1
|
Bourdon M, Santulli P, Maignien C, Bordonne C, Millischer AE, Chargui A, Marcellin L, Mantelet LM, Fouque Gadol L, Chapron C. The "freeze-all" strategy seems to improve the chances of birth in adenomyosis-affected women. Fertil Steril 2024; 121:460-469. [PMID: 38056519 DOI: 10.1016/j.fertnstert.2023.11.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE To compare assisted reproductive technologies (ARTs) outcomes between fresh vs. freeze-all strategies in infertile women affected by adenomyosis. DESIGN A single-center observational study. SETTINGS University hospital-based research center. PATIENTS Adenomyosis-affected women undergoing blastocyst embryo transfer after in vitro fertilization and intracytoplasmic sperm injection between January 1, 2018, and November 31, 2021. The diagnosis of adenomyosis was based on imaging criteria (i.e., transvaginal ultrasound and/or magnetic resonance imaging). INTERVENTION(S) Women who underwent a freeze-all strategy were compared with those who underwent a fresh embryo transfer (ET) strategy. MAIN OUTCOME MEASURE(S) Cumulative live birth rate (LBR). RESULTS A total of 306 women were included in the analysis: 111 in the fresh ET group and 195 in the freeze-all group. The adenomyosis phenotype (internal diffuse adenomyosis, external focal adenomyosis, and adenomyoma) was not significantly different between the two groups. The cumulative LBR (86 [44.1%] vs. 34 [30.6%], respectively), and the cumulative ongoing pregnancy rate (88 [45.1%] vs. 36 [32.4%], respectively) were significantly higher in the freeze-all group compared with the fresh ET group. After multivariate logistic regression analysis, the freeze-all strategy in women with adenomyosis was associated with significantly higher odds of live birth compared with fresh ET (odds ratio = 1.80; 95% confidence interval = 1.02-3.16). CONCLUSION The freeze-all strategy in women afflicted with adenomyosis undergoing ART was associated with significantly higher cumulative LBRs. Our preliminary results suggest that the freeze-all strategy is an attractive option that increases ART success rates. Additional studies, with a randomized design, should be conducted to further test whether the freeze-all strategy enhances the pregnancy rate in adenomyosis-affected women.
Collapse
Affiliation(s)
- Mathilde Bourdon
- Université de Paris Cité, Faculté de santé, Faculté de Médecine Paris Centre, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France; Department 3I "Infection, Immunité et inflammation", Institut Cochin, INSERM U1016, Paris, France
| | - Pietro Santulli
- Université de Paris Cité, Faculté de santé, Faculté de Médecine Paris Centre, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France; Department 3I "Infection, Immunité et inflammation", Institut Cochin, INSERM U1016, Paris, France.
| | - Chloé Maignien
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Corinne Bordonne
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France; Department of Radiology, Centre Hospitalier Universitaire (CHU) Hotel Dieu, Paris, France; Imagerie Médicale Paris Centre (IMPC) Bachaumont-IFEEN - Ramsay Santé, Centre de Radiologie, Paris, France
| | - Anne Elodie Millischer
- Imagerie Médicale Paris Centre (IMPC) Bachaumont-IFEEN - Ramsay Santé, Centre de Radiologie, Paris, France
| | - Ahmed Chargui
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Histology-Embryology and Reproductive Biology Centre, Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Louis Marcellin
- Université de Paris Cité, Faculté de santé, Faculté de Médecine Paris Centre, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France; Department 3I "Infection, Immunité et inflammation", Institut Cochin, INSERM U1016, Paris, France
| | - Lorraine Maitrot Mantelet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Laura Fouque Gadol
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Charles Chapron
- Université de Paris Cité, Faculté de santé, Faculté de Médecine Paris Centre, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Paris, France; Department of Gynaecology Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France; Department 3I "Infection, Immunité et inflammation", Institut Cochin, INSERM U1016, Paris, France
| |
Collapse
|
2
|
Akang EN, Dosumu OO, Ogbenna A, Akpan UU, Ezeukwu JC, Odofin M, Oremosu AA, Akanmu AS. The impact of dolutegravir-based combination antiretroviral therapy on the spermatozoa and fertility parameters of men living with human immunodeficiency virus. Andrologia 2022; 54:e14621. [PMID: 36261884 PMCID: PMC9722517 DOI: 10.1111/and.14621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/18/2022] [Accepted: 09/28/2022] [Indexed: 11/28/2022] Open
Abstract
The factors responsible for this reported fertility decline among human immunodeficiency virus (HIV) positive men is yet to be determined. This study is aimed at investigating the impact of HIV or combination antiretroviral therapy (cART) on sperm cells, reproductive hormones, oxidative stress markers, apoptosis, and sperm DNA fragmentation of men living with HIV. Twenty-one men living with HIV gave their written informed consent to participate in this study. Only 11 of the participants successfully donated blood and semen before and after 3 months of their treatment with cART. Semen, reproductive hormones, oxidative stress biomarkers, and DNA fragmentation were analysed. Data were subjected to Wilcoxon matched pairs signed rank test (ethical approval: CMUL/HREC/09/19/614). There was a significant decrease in viral load of HIV (p < 0.01), and a marked increase in progressive and total sperm motility. Total sperm count, morphology, and vitality had no significant change after 3 months of treatment with cART however, there was a significant increase (p < 0.05) in testosterone from 2.48 to 3.68 ng/ml, but luteinizing hormone decreased significantly (p < 0.05) from 9.6 to 6.5 mIU/ml. In addition, sperm DNA fragmentation increased significantly (p < 0.01). Conversely, viral load, and catalase decreased significantly, but no significant difference in malondialdehyde. This study showed that HIV depleted testosterone and impaired sperm motility which may negatively affect the fertility potential of men living with HIV. It also showed that adherence to cART (a combination of tenofovir, lamivudine, and dolutegravir) reduces the viral load and reverses the deleterious effects of cART albeit, cART appears to be toxic at subcellular spermatogenic levels.
Collapse
Affiliation(s)
- EN Akang
- Department of Anatomy, College of Medicine, University of Lagos, P.M.B. 12003, Idi-Araba, Lagos, Nigeria
| | - OO Dosumu
- Department of Anatomy, College of Medicine, University of Lagos, P.M.B. 12003, Idi-Araba, Lagos, Nigeria
| | - A Ogbenna
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - UU Akpan
- Department of Anatomy, Faculty of Basic Medical Sciences, Bowen University, Iwo, Osun state, Nigeria
| | - JC Ezeukwu
- Department of Anatomy, College of Medicine, University of Lagos, P.M.B. 12003, Idi-Araba, Lagos, Nigeria
| | - M Odofin
- Department of Haematology and Blood Transfusion, Antiretroviral therapy (ART) Clinic, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - AA Oremosu
- Department of Anatomy, College of Medicine, University of Lagos, P.M.B. 12003, Idi-Araba, Lagos, Nigeria
| | - AS Akanmu
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| |
Collapse
|
3
|
OUP accepted manuscript. Hum Reprod 2022; 37:1470-1479. [DOI: 10.1093/humrep/deac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/05/2022] [Indexed: 11/13/2022] Open
|
4
|
Vianna CA, Dupont C, Selleret L, Canestri A, Levy R, Hamid RH. Comparison of in vitro fertilization cycles in couples with human immunodeficiency virus type 1 infection versus noninfected couples through a retrospective matched case-control study. F S Rep 2021; 2:376-385. [PMID: 34934977 PMCID: PMC8655394 DOI: 10.1016/j.xfre.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To compare in vitro fertilization (IVF) outcomes in couples in which at least one partner is human immunodeficiency virus (HIV) positive with that of couples in which neither partner is HIV-positive. Design Retrospective matched case-control study. Setting Fertility center at Tenon Hospital, Paris, France. Patient(s) A total of 179 IVF cycles in couples infected with HIV-1 and 179 IVF cycles in control couples. Intervention(s) Ovarian stimulation, oocytes retrieval, IVF (standard and microinjection), embryo transfer, pregnancy, and live birth follow-up. Main Outcome Measure(s) Live birth rate and IVF outcomes Result(s) The first comparison between HIV and non-HIV couples showed poorer outcomes in the HIV group (higher administered gonadotropin doses and longer stimulation periods, lower cumulative pregnancy and live birth rates, among other things). A subgroup analysis was performed in addition. No differences were found in the “men HIV” group compared with the controls. In contrast, poorer outcomes in the “women HIV” and “women and men HIV” groups were shown in terms of administered doses, duration of stimulation, and number of oocytes retrieved. For the “women HIV” group, lower cumulative clinical pregnancy and live birth rates were found. Conclusion The data suggested that couples with HIV-positive women have poorer medically assisted procreation outcomes than couples with non-HIV-infected women. Therefore, physicians should pay particular attention to couples with HIV-positive women.
