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Lai S, Wang R, van Wely M, Costello M, Farquhar C, Bensdorp AJ, Custers IM, Goverde AJ, Elzeiny H, Mol BW, Li W. IVF versus IUI with ovarian stimulation for unexplained infertility: a collaborative individual participant data meta-analysis. Hum Reprod Update 2024; 30:174-185. [PMID: 38148104 PMCID: PMC10905504 DOI: 10.1093/humupd/dmad033] [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: 07/27/2023] [Revised: 11/02/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND IVF and IUI with ovarian stimulation (IUI-OS) are widely used in managing unexplained infertility. IUI-OS is generally considered first-line therapy, followed by IVF only if IUI-OS is unsuccessful after several attempts. However, there is a growing interest in using IVF for immediate treatment because it is believed to lead to higher live birth rates and shorter time to pregnancy. OBJECTIVE AND RATIONALE Randomized controlled trials (RCTs) comparing IVF versus IUI-OS had varied study designs and findings. Some RCTs used complex algorithms to combine IVF and IUI-OS, while others had unequal follow-up time between arms or compared treatments on a per-cycle basis, which introduced biases. Comparing cumulative live birth rates of IVF and IUI-OS within a consistent time frame is necessary for a fair head-to-head comparison. Previous meta-analyses of RCTs did not consider the time it takes to achieve pregnancy, which is not possible using aggregate data. Individual participant data meta-analysis (IPD-MA) allows standardization of follow-up time in different trials and time-to-event analysis methods. We performed this IPD-MA to investigate if IVF increases cumulative live birth rate considering the time leading to pregnancy and reduces multiple pregnancy rate compared to IUI-OS in couples with unexplained infertility. SEARCH METHODS We searched MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, and the Cochrane Gynaecology and Fertility Group Specialised Register to identify RCTs that completed data collection before June 2021. A search update was carried out in January 2023. RCTs that compared IVF/ICSI to IUI-OS in couples with unexplained infertility were eligible. We invited author groups of eligible studies to join the IPD-MA and share the deidentified IPD of their RCTs. IPD were checked and standardized before synthesis. The quality of evidence was assessed using the Risk of Bias 2 tool. OUTCOMES Of eight potentially eligible RCTs, two were considered awaiting classification. In the other six trials, four shared IPD of 934 women, of which 550 were allocated to IVF and 383 to IUI-OS. Because the interventions were unable to blind, two RCTs had a high risk of bias, one had some concerns, and one had a low risk of bias. Considering the time to pregnancy leading to live birth, the cumulative live birth rate was not significantly higher in IVF compared to that in IUI-OS (4 RCTs, 908 women, 50.3% versus 43.2%, hazard ratio 1.19, 95% CI 0.81-1.74, I2 = 42.4%). For the safety primary outcome, the rate of multiple pregnancy was not significantly lower in IVF than IUI-OS (3 RCTs, 890 women, 3.8% versus 5.2% of all couples randomized, odds ratio 0.78, 95% CI 0.41-1.50, I2 = 0.0%). WIDER IMPLICATIONS There is no robust evidence that in couples with unexplained infertility IVF achieves pregnancy leading to live birth faster than IUI-OS. IVF and IUI-OS are both viable options in terms of effectiveness and safety for managing unexplained infertility. The associated costs of interventions and the preference of couples need to be weighed in clinical decision-making.
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Affiliation(s)
- Shimona Lai
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Rui Wang
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Madelon van Wely
- Centre for Reproductive Medicine, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
- Department of Epidemiology & Data Science, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Michael Costello
- Women's Health, School of Clinical Medicine, University of New South Wales & Royal Hospital for Women and Monash IVF, Sydney, NSW, Australia
| | - Cindy Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Alexandra J Bensdorp
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Inge M Custers
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Angelique J Goverde
- Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hossam Elzeiny
- Royal Women's Hospital, Melbourne IVF, Melbourne, VIC, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Wentao Li
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
- National Perinatal Epidemiology and Statistics Unit (NPESU), Centre for Big Data Research in Health, and School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Salmanov AG, Yuzko OM, Tofan BY, Artyomenko VV, Korniyenko SM, Rud VO, Dyndar OA, Kovalyshyn OA, Nykoniuk TR, Nastradina NM. Factors associated with female infertility in Ukraine: results a multicenter study. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:790-799. [PMID: 38865639 DOI: 10.36740/wlek202404127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Aim: To determine the current prevalence of female infertility and characterize and identify risk factors associated with infertility in Ukraine. PATIENTS AND METHODS Materials and Methods: Multicenter prospective cohort study was conducted from January 2021 to December 2023 in twelve medical centers from nine regions of Ukraine. Definitions of infertility were adapted from the World Health Organization. According to the data collected from questionnaire, participants were divided into infertile and fertile groups and analyzed associated factors. RESULTS Results: Among all the 7,618 participants in this study, the prevalence of female infertility was 24.3%. The prevalence of primary infertility was 5.9%, and the prevalence of secondary infertility was 18.4%. In logistic multivariate regression analyses, female infertility was associated with age of women (p<0.001), age of first sexual intercourse (p<0.001), history of gynecological surgery (p<0.001), marital status (p<0.001), age of marriage (p<0.001), decreased ovarian reserve (DOR) (p=0.006), family history of infertility (p<0.001), history of cervicitis (p=0.007), history of surgical abortion (p<0.001), history of endometritis (p=0.027), bacterial vaginosis (p=0.023), and aerobic vaginitis (< 0.001). CONCLUSION Conclusions: Our data suggest a high prevalence of female infertility in Ukraine. The prevalence of secondary infertility was higher than primary infertility. Age of women, age of first sexual intercourse, history of gynecological surgery, marital status, age of marriage, DOR, family history of infertility, history of cervicitis, history of surgical abortion, history of endometritis, bacterial vaginosis, and aerobic vaginitis were associated with infertility.
