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Ng R, Stanar P, Louie K, Chow V, Ma S. Increased Y Chromosome Microdeletions in Cord Blood of Male Newborns From Assisted Reproductive Technology Compared to Natural Conception. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102342. [PMID: 38176679 DOI: 10.1016/j.jogc.2023.102342] [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: 09/07/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES To investigate the incidence of Y chromosome microdeletions in male newborns conceived by intracytoplasmic sperm injection (ICSI), in vitro fertilization (IVF), and natural conception (NC). METHODS A total of 186 male newborns were recruited, including 35 conceived by ICSI, 37 conceived by IVF, and 114 conceived naturally. DNA was extracted from umbilical cord blood after birth. The Yq genetic status of the newborns was determined according to 18 Y-specific sequence tagging sites (STS) markers covering 3 azoospermia factor (AZF) sub-regions and internal control sequences. RESULTS Partial AZF microdeletions were identified in 8 of 35 (22.9%) ICSI newborns, 4 of 37 (10.8%) IVF newborns, and 1 of 114 (0.9%) NC newborns. There was a statistically significant difference in the proportion of newborns with partial Y chromosome microdeletions between the ICSI, IVF, and NC groups. When analyzed individually, only the SY114 and SY152 STS markers showed a statistically significant difference in incidence between the 3 cohorts. CONCLUSIONS Our study indicates that the population of male children conceived through assisted reproductive technologies (ART), particularly ICSI, is at an increased risk of genetic defect in the form of partial Y chromosome microdeletions. The growing population of ART-conceived children emphasizes the importance of studying the genetic repercussions of these procedures regarding the future fertility of males conceived in vitro.
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Affiliation(s)
- Richard Ng
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Paloma Stanar
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Kenny Louie
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Victor Chow
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Sai Ma
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
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2
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Kimmins S, Anderson RA, Barratt CLR, Behre HM, Catford SR, De Jonge CJ, Delbes G, Eisenberg ML, Garrido N, Houston BJ, Jørgensen N, Krausz C, Lismer A, McLachlan RI, Minhas S, Moss T, Pacey A, Priskorn L, Schlatt S, Trasler J, Trasande L, Tüttelmann F, Vazquez-Levin MH, Veltman JA, Zhang F, O'Bryan MK. Frequency, morbidity and equity - the case for increased research on male fertility. Nat Rev Urol 2024; 21:102-124. [PMID: 37828407 DOI: 10.1038/s41585-023-00820-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/14/2023]
Abstract
Currently, most men with infertility cannot be given an aetiology, which reflects a lack of knowledge around gamete production and how it is affected by genetics and the environment. A failure to recognize the burden of male infertility and its potential as a biomarker for systemic illness exists. The absence of such knowledge results in patients generally being treated as a uniform group, for whom the strategy is to bypass the causality using medically assisted reproduction (MAR) techniques. In doing so, opportunities to prevent co-morbidity are missed and the burden of MAR is shifted to the woman. To advance understanding of men's reproductive health, longitudinal and multi-national centres for data and sample collection are essential. Such programmes must enable an integrated view of the consequences of genetics, epigenetics and environmental factors on fertility and offspring health. Definition and possible amelioration of the consequences of MAR for conceived children are needed. Inherent in this statement is the necessity to promote fertility restoration and/or use the least invasive MAR strategy available. To achieve this aim, protocols must be rigorously tested and the move towards personalized medicine encouraged. Equally, education of the public, governments and clinicians on the frequency and consequences of infertility is needed. Health options, including male contraceptives, must be expanded, and the opportunities encompassed in such investment understood. The pressing questions related to male reproductive health, spanning the spectrum of andrology are identified in the Expert Recommendation.
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Affiliation(s)
- Sarah Kimmins
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- The Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
- The Département de Pathologie et Biologie Cellulaire, Université de Montréal, Montreal, Quebec, Canada
| | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Christopher L R Barratt
- Division of Systems Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Hermann M Behre
- Center for Reproductive Medicine and Andrology, University Hospital, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sarah R Catford
- Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne, Victoria, Australia
| | | | - Geraldine Delbes
- Institut National de la Recherche Scientifique, Centre Armand-Frappier Sante Biotechnologie, Laval, Quebec, Canada
| | - Michael L Eisenberg
- Department of Urology and Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Brendan J Houston
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Melbourne, Australia
| | - Niels Jørgensen
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Csilla Krausz
- Department of Experimental and Clinical Biomedical Sciences, 'Mario Serio', University of Florence, University Hospital of Careggi Florence, Florence, Italy
| | - Ariane Lismer
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Robert I McLachlan
- Hudson Institute of Medical Research and the Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Monash IVF Group, Richmond, Victoria, Australia
| | - Suks Minhas
- Department of Surgery and Cancer Imperial, London, UK
| | - Tim Moss
- Healthy Male and the Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Allan Pacey
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lærke Priskorn
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stefan Schlatt
- Centre for Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - Jacquetta Trasler
- Departments of Paediatrics, Human Genetics and Pharmacology & Therapeutics, McGill University and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Leonardo Trasande
- Center for the Investigation of Environmental Hazards, Department of Paediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Frank Tüttelmann
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - Mónica Hebe Vazquez-Levin
- Instituto de Biología y Medicina Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina, Fundación IBYME, Buenos Aires, Argentina
| | - Joris A Veltman
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Feng Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Moira K O'Bryan
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Melbourne, Australia.
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3
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Assisted Reproduction and Neonatal Outcome. Indian J Pediatr 2023; 90:3-4. [PMID: 36149623 DOI: 10.1007/s12098-022-04368-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 01/10/2023]
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4
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Yixin ZMS, Yuli ZMS, Yuwen SMS, Sen WMS, Li FMD. Prenatal Ultrasound Diagnosis of Giant Cystic Meconium Peritonitis in Fetus Following in Vitro Fertilization: A Case Report. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2023. [DOI: 10.37015/audt.2023.220005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Lloyd DT, Skinner HG, Maguire R, Murphy SK, Motsinger-Reif AA, Hoyo C, House JS. Clomifene and Assisted Reproductive Technology in Humans Are Associated with Sex-Specific Offspring Epigenetic Alterations in Imprinted Control Regions. Int J Mol Sci 2022; 23:10450. [PMID: 36142363 PMCID: PMC9499479 DOI: 10.3390/ijms231810450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Children conceived with assisted reproductive technology (ART) have an increased risk of adverse outcomes, including congenital malformations and imprinted gene disorders. In a retrospective North Carolina-based-birth-cohort, we examined the effect of ovulation drugs and ART on CpG methylation in differentially methylated CpGs in known imprint control regions (ICRs). Nine ICRs containing 48 CpGs were assessed for methylation status by pyrosequencing in mixed leukocytes from cord blood. After restricting to non-smoking, college-educated participants who agreed to follow-up, ART-exposed (n = 27), clomifene-only-exposed (n = 22), and non-exposed (n = 516) groups were defined. Associations of clomifene and ART with ICR CpG methylation were assessed with linear regression and stratifying by offspring sex. In males, ART was associated with hypomethylation of the PEG3 ICR [β(95% CI) = -1.46 (-2.81, -0.12)] and hypermethylation of the MEG3 ICR [3.71 (0.01, 7.40)]; clomifene-only was associated with hypomethylation of the NNAT ICR [-5.25 (-10.12, -0.38)]. In female offspring, ART was associated with hypomethylation of the IGF2 ICR [-3.67 (-6.79, -0.55)]. Aberrant methylation of these ICRs has been associated with cardiovascular disease and metabolic and behavioral outcomes in children. The results suggest that the increased risk of adverse outcomes in offspring conceived through ART may be due in part to altered methylation of ICRs. Larger studies utilizing epigenome-wide interrogation are warranted.
