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Serapinas D, Butkeviciene E, Daugelaite K, Narbekovas A, Juskevicius J, Bartkeviciute A, Bartkeviciene D. Conjoined twins after in-vitro fertilization. Eur J Obstet Gynecol Reprod Biol 2017; 212:188-190. [DOI: 10.1016/j.ejogrb.2016.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/10/2016] [Indexed: 11/30/2022]
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The health outcomes of human offspring conceived by assisted reproductive technologies (ART). J Dev Orig Health Dis 2017; 8:388-402. [DOI: 10.1017/s2040174417000228] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Concerns have been raised about the health and development of children conceived by assisted reproductive technologies (ART) since 1978. Controversially, ART has been linked with adverse obstetric and perinatal outcomes, an increased risk of birth defects, cancers, and growth and development disorders. Emerging evidence suggests that ART treatment may also predispose individuals to an increased risk of chronic ageing related diseases such as obesity, type 2 diabetes and cardiovascular disease. This review will summarize the available evidence on the short-term and long-term health outcomes of ART singletons, as multiple pregnancies after multiple embryos transfer, are associated with low birth weight and preterm delivery, which can separately increase risk of adverse postnatal outcomes, and impact long-term health. We will also examine the potential factors that may contribute to these health risks, and discuss underlying mechanisms, including epigenetic changes that may occur during the preimplantation period and reprogram development in utero, and adult health, later in life. Lastly, this review will consider the future directions with the view to optimize the long-term health of ART children.
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Navas P, Paffoni A, Intra G, González-Utor A, Clavero A, Gonzalvo MC, Díaz R, Peña R, Restelli L, Somigliana E, Papaleo E, Castilla JA, Viganò P. Obstetric and neo-natal outcomes of ICSI cycles using pentoxifylline to identify viable spermatozoa in patients with immotile spermatozoa. Reprod Biomed Online 2017; 34:414-421. [DOI: 10.1016/j.rbmo.2017.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/19/2016] [Accepted: 01/11/2017] [Indexed: 12/18/2022]
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Qin JB, Sheng XQ, Wang H, Chen GC, Yang J, Yu H, Yang TB. Worldwide prevalence of adverse pregnancy outcomes associated with in vitro fertilization/intracytoplasmic sperm injection among multiple births: a systematic review and meta-analysis based on cohort studies. Arch Gynecol Obstet 2017; 295:577-597. [DOI: 10.1007/s00404-017-4291-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
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Tarlatzi TB, Imbert R, Alvaro Mercadal B, Demeestere I, Venetis CA, Englert Y, Delbaere A. Does oocyte donation compared with autologous oocyte IVF pregnancies have a higher risk of preeclampsia? Reprod Biomed Online 2017; 34:11-18. [DOI: 10.1016/j.rbmo.2016.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/30/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
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Chima UM, Abu AH, Dawuda PM, Kisani AI, Ahemen T. Effect of Storage Time on Cauda Epididymal Sperm Parameters of Nigerian Local Dogs. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojvm.2017.711016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Meijerink AM, Ramos L, Janssen AJ, Maas–van Schaaijk NM, Meissner A, Repping S, Mochtar MH, Braat DD, Fleischer K. Behavioral, cognitive, and motor performance and physical development of five-year-old children who were born after intracytoplasmic sperm injection with the use of testicular sperm. Fertil Steril 2016; 106:1673-1682.e5. [DOI: 10.1016/j.fertnstert.2016.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/26/2016] [Accepted: 09/07/2016] [Indexed: 11/25/2022]
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Grimstad FW, Nangia AK, Luke B, Stern JE, Mak W. Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates. Hum Reprod 2016; 31:2750-2755. [PMID: 27738114 DOI: 10.1093/humrep/dew247] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 08/20/2016] [Accepted: 08/25/2016] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does ICSI improve outcomes in ART cycles without male factor, specifically in couples with a history of tubal ligation as their infertility diagnosis? SUMMARY ANSWER The use of ICSI showed no significant improvement in fertilization rate and resulted in lower pregnancy and live birth (LB) rates for women with the diagnosis of tubal ligation and no male factor. WHAT IS KNOWN ALREADY Prior studies have suggested that ICSI use does not improve fertilization, pregnancy or LB rates in couples with non-male factor infertility. However, it is unknown whether couples with tubal ligation only diagnosis and therefore iatrogenic infertility could benefit from the use of ICSI during their ART cycles. STUDY DESIGN, SIZE, DURATION Longitudinal cohort of nationally reported cycles in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) of ART cycles performed in the USA between 2004 and 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS There was a total of 8102 first autologous fresh ART cycles from women with the diagnosis of tubal ligation only and no reported male factor in the SART database. Of these, 957 were canceled cycles and were excluded from the final analysis. The remaining cycles were categorized by the use of conventional IVF (IVF, n = 3956 cycles) or ICSI (n = 3189 cycles). The odds of fertilization, clinical intrauterine gestation (CIG) and LB were calculated by logistic regression modeling, and the adjusted odds ratios (AORs) with 95% confidence intervals were calculated by adjusting for the confounders of year of treatment, maternal age, race and ethnicity, gravidity, number of oocytes retrieved, day of embryo transfer and number of embryos transferred. MAIN RESULTS AND THE ROLE OF CHANCE The main outcome measures of the study were odds of fertilization (2PN/total oocytes), clinical intrauterine gestation (CIG/cycle) and live birth (LB/cycle). The fertilization rate was higher in the ICSI versus IVF group (57.5% vs 49.1%); however, after adjustment this trend was no longer significant (AOR 1.14, 0.97-1.35). Interestingly, both odds of CIG (AOR 0.78, 0.70-0.86), and odds of LB were lower (AOR 0.77, 0.69-0.85) in the ICSI group. Plurality at birth, mean length of gestation and birth weight did not differ between the two groups. LIMITATIONS, REASONS FOR CAUTION This was a retrospective study, therefore only the available parameters could be included, with parameters of interest such as smoking status not available for inclusion. Smoking status may have led practitioners to use ICSI to improve pregnancy and LB outcomes. WIDER IMPLICATIONS OF THE FINDINGS Studies have shown that in the USA there is an increasing usage of ICSI for non-male factor infertility despite a lack of evidence-based benefit. Our study corroborates this increasing use over the last 8 years, specifically in the tubal ligation only patient population. Even after adjusting for multiple confounders, the patients who underwent ICSI had no statistically significant improvement in fertilization rate and actually had a lower likelihood of achieving a clinical pregnancy and LB. Therefore, our data suggest that the use of ICSI in tubal ligation patients has no overall benefit. This study contributes to the body of evidence that the use of ICSI for non-male factor diagnosis does not improve ART outcomes over conventional IVF. STUDY FUNDING/COMPETING INTERESTS None.
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Affiliation(s)
- F W Grimstad
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Ajay K Nangia
- Department of Urology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - B Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 220 Trowbridge Rd, East Lansing, MI 48824, USA
| | - J E Stern
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock, 1 Medical Center Dr, Lebanon, NH 03766, USA
| | - W Mak
- Department of Obstetrics and Gynecology, Yale School of Medicine, 310 Cedar Street FMB 329 G, New Haven, CT 06519, USA
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Moradi SZ, Masoudi N, Mohseni Meybodi A, Anisi Hemaseh K, Mozafari Kermani R, Shahzadeh Fazeli A, Gourabi H. Cord Blood Karyotyping: A Safe and Non-Invasive Method for Postnatal Testing of Assisted Reproductive Technology Children. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:297-302. [PMID: 27695612 PMCID: PMC5023040 DOI: 10.22074/ijfs.2016.5046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 05/03/2016] [Indexed: 11/16/2022]
Abstract
Background: To verify the hypothesis that the incidence of chromosomal abnormalities
increases in babies conceived by different assisted reproduction procedures. The availability of the umbilical cord blood encouraged us to study this hypothesis via this method. Materials and Methods: This is a descriptive study, umbilical cord blood samples of assisted reproductive technology (ART) children were analyzed with standard cytogenetic
techniques (G banding). Karyotyping was possible in 109 cases. Results: The number of abnormal cases was four (3.7%), among which, three cases
(2.8%) were inherited and only 1 case (0.9%) was a de novo translocation. In total, the
incidence of de novo chromosomal abnormalities was in the range observed in all live
births in the general population (0.7-1%). Conclusion: No significant difference in the incidence of chromosomal abnormality was
found between ART and naturally conceived babies. To date, several studies have examined the medical and developmental outcome of ART children and still have not reached
a definite conclusion. Genetic counseling is recommended as an integral part of planning
of treatment strategies for couples wishing to undergo ART.