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Affiliation(s)
- Aidyn G Salmanov
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | | | - Bohdan Yu Tofan
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE
| | | | | | - Victor O Rud
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
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Bongaerts E, Mamia K, Rooda I, Björvang RD, Papaikonomou K, Gidlöf SB, Olofsson JI, Ameloot M, Alfaro-Moreno E, Nawrot TS, Damdimopoulou P. Ambient black carbon particles in human ovarian tissue and follicular fluid. ENVIRONMENT INTERNATIONAL 2023; 179:108141. [PMID: 37603992 DOI: 10.1016/j.envint.2023.108141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023]
Abstract
Evidence indicates a link between exposure to ambient air pollution and decreased female fertility. The ability of air pollution particles to reach human ovarian tissue and follicles containing the oocytes in various maturation stages has not been studied before. Particulate translocation might be an essential step in explaining reproductive toxicity and assessing associated risks. Here, we analysed the presence of ambient black carbon particles in (i) follicular fluid samples collected during ovum pick-up from 20 women who underwent assisted reproductive technology treatment and (ii) adult human ovarian tissue from 5 individuals. Follicular fluid and ovarian tissue samples were screened for the presence of black carbon particles from ambient air pollution using white light generation by carbonaceous particles under femtosecond pulsed laser illumination. We detected black carbon particles in all follicular fluid (n = 20) and ovarian tissue (n = 5) samples. Black carbon particles from ambient air pollution can reach the ovaries and follicular fluid, directly exposing the ovarian reserve and maturing oocytes. Considering the known link between air pollution and decreased fertility, the impact of such exposure on oocyte quality, ovarian ageing and fertility needs to be clarified urgently.
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Affiliation(s)
- Eva Bongaerts
- Centre for Environmental Sciences, Hasselt University, 3590 Hasselt, Belgium
| | - Katariina Mamia
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Ilmatar Rooda
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Richelle D Björvang
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Uppsala University, 75185 Uppsala, Sweden
| | - Kiriaki Papaikonomou
- Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Sebastian B Gidlöf
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jan I Olofsson
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Marcel Ameloot
- Biomedical Research Institute, Hasselt University, 3590 Hasselt, Belgium
| | - Ernesto Alfaro-Moreno
- Nanosafety Group, International Iberian Nanotechnology Laboratory, 4715-330 Braga, Portugal
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, 3590 Hasselt, Belgium; Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden.
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Abdullah AA, Ahmed M, Oladokun A. Characterization and risk factors for unexplained female infertility in Sudan: A case-control study. World J Methodol 2023; 13:98-117. [PMID: 37456975 PMCID: PMC10348085 DOI: 10.5662/wjm.v13.i3.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/08/2023] [Accepted: 03/15/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Female infertility with unknown causes (unexplained) remains one of the mysteries in the reproductive health field, where the diagnostic evidence is still weak and the proposed treatments still work with unknown methods. However, several studies have proposed some possible causes and risk factors for unexplained female infertility.
AIM To characterize and identify factors associated with unexplained infertility in Sudanese women.
METHODS A matched (age and body mass index) case-control study was conducted from March 2021 to February 2022. The study samples were 210 women with unexplained infertility (UI) and 190 fertile women of reproductive age who were attending the maternity hospitals and fertility clinics in Khartoum, Sudan. The risk factors of unexplained infertility were identified using a structured, pre-tested questionnaire containing information on socio-demographic variables, anthropometrics, clinical diagnosis of infertility, behavioral factors, physical activity assessment, diversity, and consumption of different food groups by the study participants.
RESULTS The results showed a higher proportion of women diagnosed with UI were residents of rural areas than controls (21.4% vs 11.1%, P < 0.05), and previous miscarriages and/or abortions were more common in fertile women compared with infertile women (13.16% vs 5.71%, P < 0.05). Additionally, infertile women had a significantly (P < 0.05) higher proportion of family history of infertility (explained and unexplained) compared with controls. Finally, after controlling for the effects of potentially confounding variables using multivariable logistic regression analysis, only marital status, family history of infertility, use of modern contraceptives, smoking, caffeine consumption, physical activity level, meals consumed, other vitamin-A-rich fruits and vegetables, and other vegetables were found to be significant (P < 0.05) factors associated with unexplained infertility among Sudanese women.
CONCLUSION Married women with a family history of infertility who smoke and consume a high amount of caffeine, who live a sedentary lifestyle, and who consume more than two meals free of vitamin-A-rich fruits and/or vegetables and/or other vegetables per day are at the highest risk of developing unexplained infertility.
