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Niazi E, Dumanski SM. Change of HeART: Cardiovascular Implications of Assisted Reproductive Technology. CJC Open 2024; 6:142-152. [PMID: 38487072 PMCID: PMC10935705 DOI: 10.1016/j.cjco.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/10/2023] [Indexed: 03/17/2024] Open
Abstract
Cardiovascular (CV) disease is the leading cause of death in women, and it may manifest differently than in men, in part related to sex-specific CV risk factors. In females, assisted reproductive technologies (ARTs) are commonly used to treat infertility, and they utilize controlled ovarian stimulation involving the administration of exogenous sex hormones. ARTs, and especially controlled ovarian stimulation, have been associated with an increased pregnancy and short-term CV risk, although the long-term CV implications of these treatments in individuals treated with ARTs and their offspring remain unclear. This review endeavors to provide a comprehensive examination of what is known about the relationship between ART and CV outcomes for females treated with ARTs, as well as their offspring, and recommendations for future research. Novel insights into female-specific CV risk factors are critical to reduce the disproportionate burden of CV disease in Canadian women. ART has revolutionized reproductive medicine, offering hope to millions of individuals with infertility worldwide, and a further understanding of the CV implications of this important sex-specific CV risk factor is warranted urgently.
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Affiliation(s)
- Elaha Niazi
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Sandra M. Dumanski
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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Ni Y, Shen H, Yao H, Zhang E, Tong C, Qian W, Huang L, Wu X, Feng Q. Differences in Fertility-Related Quality of Life and Emotional Status Among Women Undergoing Different IVF Treatment Cycles. Psychol Res Behav Manag 2023; 16:1873-1882. [PMID: 37250753 PMCID: PMC10216870 DOI: 10.2147/prbm.s411740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Objective The present study aimed to provide more insight into the possible differences in the fertility-related quality of life (FertiQoL) and emotional status of women undergoing different cycles of in vitro fertilization (IVF) treatments. Methods A prospective cohort study was performed, and a total of 432 women undergoing IVF treatment were recruited. FertiQoL scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and perceived social support scale (PSSS) were used to analyze fertility-related QoL and emotional status. Data were analyzed comparing women undergoing different cycles of IVF treatments. Results A significant decrease in FertiQoL scores occurred in women with increased cycles of IVF treatment. Both anxiety and depression scores significantly increased with increased cycles of attempting IVF treatment. There was no significant difference detected in perceived social support among groups. Conclusion With the increase in the number of IVF treatment cycles, women's FertiQoL gradually decreased, while the risk of anxiety and depression gradually increased.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hao Shen
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Haihui Yao
- Xianda College of Economics and Humanities, Shanghai International Studies University, Shanghai, People’s Republic of China
| | - Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Chenye Tong
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wen Qian
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xian Wu
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Qing Feng
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Li M, Chen Y, Wang Y, Wang H, Ding X, Li G. Maternal gestational diabetes in singleton pregnancies conceived by ART may be modified by periconceptional B vitamins. Front Nutr 2023; 9:1069911. [PMID: 36741994 PMCID: PMC9889836 DOI: 10.3389/fnut.2022.1069911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
Background The risk of maternal gestational diabetes mellitus (GDM) may be influenced by pregnancies conceived through assisted reproductive technology (ART). However, the influence of the dosage of B vitamins (folate, vitamin B6 and vitamin B12) on GDM weren't considered. Thus, we hypothesized that periconceptional B vitamins could modify maternal GDM in singleton pregnancies conceived by ART. Methods This study is a prospective cohort study using data from 3,252 women with singleton pregnancies and received a 75 g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. We included an interaction term in the multivariable logistic and linear regression models, respectively, to test our hypothesis. Results Women who underwent ART were significantly associated with the incidence of GDM compared with spontaneous pregnancy women. The adjusted odds ratio (aOR) was 1.59, and the 95% confidence interval (CI) was 1.08-2.34. ART pregnancies also elevated OGTT (oral glucose tolerance test) 1-h blood glucose levels and OGTT 2-h blood glucose levels (P < 0.05). A positive association between dietary vitamin B6 (aOR = 1.60, 95% CI: 1.13-2.27), dietary vitamin B12 (aOR = 1.88, 95% CI: 1.34-2.64) and dietary folate (aOR = 1.66, 95% CI: 1.19-2.32) with GDM risk comparing the highest to the lowest quartile (all P trend < 0.001). The aORs of GDM for inadequate (< 400 μg/day), adequate (400-800 μg/day), and excessive (> 800 μg/day) supplemental folate intake were 1.00, 0.93, and 1.30, respectively (P trend = 0.033). Since only the supplemental folate illustrates a statistically significant interaction with ART (P for interaction < 0.05), the association between ART and GDM and OGTT blood glucose levels stratifying by supplemental folate were further evaluated. These increased risks of GDM (aOR = 1.62, 95% CI: 1.39-3.39) and the regression coefficients (β) of 1-h blood glucose (β = 0.76, 95% CI: 0.39-1.13) and 2-h blood glucose (β = 0.60, 95% CI: 0.29-0.92) in the multiple linear regression model were significant only in the ART group with excessive supplemental folate (> 800 μg/day). Conclusion The risk of GDM is significantly elevated, particularly among those women who conceived ART with the intake of excessive supplemental folate (> 800 μg/day).