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Affiliation(s)
- Shabnam Zarei Moradi
- Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Najmehsadat Masoudi
- Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Anahita Mohseni Meybodi
- Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Khadijeh Anisi Hemaseh
- Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ramin Mozafari Kermani
- Child Health and Development Research Center, Iran Medical Science Branch of ACECR, Tehran, Iran
| | - Abolhasan Shahzadeh Fazeli
- Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Child Health and Development Research Center, Iran Medical Science Branch of ACECR, Tehran, Iran
| | - Hamid Gourabi
- Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Kleijkers SHM, Mantikou E, Slappendel E, Consten D, van Echten-Arends J, Wetzels AM, van Wely M, Smits LJM, van Montfoort APA, Repping S, Dumoulin JCM, Mastenbroek S. Influence of embryo culture medium (G5 and HTF) on pregnancy and perinatal outcome after IVF: a multicenter RCT. Hum Reprod 2016; 31:2219-30. [PMID: 27554441 DOI: 10.1093/humrep/dew156] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 05/19/2016] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION Does embryo culture medium influence pregnancy and perinatal outcome in IVF? SUMMARY ANSWER Embryo culture media used in IVF affect treatment efficacy and the birthweight of newborns. WHAT IS KNOWN ALREADY A wide variety of culture media for human preimplantation embryos in IVF/ICSI treatments currently exists. It is unknown which medium is best in terms of clinical outcomes. Furthermore, it has been suggested that the culture medium used for the in vitro culture of embryos affects birthweight, but this has never been demonstrated by large randomized trials. STUDY DESIGN, SIZE, DURATION We conducted a multicenter, double-blind RCT comparing the use of HTF and G5 embryo culture media in IVF. Between July 2010 and May 2012, 836 couples (419 in the HTF group and 417 in the G5 group) were included. The allocated medium (1:1 allocation) was used in all treatment cycles a couple received within 1 year after randomization, including possible transfers with frozen-thawed embryos. The primary outcome was live birth rate. PARTICIPANTS/MATERIALS, SETTING, METHODS Couples that were scheduled for an IVF or an ICSI treatment at one of the six participating centers in the Netherlands or their affiliated clinics. MAIN RESULTS AND THE ROLE OF CHANCE The live birth rate was higher, albeit nonsignificantly, in couples assigned to G5 than in couples assigned to HTF (44.1% (184/417) versus 37.9% (159/419); RR: 1.2; 95% confidence interval (CI): 0.99-1.37; P = 0.08). Number of utilizable embryos per cycle (2.8 ± 2.3 versus 2.3 ± 1.8; P < 0.001), implantation rate after fresh embryo transfer (20.2 versus 15.3%; P < 0.001) and clinical pregnancy rate (47.7 versus 40.1%; RR: 1.2; 95% CI: 1.02-1.39; P = 0.03) were significantly higher for couples assigned to G5 compared with those assigned to HTF. Of the 383 live born children in this trial, birthweight data from 380 children (300 singletons (G5: 163, HTF: 137) and 80 twin children (G5: 38, HTF: 42)) were retrieved. Birthweight was significantly lower in the G5 group compared with the HTF group, with a mean difference of 158 g (95% CI: 42-275 g; P = 0.008). More singletons were born preterm in the G5 group (8.6% (14/163) versus 2.2% (3/137), but singleton birthweight adjusted for gestational age and gender (z-score) was also lower in the G5 than in the HTF group (-0.13 ± 0.08 versus 0.17 ± 0.08; P = 0.008). LIMITATIONS, REASONS FOR CAUTION This study was powered to detect a 10% difference in live births while a smaller difference could still be clinically relevant. The effect of other culture media on perinatal outcome remains to be determined. WIDER IMPLICATIONS OF THE FINDINGS Embryo culture media used in IVF affect not only treatment efficacy but also perinatal outcome. This suggests that the millions of human embryos that are cultured in vitro each year are sensitive to their environment. These findings should lead to increased awareness, mechanistic studies and legislative adaptations to protect IVF offspring during the first few days of their existence. STUDY FUNDING/COMPETING INTERESTS This project was partly funded by The NutsOhra foundation (Grant 1203-061) and March of Dimes (Grant 6-FY13-153). The authors declare no conflict of interest. TRIAL REGISTRATION NUMBER NTR1979 (Netherlands Trial Registry). TRIAL REGISTRATION DATE 1 September 2009. DATE OF FIRST PATIENT'S ENROLMENT 18 July 2010.
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Affiliation(s)
- Sander H M Kleijkers
- Department of Obstetrics & Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Eleni Mantikou
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Els Slappendel
- IVF Department, Catharina Hospital, Eindhoven, The Netherlands
| | - Dimitri Consten
- Center for Reproductive Medicine, St. Elisabeth Hospital, Tilburg, The Netherlands
| | - Jannie van Echten-Arends
- Section of Reproductive Medicine, Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alex M Wetzels
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - Madelon van Wely
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Luc J M Smits
- Department of Obstetrics & Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Aafke P A van Montfoort
- Department of Obstetrics & Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sjoerd Repping
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - John C M Dumoulin
- Department of Obstetrics & Gynaecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sebastiaan Mastenbroek
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Feuer S, Rinaudo P. From Embryos to Adults: A DOHaD Perspective on In Vitro Fertilization and Other Assisted Reproductive Technologies. Healthcare (Basel) 2016; 4:healthcare4030051. [PMID: 27517965 PMCID: PMC5041052 DOI: 10.3390/healthcare4030051] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/13/2016] [Accepted: 07/29/2016] [Indexed: 01/18/2023] Open
Abstract
Human in vitro fertilization (IVF) as a treatment for infertility is regarded as one of the most outstanding accomplishments of the 20th century, and its use has grown dramatically since the late 1970s. Although IVF is considered safe and the majority of children appear healthy, reproductive technologies have been viewed with some skepticism since the in vitro environment deviates substantially from that in vivo. This is increasingly significant because the Developmental Origins of Health and Disease (DOHaD) hypothesis has illuminated the sensitivity of an organism to its environment at critical stages during development, including how suboptimal exposures restricted specifically to gamete maturation or the preimplantation period can affect postnatal growth, glucose metabolism, fat deposition, and vascular function. Today, some of the physiological metabolic phenotypes present in animal models of IVF have begun to emerge in human IVF children, but it remains unclear whether or not in vitro embryo manipulation will have lasting health consequences in the offspring. Our expanding knowledge of the DOHaD field is fueling a paradigm shift in how disease susceptibility is viewed across the life course, with particular emphasis on the importance of collecting detailed exposure information, identifying biomarkers of health, and performing longitudinal studies for any medical treatment occurring during a developmentally vulnerable period. As IVF use continues to rise, it will be highly valuable to incorporate DOHaD concepts into the clinical arena and future approaches to public health policy.
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Affiliation(s)
- Sky Feuer
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, San Francisco, CA 94143, USA.
| | - Paolo Rinaudo
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, San Francisco, CA 94143, USA.
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Belva F, Bonduelle M, Roelants M, Verheyen G, Van Landuyt L. Neonatal health including congenital malformation risk of 1072 children born after vitrified embryo transfer. Hum Reprod 2016; 31:1610-20. [DOI: 10.1093/humrep/dew103] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/12/2016] [Indexed: 11/14/2022] Open
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De Munck N, Belva F, Van de Velde H, Verheyen G, Stoop D. Closed oocyte vitrification and storage in an oocyte donation programme: obstetric and neonatal outcome. Hum Reprod 2016; 31:1024-33. [DOI: 10.1093/humrep/dew029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/02/2016] [Indexed: 01/04/2023] Open
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Coello A, Campos P, Remohí J, Meseguer M, Cobo A. A combination of hydroxypropyl cellulose and trehalose as supplementation for vitrification of human oocytes: a retrospective cohort study. J Assist Reprod Genet 2016; 33:413-421. [PMID: 26754749 DOI: 10.1007/s10815-015-0633-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/02/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This study aimed to determine whether the new formulation of vitrification solutions containing a combination of hydroxypropyl cellulose (HPC) and trehalose does not affect outcomes in comparison with using conventional solutions made of serum substitute supplement (SSS) and sucrose. METHODS Ovum donation cycles were retrospectively compared regarding the solution used for vitrification and warming of human oocytes. The analysis included 218 cycles (N = 2532 oocytes) in the study group (HPC + trehalose) and 214 cycles (N = 2353 oocytes) in the control group (SSS + sucrose). RESULTS No statistical differences were found in ovarian stimulation parameters and baseline characteristics of donors and recipients. The survival rate was 91.3% (95% confidence interval (CI) = 89.8-92.9) in the HPC + trehalose group vs. 92.1% (95% CI = 90.4-93.7) in the SSS + sucrose group (NS). The implantation rate (42.8%, 95% CI = 37.7-47.9 vs. 41.2%, 95% CI = 36.0-46.4), clinical pregnancy rate (CPR) per transfer (60.7%, 95% CI = 53.9-67.5 vs. 56.4%, 95% CI = 49.3-63.5), and ongoing pregnancy rate (OPR) per transfer (48.5%, 95% CI = 41.5-55.5 vs. 46.3%, 95% CI = 39.2-53.4) were similar for patients who received either HPC + trehalose-vitrified oocytes or SSS + sucrose-vitrified oocytes. Statistical differences were found when analyzing blastocyst rate both per injected oocyte (30.2%, 95% CI = 28.3-32.1 vs. 24.1%, 95% CI = 22.3-25.9) and per fertilized oocyte (40.8%, 95%CI = 38.5-43.1 vs. 33.2%, 95% CI = 30.8-35.5) (P < 0.0001). Delivery rate was comparable between groups (37.2%, 95% CI = 30.8-46.6 vs. 36.9%, 95% CI = 30.4-43.4; NS). CONCLUSIONS Our data demonstrate that HPC and trehalose are suitable and safe substitutes for serum and sucrose. Therefore, the new commercial media can be used efficiently in the vitrification of human oocytes avoiding viral and endotoxin contamination risk.