Collapse
Affiliation(s)
- Caroline Aimone Vianna
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| | - Charlotte Dupont
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| | - Lise Selleret
- Service de Gynécologie Obstétrique - Médecine de la Reproduction, Hôpital Tenon, Paris, France
| | - Ana Canestri
- Service Maladies Infectieuses et Tropicales, Hôpital Tenon, Paris, France
| | - Rachel Levy
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| | - Rahaf Haj Hamid
- Biologie de la Reproduction - Centre d'Etude et de Conservation des Oeufs et du Sperme humains, Hôpital Tenon, Paris, France
| |
Collapse
|
5
|
Santulli P, Bourdon M, Koutchinsky S, Maignien C, Marcellin L, Maitrot-Mantelet L, Pocate Cheriet K, Patrat C, Chapron C. Fertility preservation for patients affected by endometriosis should ideally be carried out before surgery. Reprod Biomed Online 2021; 43:853-863. [PMID: 34649771 DOI: 10.1016/j.rbmo.2021.08.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 12/20/2022]
Abstract
RESEARCH QUESTION What prognostic factors relate to a high oocyte yield in fertility preservation for women affected by endometriosis? DESIGN Observational cohort study conducted in a tertiary care university hospital between April 2015 and January 2019. Women who had undergone fertility preservation with ovarian stimulation for oocytes and embryo vitrification for endometriosis were included. Prognostic factors associated with the number of oocytes retrieved after the first ovarian stimulation were analysed. RESULTS A total of 146 women who had undergone 258 ovarian stimulation cycles were included; 82 (56.2%) had undergone more than one ovarian stimulation cycle; 72.6% had at least one endometrioma lesion; and 36.3% had previously undergone surgery for endometriosis. After adjustment by multiple linear regression, the factors that significantly reduced the number of oocytes retrieved were previous history of surgery for ovarian endometriosis (coefficient -1.08; 95% CI -2.02 to -0.15; P = 0.024); women's age (-0.21; 95% CI -0.41 to -0.01; P = 0.039); and total dose of gonadotrophin used (-0.01; 95% CI -0.01 to -0.00; P = 0.047). Anti-Müllerian hormone serum level and gravidity positively correlated with an increase in the number of oocytes retrieved (1.65; 95% CI 1.13 to 2.17; P < 0.001 and 3.30; 95% CI 0.91 to 5.68; P = 0.007, respectively) after the first ovarian stimulation cycle. CONCLUSION A history of surgery for ovarian endometriosis was associated with significantly lower oocyte yields. Fertility preservation should be integrated into endometriosis management. Fertility preservation should ideally be made available to the patient before surgery.
Collapse
Affiliation(s)
- Pietro Santulli
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France; Université de Paris, Department 'Infection, Immunity, Inflammation', INSERM U1016, Institut Cochin, Paris, France.
| | - Mathilde Bourdon
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France; Université de Paris, Department 'Infection, Immunity, Inflammation', INSERM U1016, Institut Cochin, Paris, France
| | - Sonia Koutchinsky
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France
| | - Chloé Maignien
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France
| | - Louis Marcellin
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France; Université de Paris, Department 'Infection, Immunity, Inflammation', INSERM U1016, Institut Cochin, Paris, France
| | - Lorraine Maitrot-Mantelet
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France
| | - Khaled Pocate Cheriet
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Université de Paris, Department 'Infection, Immunity, Inflammation', INSERM U1016, Institut Cochin, Paris, France; Service d'Histologie-Embryologie-Biologie de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin, Paris 75014, France
| | - Catherine Patrat
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service d'Histologie-Embryologie-Biologie de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin, Paris 75014, France
| | - Charles Chapron
- Université de Paris, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin - Bâtiment Port Royal, 123 Boulevard de Port-Royal 75679 Paris 14, France; Université de Paris, Department 'Infection, Immunity, Inflammation', INSERM U1016, Institut Cochin, Paris, France
| |
Collapse
|
6
|
Abstract
OBJECTIVE The aim of this study was to evaluate the cumulative live birth rate in women undergoing in-vitro fertilization/intracytoplasmic-sperm-injection (IVF/ICSI) according to the type of chronic viral infection [HIV, hepatitis-B virus (HBV) and hepatitis-C virus (HCV)]. DESIGN A cohort study. SETTING A tertiary-care university hospital. PARTICIPANTS Women with a chronic viral illness HIV, HBV or HCV- were followed until four IVF/ICSI cycles had been completed, until delivery or until discontinuation of the treatment before the completion of four cycles. MAIN OUTCOME MEASURES The primary outcome was the cumulative live birth rate after up to four IVF/ICSI cycles. RESULTS A total of 235 women were allocated to the HIV-infected group (n = 101), the HBV-infected group (n = 114) and the HCV-infected group (n = 20). The cumulative live birth rate after four cycles was significantly lower in the HIV-infected women than in those with HBV [39.1%, 95% confidence interval (95% CI): 17.7-60.9 versus 52.8%, 95% CI: 41.6-65.5, respectively; P = 0.004]. Regarding the obstetrical outcomes, the mean birth weight was lower in the HIV-infected women than in those with HBV or HCV. Multivariate analysis indicated that the age, the anti-Müllerian hormone and the number of cycles performed were significantly associated with the chances of a live birth. CONCLUSION HIV-infected women had lower cumulative live birth rate than women with chronic hepatitis, and this was due to less favourable ovarian reserve parameters. These findings underscore the need to better inform practitioners and patients regarding fertility issues and the importance of early fertility assessment. However, larger studies are necessary to gain more in-depth knowledge of the direct impact of HIV on live birth rates.
Collapse
|
7
|
Infertility in women with bowel endometriosis: first-line assisted reproductive technology results in satisfactory cumulative live-birth rates. Fertil Steril 2020; 115:692-701. [PMID: 33276963 DOI: 10.1016/j.fertnstert.2020.09.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the assisted reproductive technology (ART) cumulative live-birth rate (LBR) in a cohort of bowel endometriosis patients with no prior history of surgery for endometriosis. DESIGN Prospective cohort study. SETTING University hospital. PATIENT(S) One hundred and one consecutive infertile bowel-endometriosis patients with no prior history of surgery for endometriosis in whom the diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography and magnetic resonance imaging. INTERVENTION(S) First-line ART. MAIN OUTCOME MEASURE(S) Cumulative LBR, with statistical analysis via Kaplan Meier method with a "conservative" method, whereby it was assumed that no live births took place for patients who did not return. RESULT(S) Between January 2016 and December 2018, 101 bowel endometriosis patients underwent 176 ART cycles. The mean number of deep-infiltrating endometriosis lesions per patient was 3 ± 0.9, with a mean number of bowel lesions of 1.3 ± 0.6. Seventy-three percent of the patients had associated endometriomas, and 88.1% had associated adenomyosis. Overall, the cumulative LBR after four ART cycles was 64.4%, using the conservative Kaplan-Meier method. CONCLUSION(S) The ART cumulative LBR was very satisfactory (64.4%) in bowel endometriosis patients with no prior history of surgery for endometriosis. In light of these data, clinicians should carefully weigh the pros and cons before systematically referring infertile bowel endometriosis patients to fertility-preserving surgery because as first-line ART appears to offer satisfactory results.
