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Pellegrini L, De Angelis F, Tartaglia S, Toschi M, Galliano D, Pellicer A, Cozzolino M. The international transportation of frozen embryos does not affect IVF outcomes. Arch Gynecol Obstet 2023; 308:989-995. [PMID: 37318611 DOI: 10.1007/s00404-023-07092-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE The regulated transportation of cryopreserved human embryos resulting from assisted reproduction treatments offers opportunities for patients undergoing embryo transfer in other regions/countries. However, the principal concern for fertility clinics is maintaining unaltered embryo quality to ensure satisfactory clinical outcomes. The aim of the study was to evaluate the efficacy of the transportation process comparing the survival rate and competence of transported embryos to embryos produced and transferred on-site, in frozen embryo transfer cycles. METHODS This retrospective study assessed the outcomes of 621 blastocysts thawed at IVI Roma (Italy) between March 2021 and March 2022. Autologous or donated oocytes fertilized in vitro, cultured to the blastocyst stage, and cryopreserved in IVI Roma clinic (Group A, n = 450), were compared to embryos generated in IVI Spain clinics and transported to IVI Roma (Group B, n = 171). RESULTS Groups A and B respectively showed no significant difference in embryo survival rates after thawing (N = 440/450, 97.8% vs. N = 168/171, 98.2%, p = 0.71), pregnancy rates (N = 221/440, 50.23% vs. N = 77/168, 45.83%, p = 0.33), clinical pregnancy rates (N = 200/440, 45.45% vs. N = 62/168, 36.90%, p = 0.06), and miscarriage rates (N = 42/221, 19,00% vs. 21/77, 28.57%, p = 0.13), even after stratification for the source of the oocyte. Logistic binomial regression considering donor oocytes, preimplantation genetic testing, and patients' age, did not show any significant results on embryo survival and IVF outcomes. CONCLUSION The regulated transport of cryopreserved blastocysts did not affect embryo survival rate or IVF outcomes. Our data support the safety of embryo cryopreservation and medical transportation services, allowing clinics and patients to transport embryos with no significant risk to embryo competence.
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Affiliation(s)
| | | | - Silvio Tartaglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - Marco Toschi
- IVI-RMA Roma, Via Federico Calabresi 11, 00169, Rome, Italy
| | | | | | - Mauro Cozzolino
- IVI-RMA Roma, Via Federico Calabresi 11, 00169, Rome, Italy.
- Universidad Rey Juan Carlos, Calle Tulipan, 28933, Mostoles, Madrid, Spain.
- Fundacion IVI-IIS la Fe, Valencia, Spain.
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2
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McLean L, Ros ST, Hollond C, Stofan J, Quinn GP. Patient and clinician experiences with cross-border reproductive care: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:1943-1952. [PMID: 35339328 DOI: 10.1016/j.pec.2022.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This review analyzes the experiences of patients and clinicians with regards to international cross-border reproductive care (CBRC) for the purpose of conception. METHODS Electronic databases PubMed, Embase, Web of Science, and Scopus were searched using 'medical tourism' AND 'assisted reproductive technology' from 1978 to 2020. RESULTS Predominant patient motivators for CBRC were cost and legality of assisted reproduction technology (ART) in one's home country, followed by cultural factors like shared language, religion, and cultural familiarity. Clinicians suggested global laws for CBRC would reduce the potential for exploitation of vulnerable populations but believed the enactment of international regulations unlikely and, even if enacted, difficult to enforce. CONCLUSIONS While patient and clinician experiences with CBRC varied, patients frequently cited financial and legal reasons for pursuing CBRC, while many providers had concern for the patient's safety. CLINICAL PRACTICE IMPLICATIONS This review recommends clinicians involved in family planning counsel patients seeking treatment abroad by: (i) informing patients of the risks and benefits of treatment abroad, (ii) establishing guidelines and standards for clinicians on resuming patient care post-CBRC, and (iii) creating a directory of reputable CBRC clinicians and experts.
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Affiliation(s)
- Laura McLean
- Morsani College of Medicine, University of South Florida, Tampa, USA.
| | - Stephanie T Ros
- Morsani College of Medicine, University of South Florida, Tampa, USA
| | | | - Jordan Stofan
- Morsani College of Medicine, University of South Florida, Tampa, USA
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Multiple gestation associated with infertility therapy: a committee opinion. Fertil Steril 2022; 117:498-511. [PMID: 35115166 DOI: 10.1016/j.fertnstert.2021.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
This Committee Opinion provides practitioners with suggestions to reduce the likelihood of iatrogenic multiple gestation resulting from infertility treatment. This document replaces the document of the same name previously published in 2012 (Fertil Steril 2012;97:825-34 by the American Society for Reproductive Medicine).
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Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion. Fertil Steril 2021; 116:54-63. [PMID: 34148590 DOI: 10.1016/j.fertnstert.2021.02.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/15/2022]
Abstract
In the United States, economic, racial, ethnic, geographic, and other disparities prevent access to fertility treatment and affect treatment outcomes. This opinion examines the factors that contribute to these disparities, proposes actions to address them, and replaces the document of the same name, last published in 2015.
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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5
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Ethical issues in oocyte banking for nonautologous use: an Ethics Committee opinion. Fertil Steril 2021; 116:644-650. [PMID: 34340832 DOI: 10.1016/j.fertnstert.2021.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
Ethical considerations for the banking of oocytes for nonautologous use are discussed.