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Affiliation(s)
- Aila Coello
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Pilar Campos
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - José Remohí
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Marcos Meseguer
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain.
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Marazzo DP, Karabinus D, Johnson LA, Schulman JD. MicroSort® sperm sorting causes no increase in major malformation rate. Reprod Fertil Dev 2016. [DOI: 10.1071/rd15011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of the present study was to evaluate the safety of MicroSort (MicroSort Division, GIVF, Fairfax, VA, USA) sperm sorting by monitoring major malformations in infants and fetuses conceived using sorted spermatozoa. Data were collected in a prospective protocol with monitoring that began from conception through birth until 1 year of life. Comprehensive ascertainment identified fetuses and stillbirths with malformations after 16 weeks gestation, pregnancies terminated for malformations and babies with major malformations. Outcomes in MicroSort pregnancies were compared with outcomes in published studies that used active and comprehensive ascertainment of malformations in the general population and in pregnancies established after assisted reproduction. Using comprehensive outcomes from all pregnancies, the rate of major malformations in MicroSort pregnancies conceived after IVF with or without intracytoplasmic sperm injection was 7.8%; this did not differ significantly from the rates reported in the three assisted reproductive technology control studies not associated with MicroSort (8.6%, 9.2% and 8.3%). Similarly, the rate of major malformations in MicroSort pregnancies initiated with intrauterine insemination was 6.0%, not significantly different from that reported in non-assisted reproductive technology pregnancies not associated with MicroSort (6.9%, 4.6% and 5.7%). Prospective record review of pregnancy outcomes and paediatric evaluation to 1 year indicate no association between MicroSort sperm sorting and major malformations.
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Cobo A, García-Velasco JA, Coello A, Domingo J, Pellicer A, Remohí J. Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril 2015; 105:755-764.e8. [PMID: 26688429 DOI: 10.1016/j.fertnstert.2015.11.027] [Citation(s) in RCA: 310] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/03/2015] [Accepted: 11/17/2015] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP). DESIGN Retrospective observational multicenter study. SETTING Private university-affiliated center. PATIENT(S) A total of 1,468 women who underwent EFP because of age or having associated a medical condition other than cancer (January 2007 to April 2015). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Survival and cumulative live birth rate (CLBR) per consumed oocyte. RESULT(S) Mean age was higher with EFP due to age versus having an associated medical reason (37.7 y [95% confidence interval (CI) 36.5-37.9] vs. 35.7 y [95% CI 34.9-36.3]). In total, 137 patients (9.3%) returned to use their oocytes. Overall survival rate was 85.2% (95% CI 83.2-87.2). Live birth rate per patient was higher in women ≤35 years old than ≥36 years old (50% [95% CI 32.7-67.3] vs. 22.9% [95% CI 14.9-30.9]). CLBR was higher and increased faster in younger women. The gain in CLBR was sharp from 5 (15.4%, 95% CI -4.2 to 35.0) to 8 oocytes (40.8%, 95% CI 13.2-68.4), with an 8.4% gain per additional oocyte, in the ≤35-year-old group. The increase was slower with 10-15 oocytes, reaching a plateau CLBR of 85.2%. A milder increase (4.9% gain) was observed in the ≥36-year-old group (from 5.1% [95% CI -0.6 to 10.7] to 19.9% [95% CI 8.7-31.1] when 5-8 oocytes were consumed), reaching the plateau with 11 oocytes (CLBR 35.6%). Forty babies were born. CONCLUSION(S) At least 8-10 metaphase II oocytes are necessary to achieve reasonable success. Numbers should be individualized in women >36 years old. We suggest encouraging women who are motivated exclusively by a desire to postpone childbearing because of age, to come at younger ages to increase success possibilities.
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Affiliation(s)
- Ana Cobo
- IVI-Valencia, Institut Universitari IVI, Valencia, Spain.
| | | | - Aila Coello
- IVI-Valencia, Institut Universitari IVI, Valencia, Spain
| | | | - Antonio Pellicer
- IVI Foundation, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - José Remohí
- IVI-Valencia, Institut Universitari IVI, Valencia, Spain
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Meijerink AM, Oomen RE, Fleischer K, IntHout J, Woldringh GH, Braat DDM. Effect of maternal and treatment-related factors on the prevalence of birth defects after PESA-ICSI and TESE-ICSI: a retrospective cohort study. Acta Obstet Gynecol Scand 2015; 94:1245-53. [PMID: 26265143 DOI: 10.1111/aogs.12728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/03/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We performed a retrospective cohort study with the aim to evaluate the effect of maternal and treatment-related factors on the prevalence of birth defects after intracytoplasmic sperm injection (ICSI) using percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE). MATERIAL AND METHODS 643 newborns born after PESA-ICSI (n = 406) and TESE-ICSI (n = 237) in Radboud University Medical Center, after a gestational age of 12 weeks, 1 January 2002-1 January 2011 and 1 March-1 November 2014, respectively, were included in this study. Three sources of data were used for analysis: questionnaires, national obstetrics registration forms, and a lab-database of all ICSI treatments. Data were analyzed using generalized estimating equations and logistic regression analysis. RESULTS The prevalence of major birth defects in newborns born after PESA-ICSI was 6.9% and after TESE-ICSI was 5.9% (odds ratio 0.89, 95% confidence interval 0.46-1.75). No significant association was found between maternal or treatment-related factors and the prevalence of birth defects. CONCLUSIONS We found a similar overall prevalence of birth defects in newborns born after PESA-ICSI and TESE-ICSI. The maternal and treatment-related factors investigated did not show a significantly increased cumulative risk of birth defects.
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Affiliation(s)
- Aukje M Meijerink
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Reinoud E Oomen
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kathrin Fleischer
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joanna IntHout
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gwendolyn H Woldringh
- Department of Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Didi D M Braat
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
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Six years' experience in ovum donation using vitrified oocytes: report of cumulative outcomes, impact of storage time, and development of a predictive model for oocyte survival rate. Fertil Steril 2015; 104:1426-34.e1-8. [PMID: 26353081 DOI: 10.1016/j.fertnstert.2015.08.020] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/14/2015] [Accepted: 08/14/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe the clinical outcomes achieved after 6 years' experience in ovum donation conducted with vitrified oocytes; to attempt to find predictors of survival; and to provide information about the probability of having a baby according to the number of oocytes consumed. DESIGN Retrospective, observational study. SETTING Private university-affiliated in vitro fertilization center. PATIENT(S) Recipients of vitrified oocytes (January 2007-March 2013), including all the warming procedures (n = 3,610) and all the donations made during the same period (n = 3,467). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Survival rate per warming procedure, cumulative delivery rates (CDR) per single donation cycle, oocyte-to-baby rate, and cumulative live birth rate (CLBR) per oocyte consumed. RESULT(S) Oocyte survival rate was 90.4%. It was not possible to develop a predictive model for survival owing to the lack of prognostic value of the studied variables. Implantation, clinical, and ongoing pregnancy rates per donation cycle were 39.0% (95% confidence interval [CI], 37.8-40.5), 48.4% (95% CI, 46.7-50.1), and 39.9% (95% CI, 38.3-41.5), respectively. Statistical differences were found when comparing blastocysts versus day 3 ETs (42.5%; 95% CI, 40.4-45.2 vs. 37.5%; 95% CI, 35.3-39.7 ongoing pregnancy rate). The CDR/donation cycle, including cryotransfers, was 78.8% (95% CI, 73.5-84.1). The oocyte-to-baby rate was 6.5%. CLBR increased progressively according to the number of oocytes consumed. CONCLUSION(S) We provide detailed information about the high efficiency of using vitrified/warmed oocytes. There is currently no way of estimating donors' oocytes survival when considering baseline characteristics, storage time, or controlled ovarian stimulation parameters. The probability of achieving a baby using vitrified oocytes increases progressively with the number of oocytes consumed.