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Affiliation(s)
- Minyu Li
- Public Health School, Medical College of Qingdao University, Qingdao, Shandong, China
| | - Yanping Chen
- Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, China
| | - Yongxiang Wang
- Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, China
| | - Hong Wang
- Public Health School, Medical College of Qingdao University, Qingdao, Shandong, China
| | - Xueteng Ding
- Public Health School, Medical College of Qingdao University, Qingdao, Shandong, China
| | - Guoju Li
- Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, China,*Correspondence: Guoju Li,
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Fan L, Tang N, Yao C, Wei X, Tang Y, Li J, Huang W. Association Between Fresh Embryo Transfers and Frozen–Thawed Embryo Transfers Regarding Live Birth Rates Among Women Undergoing Long Gonadotropin-Releasing Hormone Antagonist Protocols. Front Cell Dev Biol 2022; 10:884677. [PMID: 35573703 PMCID: PMC9096096 DOI: 10.3389/fcell.2022.884677] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background: The availability and use of frozen–thawed embryos after controlled ovarian hyperstimulation for assisted reproduction have increased with improvements in vitrification techniques and the rise of gonadotropin-releasing hormone (GnRH) antagonist protocols. Although evidence has shown that frozen–thawed embryo transfers (FETs) result in higher live birth rates than fresh embryo transfers, it is uncertain whether this association exists in cycles employing the GnRH antagonist protocol. Objective: To test the hypothesis that FETs are more likely to result in a live birth than fresh embryo transfers in a GnRH antagonist protocol cycle and to investigate whether frozen blastocyst transfer increases live birth rates compared to fresh blastocyst transfer. Design: A retrospective historical cohort study was conducted using data collected from the Department of Reproductive Medicine of Liuzhou Maternity and Child Healthcare Hospital for 1,437 patients who underwent the GnRH antagonist protocol between 1 January 2015, and 31 December 2020. The primary outcome was the live birth rate, which was compared between fresh embryo transfer and FET, and the secondary outcomes were clinical pregnancy rate and miscarriage rate, which were compared between the two groups. Analyses were adjusted to account for the age of the patient, number of embryo transfers, day of embryo transfer, and type of infertility. Results: Fresh embryo transfers accounted for 1,026 (71.4%) of the 1,437 patients who underwent the GnRH antagonist protocol in our analysis, while FETs accounted for 411 (28.6%). Patients with fresh and frozen–thawed embryos had comparable median body mass index (body mass index; 22.3 [IQR, 24.6–20.0] vs. 22.0 [IQR, 24.5–19.9]). There was a significant difference in the median age of the fresh embryo transfer group (34.0 [IQR, 39.0–30.0]) and the Frozen–thawed embryo transfer group (32.0 [IQR, 37.0–29.0]). Blastocysts were transferred in 14.6% of the fresh embryo transfer cycles and 45.5% of the FET cycles, whereas they account for 10.4% and 13.0% of all patients, respectively. The mean number of embryos transferred was 2 (IQR, 2.0–1.0) for the fresh embryo transfer group and 1 (IQR, 2.0–1.0) for the FET group, with a significant difference in the mean number of embryos transferred. The live birth rate after fresh embryo transfer vs. FET was 28.7% vs. 34.5% (absolute difference, 5.9%; adjusted relative risk [aRR], 1.15 [95% CI, 0.88–1.51]). The clinical pregnancy rates were 39.9% vs. 46.0%, respectively (absolute difference, 6.1%; aRR, 1.10 [95% CI, 0.85–1.43]). The miscarriage rates were 22.5% vs. 23.8%, respectively (absolute difference, 1.3%; aRR, 1.13 [95% CI, 0.75–1.70]). Conclusion: In this retrospective study of women who underwent assisted reproduction using GnRH antagonists, FETs resulted in a higher live birth rates and clinical pregnancy rates than fresh embryo transfers, which parts of these differences were attributable to embryo stage. However, the interpretation of the findings is limited by the possibility of selection and confounding biases.
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Affiliation(s)
| | | | | | | | | | - Jingjing Li
- *Correspondence: Jingjing Li, ; Wenjie Huang,
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Miyake T, Yamamoto M, Sakurai K, Eguchi A, Yoshida M, Mori C, Kamijima M, Yamazaki S, Ohya Y, Kishi R, Yaegashi N, Hashimoto K, Ito S, Yamagata Z, Inadera H, Nakayama T, Iso H, Shima M, Nakamura H, Suganuma N, Kusuhara K, Katoh T. Neurological development in 36‐month‐old children conceived via assisted reproductive technology: The Japan Environment and Children's Study. Reprod Med Biol 2022; 21:e12457. [PMID: 35431647 PMCID: PMC9002241 DOI: 10.1002/rmb2.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/03/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose This study aimed to investigate neurodevelopment in children conceived via in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with several types of embryo transfers. Methods We analyzed data for 77 928 children and their mothers included in a Japanese birth cohort study. Among the included children, 4071 were conceived via IVF, while 1542 were conceived via ICSI. Neurodevelopmental delay at the age of 3 years was assessed using the Japanese version of the Ages and Stages Questionnaires, 3rd edition. Results In the crude model, the odds ratios for developmental delay in 1–4 domains were higher among children conceived via IVF, ICSI, and non‐ART (ovulatory induction or intrauterine insemination) than in spontaneously conceived children. After adjusting for parental background factors and the child's sex, there were no differences in the risk of developmental delay when comparing singletons conceived by IVF, ICSI, or non‐ART and those conceived spontaneously. Higher odds ratios for developmental delay in one domain were observed in singleton girls conceived via IVF when compared with those who were spontaneously conceived. Conclusion Most cases of developmental delay may be associated with multiple pregnancies and factors related to infertility, such as parental age, irrespective of the use of ART.