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6
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Eustache F, Drouineaud V, Mendes N, Delépine B, Dupont C, Mirallié S, Papaxanthos A, Metzler-Guillemain C, Rives-Feraille A, Magnan F, Grèze C, Hennebicq S, Koscinski I, Drapier H, Frapsauce C, Mayeur A, Carlotti MA, Mons J, Schmitt F, May-Panloup P, Blagosklonov O, Brugnon F, Mestres S, Cabry R, Fauque P, Loup-Cabaniols V, Ravel C, Lévy R, Patrat C, Thibault E, Frydman N, Bujan L, Morinière C, Ducrocq B, Rives N. Fertility preservation and sperm donation in transgender individuals: the current situation within the French CECOS network. Andrology 2021; 9:1790-1798. [PMID: 34236139 DOI: 10.1111/andr.13075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Many studies reported that reproductive desire could be high among transgender (TG) individuals. In France, fertility preservation (FP) and sperm donation were very little proposed to TG individuals until recently, mainly because the Bioethics Law allows the use of Assisted Reproductive Technologies (ART) only in infertile couples and prohibits surrogacy. OBJECTIVES To evaluate the distribution of care on the French territory concerning fertility preservation and sperm donation in TG individuals. MATERIALS AND METHODS A multicentric national survey was carried out between January 2019 and October 2020 in 28 ART centres of the French CECOS (Centres d'Etudes et de Conservation des Oeufs et du Sperme) network. Each centre was questioned to find out how many TG individuals came, were informed and cared for FP and sperm donation. RESULTS Concerning FP, 71.4% of centres received TG individuals and performed gamete cryopreservation; 581 TG individuals consulted for FP. TG women were more likely to desire (P<0.0001) and achieve (P<0.0001) FP than TG men. Concerning sperm donation in couples including a TG man, 68% of centres offer the complete course from the first consultation to the completion of the ART cycles; 122 offspring has been conceived with sperm donation in couples including a TG man since 1999. DISCUSSION Our results showed that even if all centres do not propose FP or sperm donation in TG individuals, these ART are present throughout the French territory. The major point is that both FP and sperm donation in TG individuals have grown significantly and that the care of these patients is improving year after year. CONCLUSION In France, most of CECOS centres can take care of TG individuals for FP and sperm donation. The French Bioethics law allows these latter, and TG individuals can benefit from a financial support of the national health care insurance for FP and sperm donation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Florence Eustache
- Service D'Histologie-Embryologie, Cytogénétique, Biologie de La Reproduction / CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, Bondy, France
| | - Véronique Drouineaud
- Service de Biologie de la Reproduction-CECOS, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP). Centre, Université de Paris, Paris, 75014, France
| | - Nicolas Mendes
- Service D'Histologie-Embryologie, Cytogénétique, Biologie de La Reproduction / CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, Bondy, France
| | - Béatrice Delépine
- CECOS Champagne-Ardenne, Chu de Reims Hôpital d'Enfants, REIMS, Cedex, 51092, France
| | | | - Sophie Mirallié
- CECOS Pays de la Loire Nantes Service de Biologie de la reproduction, Nantes, Cedex 1, 44093, France
| | - Aline Papaxanthos
- CECOS Aquitaine, BORDEAUX Maternité CHU Pellegrin, Bordeaux, 33076, France
| | | | - Aurélie Rives-Feraille
- Normandie Univ, UNIROUEN, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Biology of Reproduction-CECOS Laboratory, Rouen, 76031, France
| | - Fanny Magnan
- Service D'Histologie-Embryologie, Cytogénétique, Biologie de La Reproduction / CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Site Jean Verdier, Bondy, France
| | - Cécile Grèze
- CECOS Alsace, STRASBOURG CMCO, Schiltighem, 67303, France
| | - Sylviane Hennebicq
- CECOS Rhône Alpes, GRENOBLE Hôpital Couple Enfant CHU GRENOBLE CEDEX 9, Cedex, France
| | - Isabelle Koscinski
- CECOS Lorraine Nancy, Maternité régionale Universitaire, Nancy, 54042, France
| | - Hortense Drapier
- Biologie de la Reproduction-CECOS, Hôpital de La Cavale Blanche, Brest, 29200, France
| | - Cynthia Frapsauce
- Service de Médecine et Biologie de la Reproduction-CECOS, CHRU Bretonneau, Tours, 37000, France
| | - Anne Mayeur
- CECOS Paris BECLERE, Hôpital Antoine Béclère, CLAMART, Cedex, 92140, France
| | | | - Joffrey Mons
- CECOS Océan Indien LA REUNION Centre, d'AMP CHU de La Réunion Saint- Pierre, Cedex, 97448, France
| | - Françoise Schmitt
- CECOS ALSACE Mulhouse Groupe Hospitalier, de la Région de Mulhouse et Sud Alsace, MULHOUSE, Cedex, 68070, France
| | - Pascale May-Panloup
- CECOS Pays de Loire, Antenne Angers, Laboratoire de Biologie de la Reproduction, Angers University Hospital, Angers, 49000, France