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Affiliation(s)
- Dillon T. Lloyd
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27606, USA
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC 27607, USA
| | - Harlyn G. Skinner
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27606, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27607, USA
| | - Rachel Maguire
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27606, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27607, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Duke University, Durham, NC 27701, USA
| | - Alison A. Motsinger-Reif
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
| | - Cathrine Hoyo
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27606, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27607, USA
| | - John S. House
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27606, USA
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC 27607, USA
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6
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Liu C, Chen H, Zhao J, Chen Y, Xu B. Comparative study on risk of birth defects in singleton ART birth under high levels of estrogen after fresh embryo transfer and frozen embryo transfer. J Matern Fetal Neonatal Med 2022; 35:9536-9543. [PMID: 35253596 DOI: 10.1080/14767058.2022.2047923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate whether high estrogen (E2) levels caused by controlled ovarian hyperstimulation affect the birth defect rate in singleton assisted reproductive technology (ART) birth after conceived by fresh embryo transfer and frozen embryo transfer (FET). METHODS This was a retrospective cohort study. A total of 581 women with singletons, as well as those who have become pregnant and have had an unwanted abortion under high E2 levels on trigger day were divided into three groups. Group A received FET and the E2 levels on trigger day were higher than 5000 pg/ml. Group B received fresh embryo transfer and the E2 levels were between 3000 and 5000 pg/ml. Group C received FET and the E2 levels were between 3000 and 5000 pg/ml. RESULTS There were no significant differences in birth weight, delivery mode, preterm birth rate, and fetal sex between the three groups (p > .05). Birth defect rate in Group B was higher than that in Group A and C, and the rate between Group B and C had significant differences (p < .05). After adjusting for maternal age, BMI, and type of infertility, only a FET cycle is significantly associated with decreased birth defect rate. CONCLUSION Fresh embryo transfer under supraphysiological level of estrogen exposure may increase the birth defect rate of ART singletons. Even after prenatal screening and diagnosis, a part of birth defect could not be detected during pregnancy. When the estrogen levels on trigger day were no lower than 3000 pg/ml, FET should be advocated to reduce the occurrence of such risk.
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Affiliation(s)
- Chang Liu
- Department of Reproductive Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huihui Chen
- Department of Reproductive Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junzhao Zhao
- Department of Reproductive Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yufeng Chen
- Department of Reproductive Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Boyun Xu
- Department of Reproductive Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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7
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Libby V, DeVilbiss E, Chung M, Dilday E, Babayev SN, Weinerman R, Doody K. Obstetric outcomes in pregnancies resulting from in vitro fertilization are not different in fertile, sterilized women compared to infertile women: A Society for Assisted Reproductive Technology database analysis. Fertil Steril 2021; 115:617-626. [PMID: 33712106 DOI: 10.1016/j.fertnstert.2020.09.163] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare obstetric and neonatal outcomes resulting from assisted reproductive technology in couples with a history of female sterilization to couples with other infertility diagnoses. DESIGN Retrospective cohort study. SETTING Not applicable. PATIENT(S) Fresh, nondonor cycles excluding gestational surrogacy from 2004 to 2013 in the United States. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Preterm birth rates and low birth weight rates from in vitro fertilization (IVF) pregnancies in couples with infertility and in couples with prior tubal ligation as their sole indication for IVF. RESULT(S) The mean ages of fertile women (N = 8,478) and infertile women (N = 371,488) were 35.3 and 34.6 years, respectively. Of the singletons born to parous women (N = 26,463), the incidence of preterm birth was not significantly different in fertile, sterilized couples compared to infertile couples (13.7% vs. 12.0%). The incidence of low birth weight among term singletons was also not significantly different between fertile couples compared to infertile couples (3.5% vs. 3.2%). CONCLUSION(S) Fertile couples have similar preterm birth and low birth weight rates after IVF compared to infertile couples. This suggests that differences in perinatal outcomes may be due to assisted reproductive technology procedures rather than infertility itself.
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Affiliation(s)
- Valerie Libby
- Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Elizabeth DeVilbiss
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Monica Chung
- Department of OB/GYN, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Dilday
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility University of California, Los Angeles, Los Angeles, California
| | - Samir N Babayev
- Division of Reproductive Endocrinology, Department Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - Rachel Weinerman
- Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Kevin Doody
- Center for Assisted Reproduction, Bedford, Texas.
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8
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Zhang L, Zhang W, Xu H, Liu K. Birth defects surveillance after assisted reproductive technology in Beijing: a whole of population-based cohort study. BMJ Open 2021; 11:e044385. [PMID: 34162637 PMCID: PMC8231031 DOI: 10.1136/bmjopen-2020-044385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To compare the differences in the prevalence of birth defects among offspring conceived by assisted reproductive technology (ART) and conceived spontaneously (non-ART), and assess the contribution of ART to birth defects. DESIGN A population-based retrospective cohort study. SETTING Beijing. PARTICIPANTS Pregnant women whose expected date of childbirth was verified as occurring between October 2014 and September 2015, and were registered on the Beijing Maternal and Child Health Information Network System, were the recorded pregnancy outcomes. 2699 ART offspring and 191 368 non-ART offspring (live births, stillbirths and medical terminations) were included in our study. INTERVENTIONS None. OUTCOME MEASURES Risk ratios (RR) for birth defects were calculated among ART conceptions and non-ART conceptions with confounding factors by using logistic regression models. RESULTS 194 067 offspring were included in the present study, and 2699 (1.4%) were conceived using ART. Among all the births, the prevalence of any birth defect in the ART offspring (5.5%) was significantly higher than in the non-ART offspring (3.8%) (crude RR, 1.49, 95% CI 1.26 to 1.76). After adjusting for confounding factors, ART use was still associated with an increased risk of any birth defect (5.4% vs 3.5% in ART and non-ART group, adjusted RR (aRR), 1.43, 95% CI 1.08 to 1.90), especially for chromosomal abnormalities (0.5% vs 0.2% in ART and non-ART group, aRR, 3.11, 95% CI 1.28 to 7.58), in singleton births to mothers <35 years. Circulatory system malformations and musculoskeletal system malformations were observed to have a non-significant increase in offspring conceived by ART. However, the associations between ART and birth defects were not detected in multiple births or mothers ≥35 years. CONCLUSIONS This study confirmed a small but significant association between ART and birth defects. However, the risk tends to be non-significant under the conditions of advanced maternal age or multiple pregnancies.