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Vloeberghs V, Verheyen G, Haentjens P, Goossens A, Polyzos NP, Tournaye H. How successful is TESE-ICSI in couples with non-obstructive azoospermia? Hum Reprod 2015; 30:1790-6. [PMID: 26082482 DOI: 10.1093/humrep/dev139] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 05/21/2015] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION What are the chances of a couple with infertility due to non-obstructive azoospermia (NOA) having their genetically own child by testicular sperm extraction combined with ICSI (TESE-ICSI)? SUMMARY ANSWER Candidate TESE-ICSI patients with NOA should be counselled that, when followed-up longitudinally, only a minority (13.4%) of men embarking for TESE eventually become a biological father. WHAT IS KNOWN ALREADY Data available in the literature are only fragmentary because they report either on sperm retrieval rates after TESE or on the outcome of ICSI once testicular spermatozoa has been obtained, mostly in a selected subpopulation. Unfortunately, reliable data to counsel men with NOA on their chance to become a biological father are still lacking. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study performed in the Centre for Reproductive Medicine, University Hospital of Brussel, approved by the institutional review board of the hospital. PARTICIPANTS/MATERIALS, SETTING AND METHODS We identified all patients with NOA, based on histology, who had their first testicular biopsy between 1994 and 2009. Patients were followed longitudinally during consecutive ICSI cycles with testicular sperm. The primary outcome measure was live birth delivery. The cumulative live birth delivery rate was calculated, based only on ICSI cycles with testicular sperm (fresh and/or frozen) available for injection. When patients delivered after transfer of supernumerary frozen embryos, this delivery was tallied up to the (unsuccessful) original fresh ICSI cycle. The sperm retrieval rate and pregnancy rate were secondary outcome measures. MAIN RESULTS AND THE ROLE OF CHANCE Among the 714 men with NOA, 40.5% had successful sperm retrieval at their first TESE. In total, 261 couples had 444 ICSI cycles and 48 frozen embryo transfer cycles, leading to 129 pregnancies and 96 live birth deliveries. Crude and expected cumulative delivery rates after six ICSI cycles were 37 and 78%. LIMITATIONS AND REASON FOR CAUTION A retrospective cohort study design was the only way to study the cumulative delivery rate after TESE-ICSI in couples with NOA. Intrinsic limitations are related to the observational study design. WIDER IMPLICATION OF THE FINDING TESE-ICSI is a breakthrough in the treatment of infertility due to NOA, with almost 4 out of 10 (37%) couples having ICSI obtaining a delivery. However, unselected candidate NOA patients should be counselled, before undergoing TESE, that only one out of seven men (13.4%) eventually father their genetically own child. STUDY FUNDING AND COMPETING INTERESTS None declared.
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Affiliation(s)
- V Vloeberghs
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - G Verheyen
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - P Haentjens
- Laboratory of Experimental Surgery and Centre for Outcomes Research, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - A Goossens
- Department of Pathology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - N P Polyzos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - H Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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George M, Schneuer FJ, Jamieson SE, Holland AJA. Genetic and environmental factors in the aetiology of hypospadias. Pediatr Surg Int 2015; 31:519-27. [PMID: 25742936 DOI: 10.1007/s00383-015-3686-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 02/07/2023]
Abstract
This article reviews the current evidence and knowledge of the aetiology of hypospadias. Hypospadias remains a fascinating anomaly of the male phallus. It may be an isolated occurrence or part of a syndrome or field defect. The increasing use of assisted reproductive techniques and hormonal manipulation during pregnancy may have been associated with an apparent rise in the incidence of hypospadias. Genetic studies and gene analysis have suggested some defects that could result in hypospadias. New light has also been thrown on environmental factors that could modulate candidate genes, causing altered development of the male external genitalia.
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Affiliation(s)
- Mathew George
- Douglas Cohen Department of Paediatric Surgery, The Children's Hospital at Westmead, Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Locked Bag 4001, Westmead, NSW, 2145, Australia
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Sfontouris IA, Kolibianakis EM, Lainas GT, Navaratnarajah R, Tarlatzis BC, Lainas TG. Live birth rates using conventional in vitro fertilization compared to intracytoplasmic sperm injection in Bologna poor responders with a single oocyte retrieved. J Assist Reprod Genet 2015; 32:691-7. [PMID: 25758990 DOI: 10.1007/s10815-015-0459-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/04/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To compare reproductive outcomes following conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in poor responders fulfilling the Bologna criteria, with a single oocyte retrieved. METHODS The present retrospective study included 243 Bologna poor responders with a single oocyte retrieved, who were categorized into three groups, depending on the fertilization method and semen quality (IVF non-male factor-IVF/NMF n = 101; ICSI non-male factor ICSI/NMF n = 50; ICSI male factor-ICSI/MF n = 92). RESULTS In IVF/NMF, ICSI/NMF and ICSI/MF similar fertilization rates [65.3, 66, 58.7%, respectively], proportions of embryo formation [63.4, 60, 53.3%, respectively], proportions of good quality embryos [54.7, 56.7, 57.1%, respectively], implantation rates [8.9, 10, 8.2% respectively] and live birth rates per oocyte retrieval [5.0, 4.0, 3.3%, respectively] were observed. Degeneration rate of oocytes due to mechanical damage was significantly higher after ICSI in the ICSI/NMF and ICSI/MF groups (8 and 6.5%, respectively) compared to IVF/NMF (0%) (p = 0.02). CONCLUSIONS Conventional IVF and ICSI are associated with similar reproductive outcomes in poor responder patients with a single oocyte retrieved. Therefore, the choice of fertilization method should be based primarily on semen quality, in combination with the patient's previous history. A randomized controlled trial should be performed to confirm this study's findings that conventional IVF and ICSI have similar reproductive outcomes in poor responders.
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72
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Bernard V, Bouvattier C, Christin-Maitre S. [Therapeutic issues concerning male fertility]. ANNALES D'ENDOCRINOLOGIE 2015; 75 Suppl 1:S13-20. [PMID: 25617918 DOI: 10.1016/s0003-4266(14)70023-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Men reproductive health has long been ignored although it is responsible for 50% of couple's infertility. However, in recent years, the understanding of endocrine physiology underlying testis development and spermatogenesis has enabled the development of new therapeutic strategies. Some concern the management of male infertility. Others are dealing with finding an effective male contraceptive. In this review, we first present the management of infertility, in patients with congenital hypogonadotropic hypogonadism. We then describe the major improvements for Klinefelter patient's infertility. Finally, we review the different hormonal and non-hormonal methods for male contraception, currently in development. Efficacy and safety of the some non-hormonal methods remain to be demonstrated so far in humans.
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Affiliation(s)
- V Bernard
- Unité INSERM 693, 63 rue Gabriel-Péri, 94276 Le Kremlin-Bicêtre cedex, France.
| | - C Bouvattier
- Service d'endocrinologie et diabétologie pédiatrique, CHU de Bicêtre, Le Kremlin-Bicêtre, France
| | - S Christin-Maitre
- Service d'endocrinologie et maladies de la reproduction, Hôpital Saint-Antoine, Paris, France
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73
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Neonatal outcomes after the implantation of human embryos vitrified using a closed-system device. J Assist Reprod Genet 2015; 32:521-6. [PMID: 25617086 DOI: 10.1007/s10815-015-0431-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/06/2015] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Closed vitrification poses a risk of adversely affecting embryo development, while it may minimize the risk of contamination. We assessed the effects of closed-system human embryo vitrification on fetal development after implantation, neonatal outcome, and clinical safety. METHODS This was a retrospective cohort study conducted at a private fertility clinic. A total of 875 vitrified-warmed blastocysts that were single-transferred under hormone-replacement cycles between November 2011 and December 2013 were randomly divided into two groups (closed vitrification, n 313; open vitrification, n 562) after receiving the patients' consent forms. Developmental competence after implantation, including gestational age, birth weight, sex, Apgar score, and anomalies of newborns, after the transfer of blastocysts vitrified by closing vitrification was compared with that obtained in the case of open vitrification. RESULTS There were no significant differences between the use of closed and open vitrification systems in embryo development after implantation, gestational age, birth weight, sex ratio, Apgar score, and congenital anomalies of newborns. CONCLUSION Human embryos can be vitrified using a closed vitrification system without impairment of neonatal development.
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74
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Palmsten K, Chambers CD. Hypospadias: One Defect, Multiple Causes, Acting Through Shared Pathways. CURR EPIDEMIOL REP 2015. [DOI: 10.1007/s40471-014-0034-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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75
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Bu Z, Chen ZJ, Huang G, Zhang H, Wu Q, Ma Y, Shi J, Xu Y, Zhang S, Zhang C, Zhao X, Zhang B, Huang Y, Sun Z, Kang Y, Wu R, Wu X, Sun H, Sun Y. Live birth sex ratio after in vitro fertilization and embryo transfer in China--an analysis of 121,247 babies from 18 centers. PLoS One 2014; 9:e113522. [PMID: 25412419 PMCID: PMC4239103 DOI: 10.1371/journal.pone.0113522] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/20/2014] [Indexed: 11/18/2022] Open
Abstract
In order to study the impact of procedures of IVF/ICSI technology on sex ratio in China, we conducted this multi-center retrospective study including 121,247 babies born to 93,895 women in China. There were 62,700 male babies and 58,477 female babies, making the sex ratio being 51.8% (Male: Female = 107∶100). In univariate logistic regression analysis, sex ratio was imbalance toward females of 50.3% when ICSI was preformed compared to 47.7% when IVF was used (P<0.01). The sex ratio in IVF/ICSI babies was significantly higher toward males in transfers of blastocyst (54.9%) and thawed embryo (52.4%) when compared with transfers of cleavage stage embryo (51.4%) and fresh embryo (51.5%), respectively. Multiple delivery was not associated with sex ratio. However, in multivariable logistic regression analysis after controlling for related factors, only ICSI (adjusted OR = 0.90, 95%CI: 0.88–0.93; P<0.01) and blastocyst transfer (adjusted OR = 1.14, 95% CI: 1.09–1.20; P<0.01) were associated with sex ratio in IVF/ICSI babies. In conclusion, the live birth sex ratio in IVF/ICSI babies was influenced by the use of ICSI, which may decrease the percentage of male offspring, or the use of blastocyst transfer, which may increase the percentage of male offspring.
