022-04502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background Women undergoing in-vitro fertilization (IVF) treatments are at increased risk for maternal and neonatal complications compared to women who conceive spontaneously. Though spontaneous pregnancies of young women and adolescents have an increased risk for adverse maternal and neonatal outcomes, pregnancy outcomes of this age group, following IVF treatment have been scarcely reported. The aim of this study was to report maternal and neonatal outcomes of young women who conceived following IVF compared to women in the same age group with spontaneous conception. Methods We performed a multicenter case–control study. The study group included women aged 17–25 years who conceived by IVF with an ongoing singleton pregnancy. For the purpose of the study, a control group matched (1:2 ratio) for maternal age at delivery and parity was constructed. Demographic, medical history, pregnancy related characteristics and maternal and neonatal outcomes were compared between groups. Finally, factors associated with spontaneous vaginal delivery were assessed for the entire cohort using a univariate and multivariate logistic regression model. Results Between 2005 and 2021, we identified 80 women aged 19–25 years who conceived by IVF. A control group of 160 women was matched to the study group by age and parity. The unmatched maternal characteristics and pregnancy associated complications were similar among the groups. However, the IVF group had a significantly higher rate of induction of labor (48.1% vs. 26.6%, p = 0.001), meconium-stained amniotic fluid (27.6% vs. 14.1%, p = 0.025), prolonged second stage of labor (26.0% vs. 7.3%, p = 0.001) and operative vaginal delivery (22.5% vs.12.5%, p = 0.048). Neonatal outcomes were for the most part comparable; nevertheless, we found a higher rate of neonates with an umbilical artery pH < 7.1 in the IVF group (9.8% vs. 0.0%, respectively; p = 0.022). A logistic regression analysis for spontaneous vaginal delivery (vs. cesarean or operative vaginal deliveries) found that spontaneous onset of labor (vs. induction of labor) (OR = 2.08; 95% CI = 1.07–4.05, p = 0.03) was positively associated with spontaneous vaginal delivery while prolonged second stage of labor (OR = 0.35; 95% CI = 0.13–0.95, p = 0.04) was negatively associated with this parameter. Conclusion Young women who conceive by in-vitro fertilization are expected to reach favorable pregnancy outcomes, comparable to women who conceived spontaneously.
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Affiliation(s)
- Gilad Karavani
- Infertility and IVF Unit, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. .,Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Henry H Chill
- Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, Skokie, IL, USA
| | - Aharon Dick
- Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Marva Bergman
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Imbar
- Infertility and IVF Unit, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sorina Grisaru-Granovsky
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Assaf Ben-Meir
- Infertility and IVF Unit, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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210
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Henshaw CA, Goreish MH, Gornet ME, Cross CI. The Impact of Uterine Fibroids on Fertility: How the Uncertainty Widens the Gap in Reproductive Outcomes in Black Women. Reprod Sci 2022. [PMID: 35211882 DOI: 10.1007/s43032-022-00882-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/08/2022] [Indexed: 10/19/2022]
Abstract
Uterine fibroids (UFs) are the most common pelvic tumor in women. While the decreased quality of life and significant morbidity has been implicated with UFs, several important questions regarding the effect of UFs on reproductive outcomes remain unanswered. Furthermore, there is a disproportionate impact of UFs in Black women, in whom these tumors are known to be more common and more severe. The racial difference in UF burden is heightened during prime reproductive years, during which Black women undergo surgical intervention at an astoundingly increased rate compared to other races. Despite this, Black women are underrepresented in UF and treatment outcome research, and thus the uncertainty of the impact of UFs and UF treatment on fertility and pregnancy outcomes in this population is less defined. The purpose of this review article is to discuss recent findings in the literature regarding the impact of uterine UFs on reproductive outcomes with a primary focus on the implications for Black women. Additionally, we briefly discuss the importance of increased UF research funding and investigation and propose actionable items to help increase the representation of Black women in UF research.
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Kheil MH, Sharara FI, Ayoubi JM, Rahman S, Moawad G. Endometrioma and assisted reproductive technology: a review. J Assist Reprod Genet 2022; 39:283-290. [PMID: 35072837 PMCID: PMC8956763 DOI: 10.1007/s10815-022-02403-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/13/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Endometriomas are a common cause of infertility necessitating assisted reproductive technology (ART). It had been previously thought that surgical removal of the endometriomas prior to ART would improve reproductive outcomes, but recent data suggests that surgical cystectomy might affect the ovarian reserve, decreasing the chances of ART success. The aim of this article is to review the literature on the effects of endometrioma surgery on ART outcomes providing an overview of the current evidence and assessing the need for further studies. METHODS A literature search was performed using PubMed and MEDLINE databases to identify studies that discuss endometriomas and assisted reproductive technology before versus after surgery. RESULTS In women with an endometrioma requiring ART, growing evidence suggests that surgery might result in damage to the ovarian reserve and further decrease chances of fertility. However, pregnancy rates, implantation rates, fertilization rates, and live birth rates seemed to be consistently similar across both groups. CONCLUSION The current evidence is inconclusive on whether endometriomas should be surgically removed prior to ART. Further large randomized controlled trials are needed for a definite answer, and until then, management should be individualized.
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Affiliation(s)
- Mira H. Kheil
- grid.254444.70000 0001 1456 7807Department of Pathology, Wayne State University, Detroit, MI USA
| | - Fady I. Sharara
- grid.490589.90000 0004 0466 0970Virginia Center for Reproductive Medicine, Reston, VA USA ,grid.411841.90000 0004 0614 171XDepartment of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC USA
| | - Jean Marc Ayoubi
- grid.414106.60000 0000 8642 9959Department of Obstetrics and Gynecology, Foch Hospital, Suresnes, Faculty of Medicine, Paris Quest (UVSQ), Suresnes, France
| | - Sara Rahman
- grid.411841.90000 0004 0614 171XDepartment of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC USA
| | - Gaby Moawad
- grid.411841.90000 0004 0614 171XDepartment of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC USA
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Wrande T, Kristjansdottir BH, Tsiartas P, Hadziosmanovic N, Rodriguez-Wallberg KA. Live birth, cumulative live birth and perinatal outcome following assisted reproductive treatments using donor sperm in single women vs. women in lesbian couples: a prospective controlled cohort study. J Assist Reprod Genet 2022. [PMID: 35106694 DOI: 10.1007/s10815-022-02402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/13/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose Assisted reproductive technology (ART) treatments with donor sperm have been allowed for women in lesbian relationships (WLR) since 2005 in Sweden, but for single women (SW), these became approved only recently in 2016. This study was conducted to compare the outcomes of ART treatments in SW vs. WLR. Methods This is a prospective controlled cohort study of 251 women undergoing intrauterine insemination (D-IUI) or in vitro fertilization (D-IVF) using donor sperm between 2017 and 2019 at the department of Reproductive Medicine, Karolinska University Hospital. The cohort comprised 139 SW and 112 WLR. The main outcomes included differences in live birth rate (LBR) and cumulative live birth rate (cLBR) between the groups. The SW underwent 66 D-IUI and 193 D-IVF treatments and WLR underwent 255 D-IUI and 69 D-IVF treatments. Data on clinical characteristics, treatment protocols and clinical outcomes were extracted from the clinic’s electronic database. The outcomes of D-IUI and D-IVF were separately assessed. Results The cohort of SW was significantly older than WLR (37.6 vs. 32.4 years, P < 0.001), and more commonly underwent IVF at first treatment (83% vs. 29%, P < 0.000). Conversely, WLR underwent more frequently D-IUI as a first treatment (71% vs. 17% of SW, P < 0.001) and more often in the natural cycle (89.9% vs. 70.8%, P = 0.019), respectively. There was no statistically significant difference in the main outcome LBR between the two groups, or between the two different types of treatment, when adjusted for age. Perinatal outcomes and cLBR were also similar among the groups. Conclusions SW were, on average, older than WLR undergoing treatment with donor sperm. No significant differences were seen in the LBR and cLBR when adjusted for age between the two groups and between the two types of treatment (D-IVF vs. D-IUI). Trial registration ClinicalTrials.gov NTC04602962.
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Practice Committee of the Society for Reproductive Endocrinology and Infertility, Quality Assurance Committee of the Society for Assisted Reproductive Technologies, and the Practice Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org. Multiple gestation associated with infertility therapy: a committee opinion. Fertil Steril 2022:S0015-0282(21)02302-5. [PMID: 35115166 DOI: 10.1016/j.fertnstert.2021.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
This Committee Opinion provides practitioners with suggestions to reduce the likelihood of iatrogenic multiple gestation resulting from infertility treatment. This document replaces the document of the same name previously published in 2012 (Fertil Steril 2012;97:825-34 by the American Society for Reproductive Medicine).
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Provision of fertility services for women at increased risk of complications during fertility treatment or pregnancy: an Ethics Committee opinion. Fertil Steril 2022; 117:713-719. [PMID: 35105445 DOI: 10.1016/j.fertnstert.2021.12.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 11/04/2022]
Abstract
This opinion addresses the ethics of providing fertility treatment to women at elevated risk from fertility treatment or pregnancy. It is ethically appropriate for providers to treat women who are at elevated risk provided that the women are carefully assessed, that specialists in their medical condition are consulted as appropriate, and that they are fully informed about the risks, benefits, and alternatives, which may include oocyte or embryo donation, use of a gestational surrogate, declining fertility treatment, and adoption. Providers also may conclude that the medical risks of fertility treatment for a given patient are too high, in which case it is ethical for them for them to decline to provide treatment. Such determinations must be made in a medically objective and unbiased manner, and patients must be fully informed of the decision and its rationale. Counseling for these women should incorporate the most current knowledge available, with cognizance of the woman's personal determinants in relation to her reproductive desires. In this way, both the physician and the patient will optimize decision making in an ethically sound, patient-supportive context. This document replaces the document of the same name, last published in 2016 (Fertil Steri 2016;106:1319-23).