| | - Oxana Blagosklonov
- Service de Biologie et Médecine, de la Reproduction-Cryobiologie, CECOS CHRU Jean Minjoz, Besancon, 25030, France
| | - Florence Brugnon
- CECOS Auvergne, Clermont FERRAND CHU Estaing, CLERMONT FERRAND CEDEX 1, Clermont, 63003, France
| | - Stéphanie Mestres
- CECOS Auvergne, Clermont FERRAND CHU Estaing, CLERMONT FERRAND CEDEX 1, Clermont, 63003, France
| | | | | | - Vanessa Loup-Cabaniols
- CECOS Languedoc Roussillon, MONTPELLIER Hôpital Arnaud de Villeneuve, Montpellier, 34295, France
| | - Célia Ravel
- CECOS Bretagne, RENNES Hôpital Sud, Rennes, 35200, France
| | - Rachel Lévy
- CECOS Paris TENON Hôpital, Tenon, Paris, 75020, France
| | - Catherine Patrat
- Service de Biologie de la Reproduction-CECOS, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP). Centre, Université de Paris, Paris, 75014, France
| | - Emmanuelle Thibault
- CECOS Provence Alpes, Côte d'Azur NICE Centre de reproduction CHU de NICE, Nice, 06202, France
| | - Nelly Frydman
- CECOS Paris BECLERE, Hôpital Antoine Béclère, CLAMART, Cedex, 92140, France
| | - Louis Bujan
- CECOS Midi Pyrénées, TOULOUSE Hôpital Paule de Viguier, Toulouse, 31059, France
| | | | - Bérengère Ducrocq
- CECOS Nord LILLE CHRU, de LILLE Hôpital Calmette Lille, Cedex, 59037, France
| | - Nathalie Rives
- Normandie Univ, UNIROUEN, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Biology of Reproduction-CECOS Laboratory, Rouen, 76031, France
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Never too late? Quadruplets at the age of 65 years. Arch Gynecol Obstet 2021; 304:851-854. [PMID: 34146145 PMCID: PMC8429373 DOI: 10.1007/s00404-021-06127-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/12/2021] [Indexed: 11/25/2022]
Abstract
Background We discuss the challenges of multiple pregnancy at very advanced reproductive age. Case presentation We present the case of a quadruplet pregnancy at the maternal age of 65 following in-vitro fertilization (IVF) with donor eggs and sperm, involving cross-border reproductive care. All children born were at 25 weeks’ gestation and survived; however, poor neurodevelopmental outcome remains a major concern in one child. Conclusions The use of reproductive technology to achieve a multiple pregnancy at such an advanced post-menopausal age generated a debate on ethical, psychosocial and medical questions. We share this debate and highlight the need to reconsider international guidelines for women of advanced reproductive age.
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8
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Kool EM, van der Graaf R, Bos AME, Fauser BCJM, Bredenoord AL. Fair allocation of cryopreserved donor oocytes: towards an accountable process. Hum Reprod 2021; 36:840-846. [PMID: 33394023 DOI: 10.1093/humrep/deaa356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 11/17/2020] [Indexed: 11/14/2022] Open
Abstract
A growing number of people desire ART with cryopreserved donor oocytes. The allocation of these oocytes to couples and mothers to be is a 2-fold process. The first step is to select a pool of recipients. The second step is to decide who should be treated first. Prioritizing recipients is critical in settings where demand outstrips supply. So far, the issue of how to fairly allocate cryopreserved donor oocytes has been poorly addressed. Our ethical analysis aims to support clinics involved in allocation decisions by formulating criteria for recipient selection irrespective of supply (Part I) and recipient prioritization in case supply is limited (Part II). Relevant criteria for recipient selection are: a need for treatment to experience parenthood; a reasonable chance for successful treatment; the ability to safely undergo an oocyte donation pregnancy; and the ability to establish a stable and loving relationship with the child. Recipients eligible for priority include those who: have limited time left for treatment; have not yet experienced parenthood; did not undergo previous treatment with cryopreserved donor oocytes; and contributed to the supply of donor oocytes by bringing a donor to the bank. While selection criteria function as a threshold principle, we argue that the different prioritization criteria should be carefully balanced. Since specifying and balancing the allocation criteria undoubtedly raises a moral dispute, a fair and legitimate allocation process is warranted (Part III). We argue that allocation decisions should be made by a multidisciplinary committee, staffed by relevant experts with a variety of perspectives. Furthermore, the committees' reasoning behind decisions should be transparent and accessible to those affected: clinicians, donors, recipients and children born from treatment. Insight into the reasons that underpin allocation decisions allows these stakeholders to understand, review and challenge decisions, which is also known as accountability for reasonableness.