Collapse
|
8
|
Risk of small for gestational age is reduced after frozen compared with fresh embryo transfer in endometriosis. Reprod Biomed Online 2020; 42:133-141. [PMID: 33077356 DOI: 10.1016/j.rbmo.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 07/24/2020] [Accepted: 08/12/2020] [Indexed: 01/01/2023]
Abstract
RESEARCH QUESTION What are the perinatal outcomes and especially the risk of small for gestational age (SGA) babies born after frozen versus fresh embryo transfer in mothers affected by endometriosis undergoing treatment with assisted reproductive technology (ART)? DESIGN A cohort study conducted between November 2012 and October 2017, in which infertile women with endometriosis undergoing ART and achieving singleton pregnancies that lasted beyond 12 weeks of gestation were included. Pregnancies obtained after a frozen embryo transfer (FET) were compared with those obtained after a fresh embryo transfer. A total of 339 pregnant women were included: 112 patients in the fresh embryo transfer group and 227 in the FET group. The main outcome was the rate of SGA. Secondary analyses were performed for adverse pregnancy outcomes and perinatal complications. RESULTS Of the included women, 109/112 (97.3%) and 222/227 (97.8%) delivered a live child after at least 24 weeks of gestation in the fresh and in the frozen embryo transfer groups, respectively (P = 0.53). The risk of SGA decreased after a FET compared with a fresh embryo transfer (odds ratio [OR] 0.49 [0.25-0.98], P = 0.04) after multivariable analysis. The mean birthweight and the gestational age at delivery were not significantly different between the two study groups. Other pregnancy and perinatal complications were not statistically different between the two study populations. CONCLUSIONS The present study of endometriosis-affected women found a significantly lower risk of SGA in patients undergoing frozen, mainly blastocyst, embryo transfer compared with patients undergoing fresh, mainly cleavage stage, embryo transfer.
Collapse
|
9
|
Maignien C, Santulli P, Bourdon M, Korb D, Marcellin L, Lamau MC, Chapron C. Deep Infiltrating Endometriosis: a Previous History of Surgery for Endometriosis May Negatively Affect Assisted Reproductive Technology Outcomes. Reprod Sci 2020; 27:545-554. [DOI: 10.1007/s43032-019-00052-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 07/23/2019] [Indexed: 11/29/2022]
|
10
|
Cito G, Coccia ME, Fucci R, Picone R, Cocci A, Russo GI, Rizzello F, Trotta M, Badolato L, Basile V, Criscuoli L, Serni S, Carini M, Natali A. Influence of male human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection on the reproductive outcomes in serodiscordant couples: a case-control study. Andrology 2019; 7:852-858. [PMID: 30993859 DOI: 10.1111/andr.12623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Nowadays, serodiscordant couples (SDCs) with human immunodeficiency virus (HIV) or hepatitis C virus (HCV)-infected men have the chance to conceive safely, giving birth with a minimum risk of cross-infection. OBJECTIVE To assess the impact of male HIV and HCV infection on the assisted reproductive technologies (ART) outcomes in SDCs, with HIV or HCV seropositive men and negative partners. MATERIALS AND METHODS Of 153 couples: 24 in Group 1 (HIV-seropositive men), 60 in Group 2 (HCV-seropositive men) and 69 in Group 3 (controls). Sperm-washing procedure was performed using a three-step system. Fresh ICSI cycles were carried out in HIV SDCs, HCV SDCs and controls. Seminal parameters, fertilization rate (FR), cleavage rate (CR), pregnancy rate per cycle (PR/C), miscarriage rate, implantation rate (IR) and live birth rate were evaluated. RESULTS All the seropositive men have undetectable viral loads at the time of insemination, and both partners were free from co-morbid infections. The median number of embryos transferred was 2.0 (IQR 1.0-3.0), with no differences among groups. FR was significantly reduced in HIV and HCV SDCs compared to the controls (66%, 61% and 75%, respectively; p < 0.01). CR was similar between groups (p = 0.3). IR was 12.1%, 11.1% and 14.1%, respectively, in the three groups (p = 0.30). PR/C was 21.7%, 17.6% and 20.2% in HIV, HCV and controls, respectively. Live birth rate per cycle was 17.4%, 15.7% and 15.9%, respectively. There were no significant differences in clinical pregnancies per cycle, as well as miscarriages and live births (p = 0.30; 0.30; 0.60, respectively). CONCLUSIONS The sperm-washing technique with ICSI may generate a promising way to improve pregnancy outcomes and to reduce the risk of viral transmission in these couples. In this setting, we can correctly counsel HIV- and HCV-infected men of SDCs with regard to the likelihood of father their own biological child.
Collapse
Affiliation(s)
- G Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - M E Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - R Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - R Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - A Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - G I Russo
- Department of Urology, Vittorio Emanuele Hospital, University of Catania, Catania, Italy
| | - F Rizzello
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - M Trotta
- Department of Critical Care Medicine and Surgery, Infectious Disease Unit, Careggi Hospital, University of Florence, Florence, Italy
| | - L Badolato
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - V Basile
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - L Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - S Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - M Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| |
Collapse
|
11
|
Ninive C, Ferraretto X, Gricourt S, Llabador MA, Lepage J, Gauché-Cazalis C, Epelboin S, Peigné M. [Assisted reproductive technologies in HIV patients: Which results and which strategy in France in 2019?]. ACTA ACUST UNITED AC 2019; 47:362-369. [PMID: 30753900 DOI: 10.1016/j.gofs.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Indexed: 01/22/2023]
Abstract
With the use of antiretroviral therapy, HIV transmission from mother to fetus and between sexual partners has been significantly reduced, successively allowing pregnancy, then assisted reproductive technologies, and targeted unprotected sex among couples living with HIV. Since first French Morlat report in 2013, natural procreation is now possible under certain conditions for these couples living with HIV and the use of assisted reproductive technologies is increasingly limited to the treatment of infertility. While the results of intrauterine insemination seem satisfactory for serodiscordant couples living with HIV, in vitro fertilization results appear to be unfavorable when the woman is infected with HIV. In vitro fertilization results appear to be comparable to those in general population when only the man is infected with HIV. It can be assumed that ovaries are impacted by the treatment and/or the HIV in infected women.
Collapse
Affiliation(s)
- C Ninive
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - X Ferraretto
- Service de biologie de la reproduction, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - S Gricourt
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - M A Llabador
- Service de biologie de la reproduction, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - J Lepage
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - C Gauché-Cazalis
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - S Epelboin
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France
| | - M Peigné
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France.
| |
Collapse
|
12
|
Bourdon M, Santulli P, Chen Y, Patrat C, Pocate-Cheriet K, Maignien C, Marcellin L, Chapron C. The Deferred Embryo Transfer Strategy Seems Not to be a Good Option After Repeated IVF/ICSI Cycle Failures. Reprod Sci 2018; 26:1210-1217. [DOI: 10.1177/1933719118811648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objective: The aim of this study was to assess whether a deferred frozen–thawed embryo transfer (Def-ET) offers any benefits compared to a fresh ET strategy in women who have had 2 or more consecutive in vitro fertilization (IVF)/intracytoplasmic injection (ICSI) cycle failures. Design: An observational cohort study in a tertiary referral care center including 416 cycles from women with a previous history of 2 or more consecutive IVF/ICSI failures cycles. Both Def-ET and fresh ET strategies were compared using univariate and multivariate logistic regression models. The main outcome measured was the cumulative live birth rate (CLBR). Results: A total of 416 cycles were included in the analysis: 197 in the fresh ET group and 219 in the Def-ET group. The CLBR was not significantly different between the fresh and Def-ET groups (58/197 [29.4%] and 57/219 [26.0%], respectively, P = .437). In addition, after the first ET, there was no significant difference in the live birth rate between the fresh ET and Def-ET groups (50/197 [25.4%] vs 44/219 [20.1%], respectively). Multivariate logistic regression analysis indicated that compared to the fresh strategy, the Def-ET strategy was not associated with a higher probability of live birth. Conclusions: In cases with 2 or more consecutive prior IVF/ICSI cycle failures, a Def-ET strategy did not result in better ART outcomes than a fresh ET strategy.