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Affiliation(s)
- Abdullah Abdulslam Abdullah
- Reproductive Health Sciences Program, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Biomedical Sciences, Faculty of Veterinary Sciences, University of Gadarif, Al-Gadarif 32211, Sudan
| | - Musa Ahmed
- Reproductive Health Sciences Program, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, AL-Salam University, Al-fula 120, West Kordofan, Sudan
| | - Adesina Oladokun
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 119, Oyo state, Nigeria
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Kunjummen A, Sarkar S, Joseph T, Yadav B, Kamath M. Comparison of treatment outcomes following ovarian stimulation with intrauterine insemination in minimal or mild endometriosis versus unexplained infertility: A retrospective cohort study. J Hum Reprod Sci 2022; 15:272-277. [DOI: 10.4103/jhrs.jhrs_102_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/10/2022] [Accepted: 09/11/2022] [Indexed: 11/04/2022] Open
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Mustafa M, Dar SA, Azmi S, Haque S. The Role of Environmental Toxicant-Induced Oxidative Stress in Male Infertility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1391:17-32. [PMID: 36472814 DOI: 10.1007/978-3-031-12966-7_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Infertility is a serious public health issue affecting around 15% of couples globally. Of the 60-80 million people of reproductive age affected by infertility, 40-50% are due to male factor while 30-40% of cases are still idiopathic. The recent global deterioration in sperm quality raises apprehensions regarding the toxic effects of environmental pollutants on reproductive health of males. Environmental toxicants have shown strong evidences for inducing oxidative stress affecting spermatogenesis severely, thereby leading to reduced sperm motility, count, and DNA damage. Reactive oxygen species (ROS) influences the spermatozoa development and transit process both internally and externally. Low level of ROS is indispensable for critical physiological sperm processes like sperm capacitation, motility, acrosome reaction, hyper-activation, sperm-oocyte interaction, etc., while excessive ROS disrupt antioxidant molecules which is detrimental to normal functioning of the sperm. Hence, identification of potential environmental toxicant may have clinical relevance for early screening and diagnosis of male infertility.
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Affiliation(s)
- Mohammad Mustafa
- Scientific Research Centre, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Sajad Ahmad Dar
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Sarfuddin Azmi
- Scientific Research Centre, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Shafiul Haque
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan, Kingdom of Saudi Arabia.
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Moore V, Rumbold A, Fernandez R, McElroy H, Moore L, Giles L, Grzeskowiak L, Roughead E, Stark M, Davies M. Dispensing of clomiphene citrate to treat infertility: medication supplied and population prevalence of assisted pregnancies and multiple births. Fertil Steril 2021; 117:202-212. [PMID: 34656304 DOI: 10.1016/j.fertnstert.2021.08.030] [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: 04/15/2021] [Revised: 06/30/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the proportion of pregnancies resulting in birth that were conceived with the use of clomiphene citrate (CC) and the frequency of multiple pregnancy. DESIGN Whole-of-population cohort study, constructed through data linkage. Comprehensive Australian Government records of dispensed medications were linked to state Perinatal Registry records for all births of at least 20 weeks' gestation. SETTING The state of South Australia. PATIENT(S) Women who maintained pregnancy for at least 20 weeks and gave birth between July 2003 and December 2015, a total of 150,713 women with 241,561 pregnancies. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Ongoing pregnancy occurring in proximity to CC, defined as dispensing from 90 days before to the end of a conception window derived from newborn date of birth and gestational age. RESULT(S) Linkage to dispensed prescription records was achieved for 97.9% of women. Women who conceived with CC tended to be older and socioeconomically advantaged and more likely than other women to have a history of miscarriage. Ongoing pregnancies associated with CC comprised 1.6% of the total; 5.7% were multiple births (mostly twins, 94.6%) compared with 1.5% in the remainder (98.5% twins). CONCLUSION(S) In South Australia, 1.6% of pregnancies (1 in 60) of at least 20 weeks' gestation were conceived proximal to CC dispensing. Of these, 5.7% were multiple pregnancies. This takes the proportion of women who achieved an ongoing pregnancy with medical assistance from 4.4%, based on reports from assisted reproductive technology clinics, to 6% in total.
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Affiliation(s)
- Vivienne Moore
- School of Public Health, The University of Adelaide, South Australia; Robinson Research Institute, The University of Adelaide, South Australia.
| | - Alice Rumbold
- Robinson Research Institute, The University of Adelaide, South Australia; South Australian Health and Medical Research Institute, South Australia
| | - Renae Fernandez
- Robinson Research Institute, The University of Adelaide, South Australia; Discipline of Obstetrics and Gynaecology, The University of Adelaide, South Australia
| | - Heather McElroy
- Discipline of Obstetrics and Gynaecology, The University of Adelaide, South Australia
| | - Lynette Moore
- SA Pathology, Women's and Children's Hospital, Adelaide, South Australia; Discipline of Medical Sciences, The University of Adelaide, South Australia
| | - Lynne Giles
- School of Public Health, The University of Adelaide, South Australia; Robinson Research Institute, The University of Adelaide, South Australia
| | - Luke Grzeskowiak
- Robinson Research Institute, The University of Adelaide, South Australia; South Australian Health and Medical Research Institute, South Australia; Discipline of Obstetrics and Gynaecology, The University of Adelaide, South Australia; College of Medicine and Public Health, Flinders University, South Australia
| | - Elizabeth Roughead
- Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, South Australia
| | - Michael Stark
- Robinson Research Institute, The University of Adelaide, South Australia; Discipline of Obstetrics and Gynaecology, The University of Adelaide, South Australia
| | - Michael Davies
- Robinson Research Institute, The University of Adelaide, South Australia; Discipline of Obstetrics and Gynaecology, The University of Adelaide, South Australia
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Bosselut H, Paulmyer-Lacroix O, Gnisci A, Bretelle F, Perrin J, Courbiere B. [Prognostic factors of live-birth after in vitro fertilization for unexplained infertility: A cohort study]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:601-607. [PMID: 33434750 DOI: 10.1016/j.gofs.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES For 15 to 30% of infertile couples, no etiology can be found, leading to the diagnosis of "unexplained infertility". The aim of our study was to identify prognostic factors for live birth following in vitro fertilization (IVF) for these couples. METHODS A retrospective, monocentric study on a cohort of couples undergoing IVF for unexplained infertility with the woman aged≤40 years old. Primary analysis compared couples with a live birth following IVF versus childless couples following IVF. RESULTS Between January 2014 and December 2018, 104 couples were included, 196 transvaginal oocyte pickup were performed, followed by 234 embryo transfers (fresh or cryopreserved) which resulted in 43 deliveries. The cumulative live birth rate was 40.4% per couple. Before IVF attempts, no clinical or paraclinical prognostic factors between the two groups was observed. However, multivariate analysis showed several biological factors of good prognosis in course of treatment, such as a higher number of mature oocytes and better quality embryos in "live birth" group. CONCLUSIONS For a couple, the chances of having a child following IVF unexplained infertility are 40.4%. However, no clinical characteristic enabled us to identify favourable or unfavourable prognosis factors before starting ART. The prognostic factors identified during IVF cycle are interesting to advise or not to pursue IVF.