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Affiliation(s)
- Lu Zhang
- Department of Perinatal Health Care, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, China
| | - Wen Zhang
- Department of Perinatal Health Care, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, China
| | - Hongyan Xu
- Department of Perinatal Health Care, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, China
| | - Kaibo Liu
- Department of Perinatal Health Care, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, China
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Cai J, Zhao Y, Kan J, Chen R, Martin R, van Donkelaar A, Ao J, Zhang J, Kan H, Hua J. Prenatal Exposure to Specific PM 2.5 Chemical Constituents and Preterm Birth in China: A Nationwide Cohort Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:14494-14501. [PMID: 33146526 DOI: 10.1021/acs.est.0c02373] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Exposure to fine particulate matter (PM2.5) during pregnancy has been associated with preterm birth (PTB). However, the existing evidence is inconsistent, and the roles of specific PM2.5 chemical constituents remain unclear. Based on the China Labor and Delivery Survey, we included birth data from 89 hospitals in 25 provinces in mainland China, and conducted a national multicenter cohort study to examine the associations of PM2.5 and its chemical constituents with PTB risk in China. We applied satellite-based models to predict prenatal PM2.5 mass and six main component exposure. Multilevel logistic regression analysis was used to examine the associations, controlling for sociodemographic characteristics, seasonality, and spatial variation. We observe an increased PTB risk with an increase in PM2.5 mass and the most significant association is found during the third trimester when the adjusted odds ratio (OR) per interquartile range increases in PM2.5 total mass is 1.12 (95% confidence Interval, CI: 1.05-1.20). Infants conceived by assisted reproductive technology (ART) show greater PTB risk associated with PM2.5 exposure (OR = 1.33, 95% CI: 1.05-1.69) than those conceived naturally (OR = 1.11, 95% CI: 1.03-1.19). We also find black carbon, sulfate, ammonium and nitrate, often linked to fossil combustion, have comparable or larger estimates of the effect (OR = 1.07-1.14) than PM2.5. Our findings provide evidence that components mainly from fossil fuel combustion may have a perceptible influence on increased PTB risk associated with PM2.5 exposure in China. Additionally, compared to natural conception, conception through ART may be more susceptible to PM2.5 exposure.
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Affiliation(s)
- Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Typhoon Institute/CMA, Shanghai 200030, China
| | - Yan Zhao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201204, China
| | - Julia Kan
- University of Bristol Medical School, Bristol BS8 1TH, U.K
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Randall Martin
- Department of Physics and Atmospheric Science, Dalhousie University, 6300 Coburg Road, Halifax, Nova Scotia B3H 3J5, Canada
- Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts 02138, United States
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, 6300 Coburg Road, Halifax, Nova Scotia B3H 3J5, Canada
| | - Junjie Ao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200096, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200096, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Jing Hua
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201204, China
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Sha T, Yan Y, Gao X, Liu S, Chen C, Li L, He Q. Association of Assisted Reproductive Techniques with Infant Feeding Practices: A Community-Based Study in China. Breastfeed Med 2019; 14:654-661. [PMID: 31368783 DOI: 10.1089/bfm.2019.0061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: With births generated with assisted reproductive techniques (ARTs) increasingly, the effect of ARTs on infant feeding behaviors is an essential topic to explore. However, limited literature focused on this topic. The objective of this study is to examine the effect of ARTs on infant feeding behaviors. Materials and Methods: Participants, including 41 mothers who conceived with ARTs and 935 conceived spontaneously, were drawn from a prospective birth cohort between January 2015 and December 2015. The participants were followed up at 1, 3, 6, 8, and 12 months postpartum at their residences through a face-to-face interview. Feeding behaviors, including breastfeeding initiation, partial/exclusive breastfeeding duration and formula introduction were assessed using World Health Organization-recommended definitions. Cox and logistic regression models were applied to examine the association of assisted conception with feeding behaviors. Results: Breastfeeding initiation rates were comparable between women who conceived with and without ARTs (70.7% versus 76.0%). Breastfeeding duration and formula introduction were significantly shorter and earlier in assisted conceptions in univariate analyses at 6 months postpartum [crude hazard ratios (HRs), 95% confidence intervals (CIs) 2.02 (1.03-3.84), and 1.63 (1.09-2.44)]. However, after controlling for covariates, assisted conception was only associated with shorter breastfeeding duration at 6 months postpartum [adjusted HR 1.99, 95% CI 1.05-3.80], no significant differences were found in infant feeding outcomes at 12 months postpartum among women with ART conception versus general conception. Mothers who conceived through ARTs with cesarean deliveries were at the highest risks of shorter breastfeeding duration and earlier formula introduction than mothers who conceived spontaneously with vaginal deliveries. Conclusions: Mothers who conceive through ARTs are associated with shorter breastfeeding durations for the first 6 months, compare to mothers who conceive spontaneously. Furthermore, cesarean delivery has a joint effect with the treatment of ARTs on promoting the development of poor feeding behaviors.
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Affiliation(s)
- Tingting Sha
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yan Yan
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiao Gao
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shiping Liu
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Cheng Chen
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ling Li
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Qiong He
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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11
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Amyx MM, Albert PS, Bever AM, Hinkle SN, Owen J, Grobman WA, Newman RB, Chien EK, Gore-Langton RE, Buck Louis GM, Grantz KL. Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies. Paediatr Perinat Epidemiol 2019; 33:332-342. [PMID: 31478227 PMCID: PMC7593826 DOI: 10.1111/ppe.12570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/07/2019] [Accepted: 06/23/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Birthweight discordance is well studied, with less known about longitudinal inter-twin differences in foetal growth. OBJECTIVE To examine inter-twin per cent differences in EFW (EFW% ), head (HC% ) and abdominal circumference (AC% ), and femur length (FL% ) across gestation in dichorionic twin gestations and explore associated characteristics. METHODS Foetal biometrics were assessed by ultrasound and EFW calculated at ≤6 study visits among women with dichorionic twin pregnancies enrolled in the NICHD Fetal Growth Studies cohort (US, 2012-2013). Inter-twin per cent difference was defined: ([Sizelarger twin - Sizesmaller twin ]/Sizelarger twin × 100). Linear mixed models evaluated per cent differences in foetal biometrics at 15 weeks and their change per week overall and by maternal/neonatal characteristics in unadjusted and adjusted models. RESULTS In 140 pregnancies, inter-twin per cent differences increased across gestation for EFW (0.18%/week, 95% confidence interval [CI] 0.10, 0.27), HC (0.03%/week, 95% CI 0.00, 0.06), and AC (0.03%/week, 95%CI -0.01, 0.08) but decreased for FL (-0.03%/week, 95% CI -0.09, 0.02). After adjustment, change in EFW% difference across gestation differed by pre-pregnancy body mass index (BMI [kg/m2 ]; underweight [<18.5]; normal weight [18.5-24.9]; overweight [25.0-29.9]; obese [≥30.0]; Pinteraction = .022); and conception method (in vitro fertilisation [IVF], intrauterine insemination, ovulation induction medication, donor egg/embryo, none; Pinteraction = .060). While EFW% difference increased with normal pre-pregnancy BMI (0.24%/week, 95% CI 0.12, 0.37), little change was noted with pre-pregnancy obesity (0.01%/week, 95% CI -0.15, 0.17). EFW% difference increased in conceptions without fertility treatments (0.23%/week, 95% CI 0.11, 0.34) but not IVF conceptions (-0.00%/week, 95% CI -0.16, 0.16). Similar patterns of differences across gestation were noted for HC% by conception method (Pinteraction = .026) and AC% by pre-pregnancy BMI (Pinteraction = .071); changes in HC% differed by parity (nulliparous, multiparous; Pinteraction = .004). CONCLUSIONS EFW% difference increased across gestation in dichorionic twins, but remained stable with pre-pregnancy obesity or IVF conception, patterns mirrored for HC and AC. Research is needed to understand pathologic versus physiologic differential twin growth trajectories.