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Affiliation(s)
| | - Midori Yamamoto
- Department of Sustainable Health Science Center for Preventive Medical Sciences Chiba University Chiba Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine Center for Preventive Medical Sciences Chiba University Chiba Japan
| | - Akifumi Eguchi
- Department of Sustainable Health Science Center for Preventive Medical Sciences Chiba University Chiba Japan
| | | | - Chisato Mori
- Department of Sustainable Health Science Center for Preventive Medical Sciences Chiba University Chiba Japan
- Department of Bioenvironmental Medicine Graduate School of Medicine Chiba University Chiba Japan
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Ni Y, Huang L, Tong C, Qian W, Fang Q. Analysis of the levels of hope and influencing factors in infertile women with first-time and repeated IVF-ET cycles. Reprod Health 2021; 18:200. [PMID: 34627302 PMCID: PMC8502316 DOI: 10.1186/s12978-021-01248-y] [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: 07/19/2021] [Accepted: 09/25/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose To explore the hope levels and influencing factors in infertile women undergoing first-time and repeated in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods This study was a cross-sectional and convenient sampling study conducted among patients undergoing IVF-ET from January to June 2019. Patients were divided into first-time and repeated groups by the number of IVF-ET cycles, and then a questionnaire survey was administered. The questionnaire included demographic information, Herth hope index (HHI) scale, Locke-Wallace short marital-adjustment test scale and social support rating scale. Multiple linear regression was used to analyse the influencing factors associated with hope levels. Results A total of 298 IVF-ET patients were recruited for the study, including 150 (50.3%) in the first-time cycle group and 148 (49.7%) in the repeated cycle group. The HHI score of the repeated cycle group was significantly lower than that of the first-time cycle group (34.4 ± 3.5 vs. 37.5 ± 3.7, P < 0.001). Multiple linear regression analysis indicated that repeated IVF-ET and age were independently negatively correlated with HHI, with standardized coefficient β values of − 0.895 and − 0.223, respectively (both P < 0.001). High education level (P = 0.002), high monthly income (P = 0.020), high degree of short marital-adjustment test (P < 0.001) and social support rating (P < 0.001) were independently positively correlated with HHI. Conclusion Infertile women undergoing repeated IVF-ET have low hope levels. Maintaining a good marriage adjustment and establishing a good social support and relationship network could effectively improve their hope levels. Hope level is closely related to patients' mental health and emotional state. Therefore, improving the hope level of infertile women with IVF-ET could contribute to relieving the psychological pressure of patients and improving the success rate of pregnancy. This study aimed to evaluate the hope level of infertile women with different IVF-ET cycles and analyse its influencing factors to provide guidance for clinical nurses to clarify the intervention objects, select reasonable intervention measures and improve the hope levels of patients. A total of 298 IVF-ET patients were recruited in the study, including 150 in the first-time cycle group and 148 in the repeated cycle group. The results showed that the hope level of patients with repeated IVF-ET cycles was significantly lower than that of patients undergoing first-time treatment. We also analysed its influencing factors and found that repeated IVF-ET cycles and age were independent negative correlation factors in hope levels. High monthly income, living in the city, high marital adjustment and social support score were independent positive correlation factors in hope levels. Therefore, maintaining a good marriage adjustment and establishing a good social support and relationship network could effectively improve their hope levels.
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Affiliation(s)
- Ying Ni
- Department of Nursing, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,School of Nursing, Shanghai Jiaotong University, Shanghai, China
| | - Limin Huang
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chenye Tong
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Qian
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiong Fang
- Department of Nursing, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. .,School of Nursing, Shanghai Jiaotong University, Shanghai, China.
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One size does not fit all: variations by ethnicity in demographic characteristics of men seeking fertility treatment across North America. Fertil Steril 2021; 116:1287-1294. [PMID: 34325919 DOI: 10.1016/j.fertnstert.2021.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare racial differences in male fertility history and treatment. DESIGN Retrospective review of prospectively collected data. SETTING North American reproductive urology centers. PATIENT(S) Males undergoing urologist fertility evaluation. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Demographic and reproductive Andrology Research Consortium data. RESULT(S) The racial breakdown of 6,462 men was: 51% White, 20% Asian/Indo-Canadian/Indo-American, 6% Black, 1% Indian/Native, <1% Native Hawaiian/Other Pacific Islander, and 21% "Other". White males sought evaluation sooner (3.5 ± 4.7 vs. 3.8 ± 4.2 years), had older partners (33.3 ± 4.9 vs. 32.9 ± 5.2 years), and more had undergone vasectomy (8.4% vs. 2.9%) vs. all other races. Black males were older (38.0 ± 8.1 vs. 36.5 ± 7.4 years), sought fertility evaluation later (4.8 ± 5.1 vs. 3.6 ± 4.4 years), fewer had undergone vasectomy (3.3% vs. 5.9%), and fewer had partners who underwent intrauterine insemination (8.2% vs. 12.6%) compared with all other races. Asian/Indo-Canadian/Indo-American patients were younger (36.1 ± 7.2 vs. 36.7 ± 7.6 years), fewer had undergone vasectomy (1.2% vs. 6.9%), and more had partners who underwent intrauterine insemination (14.2% vs. 11.9%). Indian/Native males sought evaluation later (5.1 ± 6.8 vs. 3.6 ± 4.4 years) and more had undergone vasectomy (13.4% vs. 5.7%). CONCLUSION(S) Racial differences exist for males undergoing fertility evaluation by a reproductive urologist. Better understanding of these differences in history in conjunction with societal and biologic factors can guide personalized care, as well as help to better understand and address disparities in access to fertility evaluation and treatment.
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Doron-Lalehzari A, Wainstock T, Szaingurten-Solodkin I, Richter D, Zeadna A, Harlev A, Lunenfeld E, Levitas E, Har-Vardi I. Are morphokinetic parameters of embryo development associated with adverse perinatal outcomes following fresh blastocyst transfer? Reprod Biomed Online 2020; 42:207-216. [PMID: 33168490 DOI: 10.1016/j.rbmo.2020.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
RESEARCH QUESTION Are obstetric and perinatal complications associated with morphokinetic parameters of embryo development? DESIGN This proof-of-concept pilot study included a retrospective analysis of embryo morphokinetic parameters of 85 live births following day 5 single blastocyst transfer. Kinetic variables included time interval (hours) from time of pronuclei fading (tPNf) to: time of 2 cells (tPNf-t2), 9 cells (tPNf-t9), morula (tPNf-tM), start of blastulation (tPNf-tSB), full blastocyst (tPNf-tB) and expanded blastocyst (tPNf-tEB). Multivariable logistic models were used to calculate the risk of perinatal complications after adjustment for confounders. RESULTS The mean interval of tPNf-tSB was significantly longer for newborns with congenital anomalies compared with healthy newborns (79.49 ± 5.78 versus 71.7 ± 6.3, respectively, P = 0.01) and for embryos of women who had gestational diabetes mellitus compared with normoglycemic women (76.56 ± 7.55 versus 71.5 ± 6.13, respectively, P = 0.015). The mean interval of tPNf-t9 was significantly longer for low-birthweight newborns compared with normal weight (49.25 ± 5.54 versus 45.47 ± 4.77, respectively, P = 0.01). Preterm delivery was associated with several longer intervals of cell divisions compared with delivery at term (tPNf-t5: 28.76 ± 3.13 versus 26.64 ± 2.40, respectively, P = 0.01; tPNf-t6: 30.10 ± 3.05 versus 27.68 ± 2.30, respectively, P < 0.001; tPNf-t7: 32.08 ± 4.11 versus 28.70 ± 2.67, respectively, P < 0.001; tPNf-t8: 34.75 ± 4.95 versus 30.70 ± 4.10, respectively, P < 0.001; tPNf-t9: 50.23 ± 5.87 versus 45.44 ± 4.67, respectively, P < 0.001). For each of the outcomes, the association remained significant after adjusting for confounders. CONCLUSION This study indicates that there may be a possible association between adverse perinatal outcomes and morphokinetic parameters. Larger studies are needed to establish this association.