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Affiliation(s)
- H Bosselut
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - O Paulmyer-Lacroix
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, département d'histologie et embryologie, Marseille, France
| | - A Gnisci
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France
| | - F Bretelle
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, unité de recherche sur les maladies infectieuses tropicales et émergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France
| | - J Perrin
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, CNRS, IRD, Avignon université, IMBE, Marseille, France
| | - B Courbiere
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, CNRS, IRD, Avignon université, IMBE, Marseille, France
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9
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Zhang X, Gao B, Xu B. Association between plasminogen activator inhibitor-1 (PAI-1) 4G/5G polymorphism and risk of Alzheimer's disease, metabolic syndrome, and female infertility: A meta-analysis. Medicine (Baltimore) 2020; 99:e23660. [PMID: 33327353 PMCID: PMC7738113 DOI: 10.1097/md.0000000000023660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Plasminogen activator inhibitor-1 (PAI-1) is considered to be involved in the physiopathological mechanisms of Alzheimer's disease (AD), metabolic syndrome (MetS), and female infertility. Previous studies investigating the association between PAI-14G/5G (rs1799889) gene polymorphism and the risk of AD, MetS, and female infertility have reported inconsistent results. The aim of the present study was to investigate possible associations. METHODS Eligible studies were retrieved through PubMed, Medline, EMBASE, CNKI, and WANFANG databases. The odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the associations. Subgroup analyses by ethnicity and mean age, sensitivity analyses, and publication bias were performed. RESULTS Five studies (four articles) for AD, six studies (six articles) for MetS, and four studies (four articles) for female infertility were included in this meta-analysis. Our results showed no significant associations between the PAI-14G/5G polymorphism and the risk of AD and female infertility in five genetic models. For the risk of MetS, the PAI-1 4G/5G (rs1799889) polymorphism may be associated with the risk of MetS (4G vs 5G, OR = 1.31, 95%CI = 1.04-1.64, P = .021), especially in Asians (4G/4G vs 4G/5G+5G/5G, OR = 1.38, 95%CI = 1.01-1.87, P = .041) and patients with mean age > 50 years old (4G/4G vs 4G/5G+5G/5G, OR = 1.36, 95%CI = 1.03-1.78, P = .029). CONCLUSION The present meta-analysis suggested that the PAI-1 4G/5G polymorphism might be associated with the risk of MetS, but no evidence was detected for AD and female infertility.
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Affiliation(s)
- Xin Zhang
- Department of Neurology, Shenyang First People's Hospital, Dadong District
| | - Bai Gao
- Department of Nerve Function, ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning Province, People's Republic of China
| | - Bing Xu
- Department of Neurology, Shenyang First People's Hospital, Dadong District
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Kamath MS, Rikken JFW, Bosteels J. Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility? Semin Reprod Med 2020; 38:29-35. [PMID: 33080633 DOI: 10.1055/s-0040-1718942] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevalence of pelvic infection, setting, and availability of expertise. Moreover, whenever a laparoscopy is planned as a part of the fertility workup, the preparation should include ability to carry out simultaneous therapeutic intervention to maximize the benefit. Similarly, the routine use of hysteroscopy in women with unexplained infertility cannot be recommended. There is a need to investigate the impact of choice of tubal test on chances of spontaneous conception and treatment outcomes in women with unexplained infertility. Our future research agenda should also include high-quality multicenter randomized trials assessing the cost-effectiveness of screening and operative hysteroscopy prior to intrauterine insemination or in vitro fertilization.