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Affiliation(s)
- Melissa M. Amyx
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Paul S. Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Alaina M. Bever
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Stefanie N. Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - John Owen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, School of Medicine, Birmingham, Alabama
| | | | - Roger B. Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina
| | - Edward K. Chien
- Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | | | - Germaine M. Buck Louis
- Dean’s Office, College of Health and Human Services, George Mason University, Fairfax, Virginia
| | - Katherine L. Grantz
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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12
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Litzky JF, Marsit CJ. Epigenetically regulated imprinted gene expression associated with IVF and infertility: possible influence of prenatal stress and depression. J Assist Reprod Genet 2019; 36:1299-1313. [PMID: 31127477 PMCID: PMC6642239 DOI: 10.1007/s10815-019-01483-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 05/09/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Despite the growing body of research implying an impact of in vitro fertilization (IVF) on imprinted genes and epigenetics, few studies have examined the effects of underlying subfertility or prenatal stress on epigenetics, particularly in terms of their role in determining infant birthweights. Both subfertility and prenatal stressors have been found to impact epigenetics and may be confounding the effect of IVF on epigenetics and imprinted genes. Like IVF, both of these exposures-infertility and prenatal stressors-have been associated with lower infant birthweights. The placenta, and specifically epigenetically regulated placental imprinted genes, provides an ideal but understudied mechanism for evaluating the relationship between underlying genetics, environmental exposures, and birthweight. METHODS AND RESULTS In this review, we discuss the impacts of IVF and infertility on birthweight, epigenetic mechanisms and genomic imprinting, and the role of these mechanisms in the IVF population and discuss the role and importance of the placenta in infant development. We then highlight recent work on the relationships between infertility, IVF, and prenatal stressors in terms of placental imprinting. CONCLUSIONS In combination, the studies discussed, as well as two recent projects of our own on placental imprinted gene expression, suggest that lower birthweights in IVF infants are secondary to a combination of exposures including the infertility and prenatal stress that couples undergoing IVF are experiencing. The work highlighted herein emphasizes the need for appropriate control populations that take infertility into account and also for consideration of prenatal psychosocial stressors as confounders and causes of variation in IVF infant outcomes.
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Affiliation(s)
- Julia F Litzky
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA
| | - Carmen J Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, CNR 202, Atlanta, GA, 30322, USA.
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13
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Barrera CM, Kawwass JF, Boulet SL, Nelson JM, Perrine CG. Fertility treatment use and breastfeeding outcomes. Am J Obstet Gynecol 2019; 220:261.e1-261.e7. [PMID: 30513338 PMCID: PMC10983013 DOI: 10.1016/j.ajog.2018.11.1100] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/09/2018] [Accepted: 11/24/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND About 15% of women aged 15-44 years in the United States experience infertility. Factors associated with infertility and fertility treatments may also be associated with lactation difficulties. Limited data exist examining the impact of infertility or mode of conception on breastfeeding outcomes. OBJECTIVE The objectives of this study were to report breastfeeding outcomes (initiation and duration at 8 weeks) among women who conceived spontaneously compared to women who conceived using fertility treatments (assisted reproductive technology [ART], intrauterine insemination, or fertility-enhancing drugs). MATERIALS AND METHODS Maternal-reported data from 4 states from the 2012-2015 Pregnancy Risk Assessment and Monitoring System (PRAMS) were used to explore use of fertility treatment and breastfeeding initiation and continuation at 8 weeks (n = 15,615). Data were weighted to represent all women delivering live births within each state; SAS survey procedures were used to account for PRAMS complex survey design. Stepwise, multivariable logistic regression, adjusted for maternal demographics, parity, plurality, mode of delivery, preterm birth, and maternal pre-pregnancy health conditions, was used to quantify the associations between fertility treatment use and breastfeeding. RESULTS Mode of conception was not associated with breastfeeding outcomes when comparing women who conceived spontaneously to women who conceived using any fertility treatment. The odds of breastfeeding at 8 weeks were lower among women who conceived using ART, after adjusting for basic demographic covariates (adjusted odds ratio [aOR], 0.71; 95% confidence interval [CI], 0.52-0.97) and additionally adjusting for maternal health conditions (aOR, 0.68; 95% CI, 0.49-0.93), but this difference was no longer significant after adjusting for plurality and preterm birth (aOR, 0.74; 95% CI, 0.54-1.02). CONCLUSION This study suggests that mothers who conceive using ART may breastfeed for shorter durations than mothers who conceive spontaneously, partially mediated by an increased likelihood of multiples and infants born preterm. Studies are needed to elucidate these associations and to understand the intentions and barriers to breastfeeding among women who conceive with the help of ART.
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Affiliation(s)
- Chloe M Barrera
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA.
| | - Jennifer F Kawwass
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA; Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University, Atlanta, GA
| | - Sheree L Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
| | - Jennifer M Nelson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA
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14
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Finken MJJ, van der Steen M, Smeets CCJ, Walenkamp MJE, de Bruin C, Hokken-Koelega ACS, Wit JM. Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications. Endocr Rev 2018; 39:851-894. [PMID: 29982551 DOI: 10.1210/er.2018-00083] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 06/21/2018] [Indexed: 12/25/2022]
Abstract
Children born small for gestational age (SGA), defined as a birth weight and/or length below -2 SD score (SDS), comprise a heterogeneous group. The causes of SGA are multifactorial and include maternal lifestyle and obstetric factors, placental dysfunction, and numerous fetal (epi)genetic abnormalities. Short-term consequences of SGA include increased risks of hypothermia, polycythemia, and hypoglycemia. Although most SGA infants show catch-up growth by 2 years of age, ∼10% remain short. Short children born SGA are amenable to GH treatment, which increases their adult height by on average 1.25 SD. Add-on treatment with a gonadotropin-releasing hormone agonist may be considered in early pubertal children with an expected adult height below -2.5 SDS. A small birth size increases the risk of later neurodevelopmental problems and cardiometabolic diseases. GH treatment does not pose an additional risk.