Collapse
Affiliation(s)
- Mathilde Bourdon
- Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique–Hôpitaux de Paris (AP–HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Institut Cochin, INSERM U1016, Laboratoire d’immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Pietro Santulli
- Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique–Hôpitaux de Paris (AP–HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Institut Cochin, INSERM U1016, Laboratoire d’immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Yulian Chen
- Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique–Hôpitaux de Paris (AP–HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Catherine Patrat
- Faculté de Médecine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Service d’Histologie-Embryologie-Biologie de la Reproduction, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Khaled Pocate-Cheriet
- Faculté de Médecine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Service d’Histologie-Embryologie-Biologie de la Reproduction, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Chloé Maignien
- Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique–Hôpitaux de Paris (AP–HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Louis Marcellin
- Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique–Hôpitaux de Paris (AP–HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Institut Cochin, INSERM U1016, Laboratoire d’immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Institut Cochin, Inserm U1016, Département de “Génetique, Développement et Cancer”, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Charles Chapron
- Faculté de Médecine, Département de gynécologie, obstétrique II et médecine de la reproduction, Assistance Publique–Hôpitaux de Paris (AP–HP), Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Institut Cochin, INSERM U1016, Laboratoire d’immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Institut Cochin, Inserm U1016, Département de “Génetique, Développement et Cancer”, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| |
Collapse
|
13
|
The interval between oocyte retrieval and frozen-thawed blastocyst transfer does not affect the live birth rate and obstetrical outcomes. PLoS One 2018; 13:e0206067. [PMID: 30339700 PMCID: PMC6195300 DOI: 10.1371/journal.pone.0206067] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/06/2018] [Indexed: 11/23/2022] Open
Abstract
Background The ‘Freeze all’ strategy, which consists of cryopreservation of all embryos after the ovarian stimulation has undergone extensive development in the past decade. The time required for the endometrium to revert to a prestimulation state after ovarian stimulation and thus the optimal time to perform a deferred embryo transfer after the stimulation has not been determined yet. Objective To investigate the impact of the time from oocyte retrieval to frozen-thawed blastocyst transfer (FBT) on live birth rate (LBR), obstetrical and neonatal outcomes, in ‘Freeze-all’ cycle. Materials and methods We conducted a large observational cohort study in a tertiary care university hospital including four hundred and seventy-four first autologous FBT performed after ovarian stimulation in ‘freeze all’ cycles. Reproductive outcomes were compared between FBT performed within the first menstrual cycle after the oocyte retrieval (‘cycle 1’ group) or delayed FBT (‘cycle ≥ 2’ group). The main Outcome Measure was the Live birth rate. Result(s) A total of 188 FBT were included in the analysis in the ‘cycle 1’ group and 286 in the ‘cycle ≥ 2’ group. No significant differences were found between FBT performed within the first menstrual cycle after oocyte retrieval (the ‘cycle 1’ group) and delayed FBT (the ‘cycle ≥ 2’ group) in terms of the live birth rate [59/188 (31.38%) vs. 85/286 (29.72%); p = 0.696] and the miscarriage rate [20/82 (24.39%) vs. 37/125 (29.60%), respectively; p = 0.413]. The obstetrical and neonatal outcomes were also not significantly different between the two groups. Conclusion Our study did not detect statistically significant differences in the LBR for FBT performed within the first menstrual cycle after oocyte retrieval versus FBT following subsequent cycles. Embryo-endometrium interaction after a FBT does not appear to be impaired by potential adverse effects of COS whatever the number of cycle between oocyte retrieval and embryo transfer.
Collapse
|
14
|
Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation. PLoS One 2018; 13:e0202399. [PMID: 30125306 PMCID: PMC6101383 DOI: 10.1371/journal.pone.0202399] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 08/02/2018] [Indexed: 12/20/2022] Open
Abstract
Background Many women whose fertility may have been impaired by endometriosis require assisted reproductive technology (ART) in order to become pregnant. However, the influence of ovarian endometriosis (OMA) on ovarian responsiveness to hyperstimulation has not been clearly established. Objective To evaluate the risk of a poor ovarian response (POR) to stimulation and ART outcomes in women with OMA. Materials and methods We conducted a large observational controlled matched cohort study in a tertiary care university hospital between 01/10/2012 and 31/12/2015. After matching by age and anti-Müllerian hormone (AMH) levels, 201 infertile women afflicted with OMA (the OMA group) and 402 disease-free women (the control group) undergoing an ART procedure were included in the study. The main outcomes that we measured were a POR to hyperstimulation (i.e., ≤ 3 oocytes retrieved, or cancelled cycles), the clinical pregnancy rate, and the live birth rate. All of the women with endometriosis underwent a pre-ART work-up, in order to obtain an accurate diagnosis and staging of their disease. An OMA diagnosis was based on published imaging criteria (obtained by transvaginal sonography or magnetic resonance imaging) or on histological analysis for patients with a prior history of endometriosis surgery. The statistical analyses were conducted using univariate and multivariate logistic regression models. Results The incidence of a POR to hyperstimulation was significantly higher for the OMA group than for the control group [62/201 (30.8%) versus 90/402 (22.3%), respectively; p = 0.02]. However, no significant differences were found between the OMA and the control group in terms of the clinical pregnancy rate [53/151 (35%) versus 134/324 (41.3%), respectively; p = 0.23] and the live birth rate [39/151 (25.8%) versus 99/324 (30.5%), respectively; p = 0.33]. By multivariate analysis, a prior history of surgery for OMA was found to be an independent factor associated with a POR to stimulation [OR = 2.1; 95% CI: 1.1–4.0], unlike OMA without a prior history of surgery [OR: 1.5; 95% CI: 0.9–2.2]. Conclusion The presence of OMA during ART treatment increased the risk of a POR to hyperstimulation, although the live birth rate was not affected. Furthermore, having OMA and having previously undergone surgery for OMA was identified as an independent risk factor for a POR.
Collapse
|
15
|
Bourdon M, Santulli P, Maignien C, Gayet V, Pocate-Cheriet K, Marcellin L, Chapron C. The deferred embryo transfer strategy improves cumulative pregnancy rates in endometriosis-related infertility: A retrospective matched cohort study. PLoS One 2018; 13:e0194800. [PMID: 29630610 PMCID: PMC5890985 DOI: 10.1371/journal.pone.0194800] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 03/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background Controlled ovarian stimulation in assisted reproduction technology (ART) may alters endometrial receptivity by an advancement of endometrial development. Recently, technical improvements in vitrification make deferred frozen-thawed embryo transfer (Def-ET) a feasible alternative to fresh embryo transfer (ET). In endometriosis-related infertility the eutopic endometrium is abnormal and its functional alterations are seen as likely to alter the quality of endometrial receptivity. One question in the endometriosis ART-management is to know whether Def-ET could restore optimal receptivity in endometriosis-affected women leading to increase in pregnancy rates. Objective To compare cumulative ART-outcomes between fresh versus Def-ET in endometriosis-infertile women. Materials and methods This matched cohort study compared def-ET strategy to fresh ET strategy between 01/10/2012 and 31/12/2014. One hundred and thirty-five endometriosis-affected women with a scheduled def-ET cycle and 424 endometriosis-affected women with a scheduled fresh ET cycle were eligible for matching. Matching criteria were: age, number of prior ART cycles, and endometriosis phenotype. Statistical analyses were conducted using univariable and multivariable logistic regression models. Results 135 in the fresh ET group and 135 in the def-ET group were included in the analysis. The cumulative clinical pregnancy rate was significantly increased in the def-ET group compared to the fresh ET group [58 (43%) vs. 40 (29.6%), p = 0.047]. The cumulative ongoing pregnancy rate was 34.8% (n = 47) and 17.8% (n = 24) respectively in the Def-ET and the fresh-ET groups (p = 0.005). After multivariable conditional logistic regression analysis, Def-ET was associated with a significant increase in the cumulative ongoing pregnancy rate as compared to fresh ET (OR = 1.76, CI95% 1.06–2.92, p = 0.028). Conclusion Def-ET in endometriosis-affected women was associated with significantly higher cumulative ongoing pregnancy rates. Our preliminary results suggest that Def-ET for endometriosis-affected women is an attractive option that could increase their ART success rates. Future studies, with a randomized design, should be conducted to further confirm those results.