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Affiliation(s)
| | - Tamar Wainstock
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; School of Public Health, Beer-Sheva, Israel
| | - Irit Szaingurten-Solodkin
- Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
| | - Dganit Richter
- Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
| | - Atif Zeadna
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
| | - Avi Harlev
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Barzilai Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Ashkelon, Israel
| | - Eitan Lunenfeld
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
| | - Eliahu Levitas
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel
| | - Iris Har-Vardi
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Fertility and IVF Unit, Department of Obstetrics and Gynecology, Beer-Sheva, Israel.
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Wang N, Lin J, Zhu Q, Fan Y, Wang Y, Fu Y, Kuang Y. Comparison of neonatal outcomes and live-birth defects after progestin-primed ovarian stimulation versus conventional ovarian stimulation for in vitro fertilization: A large retrospective cohort study. Medicine (Baltimore) 2018; 97:e11906. [PMID: 30142796 PMCID: PMC6112954 DOI: 10.1097/md.0000000000011906] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Progestin-primed ovarian stimulation (PPOS) is a new ovarian stimulation regimen for in vitro fertilization (IVF), with the advantages of an oral administration route and more control over preovulatory luteinizing hormone (LH) levels. Assessing the safety of this novel regimen is an important premise for its routine practice.We conducted a large retrospective cohort study for infants born between August 2014 and April 2017 from IVF and embryo transfer cycles after either PPOS and the conventional gonadotropin-releasing hormone-agonist (GnRH-a) short protocol at our center. Around 1589 live-born infants were finally enrolled, corresponding to 1258 frozen-thawed (FET) cycles, which led to 855 live-born infants from PPOS (659 FET cycles) and 734 live-born infants from the short protocol (599 FET cycles).Birth characteristics regarding gestational age, birth weight and length, infant sex, and early neonatal death were comparable between the 2 groups. The incidence of live-birth defects in the PPOS group (1.52%) was similar to that in the short protocol group (1.63%) and was not statistically significant. For birth defects, the risk significantly increased for multiple births, and the adjusted odds ratio was 3.14 (95% confidence interval [CI]: 1.25-7.88). No associations were found between congenital birth defects and maternal age, body mass index (BMI), the duration of infertility, method of insemination, infant sex, embryo stage at transfer, the number of embryos transferred or ovarian stimulation regimen.Our study shows that the neonatal outcomes and risk of congenital malformations were similar between the PPOS and conventional GnRH-a short protocol. However, multiple pregnancy led to a higher likelihood of birth defects.
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Shah JS, Nasab SH, Chappell N, Chen HY, Schutt A, Mendez-Figueroa H. Neonatal outcomes among twins stratified by method of conception: secondary analysis of maternal fetal medicine (MFMU) network database. J Assist Reprod Genet 2018; 35:1011-1017. [PMID: 29520735 PMCID: PMC6030005 DOI: 10.1007/s10815-018-1149-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/25/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate whether twin pregnancies conceived by different forms of fertility treatments are associated with adverse neonatal outcomes and to examine the difference in maternal and obstetrical characteristics between patients. METHODS Our study was a retrospective analysis of twin pregnancies conceived by fertility treatments from a prospectively collected database. Treatments were stratified into two groups: group 1 (ART) consisted of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), and group 2 (non-ART) included intrauterine insemination (IUI) and ovulation induction (OI). Composite neonatal morbidity included respiratory distress syndrome, intraventricular hemorrhage, leukomalacia, chronic lung disease, and death prior to discharge. RESULTS There were 460 neonates in our study; among them, 67% (n = 310) were in group 1, and 33% (n = 150) in group 2. Group 1 patients were more likely to be older (p = 0.004), nulliparous (p = 0.01), delivered twins with lower birth weights (2278 g ± 605 vs. 2427 ± 519, p = 0.009), and had more deliveries < 32 weeks gestation (p = 0.001). In multivariable Poisson regression model, only neonatal intensive care unit admission rate was increased for group 1 twins (aRR = 1.27, 95% CI 1.003-1.60). CONCLUSIONS After adjusting for confounders, twins conceived via ART compared to non-ART had similar neonatal outcomes. These data can help when counseling this patient population and assist in planning larger prospective cohorts.
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Affiliation(s)
- Jaimin S Shah
- Department of Obstetrics & Gynecology, McGovern Medical School at the University of Texas Health Science Center, 6431 Fannin St, Suite 3.214, Houston, TX, 77030, USA.