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Affiliation(s)
- Zhiqin Bu
- Reproductive Medicine Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Guoning Huang
- Chongqing Reproductive and Genetics Institute, Chongqing Obstetrics and Gynecology Hospital, Chongqing, People's Republic of China
| | - Hanwang Zhang
- Reproductive Medicine Center, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qiongfang Wu
- Reproductive Medicine Centre, Women and Children Hospital of Jiangxi Province, Nanchang, People's Republic of China
| | - Yanping Ma
- Reproductive Medicine Center, First People's Hospital of Yunnan Province, Kunming, People's Republic of China
| | - Juanzi Shi
- Reproductive Medicine Center, Maternal and Child Health Care Hospital of Shaanxi Province, Xi'an, People's Republic of China
| | - Yanwen Xu
- Reproductive Medicine Center, First Affiliated Hospital of Sun Yat-Sen University, Guangdong, People's Republic of China
| | - Songying Zhang
- Reproductive Medicine Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Cuilian Zhang
- Reproductive Medicine Center, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
| | - Xiaoming Zhao
- Reproductive Medicine Center, Renji Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Bo Zhang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Yuanhua Huang
- Reproductive Medicine Center, Affiliated Hospital of Hainan Medical College, Haikou, People's Republic of China
| | - Zhengyi Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academic of Medical Sciences, Beijing, People's Republic of China
| | - Yuefan Kang
- Reproductive Medicine Center, Maternal and Children's Health Hospital of Fujian Province, Fuzhou, People's Republic of China
| | - Riran Wu
- Reproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, People's Public of China
| | - Xueqing Wu
- Reproductive Medicine Center, Women and Children's Hospital of Shanxi Province, Taiyuan, People's Republic of China
| | - Haixiang Sun
- Reproductive Medicine Center, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, People's Republic of China
- * E-mail: (YPS); (HXS)
| | - Yingpu Sun
- Reproductive Medicine Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
- * E-mail: (YPS); (HXS)
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Çakar E, Kavuncuoğlu S, Aldemir EY, Çetinkaya M, Güzeltaş A, Arslan G. Features of multiple pregnancies obtained by in vitro fertilization or spontaneously. Pediatr Int 2014; 56:735-41. [PMID: 24803145 DOI: 10.1111/ped.12372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/26/2014] [Accepted: 03/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate the prognosis of infants born to multiple pregnancies obtained by in vitro fertilization (IVF) or spontaneously. METHODS The records of multiple pregnancies in Bakirkoy Maternity and Children's Hospital between February 2008 and January 2009 were investigated. Maternal, perinatal and postnatal data of multiple pregnancies were evaluated. The congenital anomalies determined by physical examination and/or imaging studies in the prenatal, natal and postnatal period and the difference between groups in terms of morbidity and mortality were investigated as well. RESULTS A total of 401 spontaneous multiple pregnancies and 128 IVF multiple pregnancies were included in the study. Rate of multiple pregnancies for live births and IVF rate were 3.8% and 0.79%, respectively. The mean maternal age was 30.1 years (21-43) in the IVF group and 27.9 years (13-43) in the spontaneous group (P < 0.05). The cesarean delivery rate was 100% in the IVF group and 78% in the spontaneous group (P = 0.002). Premature rupture of membranes rate was 9.8% in the IVF group and 3.6% in the spontaneous group (P < 0.05). CONCLUSIONS Multiple pregnancies constitute an important health problem due to high perinatal risks and increased health costs. We found maternal age, premature rupture of membranes and cesarean delivery rate significantly high in the IVF group. No significant differences were found between spontaneous and IVF multiple pregnancies in terms of demographic features, hospitalization stay and rate, admission to neonatal intensive care unit, mortality and congenital malformation.
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Affiliation(s)
- Emel Çakar
- Department of Pediatrics, Neonatology Unit, İstanbul, Turkey
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Budinetz TH, Mann JS, Griffin DW, Benadiva CA, Nulsen JC, Engmann LL. Maternal and neonatal outcomes after gonadotropin-releasing hormone agonist trigger for final oocyte maturation in patients undergoing in vitro fertilization. Fertil Steril 2014; 102:753-8. [DOI: 10.1016/j.fertnstert.2014.05.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 05/12/2014] [Accepted: 05/19/2014] [Indexed: 11/24/2022]
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Henningsen AKA, Pinborg A. Birth and perinatal outcomes and complications for babies conceived following ART. Semin Fetal Neonatal Med 2014; 19:234-8. [PMID: 24840403 DOI: 10.1016/j.siny.2014.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Children born after assisted reproductive techniques (ART) have an increased risk of several adverse perinatal outcomes compared with their naturally conceived peers. This has various causes such as higher multiple birth rates, parental characteristics and higher maternal age, with more being nulliparous. Furthermore the in-vitro techniques, the controlled ovarian stimulation, culture media, and possibly additional freezing or vitrification procedures seem to play a role. However, when analyzing the perinatal trends over time, the differences between ART and naturally conceived children appear to have diminished. This is probably due to ART being more accessible and therefore couples have shorter duration of infertility before referral to ART; hence couples are nowadays less reproductively ill than in the past. A refinement of both clinical and laboratory skills during the past three decades of assisted reproduction may be another explanation. However, caution should be taken, as we do not yet know the full consequences of the observed increase in fetal growth and potential epigenetic changes in the early embryonic stages of fetal development.
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Affiliation(s)
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
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Tarín JJ, García-Pérez MA, Hermenegildo C, Cano A. Changes in sex ratio from fertilization to birth in assisted-reproductive-treatment cycles. Reprod Biol Endocrinol 2014; 12:56. [PMID: 24957129 PMCID: PMC4079184 DOI: 10.1186/1477-7827-12-56] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 06/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Western gender-neutral countries, the sex ratio at birth is estimated to be approximately 1.06. This ratio is lower than the estimated sex ratio at fertilization which ranges from 1.07 to 1.70 depending on the figures of sex ratio at birth and differential embryo/fetal mortality rates taken into account to perform these estimations. Likewise, little is known about the sex ratio at implantation in natural and assisted-reproduction-treatment (ART) cycles. In this bioessay, we aim to estimate the sex ratio at fertilization and implantation using data from embryos generated by standard in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in preimplantation genetic diagnosis cycles. Thereafter, we compare sex ratios at implantation and birth in cleavage- and blastocyst-stage-transfer cycles to propose molecular mechanisms accounting for differences in post-implantation male and female mortality and thereby variations in sex ratios at birth in ART cycles. METHODS A literature review based on publications up to December 2013 identified by PubMed database searches. RESULTS Sex ratio at both fertilization and implantation is estimated to be between 1.29 and 1.50 in IVF cycles and 1.07 in ICSI cycles. Compared with the estimated sex ratio at implantation, sex ratio at birth is lower in IVF cycles (1.03 after cleavage-stage transfer and 1.25 after blastocyst-stage transfer) but similar and close to unity in ICSI cycles (0.95 after cleavage-stage transfer and 1.04 after blastocyst-stage transfer). CONCLUSIONS In-vitro-culture-induced precocious X-chromosome inactivation together with ICSI-induced decrease in number of trophectoderm cells in female blastocysts may account for preferential female mortality at early post-implantation stages and thereby variations in sex ratios at birth in ART cycles.
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Affiliation(s)
- Juan J Tarín
- Department of Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Burjassot, Valencia 46100, Spain
| | - Miguel A García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, Valencia 46100; and Research Unit-INCLIVA, Hospital Clínico de Valencia, Valencia 46010, Spain
| | - Carlos Hermenegildo
- Department of Physiology, Faculty of Medicine, University of Valencia, Valencia 46010; and Research Unit-INCLIVA, Hospital Clínico de Valencia, Valencia 46010, Spain
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia 46010; and Service of Obstetrics and Gynecology, University Hospital Dr. Peset, Valencia 46017, Spain
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Abuelghar WM, Elkady OS, Tamara TF, Khalil MH. Risk of first trimester spontaneous miscarriage among singleton gestations following ICSI and its relation to underlying cause of infertility. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2014. [DOI: 10.1016/j.mefs.2013.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tsai YR, Lan KC, Tsai CC, Lin PY, Kung FT, Liu YC, Huang FJ. Pregnancy outcome and neonatal data of children born after intracytoplasmic sperm injection with a different duration of cryopreservation of spermatozoa obtained through testicular sperm extraction. Taiwan J Obstet Gynecol 2014; 52:329-34. [PMID: 24075368 DOI: 10.1016/j.tjog.2012.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2012] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate the impact of the duration of cryopreservation of testicular sperm on clinical and neonatal outcomes after intracytoplasmic sperm injection (ICSI) for patients experiencing azoospermia. MATERIALS AND METHODS This study included 132 azoospermic men who participated in 212 ICSI cycles. The participating men underwent testicular biopsy for the cryopreservation of tissue to be used for subsequent ICSI cycles. The duration of the storage of testicular sperm was determined by the time of oocyte retrieval. Fertilization, embryo development in vitro, pregnancy rates, and neonatal outcomes were assessed. RESULTS Although the mean percentage of viability decreased from 73.2% prior to freezing to 50.2% after thawing, viable spermatozoa were visualized subsequent to thawing of the tissue samples for all patients. The potential for fertilization and subsequent embryonic development was not influenced by the duration of sperm cryopreservation up to 2 years longer. The pregnancy outcomes also varied independently of the duration of sperm cryopreservation. The duration of storage did not appear to affect the neonatal outcomes adversely, including the Apgar score and intensive care unit admission rates, although neonatal outcomes were influenced by advanced maternal age. It also has no obvious impact on the major and minor congenital malformation rate of the newborns. CONCLUSION ICSI outcomes, pregnancy outcome, neonatal outcome, and congenital malformation rate appear not to be affected by the duration of the period of cryostorage. An earlier start of the ICSI cycle following the testicular sperm cryopreservation is preferable because longer preservation is associated with more advanced maternal age.