Collapse
Affiliation(s)
- Mathilde Bourdon
- Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
- Department “Stress oxydant, prolifération cellulaire et inflammation”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Pietro Santulli
- Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
- Department “Stress oxydant, prolifération cellulaire et inflammation”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department “Development, Reproduction and Cancer”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- * E-mail:
| | - Chloé Maignien
- Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Vanessa Gayet
- Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Khaled Pocate-Cheriet
- Department of Histology-Embryology and Reproductive Biology, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
| | - Louis Marcellin
- Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
- Department “Stress oxydant, prolifération cellulaire et inflammation”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department “Development, Reproduction and Cancer”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Charles Chapron
- Department of Gynecology Obstetrics II and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
- Department “Stress oxydant, prolifération cellulaire et inflammation”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department “Development, Reproduction and Cancer”, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| |
Collapse
|
16
|
Mataró D, García D, Coll O, Vassena R, Rodríguez A. Lower endometrial receptivity in HIV-infected women receiving oocyte donation: a comorbidity of HIV infection? Hum Reprod Open 2017; 2017:hox019. [PMID: 30895233 PMCID: PMC6276669 DOI: 10.1093/hropen/hox019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/22/2017] [Accepted: 10/07/2017] [Indexed: 01/13/2023] Open
Abstract
STUDY QUESTION Are the reproductive outcomes of HIV-infected donor oocyte recipient women comparable to those of non-infected women? SUMMARY ANSWER HIV-infected women have lower clinical pregnancy and live birth rates than non-infected women. WHAT IS ALREADY KNOWN The literature on the effect of HIV infection on reproductive outcome is scarce at best; the only report to date comparing oocyte donation cycles in HIV-infected women versus non-infected controls found no differences in pregnancy rates between the two groups. However, this study was performed nearly a decade ago and did not evaluate the effect of immuno-virological characteristics of oocyte recipients or the HIV antiretroviral therapy effect. STUDY DESIGN SIZE, AND DURATION This is a matched-cohort study including 514 oocyte donation cycles, 257 from HIV-infected women and 257 non-infected controls, performed between April 2004 and November 2014. PARTICIPANTS/MATERIALS, SETTING, AND METHOD Each cycle of an HIV-infected woman (n = 257) was matched with a cycle of a non-infected woman (1:1). Biochemical pregnancy, clinical pregnancy, ongoing pregnancy and live birth in the two groups were compared using a multivariate logistic regression analysis. The effect of antiretroviral treatment options on pregnancy outcomes of HIV-infected women was analyzed using a logistic regression model adjusted for time elapsed from diagnosis, and CD4 levels and viral load prior to embryo transfer. MAIN RESULTS AND THE ROLE OF CHANCE Cycles of HIV-infected patients receiving oocyte donation presented lower pregnancy and live birth rates than matched non-infected controls. Treatment options and infection parameters analyzed do not seem to affect the reproductive results in HIV-infected women. The variable most influencing pregnancy outcomes was the number of transferred embryos; lower pregnancy rates were obtained after single embryo transfer. LIMITATIONS REASONS FOR CAUTION Patients with HIV infection have specific health issues, such as infection/treatment side effects, which makes it impossible to find a matching control group of non-infected patients for these variables. WIDER IMPLICATIONS OF THE FINDINGS HIV-infected women receiving donated oocytes present lower pregnancy rates when compared to non-infected controls, regardless of the antiretroviral treatment followed. The complexity of the treatments (both in medication types and combinations) makes it difficult to define whether any one treatment option is better than the others in terms of pregnancy outcomes in oocyte recipients. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER Not applicable.
Collapse
Affiliation(s)
- Daniel Mataró
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Désirée García
- Fundació Privada EUGIN, Travessera de Les Corts 314, Barcelona 08029, Spain
| | - Oriol Coll
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Rita Vassena
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Amelia Rodríguez
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| |
Collapse
|
17
|
Extended culture of poor-quality supernumerary embryos improves ART outcomes. J Assist Reprod Genet 2017; 35:311-319. [PMID: 29047006 DOI: 10.1007/s10815-017-1063-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The aims of this study were to investigate the possible benefits of extending the culture of poor-quality day-2 embryos (PQE) versus good-quality embryos (GQE) and to identify factors associated with pregnancy and live birth when transferring frozen-thawed blastocysts originating from GQE and PQE. METHODS This is a retrospective cohort follow-up study performed between November 2012 and February 2015 at the IVF Laboratory Unit of Cochin University Hospital (Paris, France) including 3108 day-2 supernumerary embryos resulting from 1237 IVF/ICSI cycles. RESULTS Total blastulation rate was 67.2% from GQE and 48.7% from PQE. Percentage of good-quality blastocysts was 60.7 and 47.9% respectively including 14.7 and 7.3% top-quality blastocysts. A total of 150 blastocysts originating from GQE and 729 from PQE were frozen, and then, 37 and 164 were thawed and transferred respectively resulting in 19 (51.4%) and 61 (37.9%) clinical pregnancies with 13 (35.1%) deliveries from GQE and 32 (19.9%) from PQE (p = 0.046) without any difference in neonatal outcomes. Quality of blastocysts that resulted in live birth was similar in the two groups. Women < 35 years old and day-5 blastocyst expansion were predictive of pregnancy and live birth. CONCLUSIONS (i) PQE are able to reach the blastocyst stage, to implant, and to give healthy babies and (ii) women age and day of blastocyst expansion are predictive of pregnancy and live birth.
Collapse
|
18
|
Vankerkem P, Manigart Y, Delvigne A, Ameye L, Konopnicki D, Shaw-Jackson C, Rozenberg S, Autin C. In vitro fertilization when men, women, or both partners are positive for HIV: a case-control study. Arch Gynecol Obstet 2017; 295:1493-1507. [PMID: 28444513 DOI: 10.1007/s00404-017-4374-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/18/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare the outcomes of in vitro fertilization (IVF) for couples where one or both partners were positive for the human immunodeficiency virus (HIV) to matched control couples. METHODS A matched case-control retrospective study was performed. Data for 104 couples where the woman was HIV-positive; for 90 couples where the man was HIV-positive; and for 33 couples where both partners were HIV-positive were prospectively analyzed in comparison to matched controls treated in our center during the same period. The main outcomes were clinical pregnancy and live birth rates. RESULTS For couples involving an HIV-positive man, clinical outcomes were comparable to controls and resulted in the birth of 18 healthy babies after 90 cycles. When the woman was affected, cycle cancelation, number of retrieved oocytes, and on-going clinical pregnancy rates per transfer were statistically reduced. Implantation rates were comparable to those of non-affected controls. Seven healthy babies for 104 cycles were obtained. For a couple in which both partners were HIV-positive, only one healthy birth occurred after 33 cycles. Pregnancy rates were systematically reduced though not significantly probably due to sample size. CONCLUSIONS Our data suggest that IVF outcomes were similar to controls when men were HIV-positive and remain acceptable when women were HIV-positive. IVF outcomes were severely reduced in our sero-concordant couples; however, many patients had severe HIV disease previously, and therefore, these results should be reassessed in patients treated early in their disease.