| | - Susan Hosseini Nasab
- Department of Obstetrics & Gynecology, McGovern Medical School at the University of Texas Health Science Center, 6431 Fannin St, Suite 3.214, Houston, TX, 77030, USA
| | - Neil Chappell
- Department of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA
| | - Han-Yang Chen
- Department of Obstetrics & Gynecology, McGovern Medical School at the University of Texas Health Science Center, 6431 Fannin St, Suite 3.214, Houston, TX, 77030, USA
| | - Amy Schutt
- Department of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA
| | - Hector Mendez-Figueroa
- Department of Maternal & Fetal Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA
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11
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Cao H, You D, Yuan M, Xi M. Hysteroscopy after repeated implantation failure of assisted reproductive technology: A meta-analysis. J Obstet Gynaecol Res 2018; 44:365-373. [PMID: 29297956 DOI: 10.1111/jog.13571] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022]
Abstract
We conducted this meta-analysis to explore the prognostic value of outpatient (or office) hysteroscopy (OH) preceding in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles in women who had experienced repeated implantation failure (RIF), particularly in regard to the conflicting evidence reported by previous studies. Two reviewers independently searched Pubmed, MEDLINE, Web of Science, Cochrane Library and Embase to identify all publications of clinical trials of hysteroscopy with or without endometrial biopsy in RIF patients. The primary outcome measures were clinical pregnancy rate (CPR) and live birth rate (LBR). Pooled relative ratios (RRs) with 95% confidence intervals (CIs) were calculated. Publication bias was detected using funnel plots and Egger's regression tests. Six eligible studies comprising 4143 patients were included. The CPR and LBR were both significantly higher in RIF patients with OH than RIF patients without OH (CPR: RR 1.34, 95% CI 1.14-1.57, P < 0.05; LBR: RR 1.29, 95% CI 1.03-1.62, P < 0.05). Subgroup analysis revealed a significant association between OH and CPR in Asia (CPR: RR 1.49, 95% CI 1.31-1.69; P < 0.05) rather than in Europe (CPR: RR 1.08, 95% CI 0.93-1.26; P = 0.291). However, there was no evidence of a significant difference in either CPR or LBR between the normal and abnormal OH groups (CPR: RR 0.92, 95% CI 0.83-1.02, P = 0.12; LBR: RR 0.76, 95% CI 0.37-1.56, P = 0.450). Hysteroscopy may potentially improve pregnancy outcomes in patients with RIP.
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Affiliation(s)
- Hanyu Cao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Di You
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Mingwei Yuan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China
| | - Mingrong Xi
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
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12
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Ezzati M, Roshangar L, Soleimani Rad J, Karimian N. Evaluating The Effect of Melatonin on HAS2, and PGR expression, as well as Cumulus Expansion, and Fertility Potential in Mice. CELL JOURNAL 2017; 20:108-112. [PMID: 29308626 PMCID: PMC5759672 DOI: 10.22074/cellj.2018.4894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 01/18/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Infertility is a worldwide health problem which affects approximately 15% of sexually active couples. One of the factors influencing the fertility is melatonin. Also, protection of oocytes and embryos from oxidative stress inducing chemicals in the culture medium is important. The aim of the present study was to investigate if melatonin could regulate hyaluronan synthase-2 (HAS2) and Progesterone receptor (PGR) expressions in the cumulus cells of mice oocytes and provide an in vitro fertilization (IVF) approach. MATERIALS AND METHODS In this experimental study, for this purpose, 30 adult female mice and 15 adult male mice were used. The female mice were superovulated using 10 U of pregnant mare serum gonadotropin (PMSG) and 24 hours later, 10 U of human chorionic gonadotropin (hCG) were injected. Next, cumulus oocyte complexes (COCs) were collected from the oviducts of the female mice by using a matrix-flushing method. The cumulus cells were cultured with melatonin 10 μM for 6 hours and for real-time reverse transcription-polymerase chain reaction (RT-PCR) was used for evaluation of HAS2 and PGR expression levels. The fertilization rate was evaluated through IVF. All the data were analyzed using a t test. RESULTS The results of this study showed that HAS2 and PGR expressions in the cumulus cells of the mice receiving melatonin increased in comparison to the control groups. Also, IVF results revealed an enhancement in fertilization rate in the experimental groups compared to the control groups. CONCLUSIONS To improve the oocyte quality and provide new approaches for infertility treatment, administration of melatonin as an antioxidant, showed promising results. Thus, it is concluded that fertility outcomes can be improved by melatonin it enhances PGR.
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Affiliation(s)
- Maryam Ezzati
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Tissue Engineering, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Jafar Soleimani Rad
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Tissue Engineering, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Karimian
- Department of Advanced Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Klausen T, Juul Hansen K, Munk-Jørgensen P, Mohr-Jensen C. Are assisted reproduction technologies associated with categorical or dimensional aspects of psychopathology in childhood, adolescence or early adulthood? Results from a Danish prospective nationwide cohort study. Eur Child Adolesc Psychiatry 2017; 26:771-778. [PMID: 28120107 DOI: 10.1007/s00787-016-0937-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 12/19/2016] [Indexed: 11/28/2022]
Abstract
An increasing number of children are conceived using assisted reproduction technologies (ART), but little is known about the long-term risk in terms of mental health outcomes. All twin and singleton children conceived via ART and born in 1995 were sampled from the Danish in vitro fertilization registry and matched to four spontaneously conceived (SC) children. The children were followed-up at the age of 3, 7, 14 and 18 years in the Danish Psychiatric Central Research Registry, to estimate the prevalence of all possible psychiatric diagnoses; dimensional aspects of psychopathology were assessed at the age of 14 years, using the Child Behavior Checklist (CBCL). The study included 858 ART children and 3436 SC children. ART and SC children were not clinically distinguishable on either the categorical measures of psychopathology at the age of 3, 7, 14 and 18 years, or on CBCL scale scores at the age of 14 years. The findings remained nonsignificant after controlling for sample differences. This large, prospective, nationwide cohort study provides evidence to support that ART exposure does not increase the risk of adverse mental health outcomes considered as a whole, while power was limited to discard an effect of ART on specific mental health disorders.
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Affiliation(s)
- T Klausen
- Psychiatric Clinic South, Child and Adolescent Psychiatry, Aalborg University Hospital, Mølleparkvej 10, 9000, Aalborg, Denmark
| | - K Juul Hansen
- Psychiatric Clinic South, Child and Adolescent Psychiatry, Aalborg University Hospital, Mølleparkvej 10, 9000, Aalborg, Denmark
| | - P Munk-Jørgensen
- Psychiatric Department, Odense University Hospital, J.B. Winsløws vej 18, 5000, Odense, Denmark
| | - C Mohr-Jensen
- Psychiatric Clinic South, Child and Adolescent Psychiatry, Aalborg University Hospital, Mølleparkvej 10, 9000, Aalborg, Denmark.