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Affiliation(s)
- Yi-Ru Tsai
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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82
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Plotton I, Brosse A, Cuzin B, Lejeune H. Klinefelter syndrome and TESE-ICSI. ANNALES D'ENDOCRINOLOGIE 2014; 75:118-25. [PMID: 24786702 DOI: 10.1016/j.ando.2014.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Until few years ago, Klinefelter syndrome with a homogenous 47,XXY karyotype was considered a model of absolute male sterility. We will discuss first the potential fertility following Testicular Sperm Injection, then the physiopathology of spermatogenic failure and the origin of focal spermatogenesis and risk of aneuploidy in offspring, and third the advantage of searching spermatozoa earlier instead of adult age. The rate of positive sperm extraction seems to be better for younger patients. During childhood, there is a low rate of spermatogonia. The spermagonia, which completes the spermatogenesis, seems resulting from a rare clone of 46,XY gonia, having lost their extra X chromosome. Several arguments suggest that this focal spermatogenesis decreases with age. In addition, androgen treatment, frequently prescribed in case of Klinefelter syndrome, carries a risk of decreasing focal spermatogenesis by lowering gonadotropins. The question arises if it is necessary to expect the sperm cryopreservation before introducing androgen treatment. Further studies are necessary to determine the best age of sperm retrieval in case of Klinefelter syndrome.
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Affiliation(s)
- Ingrid Plotton
- Service de médecine de la reproduction, hôpital Femme-Mère-Enfant, France; Laboratoire d'endocrinologie moléculaire et maladies rares, centre de biologie et de pathologie Est, hospices civils de Lyon, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron cedex, France; Université Claude-Bernard - Lyon 1, 8, avenue Rockfeller, 69008 Lyon, France; Inserm U 846, 18, rue du Doyen-Lepine, 69500 Bron, France.
| | - Aurélie Brosse
- Service de médecine de la reproduction, hôpital Femme-Mère-Enfant, France
| | - Beatrice Cuzin
- Service d'urologie et de transplantation, hôpital Édouard-Herriot, CHU de Lyon, 5, place d'Arsonval, 69437 Lyon cedex 03, France
| | - Hervé Lejeune
- Service de médecine de la reproduction, hôpital Femme-Mère-Enfant, France; Université Claude-Bernard - Lyon 1, 8, avenue Rockfeller, 69008 Lyon, France; Inserm U 846, 18, rue du Doyen-Lepine, 69500 Bron, France
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Moutou C, Goossens V, Coonen E, De Rycke M, Kokkali G, Renwick P, SenGupta SB, Vesela K, Traeger-Synodinos J. ESHRE PGD Consortium data collection XII: cycles from January to December 2009 with pregnancy follow-up to October 2010. Hum Reprod 2014; 29:880-903. [PMID: 24619432 DOI: 10.1093/humrep/deu012] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION How do data in the 12th annual data collection (Data XII) of the European Society of Human Reproduction and Embryology Preimplantation Genetic Diagnosis (PGD) Consortium compare with the cumulative data for collections I-XI? SUMMARY ANSWER Since the beginning of the data collections, there has been a steady increase in the number of cycles, pregnancies and babies reported annually. WHAT IS KNOWN ALREADY The PGD Consortium has collected, analysed and published 11 previous data sets since 1997. STUDY DESIGN, SIZE, DURATION Data were collected from each participating centre using a pre-designed FileMaker Pro database (versions 5-10). Separate FileMaker Pro files were used for the cycles, pregnancies and baby records. The study documented cycles performed during the calendar year 2009 and follow-up of the pregnancies and babies born which resulted from these cycles (until October 2010). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were submitted by 60 centres (full PGD Consortium members), and the blank files were distributed to each PGD Consortium member centre at the end of 2008. The submitted data were thoroughly analysed to identify incomplete data entries and corrections were requested from the participating centres. Records remaining with incomplete data were excluded from the calculations. Corrections, tables and calculations were made by expert co-authors. MAIN RESULTS AND THE ROLE OF CHANCE For data collection XII, 60 centres reported data for 6160 cycles with oocyte retrieval (OR), along with details of the follow-up on 1607 pregnancies and 1238 babies born. A total of 870 OR were reported for chromosomal abnormalities, 113 OR for sexing for X-linked diseases, 1597 OR for monogenic diseases, 3551 OR for preimplantation genetic screening and 29 OR for social sexing. LIMITATIONS, REASONS FOR CAUTION These data cannot include every PGD cycle performed annually, and only indicate the trends in PGD worldwide. WIDER IMPLICATION OF THE FINDINGS The annual data collections provide an extremely valuable resource for data mining and for following trends in PGD practice. STUDY FUNDING/COMPETING INTEREST(S) None.
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Affiliation(s)
- C Moutou
- Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Service de la Biologie de la Reproduction, CMCO, 19, Rue Louis Pasteur, BP120, 67303 Schiltigheim, France
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84
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Maalouf WE, Mincheva MN, Campbell BK, Hardy ICW. Effects of assisted reproductive technologies on human sex ratio at birth. Fertil Steril 2014; 101:1321-5. [PMID: 24602756 DOI: 10.1016/j.fertnstert.2014.01.041] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 01/13/2014] [Accepted: 01/21/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To investigate the effect of assisted reproductive technology (ART) treatments on the sex ratio of babies born. DESIGN Assessment of direct effects of assisted conception through retrospective data analysis on the progeny sex ratio of treated women in the United Kingdom. SETTING The study uses the anonymized register of the Human Fertilisation and Embryology Authority. PATIENT(S) A total of 106,066 babies of known gender born to 76,994 treated mothers and 85,511 treatment cycles between 2000 and 2010 in the United Kingdom. INTERVENTION(S) Intrauterine insemination, IVF, or intracytoplasmic sperm injection (ICSI). MAIN OUTCOME MEASURE(S) Sex ratio of babies born. RESULT(S) Intrauterine insemination, IVF, and ICSI lead to different sex ratios, highest after IVF (proportion male = mean 0.521 ± confidence interval 0.0056) and lowest under ICSI embryo transfer (0.493 ± 0.0031). In addition, for both ICSI and IVF, transferring embryos at a later stage (blastocyst) results in approximately 6% more males than after early cleavage-stage ET. CONCLUSION(S) Because the cumulative number of IVF babies born is increasing significantly in Britain and elsewhere, more research is needed into the causes of gender bias after ART and into the public health impact of such gender bias of offspring born observed on the rest of the population.
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Affiliation(s)
- Walid E Maalouf
- Division of Child Health, Obstetrics and Gynecology, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.
| | - Mina N Mincheva
- Division of Child Health, Obstetrics and Gynecology, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - Bruce K Campbell
- Division of Child Health, Obstetrics and Gynecology, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - Ian C W Hardy
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
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Oron G, Fisch B, Sapir O, Wertheimer A, Garor R, Feldberg D, Pinkas H, Ben-Haroush A. Pregnancy outcome after ICSI with thawed testicular sperm from men with non-obstructive azoospermia compared to ICSI with ejaculated sperm from men with severe oligoasthenoteratozoospermia and IVF with normal ejaculated sperm. Gynecol Endocrinol 2014; 30:103-6. [PMID: 24303883 DOI: 10.3109/09513590.2013.850589] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to evaluate the clinical pregnancy outcomes, fetal complications and malformation rate of intracytoplasmic injection of thawed cryopreseverd sperm extracted by testicular aspiration from men with non-obstructive azoospermia (NOA) compared with intracytoplasmic injection of fresh ejaculated sperm from men with severe oligoteratoasthenozoospermia (OTA) and standard in vitro fertilization using ejaculated sperm from normospermic men. The mean oocyte fertilization rate was significantly lowest for ICSI with testicular aspirated sperm (NOA group). However, there was no significant difference among the three groups in pregnancy outcomes, namely rates of spontaneous abortion, biochemical pregnancy, extrauterine pregnancy, singleton multifetal pregnancy, preterm delivery before 36 weeks' gestation, maternal complications, transfer to the neonatal intensive care unit, intrauterine growth restriction or fetal malformations. These results suggest that despite some earlier findings that intracytoplasmic injection of aspirated sperm from men with NOA is associated with lower fertilization rates and embryo quality, the pregnancy and immediate neonatal outcomes may be unaffected.