Collapse
Affiliation(s)
- Pauline Vankerkem
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Yannick Manigart
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Annick Delvigne
- Department of Gynaecology, Clinique St Vincent, Rue François Lefèbvre 207, 4000, Rocourt, Belgium
| | - Lieveke Ameye
- Data centre, Jules Bordet Institute, Université Libre de Bruxelles, rue Hégèr Bordet 1, 1000, Brussels, Belgium
| | - Deborah Konopnicki
- Department of Infectious Diseases, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Chloë Shaw-Jackson
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium.
| | - Serge Rozenberg
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| | - Candice Autin
- Department of Gynaecology, CHU St-Pierre, Université Libre de Bruxelles, rue Haute 322, 1000, Brussels, Belgium
| |
Collapse
|
19
|
Bourdon M, Santulli P, de Ziegler D, Gayet V, Maignien C, Marcellin L, Chapron C. Does GnRH Agonist Triggering Control Painful Symptom Scores During Assisted Reproductive Technology? A Retrospective Study. Reprod Sci 2017; 24:1325-1333. [DOI: 10.1177/1933719116687659] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mathilde Bourdon
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Pietro Santulli
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Laboratoire d’immunologie, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Dominique de Ziegler
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Vanessa Gayet
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Chloé Maignien
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Louis Marcellin
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Laboratoire d’immunologie, Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Charles Chapron
- Faculté de Médecine, Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Département de “Génetique, Développement et Cancer,” Institut Cochin, Inserm, U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| |
Collapse
|
20
|
Bourdon M, Santulli P, Gayet V, Maignien C, Marcellin L, Pocate-Cheriet K, Chapron C. Assisted reproduction technique outcomes for fresh versus deferred cryopreserved day-2 embryo transfer: a retrospective matched cohort study. Reprod Biomed Online 2016; 34:248-257. [PMID: 28065417 DOI: 10.1016/j.rbmo.2016.11.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 11/19/2016] [Accepted: 11/30/2016] [Indexed: 12/17/2022]
Abstract
Ovarian stimulation could adversely affect endometrial receptivity and consequently embryo implantation. One emerging strategy is the 'freeze-all' approach. Most studies have focused on blastocyst transfers, with limited research on day-2 deferred cryopreserved embryo transfers. In this large retrospective cohort study, outcomes were compared between day-2 fresh versus deferred cryopreserved embryo transfers. After matching by age and number of previous cycles, 325 cycles were included in the fresh group and 325 in the deferred cryopreserved embryo transfers group: no significant differences were found between groups in implantation (0.20 ± 0.33 versus 0.17 ± 0.31, respectively) and ongoing pregnancy rates (21.85% versus 18.46%). Independent predictors for ongoing pregnancy after a multiple logistic regression analysis were the women's age (OR = 0.92; 95% CI 0.88 to 0.97), body mass index (OR = 0.94; 95% CI 0.89 to 0.99), the number of two pronuclei embryos (OR = 1.19; 95% CI 1.04 to 1.40) and at least one grade 1 embryo transferred (OR = 1.97; 95% CI 1.26 to 3.05). In the case of a day-2 embryo transfer, outcomes after treatment with assisted reproduction techniques are similar for fresh versus deferred cryopreserved embryo transfers when pre-transfer progesterone exposures are similar in the two groups.
Collapse
Affiliation(s)
- Mathilde Bourdon
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Pietro Santulli
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Vanessa Gayet
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Chloé Maignien
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Louis Marcellin
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Laboratoire d'immunologie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut Cochin, INSERM U1016, Département de 'Génetique, Développement et Cancer', Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Khaled Pocate-Cheriet
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique - Hôpitaux de Paris (AP- HP), Hôpital Universitaire Paris Centre, Service d'Histologie-Embryologie-Biologie de la Reproduction, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France
| | - Charles Chapron
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Department of Gynaecology Obstetrics II and Reproductive Medicine Paris, Centre Hospitalier Universitaire (CHU) Cochin, Batiment Port Royal 53, avenue de l'Observatoire, 75679 Paris, France; Institut Cochin, INSERM U1016, Département de 'Génetique, Développement et Cancer', Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| |
Collapse
|
21
|
Semen residual viral load and reproductive outcomes in HIV-infected men undergoing ICSI after extended semen preparation. Reprod Biomed Online 2016; 32:584-90. [DOI: 10.1016/j.rbmo.2016.02.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/17/2016] [Accepted: 02/24/2016] [Indexed: 11/18/2022]
|
22
|
Abstract
OBJECTIVE To evaluate HIV directly or indirectly related altered ovarian function, using serum anti-Müllerian hormone (AMH) levels in HIV-infected women as compared with seronegative women. DESIGN We conducted a matched cohort study from January 2008 to December 2013 in a tertiary university centre. Two hundred and one HIV-infected women requesting assisted reproductive technology and 603 age and cause of infertility-matched HIV seronegative women were enrolled in this study. METHODS All data were prospectively collected using a semistructured questionnaire. Serum AMH levels in HIV-infected women and matched controls were compared. To find out the contributing factors to increased serum AMH levels in HIV-infected women, a backward multiple linear regression was performed. RESULTS Serum AMH levels were significantly lower in HIV-infected group as compared with seronegative controls (3.0 ± 2.8 vs 3.7 ± 3.5 ng/ml; respectively, P = 0.001). Looking for factors associated with altered AMH among HIV-infected women, an association has been shown between tubal disease and a further decrease in serum AMH levels (2.4 ± 2.4 vs 3.4 ± 3.0 ng/ml; respectively, P = 0.011). Among HIV-infected women, after multivariate linear regression analysis, we showed that increased age, BMI and viral load were associated with decreased serum AMH levels whereas in striking contrast an increase in CD4⁺ cell count was associated with an increase of serum AMH levels. CONCLUSION Serum AMH levels were lower in the HIV-infected group than in the control group. Age, BMI, CD4⁺ cell count and viral load were the independent contributors affecting serum AMH levels among HIV-infected women.
Collapse
|
23
|
Santulli P, Bourdon M, Presse M, Gayet V, Marcellin L, Prunet C, de Ziegler D, Chapron C. Endometriosis-related infertility: assisted reproductive technology has no adverse impact on pain or quality-of-life scores. Fertil Steril 2016; 105:978-987.e4. [DOI: 10.1016/j.fertnstert.2015.12.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/27/2015] [Accepted: 12/03/2015] [Indexed: 01/24/2023]
|
24
|
Stora C, Epelboin S, Devouche E, Matheron S, Epelboin L, Yazbeck C, Damond F, Longuet P, Dzineku F, Rajguru M, Delaroche L, Mandelbrot L, Luton D, Patrat C. Women infected with human immunodeficiency virus type 1 have poorer assisted reproduction outcomes: a case-control study. Fertil Steril 2016; 105:1193-1201. [PMID: 26801068 DOI: 10.1016/j.fertnstert.2015.12.138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 12/27/2015] [Accepted: 12/31/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To compare the efficacy of assisted reproductive technology (ART) in women infected with human immunodeficiency virus type 1 (HIV-1) versus HIV-negative controls. DESIGN Retrospective case-control study. SETTING University hospital ART unit. PATIENT(S) Eighty-two women infected with HIV-1 and 82 women as seronegative controls. INTERVENTION(S) Ovarian stimulation, oocytes retrieval, standard in vitro fertilization (IVF) or intracytoplasmic sperm injection, embryo transfer. MAIN OUTCOME MEASURE(S) Clinical pregnancies and live-birth rates. RESULT(S) After oocyte retrieval, all women infected with HIV-1 infected were matched 1:1 to HIV-negative controls according to the following criteria: date of ART attempt, age, parity, main cause of infertility, ART technique, and rank of attempt. Only the first IVF cycle during the study period was considered for each couple. We found no statistically significant differences between the two groups for ovarian stimulation data, fertilization rate, or average number of embryos transferred. The clinical pregnancy rate per transfer was statistically significantly lower for the cases compared with the controls (12% vs. 32%), as were the implantation rate (10% vs. 21%) and the live-birth rate (7% vs. 19%). CONCLUSION(S) In one of the largest studies to pair six factors that influence the results of ART, HIV infection in women was associated with poorer outcomes after ART. These results suggest that women with controlled HIV-1-infection should be counseled not to delay ART in cases of self-insemination failure or other causes of infertility. Fertility preservation by vitrification of oocytes in women whose pregnancy should be delayed may be an important future consideration.
