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Applebaum J, Kim EK, Sharp M, Dokras A, Shah DK. Racial and socioeconomic disparities in fertility treatment provision for patients with polycystic ovary syndrome. Fertil Steril 2024:S0015-0282(24)00545-4. [PMID: 38909670 DOI: 10.1016/j.fertnstert.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 06/09/2024] [Accepted: 06/17/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE To assess whether the provision of fertility treatment for patients with polycystic ovary syndrome (PCOS) varies by patient and physician-level demographic characteristics. DESIGN Retrospective cohort study. SETTING University health system. PATIENT(S) Patients seeking care for PCOS and infertility from 2007-2021. INTERVENTION(S) Patient age, body mass index, race, ethnicity, estimated household income, primary insurance payor, provider sex, and provider medical specialty. MAIN OUTCOME MEASURE(S) Prescriptions for fertility treatment, including clomiphene citrate (CC), letrozole, and injectable gonadotropins. Differences in patient and physician demographics between patients who did as well as did not receive a prescription were identified with univariable analysis. Multilevel mixed-effects logistic regression was performed to determine associations between patient and physician demographics and prescription receipt. RESULT(S) A total of 3,435 patients with PCOS and infertility were identified, with a mean age of 31.1 ± 5.7 years. Of the 68.8% of patients who received a prescription, 47.8% of prescriptions were CC, 38.6% were letrozole, and 13.7% were injectable gonadotropins. There were lower odds of prescription receipt for Black patients compared with White patients (adjusted odds ratio [aOR], 0.75; 95% confidence interval [CI], 0.61-0.93), those with estimated household income below the federal poverty level compared with those above the national median (aOR, 0.71; 95% CI, 0.46-0.97), and those with public compared with commercial insurance (aOR, 0.53; 95% CI, 0.40-0.71). These disparities persisted in a subanalysis of patients prescribed oral medications only with lower odds of prescription receipt for Black compared with White patients (aOR, 0.74; 95% CI, 0.57-0.95), those with estimated household income below the federal poverty level compared with above the national median (aOR, 0.93; 95% CI, 0.87-0.98), and those with public compared with commercial insurance (aOR, 0.57; 95% CI, 0.42-0.76). Black patients waited, on average, 153.3 days longer than White patients, from the initial visit to the prescription receipt. Patients had lower odds of receiving any prescription from family medicine physicians (aOR, 0.36; 95% CI, 0.24-0.52) and general internal medicine physicians (aOR, 0.55; 95% CI, 0.42-0.73) compared with reproductive endocrinologists. CONCLUSION(S) Racial and socioeconomic disparities exist in the provision of infertility treatments for patients with PCOS. Fewer primary care physicians engaged in first-line fertility treatment, indicating an opportunity for physician education to improve access to fertility care.
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Affiliation(s)
- Jeremy Applebaum
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Edward K Kim
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Madison Sharp
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Divya K Shah
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Trapphoff T, Ontrup C, Krug S, Dieterle S. Consumption of hookahs, e-cigarettes, and classic cigarettes and the impact on medically assisted reproduction treatment. Sci Rep 2024; 14:9597. [PMID: 38671174 PMCID: PMC11053167 DOI: 10.1038/s41598-024-60251-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024] Open
Abstract
Smoking of classic cigarettes has been well-established as a health risk factor, including cardiovascular, neurological, and pulmonary diseases. Adverse effects on human reproduction have also been shown. Smokers are assumed to have a significantly lower chance of pregnancy, however, the impact of smoking on medically assisted reproduction (MAR) treatment outcomes is controversial. Moreover, smoking habits have changed during the last decades since e-cigarettes and hookahs, or water pipes, have become very popular, yet little is known regarding vaping or hookah-smoking patients undergoing MAR treatments. This prospective study aimed to examine the presence of benzo[a]pyrene, nicotine, and its main metabolite, cotinine, in human follicular fluid (FF) in non-smoking, smoking, and vaping/hookah-smoking patients and to evaluate the impact on female fertility. Human FF samples were collected from 320 women subjected to intracytoplasmic sperm injection (ICSI) cycles due to male subfertility. Gas chromatography combined with mass spectrometry was used to analyse the presence of benzo[a]pyrene, nicotine, and cotinine. A questionnaire was provided to assess patient consumption behaviour and to identify (1) non-smoking patients, (2) patients who consumed cigarettes, and (3) patients with exclusive consumption of e-cigarettes or hookahs. Data were analysed using linear and logistic regression, Fisher's exact test, and the Mann-Whitney U Test. Nicotine was present in 22 (6.8%) and cotinine in 65 (20.3%) of the 320 samples. The nicotine and cotinine concentrations per sample ranged from 0 to 26.3 ng/ml and 0-363.0 ng/ml, respectively. Benzo[a]pyrene was not detectable in any of the samples analysed. Nicotine and cotinine were also present in the FF of patients with exclusive consumption of e-cigarettes or hookahs. The clinical pregnancy rate, fertilization and maturation rates, and number of oocytes per oocyte pick-up were not statistically significantly different between non-smoking, smoking, or vaping/hookah-smoking patients. Smoking and the accumulation of smoking toxins in the FF have no impact on the outcome of MAR treatments-neither the clinical pregnancy rate, maturation and fertilization rates, nor the number of retrieved oocytes were affected. For the first time, nicotine and cotinine were quantified in the FF of patients exclusively vaping e-cigarettes or smoking hookahs. Since vaping liquids and hookah tobaccos contain potentially harmful substances, other adverse effects cannot be excluded.Trial registration ClinicalTrials.gov Identifier: NCT03414567.