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Affiliation(s)
- E M Kool
- Department of Medical Humanities, University Medical Center, Julius Centre, Utrecht, The Netherlands
| | - R van der Graaf
- Department of Medical Humanities, University Medical Center, Julius Centre, Utrecht, The Netherlands
| | - A M E Bos
- Department of Reproductive Medicine and Gynecology, University Medical Centre, Utrecht, The Netherlands
| | - B C J M Fauser
- Department of Reproductive Medicine and Gynecology, University Medical Centre, Utrecht, The Netherlands
| | - A L Bredenoord
- Department of Medical Humanities, University Medical Center, Julius Centre, Utrecht, The Netherlands
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Yang N, Sun L, Tan J. Theme trends and knowledge structure of assisted reproductive technology and birth defects: A quantitative and co-word analysis. J Obstet Gynaecol Res 2021; 47:1780-1788. [PMID: 33783096 DOI: 10.1111/jog.14702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 12/02/2020] [Accepted: 01/29/2021] [Indexed: 12/22/2022]
Abstract
AIM The main purpose of our study is to determine the current research status of assisted reproductive technology (ART) and birth defects by means of co-word analysis, to explore the hot spots and weak points of current research, and to provide ideas and opinions for follow-up researchers. METHODS The PubMed database was used to investigate the knowledge structures of the applied words ART and birth defects. The published literature was searched until December 31, 2018. The extracted MeSH terms were quantified using the Bibliographic Item Co-Occurrence Matrix Builder and the high-frequency MeSH terms were determined. According to the MeSH term-source article matrix, hierarchical cluster analysis was performed using SPSS 19.0. The high frequency MeSH term co-occurrence matrix was constructed to support strategic diagram and social network analysis (SNA). RESULTS According to the search strategy, 1635 papers were included. Of all the extracted MeSH terms, 105 high frequency MeSH terms were identified and the hotspots were classified into nine categories. In the strategic diagram, research on the effects of prenatal diagnosis methods and ART on the development of offspring has been well developed. In contrast, research on reproductive ethics, epigenetics, and epidemiology is relatively immature, indicating the need for future research. For SNA results, the position status of each component is described by the center value. CONCLUSIONS By providing a quantitative bibliometric study, it can help with the overall command of the latest topic and guide researchers in their new projects.
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Affiliation(s)
- Na Yang
- Department of Obstetrics and Gynaecology, Assisted Reproduction Centre, Shengjing Hospital Affiliated to China Medical University, Shenyang, China.,Gynecology Clinic, Shenyang Jianghua Hospital, Shenyang, China
| | - Li Sun
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jichun Tan
- Department of Obstetrics and Gynaecology, Assisted Reproduction Centre, Shengjing Hospital Affiliated to China Medical University, Shenyang, China.,Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shengjing Hospital Affiliated to China Medical University, Shenyang, China
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10
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Makhijani R, Coulter M, Taggar A, Godiwala P, O'Sullivan D, Nulsen J, Engmann L, Benadiva C, Grow D. Reduction in multiple pregnancy rate in donor oocyte-recipient gestational carrier (GC) in vitro fertilization (IVF) cycles in the USA with single-embryo transfer and preimplantation genetic testing. J Assist Reprod Genet 2021; 38:1441-1447. [PMID: 33709344 DOI: 10.1007/s10815-021-02112-5] [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: 01/11/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To evaluate the utilization of single-embryo transfer (SET) and preimplantation genetic testing (PGT) in gestational carrier IVF cycles in the USA with donor oocyte and examine the impact on live birth and multiple gestation. METHODS Retrospective cohort study using the Society of Assisted Reproductive Technology (SART) clinic database of 4776 donor oocyte-recipient IVF cycles in which a GC was used. The cycles were separated into 4 groups by use of PGT and number of embryos transferred as follows: (1) PGT and single-embryo transfer (PGT-SET); (2) PGT and multiple embryo transfer (PGT-MET); (3) no PGT and SET (NoPGT-SET); (4) no PGT and MET (NoPGT-MET). Primary outcomes were live birth rate (LBR) and multiple pregnancy rate (MPR). RESULTS More than one blastocyst was transferred in 48.7% (2323/4774) of the cycles. When ≥1 blastocyst was transferred, with or without the use of PGT, the MPR was 45.5% and 42.0%, respectively. In comparison, in the PGT-SET and NoPGT-SET groups, the MPR was 1.4% (8/579) and 3.3% (29/883), respectively. Live birth rates increased with the use of PGT-A and with MET. CONCLUSION This study shows that SET, with or without PGT, is associated with a significantly reduced MPR in donor oocyte-recipient GC IVF cycles while maintaining high LBR. It also demonstrates that many infertility centers in the USA are not adhering to ASRM embryo transfer guidelines. Our findings highlight an opportunity to increase GC safety, which ultimately may lead to widened access to this increasingly restricted service outside the USA.
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Affiliation(s)
- Reeva Makhijani
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - Madeline Coulter
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - Arti Taggar
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - Prachi Godiwala
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - David O'Sullivan
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - John Nulsen
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - Lawrence Engmann
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - Claudio Benadiva
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA
| | - Daniel Grow
- Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA.
