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Karakaş S, Akarsu RH, Tandoğan Ö, Şahan Ö. "The biggest disappointment": women's expectations from sex are ignored, from the perspective of infertile women. J Reprod Infant Psychol 2023:1-13. [PMID: 37565411 DOI: 10.1080/02646838.2023.2243296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE The aim of this study is to determine the attitudes, behaviours and experiences of infertile women towards sexuality. METHODS This study was carried out in the infertility outpatient clinic of a state hospital in Istanbul of Turkey. Fifteen infertile women who had been receiving primary infertility treatment for at least two years and were actively continuing infertility treatment were included in the study. Data were collected by means of an detailed information form and a semi-structured interview. Content analysis was applied to the data obtained from semi-structured interviews. Consistency percentage calculation was made between the codes and themes determined by 4 researchers who are experts in their fields. RESULTS Results based on the interviews with the participants, 2 main themes, 6 sub-themes and 27 codes related to sub-themes were determined as 'Factors Affecting Sexual Life' and 'Overview of Sexual Health and Sexuality'. 'Disappointment' was determined as the most commonly defined code in the determined main theme and sub-themes. CONCLUSION It was determined that the majority of infertile women base their sexual lives on reproductive functions, experience serious sexual health problems, feel worthless, and describe their sexual life as a great disappointment.
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Affiliation(s)
- Sevda Karakaş
- Department of Nursing, Istanbul Arel University Faculty of Health Sciences, Istanbul, Turkey
| | - Rukiye Höbek Akarsu
- Faculty of Health Sciences, Department of Nursing, Yozgat Bozok University, Yozgat, Turkey
| | - Özden Tandoğan
- Department of Nursing, Istanbul Arel University Faculty of Health Sciences, Istanbul, Turkey
| | - Özlem Şahan
- Faculty of Health Sciences, Department of Midwifery, Antalya Bilim University, Antalya, Turkey
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Melado L, Lawrenz B, Vitorino RL, Patel R, Ruiz F, Marques LM, Bayram A, Elkhatib I, Fatemi H. Clinical and laboratory parameters associated with pregnancy outcomes in patients undergoing frozen euploid blastocyst transfer. Reprod Biomed Online 2023:S1472-6483(23)00153-0. [PMID: 37062636 DOI: 10.1016/j.rbmo.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/03/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
RESEARCH QUESTION Which factors impact on clinical pregnancy rate (CPR) and live birth rates (LBR) in euploid frozen embryo transfer (eFET) cycles? DESIGN Retrospective observational study including 1660 eFET cycles with 2439 euploid blastocysts, from November 2016 to December 2020. The impact of clinical and laboratory parameters on CPR, biochemical miscarriage rate (BMR), clinical miscarriage rate (CMR) and LBR was evaluated. RESULTS CPR per transfer was 63.4%, LBR per transfer 51.6%. CPR and LBR were significantly higher when double embryo transfer (DET) was performed (71.6% versus 57.7%, P < 0.001; 55.2% versus 49.1%, P = 0.016, respectively). However, pregnancy loss was significantly higher in the DET group (28.8% versus 22.8%, P = 0.02). When patients were classified by body mass index (BMI), no differences were observed for CPR, but CMR was lower (P < 0.001) and LBR higher (p = 0.031) for the normal BMI group. The natural cycle protocol revealed lower CMR (P < 0.001) and lower pregnancy loss (P < 0.001); subsequently, higher LBR (57.6%, 48.8%, 45.0%, P = 0.001) compared with hormonal replacement protocol and stimulated cycle. Day of trophectoderm biopsy affected CPR (P < 0.001) and LBR (P < 0.001), yet no differences were observed for BMR, CMR or pregnancy loss. The multivariate analysis showed that day 6/7 embryos had lower probabilities for pregnancy; overweight and obesity had a negative impact on LBR, and natural cycle improved LBR (adjusted odds ratio 1.445, 95% confidence interval 0.519-0.806). CONCLUSIONS Day of biopsy affected CPR, while BMI and endometrial preparation protocol were associated with LBR in eFET. DET should be discouraged as it will increase the risk of pregnancy loss. Women with higher BMI should be aware of the higher risk of pregnancy loss and lower LBR even though a euploid blastocyst is transferred.