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Zhao J, Hao J, Li Y. Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review. Reprod Health 2022; 19:19. [PMID: 35065655 PMCID: PMC8783459 DOI: 10.1186/s12978-021-01320-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/23/2021] [Indexed: 12/20/2022] Open
Abstract
Background Luteal phase support (LPS) is an important part of assisted reproductive technology (ART), and adequate LPS is crucial for embryo implantation. At present, a great number of studies have put emphasis on an individualized approach to controlled ovarian stimulation (COS) and endometrium preparation of frozen- thawed embryo transfer (FET); However, not much attention has been devoted to the luteal phase and almost all ART cycles used similar LPS protocol bases on experience. Main body This review aims to concisely summarize individualized LPS protocols in fresh embryo transfer cycles with hCG trigger or GnRH-a trigger. The PubMed and Google Scholar databases were searched using the keywords: (luteal phase support or LPS) AND (assisted reproductive technology or ART or in vitro fertilization or IVF). We performed comprehensive literature searches in the English language describing the luteal phase support after ART, since 1978 and ending in May 2019. Recent studies have shown that many modified LPS programs were used in ART cycle. In the cycle using hCG for final oocyte maturation, the progesterone with or without low dose of hCG may be adequate to maintain pregnancy. In the cycle using GnRH-a for trigger, individualized low dose of hCG administration with or without progesterone was suggested. The optimal timing to start the LPS would be between 24 and 72 h after oocyte retrieval and should last at least until the pregnancy test is positive. Addition of E2 and the routes of progesterone administration bring no beneficial effect on the outcomes after ART. Conclusions Individualized LPS should be applied, according to the treatment protocol, the patients’ specific characteristics, and desires. Luteal phase support (LPS) is an important part of assisted reproductive technology (ART). In the cycle using hCG for final oocyte maturation, the progesterone with or without low dose of hCG may be adequate to maintain pregnancy. In the cycle using GnRH-a for trigger, individualized low dose of hCG administration with or without progesterone was suggested. The optimal timing to start the LPS would be between 24 and 72 h after oocyte retrieval and should last at least until the pregnancy test is positive. Addition of E2 and the routes of progesterone administration bring no beneficial effect on the outcomes after ART. Individualized LPS should be applied, according to the treatment protocol, the patients’ specific characteristics, and desires.
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Affiliation(s)
- Jing Zhao
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, People's Republic of China.,Clinical Research Center For Women's Reproductive Health In Hunan Province, Hunan, People's Republic of China
| | - Jie Hao
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, People's Republic of China.,Clinical Research Center For Women's Reproductive Health In Hunan Province, Hunan, People's Republic of China
| | - Yanping Li
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, People's Republic of China. .,Clinical Research Center For Women's Reproductive Health In Hunan Province, Hunan, People's Republic of China.
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216
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Sanderman EA, Willis SK, Wise LA. Female dietary patterns and outcomes of in vitro fertilization (IVF): a systematic literature review. Nutr J 2022; 21:5. [PMID: 35042510 PMCID: PMC8764863 DOI: 10.1186/s12937-021-00757-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/18/2021] [Indexed: 01/14/2023] Open
Abstract
Background Infertility affects up to 15% of couples. In vitro fertilization (IVF) treatment has modest success rates and some factors associated with infertility and poor treatment outcomes are not modifiable. Several studies have assessed the association between female dietary patterns, a modifiable factor, and IVF outcomes with conflicting results. We performed a systematic literature review to identify female dietary patterns associated with IVF outcomes, evaluate the body of evidence for potential sources of heterogeneity and methodological challenges, and offer suggestions to minimize heterogeneity and bias in future studies. Methods We performed systematic literature searches in EMBASE, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies with a publication date up to March 2020. We excluded studies limited to women who were overweight or diagnosed with PCOS. We included studies that evaluated the outcome of pregnancy or live birth. We conducted an initial bias assessment using the SIGN 50 Methodology Checklist 3. Results We reviewed 3280 titles and/or titles and abstracts. Seven prospective cohort studies investigating nine dietary patterns fit the inclusion criteria. Higher adherence to the Mediterranean diet, a ‘profertility’ diet, or a Dutch ‘preconception’ diet was associated with pregnancy or live birth after IVF treatment in at least one study. However, causation cannot be assumed. Studies were potentially hindered by methodological challenges (misclassification of the exposure, left truncation, and lack of comprehensive control for confounding) with an associated risk of bias. Studies of the Mediterranean diet were highly heterogenous in findings, study population, and methods. Remaining dietary patterns have only been examined in single and relatively small studies. Conclusions Future studies with rigorous and more uniform methodologies are needed to assess the association between female dietary patterns and IVF outcomes. At the clinical level, findings from this review do not support recommending any single dietary pattern for the purpose of improving pregnancy or live birth rates in women undergoing IVF treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00757-7.
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Affiliation(s)
| | | | - Lauren A Wise
- Boston University School of Public Health, Boston, USA
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217
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Pettersson ML, Bladh M, Nedstrand E, Svanberg AS, Lampic C, Sydsjö G. Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age. BMC Pediatr 2022; 22:39. [PMID: 35031006 PMCID: PMC8759211 DOI: 10.1186/s12887-021-03103-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers. Methods A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression. Results Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period. Conclusion The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.
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Affiliation(s)
- Malin Lindell Pettersson
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden.
| | - Marie Bladh
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Elizabeth Nedstrand
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden
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218
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Clarke AR, Stransky OM, Bernard M, Hughan KS, Ladores S, Sawicki GS, Stalvey M, Kazmerski TM. Exploring provider attitudes and perspectives related to men's health in cystic fibrosis. J Cyst Fibros 2022; 21:652-656. [PMID: 34998704 DOI: 10.1016/j.jcf.2021.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/06/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND New modulator therapies have markedly improved the health of people with cystic fibrosis (CF), allowing an increased focus on quality-of-life improvements for men with CF, including those related to sexual and reproductive health (SRH). This study explored CF providers' attitudes and experiences with addressing men's health in CF. METHODS We interviewed geographically diverse adult and pediatric United States (U.S.) CF program directors via semi-structured telephone interviews exploring their perspectives and practices related to men's SRH in CF. Two coders analyzed transcribed interviews and created a codebook to identify key themes. RESULTS We interviewed 20 providers and identified the following themes: 1) Men's SRH is important to address within CF care, but there is no standardization around this aspect of care; 2) There is no consensus about the recommendation or utilization of semen analysis to assess men's infertility; 3) There are many barriers to men's SRH care provision in CF centers, including the low priority of SRH concerns and provider discomfort and lack of expertise in SRH; 4) Providers desire clear evidence-based guidelines and patient resources related to men's SRH in CF; and 5) Providers believe future research should focus on testosterone and the impact of modulators on men's SRH. CONCLUSIONS CF center directors acknowledge the importance of addressing SRH with men with CF, but there is a lack of standardization and research in this aspect of care. Existing barriers to optimal SRH care and identified facilitators in this study can serve as targets for interventions in the CF care model.
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Affiliation(s)
- Alison R Clarke
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Olivia M Stransky
- Center for Women's Health Research and Innovation, Pittsburgh, PA, United States.
| | - Miriam Bernard
- Center for Women's Health Research and Innovation, Pittsburgh, PA, United States.
| | - Kara S Hughan
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Sigrid Ladores
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, United States.
| | | | - Michael Stalvey
- Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Women's Health Research and Innovation, Pittsburgh, PA, United States.
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Alibhai K, Churchill I, Vause T, Lochnan HA. The impact of bariatric surgery on assisted reproductive technology outcomes: a systematic review protocol. Syst Rev 2022; 11:1. [PMID: 34980263 PMCID: PMC8722006 DOI: 10.1186/s13643-021-01870-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Individuals with obesity are at higher risk of experiencing complications during their pregnancy and may also experience infertility, requiring assisted reproductive technologies (ART) to conceive. The current body of literature demonstrates that bariatric surgery decreases an individual's risk of developing a variety of obesity-related obstetrical conditions during and after pregnancy. However, the effects of bariatric surgery on ART outcomes are not well understood. Therefore, the paucity in the literature warrants a need to determine these effects. METHODS We will search electronic databases, including MEDLINE, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL), as well as the gray literature and the reference lists of included articles. We will screen all studies published between January 1978 and the present day that explore the impact of bariatric surgery on ART outcomes for women and men. We will include observational studies. Two independent reviewers will assess the studies for inclusion and extract data for each article. The main outcome that will be analyzed is live birth rate. Secondary outcomes such as time to conception, number of rounds of ART, type of bariatric surgery, and length of time between bariatric surgery and initiation of ART will also be recorded. Risk of bias will be conducted using the National Institutes of Health Study Quality Assessment Tools. A random effects model will be used to account for statistical analysis and results will be pooled with forest plots. In the event of statistical and reporting heterogeneity, we will provide a qualitative synthesis and narrative review of the results. DISCUSSION This review will provide information on the outcomes of ART following bariatric surgery and may help healthcare professionals make informed decisions about the length of time between bariatric surgery and initiation of ART. The study findings may be of interest to various stakeholders including patients, bariatric surgeons, obstetricians, and gynecologists, and those who specialize in obesity medicine and reproductive endocrinology and infertility. We plan to disseminate our findings through presentations, publications, and social media releases to individuals who are navigating infertility and are interested in undergoing or have undergone bariatric surgery, healthcare professionals, policymakers, and researchers. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021252561.
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Affiliation(s)
- Kameela Alibhai
- Faculty of Medicine, University of Ottawa, 501 Smyth Rd, Ottawa, Ontario K1H 8L6 Canada
| | - Isabella Churchill
- Faculty of Medicine, University of Ottawa, 501 Smyth Rd, Ottawa, Ontario K1H 8L6 Canada
| | - Tannys Vause
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Heather Anne Lochnan
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
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220
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Jenabi E, Bashirian S, Khazaei S, Farhadi Nasab A, Maleki A. The Association between Assisted Reproductive Technology and the Risk of Autism Spectrum Disorders among Offspring: A Meta-analysis. Curr Pediatr Rev 2022; 19:83-89. [PMID: 35410610 DOI: 10.2174/1573396318666220410231435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/21/2022] [Accepted: 02/02/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND This review aimed to determine the association between assisted reproductive technology (ART) and increased chances of having an autistic child. METHODS The Web of Science, PubMed, and Scopus databases were systematically searched for studies published until December 2020 with the restricted English language. The Newcastle-Ottawa Scale (NOS) for cohort and case-control studies has been used for the evaluation of quality in individual studies. We evaluated the heterogeneity among the studies using I-squared. Publication bias was assessed using the funnel plot and Egger's and Begg's tests. We presented results using odds ratio (OR) and relative ratio (RR) estimates with its 95% confidence intervals (CI) using a randomeffects model. RESULTS In total, 18 articles were included in the present study. The overall findings of the present meta-analysis show that the use of ART didn't associate with the risk of autism spectrum disorders (ASD) among offspring based on OR and RR (OR = 1.04, 95% CI: 0.88-1.21) and (RR = 1 .26, 95% CI: 0.96- 1 .55), respectively. We showed a significant association between ART and the risk of ASD in Asia than in the other regions without heterogeneity. CONCLUSION Our result showed that the risk of ASD was not increased in children born from ART. Possible interaction between ART and other regions with increased risk of ASD is important to point and future studies of this topic were recommended.