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Reproductive Travel of Intended Parents for Delivery of Gestational Carrier Pregnancies. Obstet Gynecol 2020; 136:591-596. [PMID: 32769637 DOI: 10.1097/aog.0000000000003898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explore the role of reproductive travel (travel to another state or country for reproductive services) for intended parents at the time of delivery of gestational carrier pregnancies and to analyze the sociodemographic characteristics of those who build families through gestational surrogacy. METHODS We conducted a cross-sectional study of births involving gestational surrogacy in Utah from 2009 to 2018. Data were obtained from birth certificates. State and country of residence were collected for intended parents, and the legal climates of these locations were assessed by reviewing laws at the time. Sociodemographic characteristics were compared among intended parents, parents with pregnancies resulting from assisted reproductive technology (ART) without gestational surrogacy, and parents with spontaneous pregnancies. RESULTS A total of 361 gestational carrier pregnancies resulted in the birth of at least one liveborn neonate during the study period, involving 715 intended parents. Additionally, 50,434 parents delivered children after nonsurrogacy ART, and 950,460 parents delivered children after spontaneous fertilization. Many intended parents (17.2%) lived in countries outside of the United States, the majority of which (69.9%) had laws against surrogacy. Of those who lived within the United States, 57.4% lived outside of Utah, but only 15.9% lived in states that banned compensated surrogacy. Statutes in Utah support compensated and uncompensated gestational surrogacy. Intended parents were significantly older than parents with both nonsurrogacy ART pregnancies and spontaneous pregnancies (median age 38, 31, and 29 years, respectively) and had higher levels of education; 70.2% of intended parents had a bachelor's degree or above, compared with 48.2% of parents with nonsurrogacy ART pregnancies and 33.1% of parents with spontaneous pregnancies. DISCUSSION A majority of intended parents live outside of Utah, which may be an important consideration for health care professionals caring for women with gestational carrier pregnancies. However, most intended parents live in places that do not have laws banning surrogacy, suggesting that there may be other reasons that intended parents travel for delivery.
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Jacobson H. Cross-border reproductive care in the USA: Who comes, why do they come, what do they purchase? REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2020; 11:42-47. [PMID: 33204864 PMCID: PMC7653003 DOI: 10.1016/j.rbms.2020.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/06/2020] [Accepted: 09/03/2020] [Indexed: 05/24/2023]
Abstract
This article explores the participation of non-US-resident patients/clients in the US reproductive market, garnering a picture of cross-border reproductive care (CBRC) into the USA by drawing on the existing literature, identifying the frequency of and motivations for such arrangements, the primary sending countries, and the reproductive services sought. I find that although the expense of US CBRC necessarily limits the patient/client pool, it is largely non-economic factors that drive CBRC into the USA. The US CBRC patient/client base, which is diverse in terms of national origin, race and sexual orientation, is recruited by the US fertility industry and drawn to the full range of assisted reproductive technology (ART) services, such as in-vitro fertilization, surrogacy, oocyte donation and preimplantation genetic screening/preimplantation genetic diagnosis, available in the US market which are often restricted or limited in their countries of origin. CBRC patients/clients enjoy the legal clarity for establishing parentage and citizenship for their children available in the USA, as well as what some view as a medically and ethically superior ART market.
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Affiliation(s)
- Heather Jacobson
- Department of Sociology and Anthropology, The University of Texas at Arlington, Arlington, TX, USA
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Payment to gamete donors: equality, gender equity, or solidarity? J Assist Reprod Genet 2019; 37:133-140. [PMID: 31734858 DOI: 10.1007/s10815-019-01625-4] [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: 07/28/2019] [Accepted: 11/01/2019] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Regulation of payment to gamete donors varies substantially across countries. The development of an ethically sustainable governance system of payments in gamete donation demands that the preferences of different stakeholders be heard. This study intends to contribute to improving the understanding of payment to gamete donors by analysing the views of donors and recipients about the preferred form of payment and its associations with their sociodemographic characteristics. METHODS This cross-sectional study included 70 donors and 172 recipients recruited at the Portuguese Public Bank of Gametes (July 2017-June 2018). Participants completed a self-reported questionnaire. Views about the preferred form of payment were collected through a multiple-choice question and an open-ended item. Associations were quantified through χ2 tests; content analysis was conducted with the open-ended answers. RESULTS Both donors (48.6%) and recipients (40.7%) considered that reimbursement is the preferred form of payment to ensure solidarity-based motivations to donate. This option was followed by compensation for non-financial losses (41.4% of donors; 33.7% of recipients) based on gender equity. Preference for a fixed reward (22.7% of recipients; 8.6% of donors) was less frequent among younger donors and married/living with a partner or employed recipients, being based on the promotion of equality. CONCLUSION In the context of the search for cross-border reproductive care and gamete circulation across countries, the findings from this study claim for the need to create solutions for payment to gamete donors that take into account gender equity and are simultaneously sensitive to donor's actual expenses and further health complications.
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Salama M, Anazodo A, Woodruff TK. Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach. Ann Oncol 2019; 30:1760-1775. [PMID: 31418765 DOI: 10.1093/annonc/mdz284] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.
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Affiliation(s)
- M Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - T K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA.
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Yee S, Goodman CV, Librach CL. Determinants of gestational surrogates’ satisfaction in relation to the characteristics of surrogacy cases. Reprod Biomed Online 2019; 39:249-261. [DOI: 10.1016/j.rbmo.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/15/2019] [Accepted: 04/01/2019] [Indexed: 11/16/2022]
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Whittaker A, Inhorn MC, Shenfield F. Globalised quests for assisted conception: Reproductive travel for infertility and involuntary childlessness. Glob Public Health 2019; 14:1669-1688. [PMID: 31204900 DOI: 10.1080/17441692.2019.1627479] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The global movement of people across international borders to undergo assisted reproductive treatment is common, although there is little accurate data. In this article, we synthesise findings from our own empirical research on reproductive travel in addition to a review of clinical, ethical, legal, and regulatory complexities from studies on reproductive travel since 2010. Motivations for travel include legal and religious prohibitions; resource considerations; lack of access to gametes and reproductive assistors; quality and safety concerns; and personal preferences. Higher risks to mothers and children are associated with multiple embryo transfer and subsequent multiple and higher order pregnancies and the average older age of women undertaking reproductive travel. The potential exploitation of other women as providers of oocytes or surrogacy services, the lack of equity in access to assisted reproduction and the ambiguous legal status of children conceived from international reproductive travel are important ethical considerations. A range of significant legal issues remain given variable and limited international regulation. Scholarship on this trade necessarily engages with issues of power and gender, social inequities, global capitalism and the private decision-making of individuals seeking to form families. Research gaps remain given recent changes in the organisation, demands and destinations of the trade.