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El Ansari W, Arafa M, Majzoub A, Elbardisi H, Albakr A, Mahdi M, El-Ansari K, Al Ansari A, AlRumaihi K. Bibliometric and Visualization Analysis of the Ecology of Men's Sexual and Reproductive Healthcare Research in MENA (1985-2022): Outputs, Trends, Shortcomings and Hotspots. Arab J Urol 2022; 21:82-93. [PMID: 37234677 PMCID: PMC10208131 DOI: 10.1080/2090598x.2022.2141864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background To date, no previous research assessed the bibliometrics of men's sexual and reproductive healthcare (SRHC) across Arab countries. This study appraised the current standing of men's SRHC research in the MENA (Middle East and North Africa) region. Methods We performed a bibliometric analysis to assess qualitatively and quantitatively the peer-reviewed articles published from Arab countries from inception to 2022. In addition, we conducted a visualization analysis, and assessed outputs, trends, shortcomings and hotspots over the given time period. Results There was a generally low numbers of publications, 98 studies were identified, all with cross-sectional design, and two thirds explored prevention and control of HIV/other STDs. Studies were published in 71 journals, of which the Eastern Mediterranean Health Journal, Journal of Egyptian Public Health Association, AIDS Care and BMC public health were most common. The Journal of Adolescent Health, Fertility Sterility and Journal of Cancer Survivorship were among the highest IF ranking. Publishers were commonly USA or UK-based, median journal IF was 2.09, and five articles were in journals of IF > 4. Saudi Arabia had the highest published output followed by Egypt, Jordan and Lebanon, while 10 Arab countries had no publications on the topic. Corresponding authors expertise fields were most commonly public health, infectious diseases and family medicine). Collaborations in-between MENA countries were notably low. Conclusions There is general paucity of published outputs on SRHC. More research across MENA is needed, with more inter-MENA collaborations, and with inclusion of countries that currently have no outputs on SRHC. In order to accomplish such goals, R&D funding and capacity building are required. Research and published outputs should address SRHC burdens.
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Affiliation(s)
- Walid El Ansari
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Weill Cornell Medicine – Qatar, Doha, Qatar
| | - Mohamed Arafa
- Weill Cornell Medicine – Qatar, Doha, Qatar
- Urology Department, Hamad Medical Corporation, Doha, Qatar
- Andrology Department, Cairo University, Cairo, Egypt
| | - Ahmad Majzoub
- Weill Cornell Medicine – Qatar, Doha, Qatar
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Haitham Elbardisi
- College of Medicine, Qatar University, Doha, Qatar
- Weill Cornell Medicine – Qatar, Doha, Qatar
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Albakr
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Mahdi
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdulla Al Ansari
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine – Qatar, Doha, Qatar
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Khalid AlRumaihi
- College of Medicine, Qatar University, Doha, Qatar
- Weill Cornell Medicine – Qatar, Doha, Qatar
- Urology Department, Hamad Medical Corporation, Doha, Qatar
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Whole-Genome Profile of Greek Patients with Teratozοοspermia: Identification of Candidate Variants and Genes. Genes (Basel) 2022; 13:genes13091606. [PMID: 36140773 PMCID: PMC9498395 DOI: 10.3390/genes13091606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 01/09/2023] Open
Abstract
Male infertility is a global health problem that affects a large number of couples worldwide. It can be categorized into specific subtypes, including teratozoospermia. The present study aimed to identify new variants associated with teratozoospermia in the Greek population and to explore the role of genes on which these were identified. For this reason, whole-genome sequencing (WGS) was performed on normozoospermic and teratozoospermic individuals, and after selecting only variants found in teratozoospermic men, these were further prioritized using a wide range of tools, functional and predictive algorithms, etc. An average of 600,000 variants were identified, and of them, 61 were characterized as high impact and 153 as moderate impact. Many of these are mapped in genes previously associated with male infertility, yet others are related for the first time to teratozoospermia. Furthermore, pathway enrichment analysis and Gene ontology (GO) analyses revealed the important role of the extracellular matrix in teratozoospermia. Therefore, the present study confirms the contribution of genes studied in the past to male infertility and sheds light on new molecular mechanisms by providing a list of variants and candidate genes associated with teratozoospermia in the Greek population.