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Affiliation(s)
- Ensiyeh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdollah Farhadi Nasab
- Psychiatry, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azam Maleki
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
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Knudtson JF, Robinson RD, Sparks AE, Hill M, Chang TA, Van Voorhis BJ. Common practices among consistently high-performing in vitro fertilization programs in the United States: 10-year update. Fertil Steril 2022; 117:42-50. [PMID: 34674830 PMCID: PMC8714682 DOI: 10.1016/j.fertnstert.2021.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate similarities and differences in clinical and laboratory practices among high-performing fertility clinics. DESIGN Cross-sectional questionnaire study of selected programs. SETTING Academic and private fertility practices performing in vitro fertilization (IVF). PATIENT(S) Not applicable. INTERVENTION(S) A comprehensive survey was conducted of 13 IVF programs performing at least 100 cycles a year and having high cumulative singleton delivery rates for 2 years. MAIN OUTCOME MEASURE(S) Clinical and laboratory IVF practices. RESULT(S) Although many areas of clinical practice varied among top programs, some commonalities were observed. All programs used a combination of follicle-stimulating hormone and luteinizing hormone for IVF stimulation, intramuscular progesterone in frozen embryo transfer cycles, ultrasound-guided embryo transfers, and a required semen analysis before starting the IVF cycle. Common laboratory practices included vitrification of embryos at the blastocyst stage, air quality control with positive air pressure and high-efficiency particulate air filtration, use of incubator gas filters, working on heated microscope stages, and incubating embryos in a low-oxygen environment, most often in benchtop incubators. CONCLUSION(S) Some areas of consistency in clinical and laboratory practices were noted among high-performing IVF programs that are likely contributing to their success. High-performing programs focused on singleton deliveries. As the field of IVF is rapidly evolving, it is imperative that we share best practices in an effort to improve outcomes from all clinics for the good of our patients.
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Affiliation(s)
- Jennifer F. Knudtson
- Department of Obstetrics and Gynecology, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Randal D. Robinson
- Department of Obstetrics and Gynecology, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Amy E. Sparks
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Micah Hill
- Program in Reproductive Endocrinology and Gynecology, Eunice Kennedy Shriver National Institute for Children Health and Development, National Institutes of Health, Bethesda, Maryland
| | - T. Arthur Chang
- Department of Obstetrics and Gynecology, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Bradley J. Van Voorhis
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Vianna CA, Dupont C, Selleret L, Canestri A, Levy R, Hamid RH. Comparison of in vitro fertilization cycles in couples with human immunodeficiency virus type 1 infection versus noninfected couples through a retrospective matched case-control study. F S Rep 2021; 2:376-385. [PMID: 34934977 PMCID: PMC8655394 DOI: 10.1016/j.xfre.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To compare in vitro fertilization (IVF) outcomes in couples in which at least one partner is human immunodeficiency virus (HIV) positive with that of couples in which neither partner is HIV-positive. Design Retrospective matched case-control study. Setting Fertility center at Tenon Hospital, Paris, France. Patient(s) A total of 179 IVF cycles in couples infected with HIV-1 and 179 IVF cycles in control couples. Intervention(s) Ovarian stimulation, oocytes retrieval, IVF (standard and microinjection), embryo transfer, pregnancy, and live birth follow-up. Main Outcome Measure(s) Live birth rate and IVF outcomes Result(s) The first comparison between HIV and non-HIV couples showed poorer outcomes in the HIV group (higher administered gonadotropin doses and longer stimulation periods, lower cumulative pregnancy and live birth rates, among other things). A subgroup analysis was performed in addition. No differences were found in the “men HIV” group compared with the controls. In contrast, poorer outcomes in the “women HIV” and “women and men HIV” groups were shown in terms of administered doses, duration of stimulation, and number of oocytes retrieved. For the “women HIV” group, lower cumulative clinical pregnancy and live birth rates were found. Conclusion The data suggested that couples with HIV-positive women have poorer medically assisted procreation outcomes than couples with non-HIV-infected women. Therefore, physicians should pay particular attention to couples with HIV-positive women.
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Affiliation(s)
- Caroline Aimone Vianna
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| | - Charlotte Dupont
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| | - Lise Selleret
- Service de Gynécologie Obstétrique - Médecine de la Reproduction, Hôpital Tenon, Paris, France
| | - Ana Canestri
- Service Maladies Infectieuses et Tropicales, Hôpital Tenon, Paris, France
| | - Rachel Levy
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| | - Rahaf Haj Hamid
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
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Kirshenbaum M, Gil O, Haas J, Nahum R, Zilberberg E, Lebovitz O, Orvieto R. Recombinant follicular stimulating hormone plus recombinant luteinizing hormone versus human menopausal gonadotropins- does the source of LH bioactivity affect ovarian stimulation outcome? Reprod Biol Endocrinol 2021; 19:182. [PMID: 34886872 PMCID: PMC8655989 DOI: 10.1186/s12958-021-00853-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/03/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) activate distinct intracellular signaling cascades. However, due to their similar structure and common receptor, they are used interchangeably during ovarian stimulation (OS). This study aims to assess if the source of LH used during OS affects IVF outcome. PATIENTS AND METHODS This was a cross sectional study of patients who underwent two consecutive IVF cycles, one included recombinant follicular stimulating hormone (FSH) plus recombinant LH [rFSH+rLH, (Pergoveris)] and the other included urinary hCG [highly purified hMG (HP-hMG), (Menopur)]. The OS protocol, except of the LH preparation, was identical in the two IVF cycles. RESULTS The rate of mature oocytes was not different between the treatment cycles (0.9 in the rFSH+rLH vs 0.8 in the HP-hMG, p = 0.07). Nonetheless, the mean number of mature oocytes retrieved in the rFSH+rLH treatment cycles was higher compared to the HP-hMG treatment cycles (10 ± 5.8 vs 8.3 ± 4.6, respectively, P = 0.01). Likewise, the mean number of fertilized oocytes was higher in the rFSH+rLH cycles compared with the HP-hMG cycles (8.5 ± 5.9 vs 6.4 ± 3.6, respectively, p = 0.05). There was no difference between the treatment cycles regarding the number of top-quality embryos, the ratio of top-quality embryos per number of oocytes retrieved or fertilized oocytes or the pregnancy rate. CONCLUSION The differences in treatment outcome, derived by different LH preparations reflect the distinct physiological role of these molecules. Our findings may assist in tailoring a specific gonadotropin regimen when assembling an OS protocol.
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Affiliation(s)
- M Kirshenbaum
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - O Gil
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
| | - J Haas
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Nahum
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Zilberberg
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O Lebovitz
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, at the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Sánchez Soler MJ, López-González V, Ballesta-Martínez MJ, Gálvez-Pradillo J, Nicolás-Arnao M, Gómez-Sánchez E, Pérez-Fernández V, Guillén Navarro E. Risk of mayor and minor birth defects in children conceived by assisted reproductive technology (IVF/ICSI): A prospective controlled cohort study. An Pediatr (Barc) 2021; 95:448-458. [PMID: 34857501 DOI: 10.1016/j.anpede.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION About 0.2-6.1% of newborns in the developed world have been conceived by assisted reproductive techniques (ART). Higher rate of major and minor malformations have been described in this population, but the multiple possible confounders associated make it difficult to establish a direct causal relationship and the specific factors involved. MATERIAL AND METHODS To determine the risk of these malformations in our population, a collaborative prospective controlled cohort study was designed. We collected the specific ART-data related to the clinical gestation of women treated in a period of 2 years in the Reproduction Unit from a Spanish public tertiary-level hospital. 231 out of 267 newborns of these gestation (88%) participated in the study and were assessed by a pediatrician with expertise in Clinical Genetics and Dysmorphology at 12-20 and 26-40 months of age. At the same time a controlled group of children naturally conceived (NC) was selected according to the following criteria: the next NC newborn belonging to the same group of maternal and gestational age, and type of gestation (single or multiple). 230 controls were chosen and 208 participated in the study (90%). RESULTS Major malformations were presented in 7.8% of the ART-children and 7.2% of the controls, without founding statistically differences between groups. However, differences were found in the risk of some minor malformations such as capillary malformations and pigmentary lesions, higher in the ART-group. A recurrent pattern of craneofacial anomalies was also unexpectedly detected. CONCLUSIONS In spite of the high rate of major congenital malformations detected, there were no differences between groups. Thus, our results suggest that ART may affect the normal embryonic development but in a milder way than other confounding factors do. The facial phenotype identified has not previously been described, either the higher risk of capillary malformations and pigmentary lesions. More studies are needed to confirm this association.
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Affiliation(s)
- María José Sánchez Soler
- Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
| | - Vanesa López-González
- Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | | | - Jorge Gálvez-Pradillo
- Unidad de Reproducción, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | | | - Encarna Guillén Navarro
- Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
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225
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Jwa SC, Ishihara O, Kuwahara A, Saito K, Saito H, Terada Y, Kobayashi Y, Maeda E. Social capital and use of assisted reproductive technology in young couples: Ecological study using application information for government subsidies in Japan. SSM Popul Health 2021; 16:100995. [PMID: 34950764 PMCID: PMC8671120 DOI: 10.1016/j.ssmph.2021.100995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/28/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Assisted reproductive technology (ART) is a globally established treatment; however, large disparities exist in ART use among young couples. We investigated regional-level factors associated with ART use in Japan. METHODS We calculated the use rate of ART using the number of women aged <35 years who applied for government subsidies in 2017; we divided that figure by the number of women aged 20-35 years in each prefecture. Prefectural-level average household income; social capital indicators including voting rate, volunteer rate, and move-in rate; and Gini coefficients as indicators of income inequality were linked to ART use, adjusting for prefectural size, the mean age of women at first marriage, number of ART facilities, and additional prefectural subsidies. RESULTS The rate of ART use (per 10,000 women) varied significantly from 22.0 to 58.8 across Japan's 47 prefectures. Multivariate analysis demonstrated that the use rate increased by 0.048 (95% confidence interval [CI], 0.007 to 0.088) for each 10,000-yen increase in average household income and 1.5 (95% CI, 0.65 to 2.3) for each 1% increase in volunteer rate. Conversely, the use rate decreased by 18.4 (95% CI, -28.6 to -8.1) for each 1% increase in the move-in rate. There was no significant association between ART use and income inequality. CONCLUSION Although we cannot infer causal relationships, the findings suggest that improving financial access and enhancing social capital may increase access to ART. Further research, particularly multilevel analysis using individual data, is required to confirm these findings.