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Affiliation(s)
- Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | - Judith F W Rikken
- Center for Reproductive Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jan Bosteels
- Department of Obstetrics and Gynaecology, Imelda Hospital, Bonheiden, Belgium.,Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Development and Regeneration, Gent University, Gent, Belgium
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11
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A surprising link with unexplained infertility: a possible Covid-19 paradox? J Assist Reprod Genet 2020; 37:2661-2662. [PMID: 32845433 PMCID: PMC7447604 DOI: 10.1007/s10815-020-01911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022] Open
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12
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CD52+ regulatory T cells and CD52-expressing sperms downregulated in couples with unexplained infertility: A case-control study. Int J Reprod Biomed 2020; 18:385-387. [PMID: 32637867 PMCID: PMC7306058 DOI: 10.18502/ijrm.v13i5.7159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 01/27/2019] [Accepted: 10/28/2019] [Indexed: 11/24/2022] Open
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13
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Cao D, Ren Z, Lu D, Liu L, Xu P, Zhang Q, Wei Q. Association between CYP1A1 rs4646903 T > C genetic variations and male infertility risk: A meta-analysis. Medicine (Baltimore) 2019; 98:e16543. [PMID: 31374016 PMCID: PMC6709244 DOI: 10.1097/md.0000000000016543] [Citation(s) in RCA: 5] [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: 12/21/2018] [Revised: 03/31/2019] [Accepted: 06/28/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Number of studies have been performed to investigate the relationship between the CYP1A1 rs4646903 polymorphism and male infertility risk, but the sample size was small and the results were conflicting. A meta-analysis was performed to assess these associations. METHODS A systematic search was conducted to identify all relevant studies from Medline, Web of science, Embase, China biology medical literature database (CBM), China National Knowledge Infrastructure (CNKI), WanFang and Weipu (VIP) databases up to June 30, 2018. The odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of associations. All of the statistical analyses were conducted using Revman 5.3 and Stata 14.0. RESULTS Ten studies involved 3028 cases and 3258 controls. Overall, significant association was observed between the CYP1A1 rs4646903 polymorphism and male infertility (C vs T: OR = 1.42, 95%CI = 1.14-1.76; CC vs TT: OR = 2.13, 95%CI = 1.36-3.34; CC vs CT+TT: OR = 1.96, 95%CI = 1.30-2.95; CC+CT vs TT: OR = 1.51, 95%CI = 1.16-1.97). In subgroup analysis by ethnic group, a statistically significant association was observed in Asians (C vs T: OR = 1.59, 95%CI = 1.22-2.08), but not in Non-Asians (C vs T: OR = 1.01, 95%CI = 0.79-1.30). Additionally, none of the individual studies significantly affected the association between CYP1A1 rs4646903 polymorphism and male infertility, according to sensitivity analysis. CONCLUSION Our meta-analysis supports that the CYP1A1 rs4646903 polymorphism might contribute to individual susceptibility to male infertility in Asians.
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Affiliation(s)
- DeHong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - ZhengJu Ren
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | | | - LiangRen Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | | | - Qin Zhang
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu
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14
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Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani Z, Kamali K, Mohammad K. Practical Difficulties in Estimating The Prevalence of Primary Infertility in Iran. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:113-117. [PMID: 31037921 PMCID: PMC6500078 DOI: 10.22074/ijfs.2019.5583] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 01/26/2019] [Indexed: 11/30/2022]
Abstract
Background According to the World Health Organization (WHO)'s clinical, epidemiological and demographic defi-
nitions, infertility is an inability to become pregnant within one, two or five years of exposure to pregnancy, respec-
tively. Inconsistent infertility-related definitions and various methodological approaches make it difficult to compare
quantitative data in this regard and consequently, have negatively influenced estimating the prevalence of infertility.
The present study reviewed the results of a large population-based survey on how the clinical, epidemiological and de-
mographic definitions of infertility produce different results in terms of infertility prevalence in Iran and subsequently,
compared the findings in order to find the right time of treatment-seeking by couples. Materials and Methods This community-based, cross-sectional study was carried out by Avicenna Research Insti-
tute in the urban and rural parts of Iran between 2010 and 2011. Using cluster sampling, the reproductive history of
17,187 married women aged 20-40 years, was recorded. Totally, 1011 clusters were randomly selected according to
post office codes, proportional to the population of the province. Descriptive and inferential statistical analysis of the
data was carried out by SPSS statistical software. Results The prevalence of primary infertility based on the WHO’s clinical, epidemiological and demographic definitions
were 20.2, 12.8 and 9.2%, respectively. In addition, secondary infertility rate was 4.9%. Conclusion Infertility estimates over a two-year exposure period made a 50% decrease in infertility rate; however,
increasing exposure period to five years made no significant difference in infertility rate. The findings showed that most
of the couples will get pregnant within two years of unprotected sexual intercourse and thus, need no treatment. Due to
practical difficulties in estimating the prevalence of primary infertility, the reference limit for time to pregnancy, should
be reconsidered and giving more time to younger women to become pregnant, seems reasonable.
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Affiliation(s)
- Mohammad Mehdi Akhondi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Fahime Ranjbar
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Shirzad
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Zohre Behjati Ardakani
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Koorosh Kamali
- Department of Public Health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Fuller EA, Sominsky L, Sutherland JM, Redgrove KA, Harms L, McLaughlin EA, Hodgson DM. Neonatal immune activation depletes the ovarian follicle reserve and alters ovarian acute inflammatory mediators in neonatal rats. Biol Reprod 2018; 97:719-730. [PMID: 29040417 DOI: 10.1093/biolre/iox123] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 10/07/2017] [Indexed: 12/30/2022] Open
Abstract
Normal ovarian development is crucial for female reproductive success and longevity. Interruptions to the delicate process of initial folliculogenesis may lead to ovarian dysfunction. We have previously demonstrated that an early life immune challenge in the rat, induced by administration of lipopolysaccharide (LPS) on postnatal day (PND) 3 and 5, depletes ovarian follicle reserve long term. Here, we hypothesized that this neonatal immune challenge leads to an increase in peripheral and ovarian inflammatory signaling, contributing to an acute depletion of ovarian follicles. Morphological analysis of neonatal ovaries indicated that LPS administration significantly depleted PND 5 primordial follicle populations and accelerated follicle maturation. LPS exposure upregulated circulating interleukin 6, tumor necrosis factor alpha (TNFa), and C-reactive protein on PND 5, and upregulated ovarian mRNA expression of Tnfa, mitogen-activated protein kinase 8 (Mapk8/Jnk1), and growth differentiation factor 9 (Gdf9) (P < 0.05). Mass spectrometry and cell signaling pathway analysis indicated upregulation of cellular pathways associated with acute phase signaling, and cellular survival and assembly. Apoptosis assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling indicated significantly increased positive staining in the ovaries of LPS-treated neonates. These findings suggest that increased proinflammatory signaling within the neonatal ovary may be responsible for the LPS-induced depletion of the primordial follicle pool. These findings also have implications for female reproductive health, as the ovarian reserve is a major determinate of female reproductive longevity.