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Webair HH, Ismail TAT, Ismail SB, Khaffaji AJ. Patient-centred infertility care among Arab women experiencing infertility: a qualitative study. BMJ Open 2021; 11:e044300. [PMID: 34145008 PMCID: PMC8215246 DOI: 10.1136/bmjopen-2020-044300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The current study aims to define patient-centred infertility care (PCIC) from the perspective of Arab women with infertility. DESIGN Semistructured in-depth telephone interviews. SETTING Hospitals providing infertility care, Jeddah, Saudi Arabia. PARTICIPANTS Arab women who received infertility treatment during the 6 months preceding the interview at any hospital in Jeddah, Saudi Arabia. Interviews were conducted with Arab women experiencing infertility from January 2017 to December 2018. A purposive sample of 14 women were included in the final analysis with maximum variation. RESULTS Participants highlighted nine important PCIC dimensions. Of these, four were agreed on by all participants: accessibility, minimising cost, information and education, and staff attitudes and communication. The remaining five dimensions were staff competence, physical comfort, privacy, psychological and emotional support, and continuity and coordination of care. The concept of PCIC was related to three major contributors: participants' demographics, patient experience with infertility care and health-seeking behaviour. CONCLUSIONS The current study provided nine PCIC dimensions and items, which can guide efforts to improve the quality of infertility care in Arab countries in two ways: first, by raising infertility care providers' awareness of their patients' needs, and second, by developing a validated tool based on the dimensions for measuring PCIC from Arab patients' perspective. Clear differences between the Arab and the European PCIC model were found. Our findings concluded that women continued to exhibit basic unmet needs.
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Affiliation(s)
- Hana Hasan Webair
- Family Medicine Department, School of Medical Sciences, Health campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Family Medicine Department, Hadhramout University College of Medicine, Al Mukalla, Hadhramout, Yemen
| | - Tengku Alina Tengku Ismail
- Community Medicine Department, School of Medical Sciences, Health campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Shaiful Bahari Ismail
- Family Medicine Department, School of Medical Sciences, Health campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Azza Jameel Khaffaji
- Obstetrics & Gynaecology, King Abdulaziz Hospital and Oncology Center, Jeddah, Makkah, Saudi Arabia
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Ha JY, Ban SH. Effects of Mind-Body Programs on Infertile Women: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:77-88. [PMID: 33607300 DOI: 10.1016/j.anr.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/23/2021] [Accepted: 02/08/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was to systematically review randomized controlled trials and conduct a meta analysis. The results of randomized controlled trials were integrated and analyzed to assess the effects of mind-body programs on anxiety, depression, quality of life, and pregnancy rate in infertile women. METHODS Using electronic databases (i.e., Research Information Sharing Service, Korean Studies Information Service System, Korean Medical Database, National Digital Science Library, Cochrane Library, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycARTICLES), 10 of 2,259 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. RESULTS The mind-body program was effective in relieving anxiety [standardized mean difference (SMD) = -3.44; 95% confidence interval (CI) = -5.94, -0.95; p = .007; I2 = 69%] and depression (SMD = -5.79; 95% CI = -10.36, -1.22; p = .010; I2 = 86%). Furthermore, it was effective in enhancing the quality of life (SMD = 7.40; 95% CI = 2.92, 11.88; p = .001; I2 = 53%) and pregnancy rate (SMD = 2.06; 95% CI = 1.08, 3.95; p = .030; I2 = 73%). The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. CONCLUSION The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. The mind-body program needs to be considered to a wider audience for positive effects on emotions and pregnancy outcomes of infertile women.