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Affiliation(s)
- Seung Chik Jwa
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama, Saitama, 350-0495, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama, Saitama, 350-0495, Japan
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Kazuki Saito
- Department of Pediatrics, Perinatal, and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Hidekazu Saito
- Umegaoka Women's Clinic, 1-33-3, Umegaoka, Setagaya-ku, Tokyo, 154-0022, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Akita University, 1-1-1, Hondo, Akita, 010-8543, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita, 010-8543, Japan
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Zagadailov P, Cho KS, Seifer DB. Differences in ICSI utilization rates among states with insurance mandates for ART coverage. Reprod Biol Endocrinol 2021; 19:174. [PMID: 34847941 PMCID: PMC8630859 DOI: 10.1186/s12958-021-00856-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Assisted reproductive technology (ART) insurance mandates promote more selective utilization of ART clinic resources including intracytoplasmic sperm injection (ICSI). Our objective was to examine whether ICSI utilization differs by state insurance mandates for ART coverage and assess if such a difference is associated with male factor, preimplantation genetic testing (PGT), and/or live birth rates. METHODS In this retrospective analysis of the Centers for Disease Control (CDC) data from 2018, ART clinics in ART-mandated states (n = 8, AR, CT, HI, IL, MD, MA, NJ, RI) were compared individually to one another and with non-mandated states in aggregate (n = 42) for use of ICSI, male factor, PGT, and live birth rates. ANOVA was used to evaluate differences between ART-mandated states and non-mandated states. Individual ART-mandated states were compared using Welch t-tests. Statistical significance was determined by Bonferroni Correction. RESULTS There were significant differences in ICSI rates (%, mean ± SD) between MA (53.3 ± 21.3) and HI (90.7 ± 19.6), p = 0.028; IL (86.5 ± 18.7) and MA, p = 0.002; IL and MD (57.2 ± 30.8), p = 0.039; IL and NJ (62.0 ± 26.8), p = 0.007; between non-mandated states in aggregate (79.9 ± 19.9) and MA, p = 0.006, and NJ (62.0 ± 26.8), p = 0.02. Male factor rates of HI (65.8 ± 16.0) were significantly greater compared to CT (18.8 ± 8.7), IL (26.0 ± 11.9), MA (26.9 ± 6.6), MD (29.3 ± 9.9), NJ (30.6 ± 17.9), and non-mandated states in aggregate (29.7 ± 13.7), all p < 0.0001. No significant differences were reported for use of PGT and/or live birth rates across all age groups regardless of mandate status. CONCLUSIONS ICSI use varied significantly among ART-mandated states while demonstrating no differences in live birth rates. These data suggest that the prevalence of male factor and the presence of a state insurance mandate are not the only factors influencing ICSI use. It is suggested that other non-clinical factors may impact the rate of ICSI utilization in a given state.
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Affiliation(s)
- Pavel Zagadailov
- Clinical Outcomes Research Group, CORG LLC, 178 Meadow Brook Rd, Grantham, NH 03753 USA
| | - Kyung S. Cho
- Clinical Outcomes Research Group, CORG LLC, 178 Meadow Brook Rd, Grantham, NH 03753 USA
- Department of Statistics, Columbia University, 1255 Amsterdam Ave, New York, NY 10027 USA
| | - David B. Seifer
- Department of Obstetrics and Gynecology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 USA
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Chen R, Chen L, Liu Y, Wang F, Wang S, Huang Y, Hu KL, Fan Y, Liu R, Zhang R, Zhang D. Association of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles: a retrospective cohort study. BMC Pregnancy Childbirth 2021; 21:793. [PMID: 34836492 PMCID: PMC8627045 DOI: 10.1186/s12884-021-04261-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background Parental body mass index (BMI) is associated with pregnancy outcomes. But the effect of parental prepregnancy BMI on offspring conceived via in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), especially the birth defect, remains to be determined. This study aimed to investigate the associations of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles. Methods We conducted a retrospective cohort study including 5741 couples in their first fresh IVF/ICSI cycles admitted to Women’s Hospital, School of Medicine, Zhejiang University from January 2013 to July 2016. The primary outcome was birth defects, which was classified according to the International Classification of Diseases, 10th Revision. Secondary outcomes included preterm delivery rate, infant gender, birth weight, small-for-gestational age (SGA) and large-for-gestational age (LGA). Multilevel regression analyses were used to assess the associations of parental prepregnancy BMI with neonatal outcomes and birth defect. Results In singletons, couples with prepregnancy BMI ≥25 kg/m2 had higher odds of LGA than those with BMI < 25 kg/m2. The birth defect rate was significantly higher when paternal prepregnancy BMI ≥25 kg/m2 in IVF cycles (aOR 1.82, 95% CI 1.06–3.10) and maternal BMI ≥25 kg/m2 in ICSI cycles (aOR 4.89, 95% CI 1.45–16.53). For subcategories of birth defects, only the odds of congenital malformations of musculoskeletal system was significantly increased in IVF offspring with paternal BMI ≥25 kg/m2 (aOR 4.55, 95% CI 1.32–15.71). For twins, there was no significant difference among four groups, except for the lower birth weight of IVF female infants. Conclusions Parental prepregnancy BMI ≥25 kg/m2 is associated with higher incidence of LGA in IVF/ICSI singletons. Paternal prepregnancy BMI ≥25 kg/m2 was likely to have higher risk of birth defect in IVF offspring than those with BMI < 25 kg/m2, particularly in the musculoskeletal system. It is essential for overweight or obesity couples to lose weight before IVF/ICSI treatments. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04261-y.
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Affiliation(s)
- Ruixue Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Lifen Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Yifeng Liu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Feixia Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Siwen Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Yun Huang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Kai-Lun Hu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Yuzhi Fan
- School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Ruoyan Liu
- School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Runjv Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.,Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Dan Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China. .,School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China. .,Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
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Xu X, Wu H, Bian Y, Cui L, Man Y, Wang Z, Zhang X, Zhang C, Geng L. The altered immunological status of children conceived by assisted reproductive technology. Reprod Biol Endocrinol 2021; 19:171. [PMID: 34836513 PMCID: PMC8620159 DOI: 10.1186/s12958-021-00858-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/03/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND With the increased use of assisted reproductive technology (ART), assessing the potential health risks of children conceived on ART important to public health. Most research in this area has focused on the effects of ART on perinatal, metabolic, and oncological risks in children. Although an increased risk of immune-related diseases has been reported in children born after ART, there are no studies on the immunological status of these children. This study aimed to evaluate the impact of different embryo transfer methods and fertilization strategies on the immune status of the offspring. METHODS A total of 69 children born to women treated with ART and a matched control group of 17 naturally conceived (NC) children, all aged from 3 to 6 years, were recruited in the reproductive hospital affiliated to Shandong University. The frequency of immune cells in the peripheral blood was assayed using flow cytometry; plasma cytokine levels were determined by multiplex cytokine immunoassay with human cytokine magnetic beads. RESULTS Compared to children born after natural conception, children born after ART had elevated interferon-γ (IFN-γ) levels, regardless of embryo transfer and fertilization strategies. Children in the fresh-embryo transfer group had significantly higher IL-4 levels and a lower ratio of IFN-γ to IL-4 than those in the NC group ((P = 0.004, 10.41 ± 5.76 pg/mL vs 18.40 ± 7.01 pg/mL, P = 0.023, 1.00 ± 0.48 vs 0.67 ± 0.32, respectively). Similar results were shown in either the in vitro fertilization (IVF) group or the intra-cytoplasmic sperm injection (ICSI) group (P < 0.05 and P = 0.08 for IVF; P < 0.05 and P < 0.05 for ICSI, respectively). These alterations in IL-4 concentrations and the ratio of IFN-γ to IL-4 were statistically significantly correlated with supra-physical E2 (estradiol) levels on the day of hCG administration (R = 0.502, P = 0.017; R = - 0.537, P = 0.010, respectively). Consistently, the frozen embryo transfer did not result in alterations of these immune indicators in the offspring. Overall, there were no significant differences between the ART group and NC group in the frequencies of T cells, B cells, natural killer (NK) cells, CD4+T cells, CD8+T cells, T helper (TH)1 cells, TH17 cells, and regulatory T (Treg) cells and cytokine levels of IL-10 and IL-17a (all P > 0.05). CONCLUSIONS Immunological alterations existed in children born after the use of ART. The elevated E2 levels before embryo implantation contributed to the increased IL-4 levels in children conceived by fresh embryo transfer. The assessment of immunological alteration is of importance to children conceived by ART for early monitoring and intervention.
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Affiliation(s)
- Xin Xu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Han Wu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Yuehong Bian
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Linlin Cui
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Yuanyuan Man
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Zhao Wang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Xin Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Changming Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
| | - Ling Geng
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China.
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Ni Z, Xia D, Sun S, Zhang D, Kuang Y, Yu C. Association between paternal age and singleton birthweight in frozen embryo transfer cycles. Reprod Health 2021; 18:217. [PMID: 34732205 PMCID: PMC8565067 DOI: 10.1186/s12978-021-01250-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many studies have considered maternal age as a determinant factor for success in assisted reproductive technologies (ART), but the potential role of paternal age on neonatal outcomes has been overlooked. This study aimed to explore the association between paternal age and birthweight in frozen embryo transfer (FET) cycles. METHODS This retrospective study involved singleton live births born to women undergoing frozen embryo transfer from January 2013 to December 2017 at a tertiary care center in Shanghai, China. The paternal age was classified into four categories: ≤ 30, 31-35, 36-40, and ≥ 41 years. The group consisting of respondents with paternal age of 31-35 was set as the reference group. Singleton birthweight was the primary outcome measure. Z-scores were calculated according to gestational age and newborn gender on birthweight based on the national birthweight reference. Multivariable linear regression analysis was performed to reveal the relationship between paternal age and newborns' birthweight after considering several potential confounders. RESULTS Exactly 9765 women who fulfilled the inclusion criteria were enrolled. No significant difference was found on mean birthweight (P = 0.082) and gestation-adjusted Z-scores (P = 0.569) among paternal age categories. The reference group and the group with aged 36-40 years had the highest mean birthweight and Z-scores, respectively (3350.2 ± 467.8 g, 0.36 ± 1.00). A decline in mean birthweight with paternal age was observed, and the group over 40 years had the lowest value of 3309.4 ± 474.3 g, but the difference was not statistically significant. In multivariate analyses, the adjusted odds of very low birthweight (LBW), LBW, and high birthweight in the reference group did not significantly differ with the three other groups. After correcting several potential confounders, no significant correlation was observed between paternal age and neonatal birthweight (P = 0.289). CONCLUSION Paternal age was not associated with mean birthweight and gestational age- and gender-adjusted birthweight (Z-scores) of singletons among women who became pregnant in FET cycles.
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Affiliation(s)
- Zhexin Ni
- Department of Traditional Chinese Gynecology, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Demeng Xia
- The Chinese People's Liberation Army 91666 troops, Zhoushan, China
| | - Shuai Sun
- Department of Traditional Chinese Gynecology, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Danying Zhang
- Department of Traditional Chinese Gynecology, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital of JiaoTong University School of Medicine, Shanghai, China.
| | - Chaoqin Yu
- Department of Traditional Chinese Gynecology, Changhai Hospital Affiliated with Naval Medical University, Shanghai, China.