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Affiliation(s)
- Erin A Fuller
- Laboratory of Neuroimmunology, Priority Research Centre for Brain and Mental Health Research, School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Luba Sominsky
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Melbourne, Victoria, Australia
| | - Jessie M Sutherland
- School of Environmental and Life Sciences, Priority Research Centre in Chemical Biology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kate A Redgrove
- School of Environmental and Life Sciences, Priority Research Centre in Chemical Biology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Lauren Harms
- Laboratory of Neuroimmunology, Priority Research Centre for Brain and Mental Health Research, School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Eileen A McLaughlin
- School of Environmental and Life Sciences, Priority Research Centre in Chemical Biology, University of Newcastle, Callaghan, New South Wales, Australia.,School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Deborah M Hodgson
- Laboratory of Neuroimmunology, Priority Research Centre for Brain and Mental Health Research, School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
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16
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Kumaresan A, Johannisson A, Nordqvist S, Kårehed K, Åkerud H, Lindgren KE, Morrell JM. Relationship of DNA integrity to HRG C633T SNP and ART outcome in infertile couples. Reproduction 2017; 153:865-876. [PMID: 28356499 DOI: 10.1530/rep-17-0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/17/2017] [Accepted: 03/29/2017] [Indexed: 11/08/2022]
Abstract
The status of sperm DNA fragmentation, protamine deficiency, free thiols and disulphide bonds in colloid-selected samples and its relationship to ART outcome or HRG C633T SNP is not known. The objective of this study was to determine these relationships in spermatozoa from men with male factor or unknown factor infertility (n = 118) undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Sperm DNA integrity was analysed by flow cytometry using three fluorescent probes (acridine orange, monobromobimane and chromomycin A3). Principal component analysis (PCA) was used to identify the parameters that most influenced fertility. The relationships of sperm DNA integrity with seminal parameters, HRG C633T SNP and ART outcome were established using ANOVA and t-test. Sperm concentration and yield after preparation accounted for 27% of the total variance; sperm DNA integrity (%DFI and disulphide bonds) accounted for 16% of the variance in men from infertile couples. Sperm %DFI was significantly higher (P < 0.05) in older men than in younger men. A significant difference (P < 0.01) was observed in %DFI between smokers and non-smokers. Sperm %DFI was significantly higher (P < 0.01) in male factor infertility compared to either female factor or unknown factor infertility while free thiols were significantly higher (P < 0.01) in unknown infertility factor. No significant difference was observed between IVF success/failure in any of the seminal parameters studied. There was a tendency for protamine deficiency to be higher and disulphide concentration to be lower in men with HRG 633T. Such assessments may provide additional useful information about the prognosis for ART outcome, although more research is needed before clinical guidelines can be provided.
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Affiliation(s)
- Arumugam Kumaresan
- Department of Clinical Sciences/Division of ReproductionSwedish University of Agricultural Sciences, Uppsala, Sweden.,Theriogenology LaboratoryAnimal Reproduction, Gynaecology & Obstetrics, National Dairy Research Institute, Karnal, Haryana, India
| | - Anders Johannisson
- Department of Clinical Sciences/Division of ReproductionSwedish University of Agricultural Sciences, Uppsala, Sweden
| | - Sarah Nordqvist
- Department of GeneticsImmunology and Pathology, and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Karin Kårehed
- Department of GeneticsImmunology and Pathology, and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Åkerud
- Department of GeneticsImmunology and Pathology, Uppsala University, Uppsala, Sweden
| | - Karin E Lindgren
- Department of GeneticsImmunology and Pathology, and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jane M Morrell
- Department of Clinical Sciences/Division of ReproductionSwedish University of Agricultural Sciences, Uppsala, Sweden
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17
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Effect of time interval between human chorionic gonadotropin injection and intrauterine insemination on pregnancy rate. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2016. [DOI: 10.1016/j.mefs.2016.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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18
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Santos C, Sobral MP, Martins MV. Effects of life events on infertility diagnosis: comparison with presumably fertile men and women. J Reprod Infant Psychol 2016. [PMID: 29517288 DOI: 10.1080/02646838.2016.1249834] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To compare the occurrence and degree of stress attributed to life events during childhood/adolescence and adulthood between individuals diagnosed with infertility and presumably fertile individuals, and to examine the effect of life events occurrence and stress levels on an infertility diagnosis. BACKGROUND Although stress has been explored as a consequence of the experience of infertility, its role as a predictor of this disease still lacks research, particularly regarding the use of adequate control groups composed of non-parents. METHODS The final sample had 151 infertile subjects (74 males and 77 females) and 225 presumably fertile participants (95 males and 130 females), who completed a questionnaire indicating occurrence (y/n) and degree of stress of life events (1-5) during childhood/adolescence and adulthood. RESULTS Significant differences regarding occurrence were found in seven stressful life events in men and in nine events in women, with infertile groups presenting higher occurrence than presumably fertile groups. Eleven stressful life events were rated differently by men and women regarding the degree of stress, with group significant differences observed in both directions. While most events were rated as more stressful by infertile men, infertile women reported less stress resulting from these events than presumably fertile women. After controlling for age, the degree of stress induced by life events in childhood/adolescence and adulthood were not significant predictors of infertility diagnosis, for both men and women. CONCLUSION The amount of stress associated with earlier or concurrent life events does not seem to be related with infertility. Further prospective research is needed to validate these findings.