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Affiliation(s)
- Ju-Young Ha
- College of Nursing, Pusan National University, Busan, Republic of Korea
| | - Seon-Hwa Ban
- College of Nursing, Pusan National University, Busan, Republic of Korea.
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Melado L, Vitorino R, Coughlan C, Bixio LD, Arnanz A, Elkhatib I, De Munck N, Fatemi HM, Lawrenz B. Ethnic and Sociocultural Differences in Ovarian Reserve: Age-Specific Anti-Müllerian Hormone Values and Antral Follicle Count for Women of the Arabian Peninsula. Front Endocrinol (Lausanne) 2021; 12:735116. [PMID: 34745004 PMCID: PMC8567992 DOI: 10.3389/fendo.2021.735116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) and antral follicle count (AFC) age-specific reference values form the basis of infertility treatments, yet they were based upon studies performed primarily on Caucasian populations. However, they may vary across different age-matched ethnic populations. This study aimed to describe age-specific serum AMH and AFC for women native to the Arabian Peninsula. METHODS A retrospective large-scale study was performed including 2,495 women, aged 19 to 50 years, native to the Arabian Peninsula. AMH and AFC were measured as part of their fertility assessment at tertiary-care fertility centres. Age-specific values and nomograms were calculated. RESULTS 2,495 women were evaluated. Mean, standard deviation and median values were calculated for AMH and AFC by 1-year and 5-years intervals. Median age was 34.81 years, median AMH was 1.76ng/ml and median AFC was 11. From the total group, 40.60% presented with AMH levels below 1.3ng/mL. For women <45 years old, the decrease in AFC was between -0.6/-0.8 per year. Up to 36 years old, the decrease of AMH was 0.1ng/ml. However, from 36 to 40 years old, an accelerated decline of 0.23ng/ml yearly was noted. In keeping with local customs, 71.23% of women wore the hijab and 25.76% the niqab. AMH and AFC were significantly lower for niqab group compared with hijab group (p=0.02 and p=0.04, respectively). CONCLUSION This is to-date the largest data set on age-specific AMH and AFC values in women from the Arabian Peninsula aiming to increase clinical awareness of the ovarian reserve in this population.
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Affiliation(s)
- Laura Melado
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- *Correspondence: Laura Melado,
| | - Raquel Vitorino
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Carol Coughlan
- Medical Department, Advanced Reproductive Technologies (ART) Fertility Clinics, Dubai, United Arab Emirates
| | | | - Ana Arnanz
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- Departamento de Biomedicina y Biotecnología, Universidad de Alcalá, Madrid, Spain
| | - Ibrahim Elkhatib
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Neelke De Munck
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Human M. Fatemi
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Barbara Lawrenz
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- Medical Department, Women’s University Hospital Tuebingen, Tuebingen, Germany
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Özman O, Bakırcıoğlu ME. Clinical impact of parental consanguineous marriage in idiopathic nonobstructive azoospermia. F S Rep 2020; 1:209-212. [PMID: 34223246 PMCID: PMC8244382 DOI: 10.1016/j.xfre.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To determine the frequency of parental consanguineous marriages (PCMs) in men with diagnosed idiopathic nonobstructive azoospermia (INOA) and to compare clinical and pathological parameters between azoospermic men with and without PCM. DESIGN Retrospective. SETTING A private clinic. PATIENTS Two hundred forty-six men with INOA. Patients were divided into two groups: group 1 with PCM and group 2 without PCM. Clinical parameters, surgical sperm retrieval rates, and pathological findings were compared between the groups. INTERVENTIONS Surgical sperm retrieval. MAIN OUTCOME MEASURES PCM and clinical parameters. RESULTS Among the 246 patients with INOA, 81 had PCM. Men with PCM had lower follicle-stimulating hormone (13.7 vs. 21.9 mIU/mL), higher testosterone (3.8 vs. 3.4 ng/mL), and larger testes (14.1 vs. 11.8 mL). In parallel with the clinical findings, the most common pathological pattern in men with PCM was maturation arrest. However, there was no difference in surgical sperm retrieval rate between men with (23.4%) and without (32.1%) PCM. CONCLUSIONS Our data showed that PCM was present for 33% of men with INOA. The clinical parameters of men with PCM and INOA were significantly different than those without PCM, primarily demonstrating maturation arrest in testicular pathology. Further genetic research in families who have infertile male siblings may elucidate underlying rare genetic abnormalities in spermatogenesis.