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Wei D, Sun Y, Liu J, Liang X, Zhu Y, Shi Y, Chen ZJ. Live birth after fresh versus frozen single blastocyst transfer (Frefro-blastocyst): study protocol for a randomized controlled trial. Trials 2017; 18:253. [PMID: 28583140 PMCID: PMC5460334 DOI: 10.1186/s13063-017-1993-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 05/18/2017] [Indexed: 11/15/2022] Open
Abstract
Background Multiple pregnancies are one of the major safety concerns of in vitro fertilization (IVF) due to the increased risk of maternal and neonatal complications. Single embryo transfer is the most effective way to reduce the risk of multiple pregnancies. Selection of the embryo and optimization of the implantation environment are crucial to retain the success rate when the number of transferred embryos is diminished. Fresh embryo transfer with supra-physiological levels of hormones has been suggested to have an adverse effect on implantation. Elective frozen embryo transfer has been suggested to result in a higher rate of live birth than fresh embryo transfer. However, there is still a lack of evidence from randomized clinical trials comparing the efficacy and safety between frozen and fresh single blastocyst transfers. Methods/design We are conducting a randomized controlled trial in women aged 20–35 undergoing their first cycle of IVF with or without intracytoplasmic sperm injection. After ovarian stimulation with a gonadotropin-releasing hormone antagonist protocol, women who obtain four or more embryos on day 3 of the embryo culture are randomized into two parallel groups: a single fresh blastocyst transfer group and a single frozen blastocyst transfer group (all blastocysts vitrified and a deferred frozen blastocyst transfer). The primary outcome is singleton live birth. Discussion The results of this study will provide evidence for the efficacy and safety of the strategy of elective frozen single blastocyst transfer in women with a good prognosis. Trial registration Chinese Clinical Trial Registry, ChiCTR-IOR-14005405. Registered on 30 Oct 2014. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1993-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daimin Wei
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Key Laboratory of Reproductive Endocrinology, Shandong University, Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China
| | - Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jiayin Liu
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyan Liang
- Reproductive Medicine Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yimin Zhu
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuhua Shi
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Key Laboratory of Reproductive Endocrinology, Shandong University, Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China. .,, 157 Jingliu Road, Jinan, 250000, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Key Laboratory of Reproductive Endocrinology, Shandong University, Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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15
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Zhao J, Xu B, Zhang Q, Li YP. Which one has a better obstetric and perinatal outcome in singleton pregnancy, IVF/ICSI or FET?: a systematic review and meta-analysis. Reprod Biol Endocrinol 2016; 14:51. [PMID: 27577996 PMCID: PMC5006501 DOI: 10.1186/s12958-016-0188-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/23/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The present study aims to compare which one has a better obstetric and perinatal outcome in singleton pregnancy, frozen embryo transfer (FET) or. in vitro fertilization treatment/intracytoplasmic sperm injection (IVF/ICSI)? METHODS MEDLINE, Google Scholar and the Cochrane Library were searched for the obstetric and perinatal outcomes in singleton pregnancy after assisted reproductive technology (ART) from inception until July 2016. Clinical trials, which compared obstetric/perinatal outcomes in singleton pregnancy after FET and IVF/ICSI-ET, were included. The primary outcome was low birth weight, preterm birth, perinatal mortality, still birth, and cesarean section. RESULTS Thirteen cohort studies with 126,911 women were included, of which 12, 11, 6, 6, 5 studies were used to analyze low birth weight, preterm birth, perinatal mortality, still birth, and cesarean section, respectively. IVF/ICSI is associated with a high risk of preterm birth (OR = 1.14, 95 % CI: 1.02, 1.28) and low birth rate (OR = 1.48, 95 % CI: 1.37, 1.60). There was no significant difference in the risk of the still birth (OR = 1.01, 95 % CI: 0.76, 1.35) and perinatal mortality (OR = 1.11, 95 % CI: 0.85, 1.46) between FET and IVF/ICSI. Singleton pregnancy after FET was associated with higher cesarean section rate compared with IVF/ICSI (OR = 0.85, 95 % CI: 0.80, 0.91). CONCLUSIONS Singleton pregnancy after FET seems to have a better perinatal outcome compared with that after IVF/ICSI. Further randomized controlled trials which adjust for a variety of meaningful confounders are needed in order to draw sound conclusions.
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Affiliation(s)
- J. Zhao
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, 410008 Hunan Province People’s Republic of China
| | - B. Xu
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, 410008 Hunan Province People’s Republic of China
| | - Q. Zhang
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, 410008 Hunan Province People’s Republic of China
| | - Y. P. Li
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, 410008 Hunan Province People’s Republic of China
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16
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Timur H, Çinar M, Hançerlioğullari N, Alkan M, İnal HA, Uygur D, Yilmaz N. Associations between first-trimester uterine artery Doppler velocimetry indices and adverse perinatal outcomes in women conceiving via in vitro fertilization. J Matern Fetal Neonatal Med 2016; 30:684-688. [DOI: 10.1080/14767058.2016.1182979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hakan Timur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Mehmet Çinar
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Necati Hançerlioğullari
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Mihriban Alkan
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Hasan Ali İnal
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
| | - Nafiye Yilmaz
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey
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17
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Ozgur K, Humaidan P, Coetzee K. Segmented ART - The new era in ART? Reprod Biol 2016; 16:91-103. [PMID: 27288333 DOI: 10.1016/j.repbio.2016.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/29/2016] [Accepted: 04/03/2016] [Indexed: 01/31/2023]
Abstract
Currently up to 4% of infants born in developing countries are conceived through assisted reproductive technology (ART). Even though most of these conceptions occur and progress without complications, ART procedures and processes may increase iatrogenesis through complications in - and after conception. We herein review and discuss the clinically and scientific implications and evidence of iatrogenesis, and show how the evolution in ART technologies and procedures has led to the current presumption that frozen embryo transfer might be a more optimal strategy than fresh embryo transfer, in terms of not only reproduction, but also of maternal and fetal outcomes. There is increasing scientific evidence to support the notion that controlled ovarian stimulation could induce significant changes to the endocrine profile of a reproductive cycle, especially to the reproductively important early luteal phase. These changes may not only have a negative effect on implantation and early placentation, but also on the mother, the fetus, and the infant. The overt consequences of controlled ovarian stimulation include ovarian hyperstimulation syndrome, reduced embryo implantation, increased ectopic pregnancy, and altered placentation and fetal growth. The cumulative scientific evidence from this review suggests that GnRHa trigger in segmented ART might constitute the future routine treatment regimen for IVF patients, providing a safe, effective, and patient friendly treatment.