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Affiliation(s)
- Andrea Whittaker
- School of Social Sciences, Faculty of Arts, Monash University , Melbourne , Australia
| | - Marcia C Inhorn
- Anthropology and International Affairs, Council on Middle East Studies, The MacMillan Center, Yale University , New Haven , CT , USA
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The demise of preimplantation genetic testing for aneuploidy (PGT-A) in Hungary and its effect on patient care. Eur J Med Genet 2019; 62:103669. [PMID: 31082515 DOI: 10.1016/j.ejmg.2019.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/10/2019] [Accepted: 05/07/2019] [Indexed: 11/23/2022]
Abstract
Preimplantation genetic testing for aneuploidy (PGT-A) is a suitable technique to identify euploid embryos, which have the highest potential to implant, thus increase the chance of a healthy live birth. The main indications of PGT-A are advanced maternal age, repeated implantation failure, repeated miscarriages and severe male infertility. Several studies have already proven that testing embryos for genetic abnormalities in the above cases results in higher implantation rate and reduced number of pregnancy loss. In spite of these - due to a legislative change in Hungary in 2015 - PGT-A was reclassified as an experimental procedure and its use became banned throughout the country. For this reason, after 4 years of successful practice, Hungarian patients were not able to participate in IVF procedure combined with PGT-A anymore. In this retrospective analysis, efficacy of PGT-A-based embryo selection was evaluated and was compared to the conventional morphology-based selection (MBS) in patients with advanced maternal age, between 2013 and 2017 at our private fertility clinic. PGT-A was performed with array comparative genomic hybridization. We found that implantation rate was significantly higher (43.62% vs. 27.88%; p = 0.0208) and miscarriage rate was significantly lower (17.07% vs. 37.93%; p = 0.0492) in the PGT-A group compared to the MBS group from 2013 to 2015. These outcomes were achieved with a significantly lower number of transferred embryos in the PGT-A group (1.25 vs. 1.58; p = 0.0003). In 2016-2017, the number of transferred embryos were significantly reduced in the MBS group as well (1.14 vs. 1.58; p < 0.0001). However, outcomes of the IVF treatments did not change significantly compared to the previous two years (2013-2015). Our results imply that PGT-A-based embryo selection is more efficient than morphology-based selection in patients with advanced maternal age. Therefore, prohibition of the use of PGT-A had significant consequences on the efficiency and safety of IVF treatment in the country.
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Zhuang C, Li T, Li L. Resumption of sexual intercourse post partum and the utilisation of contraceptive methods in China: a cross-sectional study. BMJ Open 2019; 9:e026132. [PMID: 30862636 PMCID: PMC6429937 DOI: 10.1136/bmjopen-2018-026132] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This is a cross-sectional study that aimed to examine the resumption of sexual intercourse post partum, the utilisation of contraceptive methods and the influencing factors among Chinese women at a tertiary teaching hospital. DESIGN This is a questionnaire survey by written and online interview for participants. PARTICIPANTS Based on medical records, we sent online questionnaires about postpartum sexual intercourse and contraception plans to 550 eligible women. MAIN OUTCOME MEASURES Potential factors affecting postpartum sexual intercourse and utilisation of contraception were determined by analysis of epidemiological and clinical factors and sexual experiences during and after pregnancy. RESULTS Of 550 eligible participants, 406 women (73.8%) with a postpartum period of 8.5 months (range 6-10) completed the questionnaires; 146 of 406 (36.0%) resumed sexual intercourse within 3 months, and 259 of 279 (92.8%) used contraceptive methods. In univariate and multivariate analyses, sexual intercourse during pregnancy (adjusted OR 4.4, 95% CI 2.8 to 6.9) and resumption of menstruation (adjusted OR 2.5, 95% CI 1.5 to 4.3) were significant influencing factors in resumption of sexual intercourse within 3 months after childbirth. No factor was found to be associated with using contraceptive methods or the general resumption of sexual intercourse post partum. The questionnaire had good reliability and validity. CONCLUSIONS Having sexual intercourse during pregnancy and resuming menstruation earlier were independent factors for resumption of sexual intercourse within 3 months after delivery. Almost all women who had postpartum sexual intercourse used various contraceptive methods.
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Affiliation(s)
- Caixia Zhuang
- Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Ting Li
- Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Lei Li
- Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
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Abstract
Surrogacy is an increasingly frequent form of family building and allows individuals to become parents despite an infertility diagnosis or a biological impossibility. Positive outcomes for both the surrogacy child and the surrogate mother have been reported, including in cases of same-sex male couples and single persons. There is an on-going debate because remuneration does not necessarily involve undue inducement of the surrogate or transformation of the child into a commodity. The right to regret and the doctors' autonomy are also addressed in this paper. Nevertheless, literature on surrogacy is scarce, and most of the existing studies have important methodological limitations, so further investigation is much needed. We believe that counselling should be granted for both intended parents and surrogate, in order to prevent the majority of problems. We also agree that parental vetting should be possible, focusing the doctor's responsibility also in the future child.