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Affiliation(s)
- Oktay Özman
- Health Sciences University, Gaziosmanpaşa Education and Research Hospital, Urology Clinic, Istanbul, Turkey
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Zauner G, Girardi G. Potential causes of male and female infertility in Qatar. J Reprod Immunol 2020; 141:103173. [PMID: 32652349 DOI: 10.1016/j.jri.2020.103173] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/14/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022]
Abstract
A steady decline in the fertility rate has been observed in Qatar during the past fifty years. Therefore, infertility is considered a national priority in Qatar, a pronatalist society. This review article summarises the potential causes of infertility that are particularly prevalent in the Qatari population. The high rate of consanguinity leading to genetic abnormalities, the high incidence of metabolic disease, environmental contamination due to the rapid urbanization and oil and natural gas extraction procedures are discussed. In addition, the particular lifestyle of the Qatari population and the influence of religion and culture on sexual and reproductive behavior in an Arab/Islamic society are considered. The active response of the state of Qatar in implementing ways to mitigate the effects of these factors to protect fertility are also presented.
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Affiliation(s)
- Gerhild Zauner
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar
| | - Guillermina Girardi
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar.
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Melado L, Arnanz A, Bayram A, Elkhatib I, De Munck N, Navarro AT, Coughlan C, Lawrenz B, Fatemi HM. Anti-Müllerian hormone is an independent marker for oocyte survival after vitrification. Reprod Biomed Online 2020; 41:119-127. [PMID: 32499103 DOI: 10.1016/j.rbmo.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/26/2020] [Accepted: 03/23/2020] [Indexed: 01/04/2023]
Abstract
RESEARCH QUESTION This study explored the relationship between anti-Müllerian hormone (AMH) and oocyte survival after vitrification. The association between AMH and blastocyst formation after oocyte vitrification was also assessed. DESIGN A retrospective observational analysis was performed in a private IVF centre. A total of 4507 metaphase-II warmed oocytes were included from 450 couples, predominantly of Arab ethnicity. Between August 2015 and August 2018, couples underwent 484 intracytoplasmic sperm injection (ICSI) treatments using vitrified-warmed oocytes. RESULTS Patients' median age ± SD was 36.2 ± 6.1 years, AMH concentration 2.6 ± 3.4 ng/ml and body mass index (BMI) 26.5 ± 4.6 kg/m2. The oocyte survival rate after vitrification was 87.37 ± 20.42%. AMH concentration showed a significant correlation (Kendall's tau 0.087, P = 0.0079) with oocyte survival rate independent of oocyte yield. Correlation was significant (odds ratio 1.041, 95% confidence interval 1.007-1.077, P = 0.018) when a multivariant model was applied that included AMH, age and BMI. The receiver operating characteristic curve showed an AMH cut-off value of 1.09 ng/ml that could obtain at least a 70% survival rate, with an area under the curve of 0.669. Regarding embryo development in ICSI cycles including fresh and warmed oocytes for the same patient, blastocyst formation rate was higher in fresh compared with warmed oocytes (P < 0.001). In this subgroup no significant correlation was seen between fertilization or blastocyst rate and AMH concentration. CONCLUSIONS AMH concentration showed a significant correlation with oocyte survival. Blastocyst formation was significantly lower after oocyte vitrification, but no correlation was found with AMH. Clinicians should carefully evaluate oocyte vitrification for patients with AMH below 1.09 ng/ml and consider embryo accumulation for these patients in preference to oocyte accumulation.