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Affiliation(s)
- Galia Oron
- Infertility and IVF Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Hospital , Petach Tikva , Israel and
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86
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Lejeune H, Brosse A, Plotton I. Fertilité dans le syndrome de Klinefelter. Presse Med 2014; 43:162-70. [DOI: 10.1016/j.lpm.2013.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 12/05/2013] [Accepted: 12/05/2013] [Indexed: 11/30/2022] Open
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Liu XH, Yan LY, Lu CL, Li R, Zhu XH, Jin HY, Zhang Y, Zhang WX, Gao SH, Qiao J. ART do not increase the risk of Y-chromosome microdeletion in 19 candidate genes at AZF regions. Reprod Fertil Dev 2014; 26:778-86. [DOI: 10.1071/rd13092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 05/11/2013] [Indexed: 11/23/2022] Open
Abstract
Y-chromosome microdeletions (YCMs) have been found at a much higher rate in infertile men than fertile controls. A specific deletion in the azoospermia factor locus (AZF) at Yq11 is significantly associated with male infertility. Whether assisted reproductive technology (ART) increases the risk of YCM in ART-derived offspring remains unclear. In this study the occurrence of YCM in 199 fathers and their 228 sons (Chinese, Han ethnicity), including 85 offspring conceived by IVF, 73 by intra-cytoplasmic sperm injection (ICSI) and 70 by natural conception, was investigated. Nineteen candidate genes related to YCM were analysed by multiplex ligation-dependent probe amplification. We identified one de novo YCM from 70 naturally-conceived offspring and none from 158 ART-conceived offspring and found no statistical significance between these two groups. There was no statistically-significant difference in the detection rate of the father’s Y-chromosome microdeletion group: IVF 10.7% (8/75), ICSI 3.2% (2/63), natural conception 8.2% (5/61). These results suggest that ART does not increase the risk of YCM in male offspring.
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88
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Declercq ER, Belanoff C, Diop H, Gopal D, Hornstein MD, Kotelchuck M, Luke B, Stern JE. Identifying women with indicators of subfertility in a statewide population database: operationalizing the missing link in assisted reproductive technology research. Fertil Steril 2013; 101:463-71. [PMID: 24289994 DOI: 10.1016/j.fertnstert.2013.10.028] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 10/16/2013] [Accepted: 10/16/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To identify a group of deliveries to mothers with indicators of subfertility (SUBFERTILITY). DESIGN Longitudinal cohort study. SETTING Hospital. PATIENT(S) A total of 334,152 deliveries to Massachusetts mothers in a Massachusetts hospital between July 1, 2004, and December 31, 2008. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Subfertility was defined by an indication on a current or past birth certificate or hospital utilization data of infertility or assisted reproductive technology (ART) cycle before index delivery and no indication of ART use with index delivery. RESULT(S) Initially, 12,367 deliveries met the inclusion criteria for SUBFERTILITY (8,019 from birth certificates, 2,777 from hospital data, 1,571 from prior ART treatment). Removing deliveries from more than one data source resulted in 10,764 unique deliveries. Removing deliveries resulting from ART treatments left 6,238 deliveries in the SUBFERTILITY category. Demographic analysis indicated that deliveries in SUBFERTILITY were more similar to those in the ART population than to those in the fertile population. CONCLUSION(S) We have demonstrated the feasibility of using existing population-based linked public health data sets to identify SUBFERTILITY deliveries, and we have used ART data to distinguish ART and SUBFERTILITY births. The SUBFERTILITY category can serve as a comparison group of subfertile patients for studies of ART delivery and longitudinal health outcomes.
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Affiliation(s)
- Eugene R Declercq
- Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
| | - Candice Belanoff
- Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Hafsatou Diop
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Daksha Gopal
- Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Mark D Hornstein
- Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Milton Kotelchuck
- MGH Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Barbara Luke
- Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, Michigan
| | - Judy E Stern
- Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
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Fauser BCJM, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-van de Waal HA, Estella C, Ezcurra D, Geraedts JPM, Howles CM, Lerner-Geva L, Serna J, Wells D. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature. Reprod Biomed Online 2013; 28:162-82. [PMID: 24365026 DOI: 10.1016/j.rbmo.2013.10.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 10/03/2013] [Accepted: 10/08/2013] [Indexed: 01/28/2023]
Abstract
The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence for the effects of assisted reproduction treatment on children's health. The purpose of this review was to reach an agreement on whether there are differences in the health of assisted-conception children with naturally conceived children. The researchers discovered no increased risk in birth defects in assisted-conception children compared with naturally conceived children. They found that IVF-conceived children have lower birth weights and higher fat under the skin, higher blood pressure and higher fasting glucose concentrations than naturally conceived children; however, growth, development and cognitive function are similar between groups. A very low risk of disorders of genetic control was observed in assisted-conception children. Overall, there did not appear to be a direct link between assisted reproduction treatment and children's health. The researchers concluded that the cause of some differences in the health of children conceived using assisted reproduction treatment may be due to the age of the woman receiving treatment. Large-scale, research studies are needed to study the long-term health of children conceived using assisted reproduction treatment.
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Affiliation(s)
- B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - P Devroey
- Center for Reproductive Medicine, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - K Diedrich
- Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, 23538 Luebeck, Germany
| | - B Balaban
- Assisted Reproduction Unit, American Hospital of Istanbul, Guzelbahce Sokak No 20, Nisantasi, Istanbul 34365, Turkey
| | - M Bonduelle
- Centre for Medical Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - C Estella
- Fundación Instituto Valenciano de Infertilidad (FIVI), Valencia University, and Instituto Universitario IVI/INCLIVA, Parc Científic Universitat de València C/Catedrático Agustín Escardino n(o) 9, Edificio 3, 46980 Paterna, Spain; Departamento de Biología Molecular and Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain
| | - D Ezcurra
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - J P M Geraedts
- Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - C M Howles
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - L Lerner-Geva
- Woman and Child Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer 52621, Israel
| | - J Serna
- Instituto Valenciano de Infertilidad (IVI) Zaragoza, C/María Zambrano, 31, 50018 Zaragoza, Spain
| | - D Wells
- University of Oxford, Nuffield Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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90
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Eskild A, Monkerud L, Tanbo T. Birthweight and placental weight; do changes in culture media used for IVF matter? Comparisons with spontaneous pregnancies in the corresponding time periods. Hum Reprod 2013; 28:3207-14. [PMID: 24108218 DOI: 10.1093/humrep/det376] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Have changes in culture media used for IVF resulted in changes in offspring birthweight or placental weight that differed from the trends in offspring from spontaneous conceptions during the corresponding time periods? SUMMARY ANSWER Changes in culture media used for IVF were associated with significant differences in offspring birthweight and in placental weight to birthweight ratio when compared with the trend in offspring from spontaneous conceptions during the time periods. WHAT IS KNOWN ALREADY The effect of culture media used for IVF on offspring birthweight has varied between studies. There is a large variation in birthweight between newborns, and birthweight may vary across populations and over time. Such variations may therefore have influenced previous results. STUDY DESIGN, SIZE, DURATION We included all singleton births from IVF at one treatment center in Norway during the years 1999-2011(n = 2435) and all singleton births from spontaneous conceptions in Norway during the same years (n = 698 359). PARTICIPANTS/MATERIALS, SETTING, METHODS Three different media were used for embryo culture; Medicult Universal IVF (1999 through 2007, n = 1584), Medicult ISM1 (2008 until 20 September 2009, n = 402) and Vitrolife G-1 PLUS (21 September 2009 through 2011, n = 449). We estimated mean birthweight and placental weight in IVF pregnancies by culture media. We also estimated mean weights in IVF and in spontaneous pregnancies by year of birth. Thereafter, we studied whether the changes in mean weights in IVF pregnancies differed from the changes in weight in spontaneous pregnancies in the periods corresponding to culture media changes by applying a grouped difference-in-difference analysis. Adjustments were made for parity, maternal age and gestational age at birth. MAIN RESULTS AND THE ROLE OF CHANCE In singleton offspring from IVF the mean birthweight was 3447.6 g with Medicult Universal, 3351.7 g with Medicult ISM1 and 3441.4 g with Vitrolife G-1 PLUS (P < 0.05). The corresponding mean placental weights were 684.1, 693.4 and 704.3 g (P < 0.05). In offspring from spontaneous conceptions the mean birthweight decreased (56.9 g) and the placental weight increased (9.3 g) during the study period. The adjusted difference in birthweight in offspring from IVF decreased with 35.0 g by the change from Medicult Universal to Medicult ISM1 (P = 0.16) and increased with 79.9 g by the change from Medicult ISM1 to Vitrolife G-1 PLUS (P = 0.01) when compared with changes in offspring after spontaneous conceptions, We also found a significant increase in placental weight in relation to birthweight by the change from Medicult ISM1 to Vitrolife G-1 PLUS (P = 0.02). LIMITATIONS, REASONS FOR CAUTION There may be underlying factors that have influenced both birthweight and the use of culture media in IVF pregnancies. Lack of adjustment for such possible factors may have biased our results. WIDER IMPLICATIONS OF THE FINDINGS We found a significant effect of culture media used for IVF on birthweight and on placental weight in relation to birthweight. Also the population changes over time should encourage identification of factors in very early embryonic life that may influence birthweight and placental weight. STUDY FUNDING/COMPETING INTERESTS We received funding from the South-Eastern Regional Health Authority in Norway for this study (2011136-2012). None of the authors has any conflicts of interest to declare.