Collapse
Affiliation(s)
- Camille Stora
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Sylvie Epelboin
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France; Paris 7-Denis Diderot University, Paris, France.
| | - Emmanuel Devouche
- Laboratory of Psychopathology and Health Process, Paris-Descartes University, Paris, France
| | - Sophie Matheron
- Department of Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris France; Paris 7-Denis Diderot University, INSERM UMR 1137 IAME, Paris, France
| | - Loïc Epelboin
- Infectious and Tropical Diseases Unit, Andrée Rosemon Hospital, Guiana University, Pasteur Institute of Guiana (EPaT) EA 3593, Cayenne, French Guiana
| | - Chadi Yazbeck
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France; Paris 7-Denis Diderot University, Paris, France
| | - Florence Damond
- Department of Virology, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Pascale Longuet
- Department of Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris France
| | - Frederick Dzineku
- Department of Gynecology, Hôpital Maisonneuve-Rosemont, Centre Hospitalier Universitaire Affilié-Université de Montréal, Montréal, Quebec, Canada
| | - Mandovi Rajguru
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Lucie Delaroche
- Department of Reproductive Biology, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| | - Laurent Mandelbrot
- Paris 7-Denis Diderot University, Paris, France; Department of Gynecology and Obstetrics, Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Colombes, France
| | - Dominique Luton
- Department of Gynecology, Obstetrics and Reproduction, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France; Paris 7-Denis Diderot University, Paris, France
| | - Catherine Patrat
- Paris 7-Denis Diderot University, Paris, France; Department of Reproductive Biology, Assistance Publique-Hôpitaux de Paris, Bichat Claude Bernard Hospital, Paris, France
| |
Collapse
|
25
|
Lights and Shadows about the Effectiveness of IVF in HIV Infected Women: A Systematic Review. Infect Dis Obstet Gynecol 2015; 2015:517208. [PMID: 26778910 PMCID: PMC4686718 DOI: 10.1155/2015/517208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/06/2015] [Accepted: 11/12/2015] [Indexed: 01/20/2023] Open
Abstract
Background. HIV infected women have higher rates of infertility. Objective. The purpose of this literature review is to evaluate the effectiveness of fresh IVF/ICSI cycles in HIV infected women. Materials and Methods. A search of the PubMed database was performed to identify studies assessing fresh nondonor oocyte IVF/ICSI cycle outcomes of serodiscordant couples with an HIV infected female partner. Results and Discussion. Ten studies met the inclusion criteria. Whenever a comparison with a control group was available, with the exception of one case, ovarian stimulation cancelation rate was higher and pregnancy rate (PR) was lower in HIV infected women. However, statistically significant differences in both rates were only seen in one and two studies, respectively. A number of noncontrolled sources of bias for IVF outcome were identified. This fact, added to the small size of samples studied and heterogeneity in study design and methodology, still hampers the performance of a meta-analysis on the issue. Conclusion. Prospective matched case-control studies are necessary for the understanding of the specific effects of HIV infection on ovarian response and ART outcome.
Collapse
|
26
|
Barnes A, Riche D, Mena L, Sison T, Barry L, Reddy R, Shwayder J, Parry JP. Efficacy and safety of intrauterine insemination and assisted reproductive technology in populations serodiscordant for human immunodeficiency virus: a systematic review and meta-analysis. Fertil Steril 2014; 102:424-34. [DOI: 10.1016/j.fertnstert.2014.05.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/27/2014] [Accepted: 05/01/2014] [Indexed: 02/05/2023]
|
27
|
[Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission]. Enferm Infecc Microbiol Clin 2014; 32:310.e1-310.e33. [PMID: 24484733 DOI: 10.1016/j.eimc.2013.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 12/02/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. METHODS We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. RESULTS AND CONCLUSIONS The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.).
Collapse
|
28
|
MacCarthy S, Rasanathan JJK, Ferguson L, Gruskin S. The pregnancy decisions of HIV-positive women: the state of knowledge and way forward. REPRODUCTIVE HEALTH MATTERS 2013. [PMID: 23177686 DOI: 10.1016/s0968-8080(12)39641-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Despite the growing number of women living with and affected by HIV, there is still insufficient attention to their pregnancy-related needs, rights, decisions and desires in research, policy and programs. We carried out a review of the literature to ascertain the current state of knowledge and highlight areas requiring further attention. We found that contraceptive options for pregnancy prevention by HIV-positive women are insufficient: condoms are not always available or acceptable, and other options are limited by affordability, availability or efficacy. Further, coerced sterilization of women living with HIV is widely reported. Information gaps persist in relation to effectiveness, safety and best practices regarding assisted reproductive technologies. Attention to neonatal outcomes generally outweighs attention to the health of women before, during and after pregnancy. Access to safe abortion and post-abortion care services, which are critical to women's ability to fulfill their sexual and reproductive rights, are often curtailed. There is inadequate attention to HIV-positive sex workers, injecting drug users and adolescents. The many challenges that women living with HIV encounter in their interactions with sexual and reproductive health services shape their pregnancy decisions. It is critical that HIV-positive women be more involved in the design and implementation of research, policies and programs related to their pregnancy-related needs and rights.
Collapse
Affiliation(s)
- Sarah MacCarthy
- The Miriam Hospital and Alpert Medical School of Brown University, Providence, RI, USA.
| | | | | | | |
Collapse
|
29
|
Sullivan-Pyke CS, Nurudeen SK, Grossman LC, Sauer MV, Douglas NC. Fertility treatment options for HIV-infected individuals. Future Virol 2013. [DOI: 10.2217/fvl.13.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Many HIV-serodiscordant couples desire children and physician-assisted techniques can help individuals achieve pregnancy while reducing the risk of seroconversion in their seronegative partner. For HIV-seropositive males, sperm washing with intrauterine insemination (SW-IUI) was introduced in Europe in the early 1990s, while in the USA in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) has been primarily used to reduce the risk of viral transmission. When properly applied to well-selected populations, no seroconversion has been reported with either of these methods. Within the last 5 years, randomized controlled studies have demonstrated the efficacy of daily pre-exposure prophylaxis in reducing the risk of seroconversion in couples having intercourse when an HIV-seropositive male has undetectable viral loads. In both the USA and Europe, favorable reproductive outcomes have been reported for HIV-seropositive females undergoing IUI and IVF-ICSI. Herein, we review the use of various contemporary reproductive techniques available to HIV-serodiscordant couples interested in having children, including new data on cumulative clinical pregnancy rates and cumulative live-birth rates after IVF-ICSI for male serodiscordant couples. We conclude by proposing that pre-exposure prophylaxis with SW-IUI may be a safe, economical and effective alternative for achieving pregnancy in well-selected, monogamous HIV-serodiscordant couples where the male partner is seropositive.