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Affiliation(s)
- Laura Melado
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE.
| | - Ana Arnanz
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Asina Bayram
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Ibrahim Elkhatib
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Neelke De Munck
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | | | - Carol Coughlan
- IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE
| | - Barbara Lawrenz
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; Women's University Hospital Tuebingen, Tuebingen, Germany
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Arnanz A, De Munck N, El Khatib I, Bayram A, Abdala A, Melado L, Lawrenz B, Coughlan C, Pacheco A, Garcia-Velasco JA, Fatemi HM. Vitamin D in Follicular Fluid Correlates With the Euploid Status of Blastocysts in a Vitamin D Deficient Population. Front Endocrinol (Lausanne) 2020; 11:609524. [PMID: 33584542 PMCID: PMC7874043 DOI: 10.3389/fendo.2020.609524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/03/2020] [Indexed: 11/13/2022] Open
Abstract
CONTEXT The widespread distribution of the Vitamin D (VitD) receptor in reproductive tissues suggests an important role for VitD in human reproduction. The assessment of patient´s VitD is based on the 25-hydroxyvitamin D (25(OH)D) metabolite measurement. However, most of the circulating 25(OH)D is bound to either VitD-binding protein (VDBP) (88%) or albumin (12%) and less than 1% circulates free. OBJECTIVE To determine a possible correlation between VitD levels in serum (S) and follicular fluid (FF) and blastocyst ploidy status in patients undergoing infertility treatment. METHODS A prospective observational study was performed including couples planned for preimplantation genetic testing for aneuploidies (PGT-A) from ART Fertility Clinics. Patients were classified according to their 25(OH)D-Serum levels: VitD deficient group <20 ng/ml and insufficient/replete ≥20 ng/ml defined as VitD non-deficient group. RESULTS Serum samples and 226 FF from individual follicles were collected for 25(OH)D, bioavailable 25(OH)D, free 25(OH)D, and % free 25(OH)D measurement. 25(OH)D-Serum in VitD deficient and non-deficient were 13.2±4.0 ng/ml vs 32.3±9.2 ng/ml; p<0.001. FF from 40 and 74 biopsied blastocysts was analysed of which 52.5 and 60.8% were euploid (p = 0.428), respectively. In VitD deficient patients, mean 25(OH)D-FF, bioavailable 25(OH)D-FF, and free 25(OH)D-FF were higher in euploid vs aneuploid blastocysts (18.3±6.3 ng/ml vs 13.9±4.8 ng/ml; p = 0.040; 1.5±0.5 ng/ml vs 1.1±0.4 ng/ml; p = 0.015; 0.005±0.002 ng/ml vs 0.003±0.001 ng/ml; p = 0.023, respectively), whilst no differences were found in VitD non-deficient patients (37.9±12.3 ng/ml vs 40.6±13.7 ng/ml; p = 0.380; 3.1±1.1 ng/ml vs 3.3±1.2 ng/ml; p = 0.323; 0.01±0.003 ng/ml vs 0.01±0.004 ng/ml; p = 0.319, respectively). CONCLUSION VitD non-deficient patients have a significantly higher probability of obtaining a euploid blastocyst compared to VitD deficient patients (OR:33.36, p = 0.002).