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Affiliation(s)
- Martijn J J Finken
- Department of Pediatrics, VU University Medical Center, MB Amsterdam, Netherlands
| | - Manouk van der Steen
- Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, CN Rotterdam, Netherlands
| | - Carolina C J Smeets
- Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, CN Rotterdam, Netherlands
| | - Marie J E Walenkamp
- Department of Pediatrics, VU University Medical Center, MB Amsterdam, Netherlands
| | - Christiaan de Bruin
- Department of Pediatrics, Leiden University Medical Center, RC Leiden, Netherlands
| | - Anita C S Hokken-Koelega
- Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, CN Rotterdam, Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, RC Leiden, Netherlands
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15
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Hoorsan H, Mirmiran P, Chaichian S, Moradi Y, Hoorsan R, Jesmi F. Congenital Malformations in Infants of Mothers Undergoing Assisted Reproductive Technologies: A Systematic Review and Meta-analysis Study. J Prev Med Public Health 2018; 50:347-360. [PMID: 29207452 PMCID: PMC5717326 DOI: 10.3961/jpmph.16.122] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 06/20/2017] [Indexed: 11/22/2022] Open
Abstract
Objectives This meta-analysis aimed to evaluate congenital malformations in infants conceived by assisted reproductive techniques (ART), compared with infants conceived spontaneously. Methods In this study, available resources searched to find relevant articles included PubMed, ScienceDirect, Scopus, Google Scholar, Cochrane, ProQuest, Iranmedex, Magiran, and Scientific Information Database. After extracting the necessary information from evaluated articles, meta-analysis on the articles’ data was performed using Stata version 11.2. Results In this study, from a total of 339 articles, extracted from the initial investigation, ultimately 30 articles were selected for meta-analysis that assessed the use of ART on the risk of congenital abnormalities and some birth complications on 5 470 181 infants (315 402 cases and 5 154 779 controls). The odds ratio (95% confidence interval [CI]) for low birth weight was 1.89 (95% CI, 1.36 to 2.62), preterm labor 1.79 (95% CI, 1.21 to 2.63), cardiac abnormalities 1.43 (95% CI, 1.27 to 1.62), central nervous system abnormalities 1.36 (95% CI, 1.10 to 1.70), urogenital system abnormalities 1.58 (95% CI, 1.28 to 1.94), musculoskeletal disorders 1.35 (95% CI, 1.12 to 1.64), and chromosomal abnormalities in infants conceived by ART was 1.14 (95% CI, 0.90 to 1.44), which were all statistically significant, except chromosomal abnormalities. Conclusions The risk of congenital abnormalities and some birth complications were significantly higher in ART than normal conception, while chromosomal abnormalities were not; therefore, the application of ART should be selected individually for patients by detailed assessment to reduce such risks in the population.
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Affiliation(s)
- Hayedeh Hoorsan
- Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran
| | - Parvin Mirmiran
- Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran
| | - Shahla Chaichian
- Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran
| | - Yousef Moradi
- Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran
| | - Roza Hoorsan
- Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran
| | - Fatemeh Jesmi
- Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran
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16
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Assisted reproductive technologies: a hierarchy of risks for conception, pregnancy outcomes and treatment decisions. J Dev Orig Health Dis 2018; 8:443-447. [PMID: 28721836 DOI: 10.1017/s2040174417000526] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The use of assisted reproductive technologies (ART) for the treatment of infertility has grown exponentially over the last 20 years, and now accounts for 4% of all births in Australia, and over 1 m births annually around the globe. There is consistent reporting of increased risk of adverse perinatal outcomes and birth defects following infertility treatment. However, change in practice has been stymied by critical knowledge gaps with regards to (a) the relative contribution of patient and treatment factors to adverse outcomes, (b) the independent contribution of specific contemporary treatments and treatment combinations to outcomes, (c) the impact of innovations in laboratory and clinical practice on treatment success and observed risk and (d) changes over time in patient characteristics. Here we summarize key findings from the South Australian Birth Cohort, which is a whole-of-population cohort of over 300,000 births from 1986 to 2002. Relative to spontaneous conceptions, singletons from assisted conception were more likely to be stillborn [odds ratio (OR)=1.82; 95% confidence interval (CI) 1.34-2.48], while survivors as a group were comprehensively disadvantaged at birth, including lower birth weight (OR=2109 g; 95% CI 2129-289), very low birth weight (OR=2.74; 95% CI 2.19-3.43), very preterm birth (OR=2.30; 95% CI 1.82-2.90) and neonatal death (OR=2.04; 95% CI 1.27-3.26). Major birth defects, including cardiac, urogenital and musculoskeletal defects are doubled after fresh ICSI cycles, which is a particular concern as ICSI now accounts for 70% of all treatment cycles globally. Future study is needed to provide contemporary, precise evidence to inform patient and clinic decision making, and generate knowledge for future innovation in ART laboratory methods and clinical practice, thereby optimizing treatment and health outcomes while reducing adverse events.
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17
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Zhong X, Jiang YZ, Liu P, He W, Xiong Z, Chang W, Zhu J, Cui Q. Toll-like 4 receptor /NFκB inflammatory/miR-146a pathway contributes to the ART-correlated preterm birth outcome. Oncotarget 2018; 7:72475-72485. [PMID: 27636999 PMCID: PMC5341923 DOI: 10.18632/oncotarget.11987] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/06/2016] [Indexed: 12/14/2022] Open
Abstract
Assisted reproductive technology (ART) is widely used for the women with infertility conditions to achieve pregnancy. However, the adverse effects of ART may lead to poor perinatal and neonatal outcomes, e.g., preterm birth and low body weight. In this study, we investigated the inflammatory molecular factors and microRNA that might be involved in ART related preterm birth. We found the elevation of Toll-like 4 receptor (TLR4), activation of NFκB pathway and down-regulation of microRNA-146a (miR-146a), a negative regulator of NFκB, in the placenta of preterm birth and ART, indicating preterm birth and ART were associated with inflammation signaling activation. In vitro experiments demonstrated that miR-146a suppressed NFκB pathway and shifted the balance of cytokines in the cord blood toward a repertoire of pro-inflammatory outcomes by down-regulating IRAK1 and TRAF6. The pro-inflammatory cytokines IL-6, IFNγ and TNFα in the cord blood were highly expressed in the preterm and ART, while anti-inflammatory cytokine IL-10 was the lower in the preterm and ART. In summary, we firstly uncovered that TLR4/NFκB mediated inflammation signaling and miR-146a participated in ART-related preterm birth patients, which suggests that importance of TLR4/NFκB/miR-146a signaling in clinical interventions and biomarkers of ART-related perinatal or neonatal outcomes.
