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Qu H, Lv H, Kang Y, Yan L, Du Y. Reproductive outcomes of single frozen-thawed embryo transfer in patients with endometriosis after preimplantation genetic testing. J Assist Reprod Genet 2024; 41:429-435. [PMID: 38079077 PMCID: PMC10894775 DOI: 10.1007/s10815-023-02996-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/21/2023] [Indexed: 02/27/2024] Open
Abstract
PURPOSE The reproductive outcomes of patients with endometriosis who are infertile have attracted recent attention. We aimed to explore whether endometriosis affects endometrial receptivity by observing pregnancy outcomes following a euploid blastocyst frozen embryo transfer. METHODS This retrospective cohort study analyzed the data of patients with endometriosis from the reproductive hospital affiliated to Shandong University between January 2015 and December 2021. Control groups were matched using the 1:3 propensity score. The live birth, clinical pregnancy, biochemical pregnancy, clinical abortion, premature birth, and aneuploid rates were compared between the control group and endometriosis group. RESULTS A total of 625 patients who underwent preimplantation genetic testing (PGT) prior to embryo implantation were included in the analysis. There were no significant differences in the live birth, clinical pregnancy, biochemical pregnancy, clinical abortion, and premature birth rates between the two groups. The aneuploidy rate of blastocysts obtained from the endometriosis group was higher than that of the control group (P = 0.012). CONCLUSION Pregnancy outcomes using frozen embryos after PGT in patients with endometriosis did not differ from those in other women experiencing infertility. However, endometriosis may affect the quality of oocytes, resulting in a higher rate of aneuploidy.
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Affiliation(s)
- Huiling Qu
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China
- Center for Reproductive Medicine, The Reproductive Hospital Affiliated to Shandong University, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Hong Lv
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China
- Center for Reproductive Medicine, The Reproductive Hospital Affiliated to Shandong University, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Yan Kang
- Department of Obstetrics, Maternal Child Health Hospital of Shandong Province, Jinan, 250014, China
| | - Lei Yan
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Center for Reproductive Medicine, The Reproductive Hospital Affiliated to Shandong University, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.
- Medical Integration and Practice Center, Shandong University, Jinan, China.
| | - Yanbo Du
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Center for Reproductive Medicine, The Reproductive Hospital Affiliated to Shandong University, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.
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Hawkes A, Shields RC, Quenby S, Bick D, Parsons J, Harris B. Lived experience of recurrent miscarriage: women and their partners' experience of subsequent pregnancy and support within an NHS specialist clinic - a qualitative study. BMJ Open 2023; 13:e075062. [PMID: 38123186 DOI: 10.1136/bmjopen-2023-075062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE This study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and cytogenetic investigations. DESIGN A qualitative interview study with a phenomenological approach. Semistructured interviews were conducted using video conferencing software. Two researchers coded the transcripts and developed themes. SETTING A National Health Service (NHS) hospital in central England between May 2021 and July 2021, during the COVID-19 pandemic. PARTICIPANTS Patients attending a specialist recurrent miscarriage clinic and their partners. This clinic accepts referrals from all over the UK for couples who have suffered two or more miscarriages. RESULTS Seventeen participants were interviewed: 14 women and 3 male partners. Six main themes were identified from the data. Three related to the women's lived experience of recurrent miscarriage (emotions in pregnancy, confidence in their bodies, expectations and coping strategies) and three related to the clinical support offered by the NHS service (impact of early pregnancy scanning, effect of the COVID-19 pandemic and cytogenetic investigations). CONCLUSIONS Pregnancy following recurrent miscarriage is extremely difficult. Recurrent miscarriage specialist services can provide couples with support and access to early pregnancy scanning, which can make the first trimester of pregnancy manageable. Partners should not be excluded from the clinic as it can result in a feeling of disconnect. Cytogenetic testing of pregnancy tissue can offer couples with recurrent miscarriage closure after pregnancy loss and is a desired investigation.
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Affiliation(s)
- Amelia Hawkes
- University of Warwick, Warwick Medical School, Coventry, UK
- University Hospital Coventry and Warwickshire, Coventry, UK
| | - Rebecca Claire Shields
- University of Warwick, Warwick Medical School, Coventry, UK
- University Hospital Coventry and Warwickshire, Coventry, UK
| | - Siobhan Quenby
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jo Parsons
- Division of Health Sciences, Warwick Medical School, University of Warwick, Conventry, UK
| | - Bronwyn Harris
- Division of Health Sciences, Warwick Medical School, University of Warwick, Conventry, UK
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Severijns Y, de Die-Smulders CEM, Gültzow T, de Vries H, van Osch LADM. Hereditary diseases and child wish: exploring motives, considerations, and the (joint) decision-making process of genetically at-risk couples. J Community Genet 2021; 12:325-335. [PMID: 33611773 PMCID: PMC8241960 DOI: 10.1007/s12687-021-00510-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/10/2021] [Indexed: 11/29/2022] Open
Abstract
Couples who are at risk of transmitting a genetic disease to their offspring may face difficult challenges regarding reproductive decision-making. Deciding if, and how, to purse their child wish can be a demanding process. This study aims to describe the reproductive joint decision-making process of genetically at-risk couples. A qualitative study was conducted with 16 couples (N=31) at risk of transmitting a genetic disease to their offspring and who received genetic counseling. Most couples were not aware of all available reproductive options in the Netherlands. A variety of motives was reported with almost all couples expressing a preference towards a reproductive option in which the child is genetically related to both parents. Only a few couples considered other options such as the use of donor gametes, adoption, and foster parenting. All couples indicated that they had multiple conversations to reach a mutually supported reproductive decision. Several carriers reported feelings of guilt and in some couples, the woman appeared to have a greater impact in the decision-making process as she should carry a pregnancy and should undergo medical treatments. This study provides insight in the extensive decision-making process of genetically at-risk couples and the role of both partners in this process. These findings can guide the development of genetic counseling (e.g., increase awareness of available reproductive options) and decision support for these couples.
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Affiliation(s)
- Y Severijns
- Department of Health Promotion/CAPHRI, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. .,GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - C E M de Die-Smulders
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - T Gültzow
- Department of Health Promotion/CAPHRI, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - H de Vries
- Department of Health Promotion/CAPHRI, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - L A D M van Osch
- Department of Health Promotion/CAPHRI, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Centre +, Maastricht, The Netherlands
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