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Affiliation(s)
- Ana Arnanz
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
- *Correspondence: Ana Arnanz, , orcid.org/0000-0003-2715-3480
| | | | | | - Aşina Bayram
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | - Andrea Abdala
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | - Laura Melado
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | - Barbara Lawrenz
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
- Obstetrical Department, Women’s University Hospital Tuebingen, Tuebingen, Germany
| | - Carol Coughlan
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | | | - Juan A. Garcia-Velasco
- IVIRMA, Madrid, Spain
- Department of Reproductive Endocrinology and Infertility, Rey Juan Carlos University, Madrid, Spain
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Dissanayake DMIH, Keerthirathna WLR, Peiris LDC. Male Infertility Problem: A Contemporary Review on Present Status and Future Perspective. GENDER AND THE GENOME 2019. [DOI: 10.1177/2470289719868240] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Semen quality plays a pivotal role in maintaining healthy fertilizing ability of spermatozoa. Male infertility is a rising global problem with an increasing declining in male semen quality among men living in Africa, Europe, North American, and Asia. Though the sperm acquire proactive mechanisms during spermatogenesis and their epididymal maturation, they still remain viable for toxic insult. Declining semen quality is a major contributor to infertility. Studies have postulated that different factors, such as exposure to pesticides, industrial chemicals, heavy metals, obesity, alcoholism, tobacco smoking, sedentary lifestyles, poor nutrient intake, oxidative stress, physiological factors, genetic factors can influence male fertility. Routine semen analysis and assays for sperm chromatin integrity are the most widely utilized and best studied adjunctive diagnostics in male infertility. Over the years, scientists have developed different treatment options for male infertility. Male infertility with known etiology can be treated successfully, but other causes like genetic factors require pragmatic approaches. This article summarizes protective mechanisms of spermatogenesis, causes, diagnosis, and both modern and traditional treatment approaches of male infertility. Further, this article highlights present issues and direction for future exploration of the male infertility problem.
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Affiliation(s)
- D. M. I. H. Dissanayake
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - W. L. R. Keerthirathna
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - L. Dinithi C. Peiris
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Husain S, Izhar R, Masood Z, Tahir S, Mataa-E-Masood. The effect of suboptimal semen parameters on male partner's ability to conceive. Is he really subfertile because the test says so? J Hum Reprod Sci 2019; 12:294-298. [PMID: 32038078 PMCID: PMC6937768 DOI: 10.4103/jhrs.jhrs_29_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/15/2019] [Accepted: 09/11/2019] [Indexed: 11/14/2022] Open
Abstract
Context: In many developing countries, subfertility treatment is not covered by government-funded institutions. It is observed that healthcare providers incriminate male factor for subfertility even when only a slight deviation from presumed normal criteria is observed. Aim: This study aims to provide scientific evidence that pregnancies are possible at semen parameters that are below the generally accepted lower limits of normal. Setting and Design: This was a retrospective cohort study conducted from January 2014 to December 2018. Materials and Methods: During the study period, couples who conceived without any treatment of male partner were included. The World Health Organization (WHO) reference values for semen analysis were utilized to assess the reports. The primary outcome measure was conception despite abnormal semen parameters. Statistical Analysis Used: Data were analyzed using the SPSS software program, version 15.0 (IBM, Armonk, USA). Results: Of the 332 couples included, 233 (70.1%) couples conceived despite suboptimal semen parameters, The most common criterion not satisfied was rapid linear motility –200 (85.8%), 87 (37.3%) men were oligozoospermic, 94 (40.3%) were asthenozoospermic, and 21 (9%) were teratozoospermic. The abnormalities were more common in men having primary subfertility (71.7% vs. 28.3%, P = 0.002). The abnormalities were most common in the age group 40–44 years (n = 91, 39.1%) and those who were overweight (n = 110, 47%). Conclusions: A consensus for defining poor semen criteria is the need of the hour so that these males can be counseled satisfactorily. WHO criteria are a standard commonly employed, but they do not necessarily predict the fertility potential.
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