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Affiliation(s)
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark
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18
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Namvar Vansofla F, Roshangar L, Montaseri A, Soleimani Rad J. Impact of Prunus Cerasus on PGR and HAS2 in Cumulus Cells and Fertility Outcome. Adv Pharm Bull 2016; 6:65-9. [PMID: 27123419 PMCID: PMC4845541 DOI: 10.15171/apb.2016.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 01/06/2016] [Accepted: 01/18/2016] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Cumulus cells have a critical role in normal oocyte development and fertilization. Prunus cerasus is an anthocyanin rich berry and performs strong antioxidant activity. The present study set to determine if Prunus cerasus can affect expression of HAS2 (hyaluronan synthase 2) and progesterone receptor in Cumulus cells and its consequences outcome of the in vitro fertilization. METHODS 60 female and 15 male adult mice were used for mating and IVF (in vitro fertilization). Prunus cerasus extraction was added to the diet of female mice for 30 days. Ovulation induction and oocytes collection were done as routine. The cumulus cells were dissected apart, and the expression of progesterone receptor and HAS2 was detected using RT-PCR (real-time polymerase chain reaction). Fertilization rate was evaluated by IVF. All data were analyzed using t-test. RESULTS Data was showed that expression of progesterone receptor and HAS2 in cumulus cells of mice that received prunus cerasus increased. Moreover, oocyte fertilization rate also increased significantly. CONCLUSION Prunus cerasus as an antioxidant natural can become an important medication for improving oocyte quality and opening new opportunities for infertility treatment. It is concluded that Prunus cerasus consumption could improve fertility rate by increasing progesterone receptor and HAS2 activity in cumulus cells.
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Affiliation(s)
- Fatemeh Namvar Vansofla
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Cord Blood Stem Cell Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of Tissue Engineering, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azadeh Montaseri
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of Tissue Engineering, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jafar Soleimani Rad
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of Tissue Engineering, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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19
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Ozgur K, Berkkanoglu M, Bulut H, Humaidan P, Coetzee K. Perinatal outcomes after fresh versus vitrified-warmed blastocyst transfer: retrospective analysis. Fertil Steril 2015. [PMID: 26211882 DOI: 10.1016/j.fertnstert.2015.06.031] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the possible effect of controlled ovarian stimulation on the perinatal outcomes of assisted reproductive technology pregnancies, by comparing the outcomes from fresh ET with frozen ET (FET) with blastocysts of similar quality. DESIGN Retrospective observational study. SETTING Private fertility center. PATIENT(S) Seven hundred eighty-four fresh transfers and 382 vitrified-warmed double blastocyst transfers. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Miscarriage, perinatal mortality, preterm delivery, live birth, live-birth weights, and gestational age of live births. RESULT(S) FET resulted in higher implantation rates (51.5% vs. 40.6%), higher live-birth rates per transfer (56.8% vs. 44.3%), and lower ectopic pregnancy rates (0.32% vs. 1.80%). FET pregnancies also had higher day 14 βhCG levels per implantation (148.2 vs. 176.2 IU/L) and higher infant birth weights (singletons Δ109.4 g, twins Δ124 g). Female infants benefitted the most in terms of birth weight. Miscarriage, premature delivery, perinatal morbidity, and live birth per pregnancy were all nonsignificantly different between fresh ET and FET. CONCLUSION(S) Clinically significant differences between the peri-implantation and perinatal outcomes of fresh ET and FET suggest better endometrial receptivity and placentation in FET cycles.
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Affiliation(s)
- Kemal Ozgur
- Antalya IVF, Özel Antalya Tüp Bebek Merkezi, Antalya, Turkey.
| | | | - Hasan Bulut
- Antalya IVF, Özel Antalya Tüp Bebek Merkezi, Antalya, Turkey
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Kevin Coetzee
- Antalya IVF, Özel Antalya Tüp Bebek Merkezi, Antalya, Turkey
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20
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Hotaling JM, Patel DP, Brant WO, Myers JB, Cullen MR, Eisenberg ML. Demographic and socio-economic differences between men seeking infertility evaluation and those seeking surgical sterilization: from the National Survey of Family Growth. BJU Int 2015; 116:288-92. [DOI: 10.1111/bju.13012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- James M. Hotaling
- Center for Reconstructive Urology and Men's Health; University of Utah; Salt Lake City UT USA
| | - Darshan P. Patel
- Center for Reconstructive Urology and Men's Health; University of Utah; Salt Lake City UT USA
| | - William O. Brant
- Center for Reconstructive Urology and Men's Health; University of Utah; Salt Lake City UT USA
| | - Jeremy B. Myers
- Center for Reconstructive Urology and Men's Health; University of Utah; Salt Lake City UT USA
| | - Mark R. Cullen
- Department of Urology; Stanford University School of Medicine; Palo Alto CA USA
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Simonson OE, Domogatskaya A, Volchkov P, Rodin S. The safety of human pluripotent stem cells in clinical treatment. Ann Med 2015; 47:370-80. [PMID: 26140342 DOI: 10.3109/07853890.2015.1051579] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Human pluripotent stem cells (hPSCs) have practically unlimited proliferation potential and a capability to differentiate into any cell type in the human body. Since the first derivation in 1998, they have been an attractive source of cells for regenerative medicine. Numerous ethical, technological, and regulatory complications have been hampering hPSC use in clinical applications. Human embryonic stem cells (ESCs), parthenogenetic human ESCs, human nuclear transfer ESCs, and induced pluripotent stem cells are four types of hPSCs that are different in many clinically relevant features such as propensity to epigenetic abnormalities, generation methods, and ability for development of autologous cell lines. Propensity to genetic mutations and tumorigenicity are common features of all pluripotent cells that complicate hPSC-based therapies. Several recent advances in methods of derivation, culturing, and monitoring of hPSCs have addressed many ethical concerns and technological challenges in development of clinical-grade hPSC lines. Generation of banks of such lines may be useful to minimize immune rejection of hPSC-derived allografts. In this review, we discuss different sources of hPSCs available at the moment, various safety risks associated with them, and possible solutions for successful use of hPSCs in the clinic. We also discuss ongoing clinical trials of hPSC-based treatments.