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Huang MZ, Sun YC, Gau ML, Puthussery S, Kao CH. First-time mothers' experiences of foetal reduction in pregnancy following assisted reproductive technology treatment in Taiwan: a qualitative study. J Health Popul Nutr 2021; 40:47. [PMID: 34727986 PMCID: PMC8562006 DOI: 10.1186/s41043-021-00270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Foetal reduction-removal of one or more foetuses to reduce the number of foetuses in multiple conceptions-is a procedure used for improving pregnancy outcomes following assisted reproductive technology (ART) treatment. While there is a recognition of the importance of understanding the experiences of women who undergo foetal reduction to offer appropriate help and support, studies that provide relevant insights are sparse. Our aim was to gain an in-depth understanding about first-time mothers' experiences of foetal reduction following ART treatment in Taiwan. METHODS We adopted a qualitative design based on a phenomenological approach for this study. In-depth semi-structured interviews were conducted with seven first-time mothers who underwent foetal reduction following ART treatment at a fertility centre in Taipei, Taiwan. All interviews were recorded, transcribed and analysed using the Colaizzi strategy. RESULTS The views and experiences relating to foetal reduction reflected five key themes: hesitation, ambivalence and distress; the guilt of knowingly terminating a life; rituals and ceremonies to ease the sense of guilt; persuading oneself to consider the 'big picture'; and wishing for a reunion in next pregnancy. Mothers often regretted that they took clinical advice to implant multiple embryos and then having had to resort to foetal reduction. There was a sense of hesitation, ambivalence and distress reflected in the views from all participants. They believed that they ended the fetuses' lives knowingly and expressed strong feelings of guilt. Mothers often tried to persuade themselves to look at foetal reduction within the 'big picture' of the overall pregnancy outcome. Losing their unborn babies was as an unforgettable incident for most mothers, and they wished for a reunion with the lost baby in the next pregnancy. CONCLUSION Findings indicate the need for ART providers to undertake a more sensitive approach that involves detailed discussions with women and their families to tailor the embryo transfer processes to suit individual needs. Women who undergo foetal reduction should be provided with tailored interventions towards enhancing their coping strategies before and after foetal reduction taking into account the cultural and religious context.
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Affiliation(s)
- Mei-Zen Huang
- Department of Nursing, National Tainan Junior College of Nursing, 78, Sec.2 Minzu Rd., Tainan City, Taiwan
| | - Yi-Chin Sun
- Dr. Hwang Reproductive Fertility Center, 11F., No.100, Sec.2, Nanjing E. Rd., Zhongshan Dist., Taipei City, Taiwan
| | - Meei-Ling Gau
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan
| | - Shuby Puthussery
- Institute for Health Research and School of Society, Community and Health, University of Bedfordshire, Park Square Rm 206, Luton, LU1 3JU UK
| | - Chien-Huei Kao
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan
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231
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Zargar M, Rahimi M, Barati M, Moramazi F, Moghadam AE, Choghakabodi PM. Correlation between assisted reproductive technology-induced pregnancy and fetal cardiac anomalies. JBRA Assist Reprod 2021; 26:329-334. [PMID: 34709775 PMCID: PMC9118956 DOI: 10.5935/1518-0557.20210088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the incidence of fetal heart defects in assisted reproductive technology (ART)-induced pregnancies compared to natural pregnancies as well as to detect their fetal and maternal risk factors associated with ART. Methods In this retrospective cohort study, we collected data from the medical records belonging to 2877 pregnant women's fetuses, who underwent fetal echocardiography for various reasons, including ART, over the last 3 years. Results There were no major cardiac anomaly in the ART-induced pregnancies, while it was seen in 1.32% of natural pregnancies; so, ART did not increase the risk of major cardiac anomalies. However, the incidence of fetal mild cardiac anomalies among fetuses derived from ART-induced pregnancies (51.43%) was significantly higher than that of natural pregnancies (44.43%, p=0.03). None of the ART-induced pregnancies had a history of a child with cardiac disease (vs. 7.56% in natural pregnancies). Also, the increased nuchal thickness (NT) and extra-cardiac anomalies were significantly more prevalent among natural pregnancies, indicating a significant negative correlation between ART and these two risk factors [χ2=10.24, r: -0.06, 95% CI(-0.0974 to -0.0221) and χ2=47.25, r: -0.129, 95% CI(-0.1656 to -0.0913), p<0.01, respectively]. The adjusted odds ratio of developing fetal mild cardiac anomalies were 1.37 times higher greater for ART-induced pregnancies compared to natural pregnancies [95% CI(1.072-1.769), p=0.01]. Conclusions Although the likelihood of developing fetal mild cardiac anomalies was 1.37 times higher for ART-induced pregnancy compared to natural pregnancy, ART did not increase the risk of major cardiac anomalies Although the likelihood of developing fetal mild cardiac anomalies was 1.37 times higher for ART-induced pregnancy compared to natural pregnancy, ART did not increase the risk of major cardiac anomalies.
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Affiliation(s)
- Mahvash Zargar
- Department of Obstetrics and Gynecology; Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rahimi
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Barati
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farideh Moramazi
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdolrahman Emami Moghadam
- Department of Pediatric Cardiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Fertility, Infertility and Perinatology Research Center
| | - Parastoo Moradi Choghakabodi
- Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Thalassemia and Hemoglobinopathy Research Center, Health Research Institute
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232
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Amiri SE, Brassard A, Rosen NO, Rossi MA, Beaulieu N, Bergeron S, Péloquin K. Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics. J Sex Med 2021; 18:1984-1997. [PMID: 34702685 DOI: 10.1016/j.jsxm.2021.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/11/2021] [Accepted: 09/14/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Research to date suggests that couples undergoing assisted reproductive technology (ART) are at a high risk of experiencing sexual difficulties. AIM This dyadic cross-sectional study aimed to provide a better understanding of the infertility-specific personal (ie, emotional, mind-body) and relational stressors associated with the sexual desire, orgasm, arousal, and sexual satisfaction of infertile couples seeking ART. METHODS The sample included 185 mixed-sex infertile couples seeking ART. Participants completed online the Fertility Quality of Life tool and either the Female Sexual Function Index or the International Index of Erectile Function. Data were analyzed using path analyses based on the Actor-Partner Interdependence Model. OUTCOMES Individuals' own and their partners' sexual function (desire, orgasm, arousal domains) and sexual satisfaction. RESULTS For men and women, infertility-related emotional stressors were associated with their own and their partner's lower sexual desire. For women, experiencing greater infertility-related emotional stressors was also associated with their partner's lower sexual satisfaction. While experiencing greater infertility-related mind-body stressors was not associated with men and women's own sexual desire, arousal, orgasm, and satisfaction, for women, it was associated with their partner's lower sexual arousal. Lastly, for men and women, infertility-related relational stressors were associated with their own lower sexual arousal, as well as with their own and their partner's lower sexual satisfaction. For women, experiencing greater relational stressors was also associated with their own lower sexual desire and orgasm. CLINICAL IMPLICATIONS Interventions addressing the emotional, mind-body, and relational spheres of infertile couples seeking ART may help facilitate improvements in sexual function and satisfaction and better serve their needs. STRENGTHS & LIMITATIONS This study included a large sample of couples. Our sample was heterogeneous with regards to couples' cause of infertility and treatment stage. The use of an infertility-related measure allowed us to better capture personal and relational stressors specific to couples seeking ART. Given the cross-sectional design of our study, causality between infertility-related stressors and sexual function and satisfaction cannot be inferred. Our sample included predominantly White, mixed-sex individuals with a high level of education, which may reduce the generalizability of our findings. CONCLUSION Couples' subjective experience of infertility and treatment (personal and relational stressors) seems to be strongly associated with their sexual health, allowing us to identify potential targets of intervention with couples seeking ART. S.E. Amiri, A Brassard, N.O. Rosen, et al. Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics. J Sex Med 2021;18:1984-1997.
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Affiliation(s)
- Sawsane El Amiri
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Audrey Brassard
- Departement of Psychology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Meghan A Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Noémie Beaulieu
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Sophie Bergeron
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Katherine Péloquin
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada.
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Morimoto Y, Go K, Yamamoto H, Fukasawa Y, Nakai M, Morihana E, Yasuda K, Nishikawa H, Ohashi N, Takahashi Y, Kato T. Conception by assisted reproductive technology in infants with critical congenital heart disease in Japan. Reprod Biomed Online 2021; 44:163-170. [PMID: 34819250 DOI: 10.1016/j.rbmo.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/27/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
RESEARCH QUESTION What is the proportion of infants born as a result of assisted reproductive technology ART across different types of neonatal critical congenital heart disease (CCHD) in a Japanese population? DESIGN A retrospective analysis of 418 consecutive infants with CCHD that required catheter treatment or surgery within the first 28 days of life or ductal-dependent lesions, in two paediatric centres in Japan, between January 2014 and December 2019. The proportion of ART in infants with each type of CCHD was evaluated. The proportion of ART in infants with univentricular heart defect (UVH) compared with those with biventricular heart defect (BVH) was evaluated. RESULTS The study group included 229 boys and 189 girls, with a gestational age of 38 ± 2 weeks. Overall, 61 infants (14.6%) were conceived by fertility treatment with 46 (11.0%) conceived by ART. Univentricular heart defect and BVH were identified in 111 infants (26.6%) and 307 infants (73.4%), respectively. The proportion of infants conceived by ART was significantly higher in UVH (16.2%) than in BVH (9.1%) (OR 2.28, 95% CI 1.11 to 4.68, P = 0.025), regardless of maternal age and maternal history of miscarriage. CONCLUSIONS The proportion of ART in infants with CCHD, especially UVH, was high. These findings could form the basis of a rationale for carrying out fetal echocardiography in fetuses conceived by ART.
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Affiliation(s)
- Yoshihito Morimoto
- Department of Paediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya Aichi, Japan
| | - Kiyotaka Go
- Department of Paediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya Aichi, Japan
| | - Hidenori Yamamoto
- Department of Paediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya Aichi, Japan
| | - Yoshie Fukasawa
- Department of Paediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya Aichi, Japan
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita Osaka, Japan
| | - Eiji Morihana
- Department of Paediatric Cardiology, Aichi Children's Health and Medical Centre, Obu Aichi, Japan
| | - Kazushi Yasuda
- Department of Paediatric Cardiology, Aichi Children's Health and Medical Centre, Obu Aichi, Japan
| | - Hiroshi Nishikawa
- Department of Paediatric Cardiology, Chukyo Children Heart Centre, Japan. Community Health Care Organization Chukyo Hospital, Nagoya Aichi, Japan
| | - Naoki Ohashi
- Department of Paediatric Cardiology, Chukyo Children Heart Centre, Japan. Community Health Care Organization Chukyo Hospital, Nagoya Aichi, Japan
| | - Yoshiyuki Takahashi
- Department of Paediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya Aichi, Japan
| | - Taichi Kato
- Department of Paediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya Aichi, Japan.