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Affiliation(s)
- Tom Trapphoff
- Fertility Center Dortmund, Olpe 19, 44135, Dortmund, Germany.
| | - Carolin Ontrup
- Fertility Center Dortmund, Olpe 19, 44135, Dortmund, Germany
| | - Sonja Krug
- Fertility Center Dortmund, Olpe 19, 44135, Dortmund, Germany
| | - Stefan Dieterle
- Fertility Center Dortmund, Olpe 19, 44135, Dortmund, Germany
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Witten/Herdecke, 44135, Dortmund, Germany
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Lee J, Choo CW, Moon KY, Lyu SW, Kim H, Lee JY, Lee JR, Jee BC, Hwang K, Kim SH, Park SK. Risk Factors for Infertility in Korean Women. J Korean Med Sci 2024; 39:e85. [PMID: 38501182 PMCID: PMC10948255 DOI: 10.3346/jkms.2024.39.e85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/17/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Female infertility is a crucial problem with significant implications for individuals and society. In this study, we explore risk factors for infertility in Korean women. METHODS A total of 986 female patients who visited six major infertility clinics in Korea were recruited from April to December 2014. Fertile age-matched controls were selected from two nationwide survey study participants. Conditional logistic regression after age-matching was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of each risk factor for infertility. RESULTS Women with a body mass index (BMI) < 18.5 kg/m² had 1.35 times higher odds of infertility (OR, 1.35; 95% CI, 1.03-1.77), while those with a BMI ≥ 25.0 kg/m² had even higher odds (OR, 2.06; 95% CI, 1.61-2.64) compared to women with a normal BMI (18.5 kg/m² ≤ BMI < 25 kg/m²). Ever-smokers exhibited 4.94 times higher odds of infertility compared to never-smokers (95% CI, 3.45-8.85). Concerning alcohol consumption, women who consumed ≥ 7 glasses at a time showed 3.13 times significantly higher odds of infertility than those who consumed ≤ 4 glasses at a time (95% CI, 1.79-5.48). Lastly, women with thyroid disease demonstrated 1.44 times higher odds of infertility compared to women without thyroid disease (95% CI, 1.00-2.08). CONCLUSION Female infertility in Korea was associated with underweight, obesity, smoking, alcohol consumption, and thyroid disease.
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Affiliation(s)
- Juyeon Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea
- Department Cancer Institution, Seoul National University, Seoul, Korea
| | | | | | | | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
| | | | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyungjoo Hwang
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department Cancer Institution, Seoul National University, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea.
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Sharma A, Kamboj N, Saraswathy KN, Puri M, Babu N, Mahajan C. Knowledge, attitude, and practice of infertility: a comparative study in infertile and fertile Indian women. J Biosoc Sci 2023; 55:947-959. [PMID: 36189761 DOI: 10.1017/s0021932022000347] [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] [Indexed: 11/05/2022]
Abstract
For women who are trying to conceive, it is critical to assess their general knowledge regarding fertility and fertility-awareness practices to identify the fertile window and their agency to achieve pregnancy. The couple's ability to deal with the infertility issue may be influenced by their beliefs and attitudes concerning infertility, which are based on social and cultural influences as well as their inner aspirations. As a result, it's critical to examine infertile and fertile woman's general knowledge of reproduction and infertility risk factors. It's also crucial to learn about women's attitudes toward infertility (social beliefs), as well as the repercussions of infertility and the practises they employ to avoid it. The present study includes 250 fertile and 250 infertile women. Data collection for infertile women was done from the Gynecology Outpatient Department (OPD). Participants from both groups i.e., infertile and fertile women have little knowledge about infertility but, infertile women have significantly higher knowledge than fertile women. Knowledge of the fertile period, as well as several potential causes of infertility, were found to be significantly higher in women with infertility problem rather than fertile women, indicating that the knowledge they have acquired is not attributable to education system, but rather to their experience gained during visits to medical practitioners. In addition to differences with respect to knowledge, infertile and fertile women differed in terms of both attitude (societal beliefs and social consequences of infertility) and practices. Better knowledge regarding infertility is likely to bring positive notes among women with infertility problems. Which will further improve the attitude and practices of society towards infertile women. Therefore, its crucial to introduce reproductive health education at high school or undergraduate level, to assist women in avoiding infertility and to help infertile women develop healthier attitudes regarding infertility treatment and coping techniques.