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Affiliation(s)
- Ana Rita Igreja
- a Faculty of Medicine of the University of Porto , Porto , Portugal
| | - Miguel Ricou
- a Faculty of Medicine of the University of Porto , Porto , Portugal
- b CINTESIS - Center for Health Technology and Services Research , Porto , Portugal
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Silva SPD, Freitas CD, Baía I, Samorinha C, Machado H, Silva S. Doação de gametas: questões sociais e éticas (não) respondidas em Portugal. CAD SAUDE PUBLICA 2019; 35:e00122918. [DOI: 10.1590/0102-311x00122918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/25/2018] [Indexed: 12/12/2022] Open
Abstract
Resumo: Conhecer a discussão em torno dos desafios sociais e éticos da doação de gametas é fundamental para a boa governança das técnicas de reprodução assistida. Neste artigo, analisam-se os tópicos que orientaram o debate nas organizações de ética portuguesas, discutindo as suas conexões com os temas abordados internacionalmente. Para tal, em março de 2018, pesquisamos sistematicamente os websites do Conselho Nacional de Procriação Medicamente Assistida e do Conselho Nacional de Ética para as Ciências da Vida. Procedemos à análise de conteúdo temática de 25 documentos. Os resultados indicam que o debate se centrou na acessibilidade, no anonimato e na compensação de doadores e, em menor extensão, nas responsabilidades profissionais. Observaram-se posicionamentos heterogêneos e tensões entre múltiplos direitos e princípios éticos associados a receptores, a pessoas nascidas com recurso à doação de gametas e a doadores. Esses têm em comum três alegações: a escassez de evidência científica; as experiências de outros países; e regulamentações oriundas de entidades internacionais. Na literatura abordam-se tópicos adicionais, nomeadamente: uma via dupla que conjugue anonimato/identificação de doadores; implementação de sistemas de registo reprodutivo para receptores e doadores; limites do rastreio genético a doadores; doação por familiares/conhecidos; e o papel dos doadores na decisão quanto ao destino de embriões criopreservados e na escolha das características dos receptores dos seus gametas. Há espaço para expandir o debate e promover a pesquisa em torno das implicações sociais e éticas da doação de gametas, considerando a participação de todos os cidadãos.
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Affiliation(s)
| | - Cláudia De Freitas
- Universidade do Porto, Portugal; Universidade do Porto, Portugal; ISCT-Instituto Universitário de Lisboa, Portugal
| | - Inês Baía
- Universidade do Porto, Portugal; Universidade do Porto, Portugal
| | | | | | - Susana Silva
- Universidade do Porto, Portugal; Universidade do Porto, Portugal
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The current status of oocyte banks: domestic and international perspectives. Fertil Steril 2018; 110:1203-1208. [DOI: 10.1016/j.fertnstert.2018.07.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/03/2018] [Accepted: 07/13/2018] [Indexed: 01/07/2023]
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Stapleton P, Skinner D. Cross‐Border Reproductive Care: Two Lenses in Political Science. WORLD MEDICAL & HEALTH POLICY 2018. [DOI: 10.1002/wmh3.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Li HWR, Tank J, Haththotuwa R. Updated status of assisted reproductive technology activities in the Asia-Oceania region. J Obstet Gynaecol Res 2018; 44:1667-1672. [PMID: 30058253 DOI: 10.1111/jog.13742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 06/17/2018] [Indexed: 11/29/2022]
Abstract
AIM To report on a descriptive survey on the availability, regulation and funding issues of assisted reproductive technology (ART) activities in member countries of the Asia and Oceania Federation of Obstetrics and Gynaecology (AOFOG). METHODS A survey questionnaire was initially sent out to representatives of the 28 member national societies of AOFOG in 2015, and final verification and compilation of data were completed in November 2017. RESULTS A response was received from 24 countries. Artificial insemination and in vitro fertilization treatments were available in 23 and 22 of them respectively. Of the 23 responding countries where ART activities were carried out, these were governed by legislation or national regulations in 12 of them, and 15 had a national registry, to which reporting was compulsory in 11 of them. Only Australia, Nepal, New Zealand and Saudi Arabia allowed ART treatment for both single men and women, while only Australia and New Zealand allowed ART treatment for homosexual couples. In Vietnam, ART treatment was allowed only for single women (but not men) from the same country. In Israel, only single or homosexual women but not men were allowed to receive ART treatment. Government subsidy was available for artificial insemination and in vitro fertilization treatments in 10 and 9 responding countries respectively. Compensation to gamete donors and surrogate mothers were allowed in some countries, mostly on the basis of covering the medical treatment cost and compensation for leave from work. CONCLUSION There is great diversity in the availability of various forms of ART treatments, their regulations and data-monitoring mechanisms, as well as funding issues, among Asian-Oceanic countries. Availability of ART activities involving donor gametes or surrogacy, or those for nonheterosexual unions, is still limited in this region.