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Rujas Bracamonte S, Serrano Gallardo P, Martínez Marcos M. [Uncovering infertility: the experience of women undergoing assisted reproductive technologies.]. Rev Esp Salud Publica 2021; 95:e202110131. [PMID: 34643187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE Infertility is a huge reproductive health problem in developed countries. The aim was to understand the infertility experience of women who have undergone assisted reproduction technologies. METHODS Qualitative study using Grounded Theory. Through intentional sampling and theoretical sampling, 20 women who had undergone Assisted Reproduction Technologies in public hospitals and specialized private clinics in Spain were selected. Data were collected using semi-structured interviews and were analysed using the principles of Grounded Theory: initial coding and focused coding, memo writing, theoretical sampling and constant comparative method. RESULTS "Uncovering infertility: unveiling the unknown" is the core category that explains the process which women go through. Four subcategories emerged and describe the temporal process from seeking pregnancy to reception and coping with the infertility diagnosis: "Seeking for a vital desire: being mothers/fathers", "Suspecting infertility: the absence of the natural", "In search of a diagnosis: knowing and understanding the problem" and "The impact of diagnosis: a vital grief". CONCLUSIONS Uncovering infertility is a process that has an impact on the different areas of women's lives. This process produces different emotions and feelings such as guilt, frustration, sadness or anger. This process could be easier if women have the support of their partner, their social environment and if they share their problem with women who have the same situation.
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Affiliation(s)
- Sara Rujas Bracamonte
- Departamento de Enfermería. Facultad de Medicina. Universidad Autónoma de Madrid. Madrid. España
| | - Pilar Serrano Gallardo
- Departamento de Enfermería. Facultad de Medicina. Universidad Autónoma de Madrid. Madrid. España
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA). Hospital Universitario Puerta De Hierro. Majadahonda. España
- Instituto Interuniversitario "Investigación Avanzada sobre Evaluación de la Ciencia y la Universidad" (INAECU) (UAM-UC3M). Madrid. España
| | - Mercedes Martínez Marcos
- Departamento de Enfermería. Facultad de Medicina. Universidad Autónoma de Madrid. Madrid. España
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA). Hospital Universitario Puerta De Hierro. Majadahonda. España
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Maignien C, Bourdon M, Scarano-Pereira JP, Martinino A, Cheloufi M, Marcellin L, Chapron C, Santulli P. ART Outcomes After Hysteroscopic Proximal Tubal Occlusion Versus Laparoscopic Salpingectomy for Hydrosalpinx Management in Endometriosis Patients. Reprod Sci 2021; 29:427-435. [PMID: 34642914 DOI: 10.1007/s43032-021-00737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The objective of this paper is to compare assisted reproductive technology (ART) cumulative live birth rates after hysteroscopic proximal tubal occlusion and laparoscopic salpingectomy in endometriosis patients, for management of hydrosalpinx. This is an observational cohort study at a university hospital, including all endometriosis patients with hydrosalpinges undergoing ART, between January 2013 and December 2018. The patients underwent either laparoscopic salpingectomy or hysteroscopic proximal tubal occlusion with Essure® when laparoscopy was not an option (extensive pelvic adhesions at exploratory laparoscopy or a history of multiple abdominal surgeries with frozen pelvis). The diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography (TVUS) and magnetic resonance imaging (MRI). Endometriosis patients with hydrosalpinges diagnosed by hysterosalpingography and/or TVUS and/or MRI were included. The primary outcome was the cumulative live birth rate. A total of 104 patients were included in the study; 74 underwent laparoscopic salpingectomy and 30 underwent proximal tubal occlusion with Essure®. The Essure® group had longer infertility durations (58.9 ± 30.0 months vs. 39.5 ± 19.1 months, p = 0.002) and a higher incidence of associated adenomyosis (76.7% vs. 39.1%, p < 0.001) than the salpingectomy group. The cumulative live birth rate was 56.6% after 44 ART cycles in the Essure® group and 40.5% after 99 ART cycles in the salpingectomy group (p = 0.13). In a population of endometriosis patients undergoing ART, women treated by Essure® for management of hydrosalpinx have similar cumulative live birth rates as women treated by laparoscopic salpingectomy.
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Affiliation(s)
- Chloé Maignien
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Mathilde Bourdon
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Juan Pablo Scarano-Pereira
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Alessandro Martinino
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Meryam Cheloufi
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Louis Marcellin
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Charles Chapron
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Pietro Santulli
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France.
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France.
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
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Farley GJ, Sauer MV, Brandt JS, Ananth CV. Singleton pregnancies conceived with infertility treatments and the risk of neonatal and infant mortality. Fertil Steril 2021; 116:1515-1523. [PMID: 34620455 DOI: 10.1016/j.fertnstert.2021.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine the risks of neonatal and infant mortality in relation to infertility treatment and to quantify the extent to which preterm delivery mediates this relationship. DESIGN Cross-sectional study. SETTING United States, 2015-2018. PATIENT(S) A total of 14,961,207 pregnancies resulting in a singleton live birth. INTERVENTION(S) Any infertility treatment, including assisted reproductive technology and fertility-enhancing drugs. MAIN OUTCOME MEASURE(S) Neonatal (<28 days) mortality. The effect measure, risk ratio (RR), and 95% confidence interval (CI) were derived from log-linear Poisson models. A causal mediation analysis of the relationship between infertility treatment and mortality associated with preterm delivery (<37 weeks) was performed. The effects of exposure misclassification and unmeasured confounding biases were assessed. RESULT(S) Any infertility treatment was documented in 1.3% (n = 198,986) of pregnancies. Infertility treatment was associated with a 51% increased risk of neonatal mortality (RR 1.51, 95% CI 1.39-1.64), with a slightly higher risk for early neonatal mortality (RR 1.57, 95% CI 1.43-1.73) than late neonatal mortality (RR 1.33, 95% CI 1.11-1.58). These risks were similar for pregnancies conceived through assisted reproductive technology and fertility-enhancing drugs. The mediation analysis showed that 72% (95% CI 59-85) of the total effect of infertility treatment on neonatal mortality was mediated through preterm delivery. In a sensitivity analysis, following corrections for exposure misclassification and unmeasured confounding biases, these risks were higher for early, but not for late, neonatal mortality. CONCLUSION(S) Pregnancies conceived with infertility treatment are associated with increased neonatal mortality, and this association is largely mediated through preterm delivery. However, given the substantial underreporting of infertility treatment, these associations must be cautiously interpreted.
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Affiliation(s)
- Gordon J Farley
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Mark V Sauer
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Cande V Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey; Cardiovascular Institute of New Jersey and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
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Sentilhes L, Kayem G. [How to avoid a disruption of care for women reluctant to the French Health Pass?]. ACTA ACUST UNITED AC 2021; 49:727-728. [PMID: 34607653 PMCID: PMC8485725 DOI: 10.1016/j.gofs.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.
| | - Gilles Kayem
- Department of Obstetrics and Gynecology, Trousseau Hospital, AP-HP, Paris, France
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Poquet J, Chansel-Debordeaux L, Doray B, Mons J, Toutain J, Lheureux H. [ Assisted reproductive technology outcomes of infertile men carrying balanced chromosomal rearrangements or Y-chromosome microdeletions - Retrospective study]. Ann Biol Clin (Paris) 2021; 79:427-38. [PMID: 34782309 DOI: 10.1684/abc.2021.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the ART outcomes for infertile males carrying a balanced structural chromosomal rearrangement or a Y-chromosome microdeletion, and to compare the results with a control group. The primary outcome was the clinical pregnancy rate. A retrospective case-control study has been carried out in the ART departments of the university hospitals of Bordeaux and la Réunion. Results of karyotypes and Y-chromosome microdeletions analysis of infertile men with sperm concentration lower than 5 millions/mL have been extracted from the softwares Jfiv® (Bordeaux) and MédiFirst® (la Réunion). The clinical pregnancy rate for carriers of balanced chromosomal rearrangements and Y-chromosome microdeletions was 28% and 43% respectively. The clinical pregnancy rate for the controls was 24% (non-significant difference). According to this study, balanced chromosomal rearrangements and Y-chromosome microdeletions are not found to affect the clinical pregnancy rate in conventional ART. Further larger scale studies are required to confirm these results.
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Jinno M, Nagai R, Takeuchi M, Watanabe A, Teruya K, Sugawa H, Hatakeyama N, Jinno Y. Trapa bispinosa Roxb. extract lowers advanced glycation end-products and increases live births in older patients with assisted reproductive technology: a randomized controlled trial. Reprod Biol Endocrinol 2021; 19:149. [PMID: 34579763 PMCID: PMC8474760 DOI: 10.1186/s12958-021-00832-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Advanced glycation end-products (AGE), which accumulate with insulin resistance and aging, impair folliculogenesis and may decrease endometrial receptivity. Hishi (Trapa bispinosa Roxb.) extract, a safe herbal medicine, strongly inhibits AGE formation in vitro. We determined whether Hishi lowers AGE and increases live births in older assisted reproductive technology (ART) patients. METHODS This prospective randomized open-label controlled trial included 64 patients 38 to 42 years old undergoing ART with or without Hishi extract between June 11, 2015 and July 12, 2019. None had over 2 ART failures, diabetes, uterine anomalies, or exhausted ovarian reserve. After allocation, the Hishi group received Hishi extract (100 mg/day) until late pregnancy or failure. The control group received no extract. Both groups underwent 1 cycle of conventional infertility treatment; 1 long-protocol cycle of ovarian stimulation, oocyte retrieval, in vitro fertilization/intracytoplasmic sperm injection, and fresh embryo transfer (ET); and, if needed, cryopreserved ET until live birth or embryo depletion. Serum AGE were measured before and during ART, as were AGE in follicular fluid (FF). RESULTS Cumulative live birth rate among 32 Hishi patients was 47%, significantly higher than 16% among 31 controls (p<0.01; RR, 4.6; 95% CI, 1.4 - 15.0; 1 control dropped out). Live birth rate per ET, including fresh and cryopreserved, was significantly higher with Hishi (28% in 47 ET vs. 10% in 49 ET; p<0.05; RR, 3.4; 95% CI, 1.1-10.4). Among variables including age, day-3 FSH, anti-Müllerian hormone, and Hishi, logistic regression identified only Hishi as significantly associated with increased cumulative live birth (p<0.05; OR, 5.1; 95% CI, 1.4 - 18.3). Hishi significantly enhanced oocyte developmental potential, improved endometrial receptivity in natural cycles, and decreased AGE in serum and FF. Larger serum AGE decreases with Hishi were associated with more oocytes becoming day-2 embryos. CONCLUSIONS Hishi decreased AGE in serum and FF and improved oocyte developmental potential and endometrial receptivity, increasing live births in older patients. Treatment of infertility by AGE reduction represents a new addition to infertility treatment. Therapeutic trials of Hishi for other AGE-associated diseases might be considered. TRIAL REGISTRATION UMIN registration in Japan ( UMIN000017758 ) on June 1, 2015. https://www.umin.ac.jp/ctr/index.htm.