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Affiliation(s)
- Xinqi Zhong
- Department of Pediatrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Yi-Zhou Jiang
- Institute for Advanced Study, Shenzhen University, Shenzhen, Guangdong, China
| | - Peiwen Liu
- Department of Pathogen Biology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Wenzhi He
- Experimental Department of Institute of Gynecology and Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Zhongtang Xiong
- Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Weijie Chang
- Department of Pediatrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Jiandong Zhu
- Department of Pediatrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Qiliang Cui
- Department of Pediatrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong, China
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18
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Siqueira LG, Tribulo P, Chen Z, Denicol AC, Ortega MS, Negrón-Pérez VM, Kannampuzha-Francis J, Pohler KG, Rivera RM, Hansen PJ. Colony-stimulating factor 2 acts from days 5 to 7 of development to modify programming of the bovine conceptus at day 86 of gestation†. Biol Reprod 2018; 96:743-757. [PMID: 28379294 DOI: 10.1093/biolre/iox018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/27/2017] [Indexed: 11/13/2022] Open
Abstract
Colony-stimulating factor 2 (CSF2) is an embryokine that improves competence of the embryo to establish pregnancy and which may participate in developmental programming. We tested whether culture of bovine embryos with CSF2 alters fetal development and alleviates abnormalities associated with in vitro production (IVP) of embryos. Pregnancies were established by artificial insemination (AI), transfer of an IVP embryo (IVP), or transfer of an IVP embryo treated with 10 ng/ml CSF2 from day 5 to 7 of development (CSF2). Pregnancies were produced using X-sorted semen. Female singleton conceptuses were collected on day 86 of gestation. There were few morphological differences between groups, although IVP and CSF2 fetuses were heavier than AI fetuses. Bicarbonate concentration in allantoic fluid was lower for IVP than for AI or CSF2. Expression of 92 genes in liver, placenta, and muscle was determined. The general pattern for liver and placenta was for IVP to alter expression and for CSF2 to sometimes reverse this effect. For muscle, CSF2 affected gene expression but did not generally reverse effects of IVP. Levels of methylation for each of the three tissues at 12 loci in the promoter of insulin-like growth factor 2 (IGF2) and five in the promoter of growth factor receptor bound protein 10 were unaffected by treatment except for CSF2 effects on two CpG for IGF2 in placenta and muscle. In conclusion, CSF2 can act as a developmental programming agent but alone is not able to abolish the adverse effects of IVP on fetal characteristics.
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Affiliation(s)
- Luiz G Siqueira
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA.,Embrapa Gado de Leite, Juiz de Fora, Minas Gerais, Brazil
| | - Paula Tribulo
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA
| | - Zhiyuan Chen
- Division of Animal Sciences, University of Missouri, Columbia, Missouri, USA
| | - Anna C Denicol
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA
| | - M Sofia Ortega
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA
| | - Veronica M Negrón-Pérez
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA
| | - Jasmine Kannampuzha-Francis
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA
| | - Ky G Pohler
- Department of Animal Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Rocio M Rivera
- Division of Animal Sciences, University of Missouri, Columbia, Missouri, USA
| | - Peter J Hansen
- Department of Animal Sciences, D.H. Barron Reproductive and Perinatal Biology Research Program, Genetics Institute, University of Florida, Gainesville, Florida, USA
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19
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Shima Y, Kumasaka S, Nishimaki S. Urinary β2-microglobulin and bronchopulmonary dysplasia: Trends in preterm infants. Pediatr Int 2017; 59:1169-1173. [PMID: 28833913 DOI: 10.1111/ped.13407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/06/2017] [Accepted: 08/14/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The developmental process of bronchopulmonary dysplasia (BPD) is not identical between very preterm infants born small for gestational age (SGA) and those born appropriate for gestational age (AGA). In this study, we compared the pattern of the inflammatory response in infants of each group, by measuring urinary β2-microglobulin (Uβ2M) as an alternative, concise, and less-invasive biomarker. METHODS Uβ2M and clinical details were examined at birth and at 4 weeks of age in 146 very preterm infants. RESULTS Of the 57 infants diagnosed with BPD, 18 were SGA, and 39 were AGA. Uβ2M at birth was significantly lower in SGA BPD infants than in AGA BPD infants, but it increased with time. The prevalence of chorioamnionitis (CAM) was significantly lower in SGA BPD infants than in AGA BPD infants, while that of pregnancy-induced hypertension was the opposite. CONCLUSIONS Exposure to prenatal factors other than CAM may sensitize fetal lungs to become vulnerable to postnatal inflammation in very preterm SGA infants with BPD.
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Affiliation(s)
- Yoshio Shima
- Department of Neonatal Medicine, Nippon Medical School, Musashikosugi Hospital, Kanagawa, Japan.,Department of Pediatrics, Japanese Red Cross Maternity Hospital, Tokyo, Japan
| | - Sakae Kumasaka
- Department of Pediatrics, Japanese Red Cross Maternity Hospital, Tokyo, Japan
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20
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Assisted reproductive technologies: a hierarchy of risks for conception, pregnancy outcomes, and treatment decisions - ERRATUM. J Dev Orig Health Dis 2017; 9:241-246. [PMID: 28978364 DOI: 10.1017/s2040174417000757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Litzky JF, Deyssenroth MA, Everson TM, Armstrong DA, Lambertini L, Chen J, Marsit CJ. Placental imprinting variation associated with assisted reproductive technologies and subfertility. Epigenetics 2017; 12:653-661. [PMID: 28621618 PMCID: PMC5687325 DOI: 10.1080/15592294.2017.1336589] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 12/19/2022] Open
Abstract
Infertility affects one in 6 couples in developed nations, resulting in an increasing use of assisted reproductive technologies (ART). Both ART and subfertility appear to be linked to lower birth weight outcomes, setting infants up for poor long-term health. Prenatal growth is, in part, regulated via epigenetically-controlled imprinted genes in the placenta. Although differences in DNA methylation between ART and control infants have been found, it remains unclear whether these differences are due to the ART procedures or to the underlying parental subfertility and how these methylation differences affect imprinted gene expression. In this study, we examined the expression of 108 imprinted genes in placental tissues from infants born to subfertile parents (n = 79), matched naturally-conceived controls (n = 158), and infants conceived using in vitro fertilization (IVF, n = 18). Forty-five genes were identified as having significantly different expression between the subfertile infants and controls, whereas no significant differences were identified between the IVF and control groups. The expression of 4 genes-IGF2, NAPIL5, PAX8-AS1, and TUBGCP5-was significantly downregulated in the IVF compared with the subfertile group. Three of the 45 genes significantly dysregulated between subfertile and control placentae-GRB10, NDN, and CD44 -were found to have a significant positive correlation between expression and birth weight. Methylation levels for these 3 genes and 4 others-MKRN3, WRB, DHCR24, and CYR61-were significantly correlated with expression. Our findings indicate that epigenetic differences in placentas resulting from IVF pregnancies may be related to the underlying subfertility in parents using IVF rather than the IVF procedure itself.