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Affiliation(s)
- H W Raymond Li
- Reproductive Endocrinology and Infertility Committee, Asia and Oceania Federation of Obstetrics and Gynaecology, Pokfulam, Hong Kong.,Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Jaydeep Tank
- Reproductive Endocrinology and Infertility Committee, Asia and Oceania Federation of Obstetrics and Gynaecology, Pokfulam, Hong Kong.,Ashwini Maternity and Surgical Hospital, Mumbai, India
| | - Rohana Haththotuwa
- Reproductive Endocrinology and Infertility Committee, Asia and Oceania Federation of Obstetrics and Gynaecology, Pokfulam, Hong Kong.,Ninewells Care Mother and Baby Hospital, Colombo, Sri Lanka
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Salama M, Isachenko V, Isachenko E, Rahimi G, Mallmann P, Westphal LM, Inhorn MC, Patrizio P. Cross border reproductive care (CBRC): a growing global phenomenon with multidimensional implications (a systematic and critical review). J Assist Reprod Genet 2018; 35:1277-1288. [PMID: 29808382 PMCID: PMC6063838 DOI: 10.1007/s10815-018-1181-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/05/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Many people travel abroad to access fertility treatments. This growing phenomenon is known as cross border reproductive care (CBRC) or fertility tourism. Due to its complex nature and implications worldwide, CBRC has become an emerging dilemma deserving more attention on the global healthcare agenda. METHODS According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed for all relevant full-text articles published in PubMed in English during the past 18 years to explore CBRC phenomenon in the new millennium. RESULTS Little is known about the accurate magnitude and scope of CBRC around the globe. In this systematic and critical review, we identify three major dimensions of CBRC: legal, economic, and ethical. We analyze each of these dimensions from clinical and practical perspectives. CONCLUSION CBRC is a growing reality worldwide with potential benefits and risks. Therefore, it is very crucial to regulate the global market of CBRC on legal, economic, and ethical bases in order to increase harmonization and reduce any forms of exploitation. Establishment of accurate international statistics and a global registry will help diminish the current information gap surrounding the CBRC phenomenon.
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Affiliation(s)
- Mahmoud Salama
- Department of Obstetrics and Gynecology, Medical Faculty, University of Cologne, Kerpener St. 34, 50931, Cologne, Germany.
- Department of Reproductive Medicine, National Research Center, Cairo, Egypt.
| | - Vladimir Isachenko
- Department of Obstetrics and Gynecology, Medical Faculty, University of Cologne, Kerpener St. 34, 50931, Cologne, Germany
| | - Evgenia Isachenko
- Department of Obstetrics and Gynecology, Medical Faculty, University of Cologne, Kerpener St. 34, 50931, Cologne, Germany
| | - Gohar Rahimi
- Department of Obstetrics and Gynecology, Medical Faculty, University of Cologne, Kerpener St. 34, 50931, Cologne, Germany
| | - Peter Mallmann
- Department of Obstetrics and Gynecology, Medical Faculty, University of Cologne, Kerpener St. 34, 50931, Cologne, Germany
| | - Lynn M Westphal
- Department of Reproductive Endocrinology and Infertility, Stanford University, Stanford, CA, USA
| | - Marcia C Inhorn
- Department of Anthropology, Yale University, New Haven, CT, USA
| | - Pasquale Patrizio
- Department of Reproductive Endocrinology and Infertility, Yale University, New Haven, CT, USA
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Kool EM, Bos AME, van der Graaf R, Fauser BCJM, Bredenoord AL. Ethics of oocyte banking for third-party assisted reproduction: a systematic review. Hum Reprod Update 2018; 24:615-635. [DOI: 10.1093/humupd/dmy016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/20/2018] [Indexed: 12/29/2022] Open
Affiliation(s)
- E M Kool
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, GA Utrecht, The Netherlands
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
| | - A M E Bos
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
| | - R van der Graaf
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, GA Utrecht, The Netherlands
| | - B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands
| | - A L Bredenoord
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, GA Utrecht, The Netherlands
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Paulson RJ. Cross-border reproductive care: what is its significance? Fertil Steril 2017; 108:761-762. [DOI: 10.1016/j.fertnstert.2017.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022]
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Salama M, Woodruff TK. Anticancer treatments and female fertility: clinical concerns and role of oncologists in oncofertility practice. Expert Rev Anticancer Ther 2017; 17:687-692. [PMID: 28537815 DOI: 10.1080/14737140.2017.1335199] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Anticancer treatments such as aggressive chemotherapy and radiotherapy have deleterious gonadotoxic side effects and are considered the most common causes of pathological and iatrogenic fertility loss in women. Areas covered: In order to preserve fertility of young women and girls with cancer, several established, experimental, and debatable options can be offered in the emerging field of oncofertility. This article reviews the effects of anticancer treatments on female fertility and discusses the current challenges and future directions of fertility preservation options that can be offered to the female patients with cancer. Expert commentary: Although promising, several medical, economic, social and legal barriers face oncofertility practice around the globe especially in underserved areas. To overcome such barriers, more effective solutions should be provided to spread awareness and enhance communication between patients, oncologists and gynecologists. Early referral by oncologists before initiation of chemotherapy and radiotherapy is an important key factor for success in female fertility preservation strategies.
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Affiliation(s)
- Mahmoud Salama
- a Department of Obstetrics and Gynecology, Medical Faculty , University of Cologne , Cologne , Germany
| | - Teresa K Woodruff
- b Department of Obstetrics and Gynecology, Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA
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