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Affiliation(s)
- Masao Jinno
- Women's Clinic Jinno, 3-11-7 Kokuryou-chou, Choufu City, Tokyo, 182-0022, Japan.
| | - Ryoji Nagai
- Laboratory of Food and Regulation Biology, Graduate School of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
| | - Masayoshi Takeuchi
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Aiko Watanabe
- Women's Clinic Jinno, 3-11-7 Kokuryou-chou, Choufu City, Tokyo, 182-0022, Japan
| | - Koji Teruya
- Faculty of Health Sciences, Kyorin University, Mitaka City, Tokyo, 181-8612, Japan
| | - Hikari Sugawa
- Laboratory of Food and Regulation Biology, Graduate School of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
| | - Naohisa Hatakeyama
- Women's Clinic Jinno, 3-11-7 Kokuryou-chou, Choufu City, Tokyo, 182-0022, Japan
| | - Yuichi Jinno
- Women's Clinic Jinno, 3-11-7 Kokuryou-chou, Choufu City, Tokyo, 182-0022, Japan
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Sarno L, Tagliaferri S, Carlea A, Talhami F, Migliorini S, Maruotti GM, Campanile M, Guida M. Maternal haemodynamic profile in pregnancy after assisted reproductive technology: A pilot study. Pregnancy Hypertens 2021; 26:62-64. [PMID: 34536701 DOI: 10.1016/j.preghy.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/20/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
Singleton pregnancies obtained by assisted reproductive technology (ART) are at increased risk of adverse pregnancy outcome. Aim of this pilot study was to compare maternal hemodynamic profile in ART and spontaneous singleton pregnancies. Patients were enrollered during a third trimester routine obstetric examination. Maternal haemodynamic assessment was carried out by a single trained operator using an UltraSonic Cardiac Output Monitor in standardized conditions. Our pilot data suggests that women conceived after ART may have significantly lower Cardiac Output and significantly higher Systemic Vascular Resistance when compared to those conceiving spontaneously. These differences, if confirmed in larger studies, might explain the increased prevalence of adverse outcome, especially hypertensive disorders of pregnancy, in singleton ART pregnancies.
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Affiliation(s)
- Laura Sarno
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy.
| | - Salvatore Tagliaferri
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
| | - Annunziata Carlea
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
| | - Farid Talhami
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
| | - Sonia Migliorini
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
| | - Giuseppe Maria Maruotti
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
| | - Marta Campanile
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
| | - Maurizio Guida
- Department of Neurosciences, Reproductive Science and Dentistry, University Federico II of Naples, Via Pansini, 5-80131 Naples, Italy
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Fitz VW, Kanakasabapathy MK, Thirumalaraju P, Kandula H, Ramirez LB, Boehnlein L, Swain JE, Curchoe CL, James K, Dimitriadis I, Souter I, Bormann CL, Shafiee H. Should there be an "AI" in TEAM? Embryologists selection of high implantation potential embryos improves with the aid of an artificial intelligence algorithm. J Assist Reprod Genet 2021. [PMID: 34535847 DOI: 10.1007/s10815-021-02318-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE A deep learning artificial intelligence (AI) algorithm has been demonstrated to outperform embryologists in identifying euploid embryos destined to implant with an accuracy of 75.3% (1). Our aim was to evaluate the performance of highly trained embryologists in selecting top quality day 5 euploid blastocysts with and without the aid of a deep learning algorithm. MATERIALS AND METHODS A non-overlapping series of 200 sets of day 5 euploid embryo images with known implantation outcomes was distributed to 17 highly trained embryologists. One embryo in each set was known to have implanted and one failed implantation. They were asked to select which embryo to transfer from each set. The same 200 sets of embryos, with indication of which embryo in each set had been identified by the algorithm as more likely to implant was then distributed. Chi-squared, t-test, and receiver operating curves were performed to compare the embryologist performeance with and without AI. RESULTS Fourteen embryologists completed both assessments. Embryologists provided with AI results selected successfully implanted embryos in 73.6% of cases compared to 65.5% for those selected using visual assessments alone (p < 0.001). All embryologists improved in their ability to select embryos with the aid of the AI algorithm with a mean percent improvement of 11.1% (range 1.4% to 15.5%). There were no differences in degree of improvement by embryologist level of experience (junior, intermediate, senior). CONCLUSIONS The incorporation of an AI framework for blastocyst selection enhanced the performance of trained embryologists in identifying PGT-A euploid embryos destined to implant.
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Chang YE, Yu TN, Chen CH, Chou SY, Lu BJ, Chen CH. The debated role of bariatric surgery in improving in-vitro fertilization outcomes in morbidly-obese infertile women-a case report and brief overview. Taiwan J Obstet Gynecol 2021; 60:935-937. [PMID: 34507679 DOI: 10.1016/j.tjog.2021.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Obesity has a negative impact on in-vitro fertilization (IVF) outcomes, and obese women who plan IVF treatments are often encouraged to pursue weight reduction. Bariatric surgery is an effective strategy for the treatment of morbidly obese women. The current case report is to investigate the impact of bariatric surgery on IVF outcome in a morbidly obese woman with subfertility. CASE REPORT A 37-year-old, morbidly obese woman with subfertility was indicated for IVF treatment. Due to her high body mass index (47.9 kg/m2), she was advised to lose weight; initial failure at conservative measures of weight loss prompted her to undergo bariatric surgery, combined with post-operative lifestyle change, prior to receiving IVF treatment. The woman successfully conceived at the second cycle and delivered twins by cesarean section smoothly at 36 + 3/7 weeks of gestation. Both twins have normal development up to two years of age. CONCLUSIONS Weight reduction mediated by bariatric surgery in subfertile and morbidly obese women can be considered before IVF treatment.
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Affiliation(s)
- Yi-En Chang
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tzu-Ning Yu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Ching-Hui Chen
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Nuwa Fertility Center, Taipei, Taiwan
| | - Szu-Yuan Chou
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Buo-Jia Lu
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chi-Huang Chen
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Wang JW, Liao XX, Li T. Thyroid Autoimmunity in Adverse Fertility and Pregnancy Outcomes: Timing of Assisted Reproductive Technology in AITD Women. J Transl Int Med 2021; 9:76-83. [PMID: 34497747 DOI: 10.2478/jtim-2021-0001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Thyroid autoimmunity (TAI) is prevalent in women of live-birthing age and has independently been associated with complications of fertility and pregnancy, in the case of spontaneous conception or after assisted reproductive technology (ART) treatment. However, it remains challenging to identify causation between infertility and TAI, even interventional trials looking at the impact of levothyroxine (LT4) treatment on fertility and pregnancy outcomes due to differences among study results which related to small scales, impropriate study designs, enrollment criteria of infertility cause and titer/hormone concentration measurements. Furthermore, many questions remain unsettled in ART management in AITD infertile women attempt pregnancy. Therefore, further observational and interventional trials are needed more comprehensive multiple-center, double blinded, and randomized.
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Wang J, Zheng W, Zhang S, Yan K, Jin M, Hu H, Ma Z, Gong F, Lu G, Ren Y, Lin L, Lin G, Hu L, Liu S. An increase of phosphatidylcholines in follicular fluid implies attenuation of embryo quality on day 3 post-fertilization. BMC Biol 2021; 19:200. [PMID: 34503495 PMCID: PMC8428131 DOI: 10.1186/s12915-021-01118-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 08/03/2021] [Indexed: 01/02/2023] Open
Abstract
Background Although oocyte quality is the dominant factor determining embryo quality, few studies have been conducted to evaluate embryo quality based on the metabolites related to the oocyte. With quantification of the follicular fluid (FF) metabolites, in assisted reproductive technology (ART), this study sought to evaluate the embryo or oocyte quality through an informative approach. Results An evaluation model consisting of 17 features was generated to distinguish the embryo quality on day 3 post-fertilization, and phosphatidylcholines (PCs) were the key contributors to the evaluation. The model was extended to the patients under different ages and hyperstimulations, and the features were further enriched to facilitate the evaluation of the embryo quality. The metabolites were clustered through pathway analysis, leading to a hypothesis that accumulation of arachidonic acid induced by PCs might weaken embryo quality on day 3 post-fertilization. Conclusions A discriminating model with metabolic features elicited from follicular fluid was established, which enabled the evaluation of the embryo or oocyte quality even under certain clinical conditions, and the increase of PCs in follicular fluid implies the attenuation of embryo quality on day 3 post-fertilization. Supplementary Information The online version contains supplementary material available at 10.1186/s12915-021-01118-w.
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Affiliation(s)
- Ju Wang
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China.,BGI-Shenzhen, Shenzhen, 518083, China
| | - Wei Zheng
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China
| | - Shuoping Zhang
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China
| | - Keqiang Yan
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China.,BGI-Shenzhen, Shenzhen, 518083, China
| | - Miao Jin
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China
| | - Huiling Hu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Key Laboratory of National Health and Family Planning Commission, Central South University, Changsha, 410008, Hunan, China
| | - Zhen Ma
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China.,BGI-Shenzhen, Shenzhen, 518083, China
| | - Fei Gong
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Key Laboratory of National Health and Family Planning Commission, Central South University, Changsha, 410008, Hunan, China
| | - Guangxiu Lu
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Key Laboratory of National Health and Family Planning Commission, Central South University, Changsha, 410008, Hunan, China
| | - Yan Ren
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China.,BGI-Shenzhen, Shenzhen, 518083, China
| | - Liang Lin
- BGI-Shenzhen, Shenzhen, 518083, China
| | - Ge Lin
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China.,Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Key Laboratory of National Health and Family Planning Commission, Central South University, Changsha, 410008, Hunan, China
| | - Liang Hu
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, 410008, China. .,Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Key Laboratory of National Health and Family Planning Commission, Central South University, Changsha, 410008, Hunan, China.
| | - Siqi Liu
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China. .,BGI-Shenzhen, Shenzhen, 518083, China.