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Affiliation(s)
- Anne Eskild
- Department of Gynecology and Obstetrics, Akershus University Hospital, University of Oslo, Lørenskog 1478, Norway
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91
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Oocyte insemination techniques are related to alterations of embryo developmental timing in an oocyte donation model. Reprod Biomed Online 2013; 27:367-75. [DOI: 10.1016/j.rbmo.2013.06.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/21/2013] [Accepted: 06/25/2013] [Indexed: 11/18/2022]
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Wirleitner B, Vanderzwalmen P, Bach M, Baramsai B, Neyer A, Schwerda D, Schuff M, Spitzer D, Stecher A, Zintz M, Zech NH. The time aspect in storing vitrified blastocysts: its impact on survival rate, implantation potential and babies born. Hum Reprod 2013; 28:2950-7. [PMID: 24030587 DOI: 10.1093/humrep/det361] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does the storage time of vitrified human blastocysts negatively impact their survival, the implantation potential of embryos or the malformation rate of babies born? SUMMARY ANSWER There was no evidence that storage times of up to 6 years after vitrification (VIT) had a negative impact on blastocyst survival, the implantation potential of embryos or the malformation rate of babies born. WHAT IS KNOWN ALREADY Although several thousand children have been born after blastocyst VIT, many aspects of this technique remain to be elucidated. New applications, such as fertility preservation, lead to long storage times of vitrified gametes or embryos but it remains to be determined if these vitrified embryos are stable over time. STUDY DESIGN, SIZE, DURATION A retrospective study including 603 transfers was conducted between January 2009 and April 2012. Blastocysts were vitrified using a closed system. PARTICIPANTS/MATERIALS, SETTING, METHODS All patients underwent the transfer of aseptically vitrified/warmed blastocysts in a cryo-cycle. A total of 1077 blastocysts were transferred. Survival rates (SRs), implantation potential, birth rates and characteristics of the children born were evaluated. MAIN RESULTS AND THE ROLE OF CHANCE We found that the storage of vitrified blastocysts in aseptic conditions neither impaired blastocyst viability (SR after warming during the first year of storage was 83.0% compared with 83.1% after 5-6 years of storage: NS) nor decreased pregnancy rates (clinical pregnancy rate after 1 year of storage was 40.0 versus 38.5% after 6 years: NS). In addition, no increase in the malformation rate over time was observed. LIMITATIONS, REASONS FOR CAUTION Our study only included the transfer of blastocysts which had been vitrified aseptically (i.e. using a closed system). Therefore, our results might not be applicable to 'open' VIT systems. The long-term follow-up of children born will be necessary to confirm our findings. WIDER IMPLICATIONS OF THE FINDINGS The results suggest that vitrified human blastocysts can be stored for long periods of time without significant negative consequences for the offspring. Therefore, the method should be of benefit to those patients who need to consider taking measures for fertility preservation. STUDY FUNDING/COMPETING INTEREST(S) No external funding was sought for this study and the authors have no conflict of interest to declare.
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Affiliation(s)
- B Wirleitner
- IVF Centers Prof. Zech - Bregenz, Römerstrasse 2, 6900 Bregenz, Austria
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Nouri K, Ott J, Stoegbauer L, Pietrowski D, Frantal S, Walch K. Obstetric and perinatal outcomes in IVF versus ICSI-conceived pregnancies at a tertiary care center--a pilot study. Reprod Biol Endocrinol 2013; 11:84. [PMID: 24004836 PMCID: PMC3844416 DOI: 10.1186/1477-7827-11-84] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 08/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although most pregnancies after IVF result in normal healthy outcomes, an increased risk for a number of obstetric and neonatal complications, compared to naturally conceived pregnancies, has been reported. While there are many studies that compare pregnancies after assisted reproductive techniques with spontaneously conceived pregnancies, fewer data are available that evaluate the differences between IVF and ICSI-conceived pregnancies. The aim of our present study was, therefore, to compare obstetric and perinatal outcomes in pregnancies conceived after in vitro fertilization (IVF) versus intracytoplasmatic sperm injection (ICSI). METHODS Three-hundred thirty four women who had become pregnant after an IVF or ICSI procedure resulted in a total of 530 children referred between 2003 und 2009 to the Department of Obstetrics and Gynecology of the Medical University of Vienna, a tertiary care center, and were included in this retrospective cohort study. We assessed maternal and fetal parameters in both groups (IVF and ICSI). The main study outcomes were preterm delivery, the need for neonatal intensive care, and congenital malformations. Moreover, we compared the course of pregnancy between both groups and the occurrence of complications that led to maternal hospitalization during pregnancy. RESULTS There were 80 children conceived via ICSI and 450 children conceived via IVF.Mean gestational age was significantly lower in the ICSI group (p = 0.001). After ICSI, the birth weight (p = 0.008) and the mean APGAR values after 1 minute and after 10 minutes were lower compared to that of the IVF group (p = 0.016 and p = 0.047, respectively). Moreover, ICSI-conceived children had to be hospitalized more often at a neonatal intensive care unit (p = 0.004). There was no difference in pH of the umbilical artery or in major congenital malformations between the two groups. Pregnancy complications (i.e., premature rupture of membranes, cervical insufficiency, and premature uterine contractions) and the need for maternal hospitalization during pregnancy were found significantly more often after IVF (p = 0.0016 and p = 0.0095, respectively), compared to the ICSI group. CONCLUSIONS When comparing IVF versus ICSI-conceived pregnancies at a tertiary care center, we found the course of pregnancy to be more complicated after IVF, whereas the primary fetal outcome seemed to be better in this group than after ICSI treatment.
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Affiliation(s)
- Kazem Nouri
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Lucia Stoegbauer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Detlef Pietrowski
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Sophie Frantal
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics of the Medical University of Vienna, Vienna, Austria
| | - Katharina Walch
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
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94
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Impact of assisted reproduction treatments on Spanish newborns: report of 14,119 pregnancies. J Assist Reprod Genet 2013; 30:897-905. [PMID: 23779097 DOI: 10.1007/s10815-013-0023-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 05/24/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To investigate neonatal malformation, prematurity, and stillbirth in singleton and multiple pregnancies derived from different Assisted Reproductive Techniques (ART). METHODS In this prospective cohort study data were collected, from private and public Spanish IVF units, during the years 2008 and 2009. During this period, 8,682 pregnancies were analysed from the initial 14,119 pregnancies reported. Pregnancies included in the study derived from IUI (n = 1,065), IVF (n = 838), ICSI (n = 5,080), FET (n = 1,404) and PGD (n = 295). This first analysis focuses primarily on neonatal malformation, prematurity, and stillbirth both in singleton and multiple pregnancies derived from different ART. Malformations were classified according to the WHO ICD 10 code. RESULTS Malformations were found in 0.83 % of our newborns. No differences in malformations were observed between singletons or multiples independently of the ART used. There was a significant difference in prematurity rate among singletons depending on treatment but this association was not observed in multiple pregnancies. Stillbirth was significantly lower in singleton (0.72 %) than in multiple pregnancies (1.82 %). CONCLUSIONS The percentage of malformations observed in ART newborns was similar to the rate observed in the normally-conceived Spanish population. Multiplicity seems to be the most important factor associated with an increased incidence of newborn complications such as prematurity or stillbirth.
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95
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Mateizel I, Van Landuyt L, Tournaye H, Verheyen G. Deliveries of normal healthy babies from embryos originating from oocytes showing the presence of smooth endoplasmic reticulum aggregates. Hum Reprod 2013; 28:2111-7. [DOI: 10.1093/humrep/det241] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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96
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Outcome of cryotransfer of embryos developed from vitrified oocytes: double vitrification has no impact on delivery rates. Fertil Steril 2013; 99:1623-30. [DOI: 10.1016/j.fertnstert.2013.01.106] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/14/2013] [Accepted: 01/15/2013] [Indexed: 01/26/2023]
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97
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Bouillon C, Fauque P. Devenir des enfants issus des techniques d’assistance médicale à la procréation. Arch Pediatr 2013; 20:575-9. [DOI: 10.1016/j.arcped.2013.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 01/30/2013] [Accepted: 02/19/2013] [Indexed: 12/01/2022]
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98
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Pregnancy and neonatal outcomes following luteal GnRH antagonist administration in patients with severe early OHSS. Hum Reprod 2013; 28:1929-42. [DOI: 10.1093/humrep/det114] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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99
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Assisted Reproductive Techniques and Risk of Exstrophy-Epispadias Complex: A German Case-Control Study. J Urol 2013. [DOI: 10.1016/j.juro.2012.11.108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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100
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Stewart JA, Murdoch AP. The collection of data on assisted reproduction treatments in the UK: Recommendations by BFS and ACE. HUM FERTIL 2013; 16:112-20. [DOI: 10.3109/14647273.2013.770239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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