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Affiliation(s)
- Carina Santos
- a Faculty of Psychology and Educational and Education Sciences , University of Porto , Porto , Portugal
| | - Maria Pedro Sobral
- a Faculty of Psychology and Educational and Education Sciences , University of Porto , Porto , Portugal.,b Faculty of Psychology and Education Sciences , Center for Psychology at University of Porto , Porto , Portugal
| | - Mariana V Martins
- a Faculty of Psychology and Educational and Education Sciences , University of Porto , Porto , Portugal.,b Faculty of Psychology and Education Sciences , Center for Psychology at University of Porto , Porto , Portugal
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19
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Lindgren KE, Nordqvist S, Kårehed K, Sundström-Poromaa I, Åkerud H. The effect of a specific histidine-rich glycoprotein polymorphism on male infertility and semen parameters. Reprod Biomed Online 2016; 33:180-8. [DOI: 10.1016/j.rbmo.2016.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/07/2016] [Accepted: 05/10/2016] [Indexed: 12/27/2022]
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20
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The effect of delaying intrauterine insemination till 48 h after hCG injection on pregnancy rate. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2015. [DOI: 10.1016/j.mefs.2015.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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21
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Impact of A Short-Term, Mindfulness-Based Stress Reduction Program on the Well-Being of Infertile Women: A Mixed-Method Study. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2015. [DOI: 10.5301/je.5000227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Mind-body skills groups represent an experiential approach to teaching antistress techniques that can enable a person to achieve mindfulness, self-awareness and self-reflection, to engage in self-care. This study examined whether a short-term mindfulness-based stress reduction (MBSR) program improved the well-being of infertile women. Methods A cohort of 25 women was enrolled at a public academic center of reproductive medicine, while on the waiting list for in vitro fertilization (IVF). The MBSR intervention consisted of 12 weekly sessions of mindfulness meditation, relaxation, autogenic training, biofeedback and guided imagery. The participants completed a qualitative, open-ended questionnaire and the Psychological General Well-Being Index (PGWBI) questionnaire to assess anxiety, depressed mood, positive well-being, self-control, general health and vitality, before and after the intervention period. Data were analyzed by paired t-test and by 95% confidence interval. Results The qualitative analysis revealed 5 central themes in patients’ responses to the questionnaires: connections, self-discovery, stress relief, learning and consciousness. Total PGWBI score increased by 17% (mean difference 14.1 ± 3.9 points, p<0.01), and all subscales improved after the intervention course compared with the preintervention values. Conclusions Both qualitative and quantitative assessment suggest that a 12-week MBSR program may improve the general well-being of infertile women awaiting IVF.
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22
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Armanet N, Tosca L, Brisset S, Liehr T, Tachdjian G. Small Supernumerary Marker Chromosomes in Human Infertility. Cytogenet Genome Res 2015; 146:100-108. [PMID: 26398339 DOI: 10.1159/000438718] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/19/2022] Open
Abstract
Small supernumerary marker chromosomes (sSMC) are structurally abnormal chromosomes that cannot be unambiguously identified by banding cytogenetics. The objective of this study was to provide an overview of sSMC frequency and characterization in a context of infertility and to review the literature describing sSMC in relation with male and female infertility. Therefore, a systematic literature review on sSMC associated with infertility was conducted by means of a PubMed literature and a sSMC database (http://ssmc-tl.com/sSMC.html) search. A total of 234 patients with infertility were identified as carriers of sSMC. All chromosomes, except chromosomes 10, 19 and the X, were involved in sSMC, and in 72% the sSMC originated from acrocentric chromosomes. Euchromatic imbalances were caused by the presence of sSMC in 30% of the cases. Putative genes have been identified in only 1.2% of sSMC associated with infertility. The implication of sSMC in infertility could be due to a partial trisomy of some genes but also to mechanical effects perturbing meiosis. Further precise molecular and interphase-architecture studies on sSMC are needed in the future to characterize the relationship between this chromosomal anomaly and human infertility.