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Wyse BA, Fuchs Weizman N, Defer M, Montbriand J, Szaraz P, Librach C. The follicular fluid adipocytokine milieu could serve as a prediction tool for fertility treatment outcomes. Reprod Biomed Online 2021; 43:738-746. [PMID: 34474976 DOI: 10.1016/j.rbmo.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/07/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
RESEARCH QUESTION Can the adipocytokine milieu of the follicular niche improve the ability to predict treatment outcomes in infertile patients? DESIGN Follicular fluid samples from overweight patients were analysed and compared with samples from matched normal-weight patients. Concentrations of adiponectin, chemerin, C-reactive protein, interleukin-6 (IL-6), IL-10, IL-18, insulin, leptin, prolactin, resistin, tumour necrosis factor alpha (TNF-α) and bone morphogenetic protein-15 (BMP-15) were assessed by multiple magnetic bead immunoassay (MMBI) and enzyme-linked immunosorbent assay and correlated with fertility treatment outcomes. RESULTS Analysis of samples from 22 overweight and 22 normal-weight patients demonstrated that TNF-α can predict oocyte maturation rate. When stratified by body mass index (BMI), IL-10 emerges as a better predictor of oocyte maturation in normal-weight patients. Prolactin was a negative predictor for fertilization rate in the full cohort, and this prediction power was lost upon stratification. No adipocytokines were predictive of blastulation rate, and only age remained predictive. BMP-15 was a strong predictor of high-quality blastulation in the full cohort, more so in the normal-weight population. CONCLUSIONS The adipocytokine milieu of the follicular fluid provides a snapshot of the growing oocyte's environment and can help predict fertility treatment outcomes, fine-tuning understanding of the dysregulation caused by increasing BMI. Inflammatory cytokines can predict oocyte maturation; prolactin, oocyte competence; and BMP-15, high-quality blastulation. Further analysis of these findings with a larger sample size and assessing individual oocytes will help shed more light on the clinical significance of these findings.
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Affiliation(s)
| | | | | | - Janice Montbriand
- Department of Anaesthesia, Sunnybrook Health Sciences Centre, Toronto Ontario, Canada
| | - Peter Szaraz
- CReATe Fertility Centre, Toronto Ontario, Canada
| | - Clifford Librach
- CReATe Fertility Centre, Toronto Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto Ontario, Canada; Department of Physiology and Institute of Medical Sciences, University of Toronto, Toronto Ontario, Canada
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Mourad A, Antaki R, Bissonnette F, Al Baini O, Saadeh B, Jamal W. Evidence-based clinical prioritization of embryos with mosaic results: a systematic review and meta-analysis. J Assist Reprod Genet 2021; 38:2849-2860. [PMID: 34472017 DOI: 10.1007/s10815-021-02279-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/09/2021] [Indexed: 01/11/2023] Open
Abstract
PURPOSE The purpose of this review and meta-analysis is to standardize the practice of mosaic embryo transfer, based on the current available evidence. METHODS This is a systematic review and meta-analysis. Relevant studies published were comprehensively selected using PubMed, Medline, Embase, and CENTRAL until 5 March 2021. Prospective and retrospective studies reporting the genetic analysis and clinical outcomes of mosaic embryo transfer were included. Risk of bias assessment was based on the Newcastle-Ottawa scale for the non-randomized studies. The primary and secondary outcomes were combined ongoing pregnancy and live birth rate and miscarriage rate, respectively. RESULTS There were no differences between low and high mosaic embryos when a cut-off of 40% was used in terms of OP/LBR and SAB. However, low mosaics with a cut-off of 50% compared to high mosaics showed a significantly higher OP/LBR in the NGS but not in the a-CGH group, and a significantly lower risk of SAB. No differences were noted between mosaic monosomies versus trisomies and single versus double mosaics for both OP/LBR and SAB. Finally, segmental mosaics showed a higher OP/LBR and a lower SAB compared to whole chromosomes, and single and double mosaics had a higher OP/LBR compared to complex mosaics. CONCLUSIONS A cut-off of 50% in defining low versus high mosaic embryos is preferable to a threshold of 40% when using NGS platform. No priority was established for mosaic trisomies over monosomies. Single and double mosaics must be preferred over complex mosaics and segmental mosaics must be preferred over whole chromosome mosaics. These results should be interpreted in the context of specific chromosomes involved in the mosaicism.
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Affiliation(s)
- Ali Mourad
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Roland Antaki
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- OVO Fertility Center, 8000 Decarie Blvd, Montreal, QC, H4P 2S4, Canada
| | - François Bissonnette
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- OVO Fertility Center, 8000 Decarie Blvd, Montreal, QC, H4P 2S4, Canada
| | - Obey Al Baini
- Department of Research, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | | | - Wael Jamal
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
- OVO Fertility Center, 8000 Decarie Blvd, Montreal, QC, H4P 2S4, Canada.
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Belaisch-Allart J. [The new Bioethics law in France]. Gynecol Obstet Fertil Senol 2021; 49:649-650. [PMID: 34488990 DOI: 10.1016/j.gofs.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Andreadou MT, Katsaras GN, Talimtzi P, Doxani C, Zintzaras E, Stefanidis I. Association of assisted reproductive technology with autism spectrum disorder in the offspring: an updated systematic review and meta-analysis. Eur J Pediatr 2021; 180:2741-55. [PMID: 34279715 DOI: 10.1007/s00431-021-04187-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 12/18/2022]
Abstract
This study aims to provide an up-to-date meta-analysis of data from studies investigating the risk of bearing a child with autism spectrum disorder (ASD) after being conceived by assisted reproductive technology (ART). The study was conducted according to the PRISMA Statement. PubMed and Scopus databases were searched up to August 2, 2020. Observational studies using a type of conception of assisted reproductive technology and examined as outcome offspring with ASD were included. A random effect model was applied due to the heterogeneity of the studies. Statistical analysis was performed with Stata 13 software. The Newcastle-Ottawa scale was used to assess the methodological quality of the included studies. The search strategy identified 587 potentially relevant studies. A total of 15 studies provided adequate data for statistical comparisons and, therefore, were included in the meta-analysis. Analysis of the subset of studies that examined all offspring and controlled for confounder factors revealed that the use of ART is associated with a higher risk of ASD (RR = 1.11, 95% CI = 1.03-1.19, p < 0.009), while in the case of studies that focused on singletons, a statistically significant association between ART and ASD was not observed (RR = 0.96, 95% CI = 0.82-1.13, p = 0.654).Conclusion: The present meta-analysis confirmed the existing positive correlation between ART and ASD in offspring, suggesting that ART is correlated with a higher risk for bearing a child with ASD. In contrast, this relationship is not confirmed in singletons. High quality prospective studies with a larger number of participants are still required. What is Known: • Studies that investigated the association between ART and ASD in offspring have shown conflicting results. • A previous meta-analysis showed that offspring conceived by ART are 1.35 times more likely to develop ASD than offspring spontaneously conceived. What is New: • This investigation separately considered studies with and without adjustment for confounders. • The findings from the two analyses were similar.
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Ogawa K, Jwa SC, Morisaki N, Sago H. Risk factors and clinical outcomes for placenta accreta spectrum with or without placenta previa. Arch Gynecol Obstet 2021. [PMID: 34448037 DOI: 10.1007/s00404-021-06189-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To clarify risk factors and clinical outcomes for placenta accreta spectrum (PAS) stratified by placenta previa. METHODS We conducted registry-based multicenter cross-sectional study including 472,301 singleton deliveries between 2013 and 2015. PAS was considered as a primary outcome, as well as maternal age, parity, history of cesarean section, history of miscarriage, and assisted reproductive technology (ART) were considered as potential exposures. A multivariable Poisson regression analysis was conducted to assess the risk for PAS, stratified by placenta previa. In addition, the risk for subsequent blood transfusion and hysterectomy by each exposure using multivariable Poisson regression analysis was conducted. RESULTS There were 426 and 1827 cases of PAS with and without placenta previa. Among cases with placenta previa, the number of previous cesarean sections was the most powerful predictor for PAS [adjusted risk ratio (aRR) for one previous cesarean section 5.34, 95% confidence interval (CI) 3.70-7.71; aRR for two or more previous cesarean section 16.5, 95% CI 11.5-23.6]. Among cases without placenta previa, previous cesarean section was not a significant predictor, whereas the strongest predictor was conception through ART (aRR 5.05, 95% CI 4.50-5.66). Although the risks of PAS for blood transfusion and hysterectomy were higher among cases with placenta previa, those without placenta previa also demonstrated non-negligible risks. CONCLUSION The current study demonstrated that history of cesarean section was the strongest risk factor for PAS among women with placenta previa. Among those without placenta previa, ART was an important predictor, but not cesarean section.
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Tsai HW, Liao PF, Li CJ, Lin LT, Wen ZH, Tsui KH. High serum anti-Müllerian hormone concentrations have a negative impact on fertilization and embryo development rates. Reprod Biomed Online 2021; 44:171-176. [PMID: 34801403 DOI: 10.1016/j.rbmo.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/06/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
RESEARCH QUESTION What is the impact of high serum anti-Müllerian hormone (AMH) concentrations on fertilization and embryo development among infertile women undergoing treatment with assisted reproductive technology (ART)? DESIGN Retrospective study of 1036 infertile women undergoing ART; women were divided into three groups according to serum AMH concentrations: AMH <1.1 ng/ml, 1.1-5.0 ng/ml and >5.0 ng/ml. The fertilization and embryo development rates of patients with different AMH concentrations and after stratification according to age were compared. RESULTS Women with high AMH concentrations were younger and had higher testosterone concentrations (0.4 ± 0.13 versus 0.3 ± 0.12 versus 0.3 ± 0.08 µg/dl, P < 0.001) than women with low AMH concentrations. However, analysis of the embryo development rate showed negative outcomes for women with high AMH concentrations, including a poor fertilization rate (76.3 ± 17.36 versus 82.1 ± 19.15 versus 82.4 ± 25.38, P = 0.003), and poor day 3 embryo development rate (55.6 ± 23.88 versus 62.6 ± 26.52 versus 62.8 ± 32.65, P = 0.014). Multivariate linear regression analysis showed significantly negative correlations of the AMH concentrations with the fertilization rate (P < 0.001) and day 3 embryo development rate (P = 0.006). Subgroup analysis showed that age 30 years or younger had a significant negative correlation with AMH and the embryo development rate, including the fertilization rate (P < 0.001) and day 3 embryo development rate (P = 0.037). CONCLUSION These results suggest that high serum AMH concentrations, contributing to a hyperandrogenic environment and leading to decreased oocyte developmental competence, may have a negative impact on fertilization and the early stage of embryo development in women undergoing treatment with ART.
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Affiliation(s)
- Hsiao-Wen Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Pei-Fen Liao
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chia-Jung Li
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Zhi-Hong Wen
- Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Kuan-Hao Tsui
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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