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Affiliation(s)
- Oscar E Simonson
- a Division of Cardiothoracic Surgery and Anesthesiology, Department of Molecular Medicine and Surgery , Karolinska Institutet, Karolinska University Hospital , 171 77 Stockholm , Sweden
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22
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Sánchez-Calabuig MJ, López-Cardona AP, Fernández-González R, Ramos-Ibeas P, Fonseca Balvís N, Laguna-Barraza R, Pericuesta E, Gutiérrez-Adán A, Bermejo-Álvarez P. Potential Health Risks Associated to ICSI: Insights from Animal Models and Strategies for a Safe Procedure. Front Public Health 2014; 2:241. [PMID: 25478554 PMCID: PMC4235077 DOI: 10.3389/fpubh.2014.00241] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 11/03/2014] [Indexed: 12/23/2022] Open
Abstract
Artificial reproductive techniques are currently responsible for 1.7–4% of the births in developed countries and intracytoplasmatic sperm injection (ICSI) is the most commonly used, accounting for 70–80% of the cycles performed. Despite being an invaluable tool for infertile couples, the technique bypasses several biological barriers that naturally select the gametes to achieve an optimal embryonic and fetal development. In this perspective, ICSI has been associated with an increased risk for diverse health problems, ranging from premature births and diverse metabolic disorders in the offspring to more severe complications such as abortions, congenital malformations, and imprinting disorders. In this review, we discuss the possible implications of the technique per se on these adverse outcomes and highlight the importance of several experiments using mammalian models to truthfully test these implications and to uncover the molecular base that origins these health problems. We also dissect the specific hazards associated to ICSI and describe some strategies that have been developed to mimic the gamete selection occurring in natural conception in order to improve the safety of the procedure.
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Affiliation(s)
- María Jesús Sánchez-Calabuig
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain ; Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense de Madrid , Madrid , Spain
| | - Angela Patricia López-Cardona
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Raúl Fernández-González
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Priscila Ramos-Ibeas
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Noelia Fonseca Balvís
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Ricardo Laguna-Barraza
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Eva Pericuesta
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Alfonso Gutiérrez-Adán
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
| | - Pablo Bermejo-Álvarez
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA) , Madrid , Spain
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Jackson S, Hong C, Wang ET, Alexander C, Gregory KD, Pisarska MD. Pregnancy outcomes in very advanced maternal age pregnancies: the impact of assisted reproductive technology. Fertil Steril 2014; 103:76-80. [PMID: 25450294 DOI: 10.1016/j.fertnstert.2014.09.037] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 09/24/2014] [Accepted: 09/25/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine whether there are differences in adverse pregnancy outcomes in very advanced maternal age (vAMA) women who conceived with assisted reproductive technologies (ART) compared with spontaneous conceptions. DESIGN Retrospective cohort study. SETTING Academic tertiary care medical center. PATIENT(S) A total of 472 women aged ≥45 years who delivered at one institution. INTERVENTION(S) Mode of conception. MAIN OUTCOME MEASURE(S) Maternal and neonatal outcomes. RESULT(S) For singleton pregnancies, vAMA women who conceived with ART were significantly older (47.0 ± 2.3 vs. 45.6 ± 0.1 years), more likely to be white (88.1% vs. 75.6%), and less parous (0.4 ± 0.9 vs. 1.2 ± 1.8) than vAMA women who conceived spontaneously. They were at significantly increased risk for cesarean delivery (CD) (75.1% vs. 49.7%) and were more likely to undergo elective primary CD without labor (25.4% vs. 9.4%). Risk of retained placenta was also significantly higher (2.7% vs. 0%). Rates of other maternal complications and neonatal outcomes were similar. Subgroup analysis of ART singleton pregnancies did not demonstrate differences in women using autologous oocytes versus donor oocytes. CONCLUSION(S) Very advanced maternal age women who conceive after ART are more likely to be white, older, primiparous, and are more likely to proceed with an elective CD compared with vAMA women who conceive spontaneously. The increased risk of retained placenta in women who conceive with ART may indicate an underlying risk for placentation defects.
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Affiliation(s)
- Sherri Jackson
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Connie Hong
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Erica T Wang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Carolyn Alexander
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Kimberly D Gregory
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Margareta D Pisarska
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California.
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Binder NK, Evans J, Gardner DK, Salamonsen LA, Hannan NJ. Endometrial signals improve embryo outcome: functional role of vascular endothelial growth factor isoforms on embryo development and implantation in mice. Hum Reprod 2014; 29:2278-86. [DOI: 10.1093/humrep/deu211] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Padmanabhan N, Watson ED. Lessons from the one-carbon metabolism: passing it along to the next generation. Reprod Biomed Online 2013; 27:637-43. [PMID: 24139597 DOI: 10.1016/j.rbmo.2013.09.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/14/2013] [Accepted: 09/10/2013] [Indexed: 01/21/2023]
Abstract
During development, a fetus and its placenta must respond to a changing maternal environment to ensure normal growth is achieved and survival is maintained. The mechanisms behind developmental programming involve complex interactions between epigenetic and physiological processes, which are not well understood. Importantly, when programming goes awry, it puts the fetus at risk for disease later in life and may, in some instances, affect subsequent generations via epigenetic processes including DNA methylation. The one-carbon metabolism, which includes the folate, methionine and choline pathways, provides methyl groups necessary for DNA methylation and a normal epigenetic landscape. Accordingly, disruptions in this pathway affect placental development and function leading to altered fetal programming. Remarkably, recent studies have revealed that abnormal folate metabolism causes transgenerational effects probably through epigenetic inheritance. The epigenetic mechanisms behind this phenomenon are not well understood but they have important implications for the influence of the metabolic environment on epigenetic stability and non-genetic inheritance of disease. Importantly, there are increasing concerns that assisted reproductive technologies cause aberrant epigenetic profiles in embryos leading to abnormal fetal programming. How the negative epigenetic consequences of assisted reproduction treatment affect subsequent generations requires further investigation.
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Affiliation(s)
- Nisha Padmanabhan
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Physiological Laboratories, Downing Street, Cambridge CB2 3EG, United Kingdom
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