Collapse
Affiliation(s)
- Chantae S Sullivan-Pyke
- Columbia University, Department of OB-GYN, Division of Reproductive Endocrinology & Infertility, 622 W 168th Street, PH-16, New York, NY 10032, USA
| | - Sahadat K Nurudeen
- Columbia University, Department of OB-GYN, Division of Reproductive Endocrinology & Infertility, 622 W 168th Street, PH-16, New York, NY 10032, USA
| | - Lisa C Grossman
- Columbia University, Department of OB-GYN, Division of Reproductive Endocrinology & Infertility, 622 W 168th Street, PH-16, New York, NY 10032, USA
| | - Mark V Sauer
- Columbia University, Department of OB-GYN, Division of Reproductive Endocrinology & Infertility, 622 W 168th Street, PH-16, New York, NY 10032, USA
| | - Nataki C Douglas
- Columbia University, Department of OB-GYN, Division of Reproductive Endocrinology & Infertility, 622 W 168th Street, PH-16, New York, NY 10032, USA
| |
Collapse
|
30
|
Chen M, Cai LY, Kanno N, Kato T, Lu J, Jin F, Wang H, Sekita M, Higuchi M, Yoshida S, Yako H, Ueharu H, Izumi SI, Kato Y. Detection of human herpesviruses (HHVs) in semen of human male infertile patients. J Reprod Dev 2013; 59:457-62. [PMID: 23748714 PMCID: PMC3934121 DOI: 10.1262/jrd.2013-023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Recently we demonstrated an ectopic expression of the human herpesvirus 1 thymidine kinase (HHV1-TK) gene by functioning of an intrinsic endogenous promoter in the transgenic rat (TG-rat), suggesting that HHV1 infection in humans induces expression of the TK gene with the ectopic promoter in the testis and results in accumulation of HHV1-TK protein, triggering male infertility similar to that in the TG-rat. Hence, in this study, we started to investigate a relationship between infection of herpesvirus and human male infertility. Semen was donated by Chinese male infertile patients (153 men, aged 21-49 years) with informed consent, followed by DNA preparation and analysis by PCR and DNA sequencing. Semen volume, sperm number and density, and sperm motility were examined. DNAs of HHV1, HHV4, HHV5 and HHV6 were confirmed by PCR, electrophoresis and DNA sequencing. Finally, virus DNA was identified in 59 patients (39%). The number of carriers was 39 (25%) for HHV1, 6 (4%) for HHV4, 33 (22%) for HHV5 and 3 (2%) for HHV6, respectively. Moreover, double-infection was found in 22 out of 59 specimens (37%), most of which were double-infection of HHV1 and HHV5 (15 out of 22 carriers). Though slight severity was present in some of the carriers, the relationship between virus infection and sperm impairment was not conclusive. Accordingly, it is essential to examine whether the viral HHV1-TK gene is expressed in the testis of the infertile human HHV carrier.
Collapse
Affiliation(s)
- Mo Chen
- Division of Life Science, Graduate School of Agriculture, Meiji University, Kanagawa 214-8571, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Nurudeen SK, Grossman LC, Bourne L, Guarnaccia MM, Sauer MV, Douglas NC. Reproductive Outcomes of HIV Seropositive Women Treated by Assisted Reproduction. J Womens Health (Larchmt) 2013; 22:243-9. [DOI: 10.1089/jwh.2012.3855] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sahadat K. Nurudeen
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lisa C. Grossman
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lawton Bourne
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Michael M. Guarnaccia
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Mark V. Sauer
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Nataki C. Douglas
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York
| |
Collapse
|
32
|
Savasi V, Mandia L, Laoreti A, Cetin I. Reproductive assistance in HIV serodiscordant couples. Hum Reprod Update 2012; 19:136-50. [PMID: 23146867 DOI: 10.1093/humupd/dms046] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Three quarters of individuals infected with human immunodeficiency virus (HIV) are in their reproductive years and may consider pregnancy planning. Techniques have been developed which can minimize the risk of HIV transmission in these couples, and the current literature on this topic is reviewed here. METHODS We reviewed the literature for the following topics: risk of HIV transmission, effects of HIV infection on fertility, reproductive assistance in industrialized and low-income countries, pre-exposure chemoprophylaxis (PrEP) and timed intercourse in HIV-discordant couples for both male and female positivity. Relevant publications were identified through searches of the EMBASE Medline and PubMed databases, the Google-indexed scientific literature and periodic specialized magazines from the on-line Library Service of the University of Milan, Italy. RESULTS In serodiscordant couples in which the man is positive, the primary method used to prevent HIV transmission is 'sperm washing', followed by IUI or IVF. Data show that sperm washing in HIV-positive men has not produced seroconversion in women or their offspring; however, the evidence is limited. Recently, increasing evidence describing PrEP for HIV prevention has been published and PrEP could be an alternative to ART for fertile couples. Usually HIV-infected women undergo self-insemination around the time of ovulation. Few studies have been published on IVF outcome in HIV-infected women. CONCLUSIONS Assisted reproduction programmes should be integrated into global public health services against HIV. For HIV serodiscordant couples with infected men, sperm washing should be the first choice. However, timed intercourse and PrEP for HIV prevention has been reported. Recent data highlight the possible impairment of fertility in HIV-infected women. Efforts to design a multicentric study should be strengthened.
Collapse
Affiliation(s)
- V Savasi
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences, Hospital L. Sacco, University of Milan, Via G. B. Grassi, 74, 20157 Milan, Italy.
| | | | | | | |
Collapse
|
33
|
Comar M, Zanotta N, Croci E, Murru I, Marci R, Pancaldi C, Dolcet O, Luppi S, Martinelli M, Giolo E, Ricci G, Tognon M. Association between the JC polyomavirus infection and male infertility. PLoS One 2012; 7:e42880. [PMID: 22912758 PMCID: PMC3418243 DOI: 10.1371/journal.pone.0042880] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 07/13/2012] [Indexed: 01/09/2023] Open
Abstract
In recent years the incidence of male infertility has increased. Many risk factors have been taken into consideration, including viral infections. Investigations into viral agents and male infertility have mainly been focused on human papillomaviruses, while no reports have been published on polyomaviruses and male infertility. The aim of this study was to verify whether JC virus and BK virus are associated with male infertility. Matched semen and urine samples from 106 infertile males and 100 fertile males, as controls, were analyzed. Specific PCR analyses were carried out to detect and quantify large T (Tag) coding sequences of JCV and BKV. DNA sequencing, carried out in Tag JCV-positive samples, was addressed to viral protein 1 (VP1) coding sequences. The prevalence of JCV Tag sequences in semen and urine samples from infertile males was 34% (72/212), whereas the BKV prevalence was 0.94% (2/212). Specifically, JCV Tag sequences were detected in 24.5% (26/106) of semen and 43.4% (46/106) of urine samples from infertile men. In semen and urine samples from controls the prevalence was 11% and 28%, respectively. A statistically significant difference (p<0.05) in JCV prevalence was disclosed in semen and urine samples of cases vs. controls. A higher JC viral DNA load was detected in samples from infertile males than in controls. In samples from infertile males the JC virus type 2 strain, subtype 2b, was more prevalent than ubiquitous type 1. JCV type 2 strain infection has been found to be associated with male infertility. These data suggest that the JC virus should be taken into consideration as an infectious agent which is responsible for male infertility.
Collapse
Affiliation(s)
- Manola Comar
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, University of Trieste, Trieste, Italy
| | - Nunzia Zanotta
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, Trieste, Italy
| | - Eleonora Croci
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, University of Trieste, Trieste, Italy
| | - Immacolata Murru
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, Trieste, Italy
| | - Roberto Marci
- Section of Obstetrics and Gynaecology, School of Medicine and Surgery, University of Ferrara, Ferrara, Italy
| | - Cecilia Pancaldi
- Section of Cell Biology and Molecular Genetics, School of Medicine and Surgery, University of Ferrara, Ferrara, Italy
| | - Ornella Dolcet
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, Trieste, Italy
| | - Stefania Luppi
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, Trieste, Italy
| | - Monica Martinelli
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, Trieste, Italy
| | - Elena Giolo
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, Trieste, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”– Trieste, University of Trieste, Trieste, Italy
| | - Mauro Tognon
- Section of Cell Biology and Molecular Genetics, School of Medicine and Surgery, University of Ferrara, Ferrara, Italy
- * E-mail:
| |
Collapse
|