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Affiliation(s)
- Narjes Armanet
- Service d'Histologie, Embryologie et Cytogénétique, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Clamart, France
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23
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Eftekhar M, Pourmasumi S, Sabeti P, Aflatoonian A, Sheikhha MH. Mycobacterium tuberculosis infection in women with unexplained infertility. Int J Reprod Biomed 2015. [DOI: 10.29252/ijrm.13.12.749] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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24
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Do some addictions interfere with fertility? Fertil Steril 2015; 103:22-6. [DOI: 10.1016/j.fertnstert.2014.11.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/31/2014] [Accepted: 11/04/2014] [Indexed: 01/08/2023]
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Menuba IE, Ugwu EO, Obi SN, Lawani LO, Onwuka CI. Clinical management and therapeutic outcome of infertile couples in southeast Nigeria. Ther Clin Risk Manag 2014; 10:763-8. [PMID: 25328391 PMCID: PMC4199567 DOI: 10.2147/tcrm.s68726] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Infertility is highly prevalent in Nigeria and most infertile couples in southeast Nigeria are offered conventional forms of treatment, which consist mainly of ovulation induction and tubal surgery, due to limited availability and high cost of endoscopic and assisted reproductive technologies like laparoscopy and in vitro fertilization. The aim of this study was to determine the prevalence of infertility, outcome of infertility investigation, and the treatment outcome of infertile couples following therapeutic interventions in southeast Nigeria over a 12-month period. Methods This was a prospective cross-sectional study of 218 consecutive infertile couples presenting for infertility management at the infertility clinics of two tertiary health institutions in Enugu, southeast Nigeria. Infertility investigations were carried out on these couples using the available conventional diagnostic facilities. Following the results of the investigations/diagnosis, conventional treatment was offered to the couples as appropriate. Data analysis was both descriptive and inferential at 95% confidence level. Results The mean age of the women was 33.5±4.62 (range: 15–49) years. Most (58.3% [n=127]) were nulliparous. The prevalence of infertility was 12.1%. Infertility was primary in 28.4% (n=62) and secondary in 71.6% (n=156). Female etiologic factors were responsible in 32.1% (n=70), male factors in 26.1% (n=57), and a combination of male/female factors in 29.4% (n=64). The etiology was unknown in 12.4% (n=27). Tubal factors 23.8 % (n=52) and ovulation failures 26.1% (n=57) are common female factors implicated. Pregnancy rate following treatment was 16.7% (n=28). Multivariate regression analysis indicates that younger age of ≤30 years, duration of infertility ≤5 years, and female factor infertility were associated with higher pregnancy outcome following treatment. Conclusion The prevalence of infertility is high and pregnancy rate following conventional treatment is poor. There is a need to improve facilities for managing infertility as well as making artificial reproductive techniques readily available, accessible, and affordable.
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Affiliation(s)
- Ifeanyi E Menuba
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla Enugu, Enugu State, Nigeria
| | - Emmanuel O Ugwu
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla Enugu, Enugu State, Nigeria
| | - Samuel N Obi
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla Enugu, Enugu State, Nigeria
| | - Lucky O Lawani
- School of Postgraduate Studies, Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria
| | - Chidinma I Onwuka
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla Enugu, Enugu State, Nigeria
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Prendergast D, Woad KJ, Chamley LW, Holland OJ, Shelling AN. SPACA3gene variants in a New Zealand cohort of infertile and fertile couples. HUM FERTIL 2014; 17:106-13. [DOI: 10.3109/14647273.2014.907506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lynch CD, Sundaram R, Maisog JM, Sweeney AM, Buck Louis GM. Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study--the LIFE study. Hum Reprod 2014; 29:1067-75. [PMID: 24664130 DOI: 10.1093/humrep/deu032] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Are women's stress levels prospectively associated with fecundity and infertility? SUMMARY ANSWER Higher levels of stress as measured by salivary alpha-amylase are associated with a longer time-to-pregnancy (TTP) and an increased risk of infertility. WHAT IS KNOWN ALREADY Data suggest that stress and reproduction are interrelated; however, the directionality of that association is unclear. STUDY DESIGN, SIZE, DURATION In 2005-2009, we enrolled 501 couples in a prospective cohort study with preconception enrollment at two research sites (Michigan and Texas, USA). Couples were followed for up to 12 months as they tried to conceive and through pregnancy if it occurred. A total of 401 (80%) couples completed the study protocol and 373 (93%) had complete data available for this analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Enrolled women collected saliva the morning following enrollment and then the morning following their first observed study menses for the measurement of cortisol and alpha-amylase, which are biomarkers of stress. TTP was measured in cycles. Covariate data were captured on both a baseline questionnaire and daily journals. MAIN RESULTS AND THE ROLE OF CHANCE Among the 401 (80%) women who completed the protocol, 347 (87%) became pregnant and 54 (13%) did not. After adjustment for female age, race, income, and use of alcohol, caffeine and cigarettes while trying to conceive, women in the highest tertile of alpha-amylase exhibited a 29% reduction in fecundity (longer TTP) compared with women in the lowest tertile [fecundability odds ratios (FORs) = 0.71; 95% confidence interval (CI) = (0.51, 1.00); P < 0.05]. This reduction in fecundity translated into a >2-fold increased risk of infertility among these women [relative risk (RR) = 2.07; 95% CI = (1.04, 4.11)]. In contrast, we found no association between salivary cortisol and fecundability. LIMITATIONS, REASONS FOR CAUTION Due to fiscal and logistical concerns, we were unable to collect repeated saliva samples and perceived stress questionnaire data throughout the duration of follow-up. Therefore, we were unable to examine whether stress levels increased as women continued to fail to get pregnant. Our ability to control for potential confounders using time-varying data from the daily journals, however, minimizes residual confounding. WIDER IMPLICATIONS OF THE FINDINGS This is the first US study to demonstrate a prospective association between salivary stress biomarkers and TTP, and the first in the world to observe an association with infertility. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (contracts #N01-HD-3-3355, N01-HD-3-3356, N01-HD-3358). There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- C D Lynch
- The Ohio State University College of Medicine, 395 W. 12th Avenue, Room 580, Columbus, OH 43210, USA
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28
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Abstract
Anovulatory disorders are a primary cause of female infertility. Polycystic ovarian syndrome is the major cause of anovulation and is generally associated with obesity. Lifestyle changes to encourage weight loss are the initial therapy for overweight and obese patients, followed by clomiphene citrate for ovulation induction. For those patients who fail to ovulate on clomiphene citrate, alternatives, such as letrozole; gonadotropins; and complimentary agents to enhance clomiphene citrate, such as metformin and glucocorticoids, are reviewed. Women with unexplained infertility (no identifiable cause of infertility on a routine evaluation) may benefit from ovulation induction with clomiphene citrate, letrozole, or gonadotropins.
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Affiliation(s)
- Anthony M Propst
- Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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