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Affiliation(s)
- Julia F. Litzky
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Maya A. Deyssenroth
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Todd M. Everson
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - David A. Armstrong
- Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Luca Lambertini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Obstetrics; Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carmen J. Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
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Siqueira LG, Dikmen S, Ortega MS, Hansen PJ. Postnatal phenotype of dairy cows is altered by in vitro embryo production using reverse X-sorted semen. J Dairy Sci 2017; 100:5899-5908. [DOI: 10.3168/jds.2016-12539] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/06/2017] [Indexed: 12/31/2022]
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The health outcomes of human offspring conceived by assisted reproductive technologies (ART). J Dev Orig Health Dis 2017; 8:388-402. [DOI: 10.1017/s2040174417000228] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Concerns have been raised about the health and development of children conceived by assisted reproductive technologies (ART) since 1978. Controversially, ART has been linked with adverse obstetric and perinatal outcomes, an increased risk of birth defects, cancers, and growth and development disorders. Emerging evidence suggests that ART treatment may also predispose individuals to an increased risk of chronic ageing related diseases such as obesity, type 2 diabetes and cardiovascular disease. This review will summarize the available evidence on the short-term and long-term health outcomes of ART singletons, as multiple pregnancies after multiple embryos transfer, are associated with low birth weight and preterm delivery, which can separately increase risk of adverse postnatal outcomes, and impact long-term health. We will also examine the potential factors that may contribute to these health risks, and discuss underlying mechanisms, including epigenetic changes that may occur during the preimplantation period and reprogram development in utero, and adult health, later in life. Lastly, this review will consider the future directions with the view to optimize the long-term health of ART children.
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Malova M, Rossi A, Severino M, Parodi A, Morana G, Sannia A, Cama A, Ramenghi LA. Incidental findings on routine brain MRI scans in preterm infants. Arch Dis Child Fetal Neonatal Ed 2017; 102:F73-F78. [PMID: 27150976 DOI: 10.1136/archdischild-2015-310333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/07/2016] [Accepted: 04/18/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Many neonatal intensive care units (NICUs) have adopted the practice of performing routine brain MRI in very low birth weight (VLBW) infants at term-equivalent age in order to better evaluate prematurity-related acquired lesions. A number of unexpected brain abnormalities of potential clinical significance can be visualised on routine scans as well. The aim of our study was to describe these incidental findings (IFs) in a VLBW population and to assess their clinical significance. STUDY DESIGN We retrospectively reviewed a series of brain MRI scans performed in VLBW infants consecutively admitted to our NICU between November 2011 and November 2014. IFs on brain MRI, which were not detected by cranial ultrasound nor suspected clinically, were registered. Clinical significance of IF was assessed in terms of need of further diagnostic or therapeutic interventions. RESULTS IFs were detected in 28 out of 276 VLBW infants (10.1%). In total, 21 cases (7.6%) required an intervention, which was only diagnostic in 16 cases, and both diagnostic and therapeutic in 5 cases. In the remaining seven cases (2.5%), no further action was considered necessary. CONCLUSIONS This study suggests that IFs on brain MRI of VLBW infants are not rare. In our population, most of them required a diagnostic or therapeutic intervention. The need and appropriateness of routine MRI scanning in VLBW at term-equivalent age are still subject of debate, and we believe our data can contribute meaningfully to this discussion.
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Affiliation(s)
- Mariya Malova
- Neonatal Intensive Care Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Andrea Rossi
- Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Alessandro Parodi
- Neonatal Intensive Care Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Giovanni Morana
- Pediatric Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Andrea Sannia
- Neonatal Intensive Care Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Armando Cama
- Neurosurgery Unit, Istituto Giannina Gaslini, Genoa, Italy
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Turkgeldi E, Yagmur H, Seyhan A, Urman B, Ata B. Short and long term outcomes of children conceived with assisted reproductive technology. Eur J Obstet Gynecol Reprod Biol 2016; 207:129-136. [PMID: 27846448 DOI: 10.1016/j.ejogrb.2016.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/09/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Abstract
Despite their wide and global use, possible short and long-term effects of fertility treatments on children is not well-established. In this review, birth defects and perinatal complications and their relationship with assisted reproductive technology (ART), along with long-term effects of ART on cardiovascular system, metabolism, behavior, cognitive skills, and childhood cancers are discussed. Children conceived through ART are at increased risk for birth defects and perinatal complications such as preterm delivery, low birth weight and small for gestational age. Parental characteristics, underlying infertility etiology and ART procedures themselves may contribute to this. The long-term effects of ART are difficult to establish. Studies so far report that ART children have normal social, emotional, cognitive, and motor functions. Likewise, despite some minor inconsistencies in some studies, they do not seem to be at increased risk for childhood cancers. However, there are a number of studies that imply vascular system may be adversely affected by ART and its possible consequences should be further investigated with follow up studies. Large scale studies with long-term follow up periods are required to determine the effects of ART on conceived children.
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Affiliation(s)
- Engin Turkgeldi
- Dept. of Obstetrics and Gynecology, Koc University Hospital, Turkey
| | - Hande Yagmur
- Dept. of Obstetrics and Gynecology, Koc University Hospital, Turkey
| | - Ayse Seyhan
- Assisted Reproduction Center, American Hospital of Istanbul, Turkey
| | - Bulent Urman
- Dept. of Obstetrics and Gynecology, Koc University School of Medicine, Turkey
| | - Baris Ata
- Dept. of Obstetrics and Gynecology, Koc University School of Medicine, Turkey.
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Davies MJ, Rumbold AR, Marino JL, Willson K, Giles LC, Whitrow MJ, Scheil W, Moran LJ, Thompson JG, Lane M, Moore VM. Maternal factors and the risk of birth defects after IVF and ICSI: a whole of population cohort study. BJOG 2016; 124:1537-1544. [DOI: 10.1111/1471-0528.14365] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2016] [Indexed: 11/30/2022]
Affiliation(s)
- MJ Davies
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
| | - AR Rumbold
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
| | - JL Marino
- Department of Obstetrics and Gynaecology Royal Women's Hospital The University of Melbourne Parkville Vic. Australia
| | - K Willson
- School of Public Health The University of Adelaide Adelaide SA Australia
| | - LC Giles
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
- School of Public Health The University of Adelaide Adelaide SA Australia
| | - MJ Whitrow
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
- School of Public Health The University of Adelaide Adelaide SA Australia
| | - W Scheil
- Pregnancy Outcome Unit SA Health Government of South Australia Adelaide SA Australia
| | - LJ Moran
- School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia
| | - JG Thompson
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
| | - M Lane
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
| | - VM Moore
- Robinson Research Institute The University of Adelaide Adelaide SA Australia
- School of Public Health The University of Adelaide Adelaide SA Australia
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Abstract
PURPOSE OF REVIEW This article summarizes the latest evidence on the risk factors, management and outcomes of undescended testes (UDTs). RECENT FINDINGS UDTs remain common, with increasing evidence that acquired UDT or the ascending testis syndrome should be considered part of the spectrum of this disease. Prompt diagnosis and early referral for surgical evaluation and treatment would seem most likely to result in an optimal functional and cosmetic outcome. Hormonal treatment, rather than orchidopexy, remains popular in some centers, despite a lack of good evidence to support its efficacy, although it may have an important adjunct role in optimizing fertility. Although often performed, ultrasound does not generally assist in the diagnosis and management of UDT, with enhanced education of primary care physicians more likely to facilitate early referral. The testis, rather than quiescent, appears biologically active in the male infant, with increasing evidence of an adverse impact on future spermatogenesis and fertility in men with a UDT. SUMMARY Male infants with a UDT should be diagnosed and referred early for surgical evaluation. It seems likely that the optimal timing for surgery should be before the boy's first birthday. There remains a need for high-quality, long-term outcomes data to guide optimal management.
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Diop H, Gopal D, Cabral H, Belanoff C, Declercq ER, Kotelchuck M, Luke B, Stern JE. Assisted Reproductive Technology and Early Intervention Program Enrollment. Pediatrics 2016; 137:e20152007. [PMID: 26908668 PMCID: PMC4766754 DOI: 10.1542/peds.2015-2007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We examined the prevalence of Early Intervention (EI) enrollment in Massachusetts comparing singleton children conceived via assisted reproductive technology (ART), children born to mothers with indicators of subfertility but no ART (Subfertile), and children born to mothers who had no indicators of subfertility and conceived naturally (Fertile). We assessed the natural direct effect (NDE), the natural indirect effect (NIE) through preterm birth, and the total effect of ART and subfertility on EI enrollment. METHODS We examined maternal and infant characteristics among singleton ART (n = 6447), Subfertile (n = 5515), and Fertile (n = 306,343) groups and characteristics associated with EI enrollment includingpreterm birth using χ(2) statistics (α = 0.05). We estimated the NDE and NIE of the ART-EI enrollment relationship by fitting a model for enrollment, conditional on ART, preterm and the ART-preterm delivery interaction, and covariates. Similar analyses were conducted by using Subfertile as the exposure. RESULTS The NDE indicated that the odds of EI enrollment were 27% higher among the ART group (odds ratioNDE = 1.27; 95% confidence interval (CI): 1.19 ̶ 1.36) and 20% higher among the Subfertilegroup (odds ratioNDE = 1.20; 95% CI: 1.12 ̶ 1.29) compared with the Fertile group, even if the rate of preterm birth is held constant. CONCLUSIONS Singleton children conceived through ART and children of subfertile mothers both have elevated risks of EI enrollment. These findings have implications for clinical providers as they counsel women about child health outcomes associated with ART or subfertility.
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Affiliation(s)
- Hafsatou Diop
- Massachusetts Department of Public Health, Boston, Massachusetts;
| | - Daksha Gopal
- Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Candice Belanoff
- Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Eugene R. Declercq
- Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Milton Kotelchuck
- Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts
| | - Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan; and
| | - Judy E. Stern
- Department of Obstetrics and Gynecology and Pathology, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire
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Schulte K, Ehmcke J, Schlatt S, Boiani M, Nordhoff V. Lower total cell numbers in mouse preimplantation embryos cultured in human assisted reproductive technique (ART) media are not induced by apoptosis. Theriogenology 2015; 84:1620-30. [DOI: 10.1016/j.theriogenology.2015.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 08/10/2015] [Accepted: 08/21/2015] [Indexed: 12/23/2022]
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Independent factors influencing large-for-gestation birth weight in singletons born after in vitro fertilization. J Assist Reprod Genet 2015; 33:9-17. [PMID: 26547202 DOI: 10.1007/s10815-015-0601-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/21/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Higher risk for birth of singletons being large for gestational age (LGA) has been revealed after in vitro fertilization (IVF) frozen-thawed embryo-transfer (FET). This phenomenon is now being investigated, since there is a speculation that these neonates could suffer from underlying epigenetic disturbances. The aim of the study was to expose independent LGA risk factors and to identify those connected to the IVF techniques. METHODS Altogether, 4508 singleton pregnancies and births were included in the cohort case-matched study. Two hundred eleven singleton pregnancies and births after FET and 916 after fresh embryo transfer (ET) were included into two study groups. The IVF procedures were performed at the University Medical Centre Ljubljana between 2004 and 2011. For each IVF pregnancy, three matched consecutive controls after natural conception were included. Using logistic regression models, we observed LGA connection to maternal parameters (smoking, hypertension, parity, BMI, gestational diabetes, IVF conception, FET, double ET, and ICSI procedure). RESULTS Singletons born after FET had a significantly higher risk for being LGA (p = 0.032; OR 1.697; 95 % CI 1.047-2.752). BMI 25-30 was a significant independent risk factor for LGA in the IVF groups (FET p = 0.041, OR 2.460, 95 % CI 1.030-5.857 and fresh ET p = 0.003; OR 2.188, 95 % CI 1.297-3.691). ICSI and double ET had no significant effect on LGA occurrence. CONCLUSIONS Besides maternal BMI, FET is a significant independent LGA risk factor in IVF patients. Other observed factors (smoking, hypertension, multiparity, GDM, ICSI procedure, or number of embryos transferred) do not influence LGA risk significantly.
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Harbottle S, Hughes CI, Cutting R, Roberts S, Brison D. Elective Single Embryo Transfer: an update to UK Best Practice Guidelines. HUM FERTIL 2015; 18:165-83. [DOI: 10.3109/14647273.2015.1083144] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zhu J, Lian Y, Li M, Chen L, Liu P, Qiao J. Does IVF cleavage stage embryo quality affect pregnancy complications and neonatal outcomes in singleton gestations after double embryo transfers? J Assist Reprod Genet 2014; 31:1635-41. [PMID: 25326318 DOI: 10.1007/s10815-014-0351-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSES Embryo quality is associated with successful implantation and live births. Our retrospective study was carried out to determine whether or not cleavage stage embryo quality affects the miscarriage rate, pregnancy complications and neonatal outcomes of singletons conceived with assisted reproduction technology. METHOD The current study included 11,721 In Vitro Fertilization-Embryo Transfer cycles (IVF-ET) between January 2009 (the date at which electronic medical records were implemented at our center) and March 2013. Only women < 40 years of age undergoing their first fresh embryo transfer cycle using non-donor oocytes were included. RESULTS Our study indicated that the transfer of poor-quality embryos resulted in higher miscarriage (19.77% vs. 13.28%, p = 0.02) and lower ongoing pregnancy rates (15.33% vs. 48.06%, p < 0.001). Logistic regression analysis performed on data derived from 744 cycles culminating in miscarriages versus 4,333 cycles culminating in live births, suggested that embryo quality (p = 0.04) is significantly associated with miscarriage rate after adjusting for other confounding factors. Moreover, there were no differences in the mean birth weight, low birth weight (<2,500 g), very low birth weight (<1,500 g), gestational age, preterm delivery (<37 weeks), very preterm delivery (<32 weeks), congenital malformations, small-for-gestational-age singletons (SGA), and large-for-gestational-age singleton (LGA) rate (p > 0.05). Similarly, pregnancy complications resulting from poor-quality embryos were not different from good-quality embryos (4.04% vs. 2.57 %, p = 0.33). Finally, logistic regression suggested that embryo quality was not significantly associated with pregnancy complications after adjusting for other confounding factors (p = 0.40). CONCLUSIONS Our study suggests that transfer of poor-quality embryos did not increase the risk of adverse outcomes; however, the quality of cleavage stage embryos significantly affected the miscarriage rate and ongoing pregnancies.
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Affiliation(s)
- Jinliang Zhu
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Huayuan Road, 100191, Haidian District, Beijing, China
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