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Affiliation(s)
- Apoorva Sharma
- Department of Anthropology, University of Delhi, New Delhi, India
| | - Navjot Kamboj
- Department of Anthropology, University of Delhi, New Delhi, India
| | - K N Saraswathy
- Department of Anthropology, University of Delhi, New Delhi, India
| | - Manju Puri
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
| | - Nandita Babu
- Department of Psychology, University of Delhi, New Delhi, India
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Babarinsa IA, Bashir M, AbdelRahman Ahmed H, Ahmed B, Konje JC. Bariatric surgery and reproduction-implications for gynecology and obstetrics. Best Pract Res Clin Obstet Gynaecol 2023; 90:102382. [PMID: 37506498 DOI: 10.1016/j.bpobgyn.2023.102382] [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: 05/10/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
As the rates of obesity continue to rise across the world, there has been an increasing resort to bariatric surgery amongst the options for treatment. Through the reproductive lifespan, between menarche and menopause, women might benefit from this surgical intervention, which may have a bearing on other aspects of their health. The consequences of bariatric surgery have been reported and evaluated from various perspectives in obstetrics and gynecology. Fertility and sexuality are enhanced, but not all gynecological diseases are ameliorated. There are also psychological and behavioral sequelae to be cognizant of. With multi-disciplinary and responsive care, most post-bariatric pregnancies have satisfactory outcomes. The effects of bariatric surgery on the babies conceived thereafter remains a subject of interest, whereas the possible effect on the climacteric is speculative.
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Affiliation(s)
- Isaac A Babarinsa
- Women's Wellness and Research Centre, Hamad Medical Corporation, Doha.
| | | | | | - Badreldeen Ahmed
- Feto Maternal Centre, Al Markhiya, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; Qatar University, Qatar
| | - Justin C Konje
- Feto Maternal Centre, Al Markhiya, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; Department of Health Sciences University of Leicester, UK
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Galio L, Bernet L, Rodriguez Y, Fourcault C, Dieudonné M, Pinatel H, Henry C, Sérazin V, Fathallah K, Gagneux A, Krupova Z, Vialard F, Santos ED. The effect of obesity on uterine receptivity is mediated by endometrial extracellular vesicles that control human endometrial stromal cell decidualization and trophoblast invasion. JOURNAL OF EXTRACELLULAR BIOLOGY 2023; 2:e103. [PMID: 38939074 PMCID: PMC11080792 DOI: 10.1002/jex2.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 06/29/2024]
Abstract
The objectives of the present study were to determine whether obesity impacts human decidualization and the endometrial control of trophoblast invasion (both of which are required for embryo implantation) and evaluate the potential involvement of endometrial extracellular vesicles (EVs) in the regulation of these physiological processes. Using primary human cell cultures, we first demonstrated that obesity is associated with significantly lower in vitro decidualization of endometrial stromal cells (ESCs). We then showed that a trophoblastic cell line's invasive ability was greater in the presence of conditioned media from cultures of ESCs from obese women. The results of functional assays indicated that supplementation of the culture medium with EVs from nonobese women can rescue (at least in part) the defect in in vitro decidualization described in ESCs from obese women. Furthermore, exposure to endometrial EVs from obese women (vs. nonobese women) was associated with significantly greater invasive activity by HTR-8/SVneo cells. Using mass-spectrometry-based quantitative proteomics, we found that EVs isolated from uterine supernatants of biopsies from obese women (vs. nonobese women) presented a molecular signature focused on cell remodelling and angiogenesis. The proteomics analysis revealed two differentially expressed proteins (fibronectin and angiotensin-converting enzyme) that might be involved specifically in the rescue of the decidualization capacity in ESCs from obese women; both of these proteins are abundantly present in endometrial EVs from nonobese women, and both are involved in the decidualization process. In conclusion, our results provided new insights into the endometrial EVs' pivotal role in the poor uterine receptivity observed in obese women.
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Affiliation(s)
- Laurent Galio
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | - Laetitia Bernet
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | - Yoann Rodriguez
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | - Camille Fourcault
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | - Marie‐Noëlle Dieudonné
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | - Hélène Pinatel
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | - Céline Henry
- Université Paris‐Saclay, INRAEAgroParisTech, Micalis Institute, PAPPSOJouy‐en‐JosasFrance
| | - Valérie Sérazin
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
- Service de Biologie MédicaleCentre Hospitalier de Poissy‐Saint GermainPoissyFrance
| | - Khadija Fathallah
- Service de Gynécologie et ObstétriqueCentre Hospitalier de Poissy‐Saint GermainPoissyFrance
| | - Anissa Gagneux
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
| | | | - François Vialard
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
- Service de Biologie MédicaleCentre Hospitalier de Poissy‐Saint GermainPoissyFrance
| | - Esther Dos Santos
- Université Paris‐Saclay, UVSQ, INRAE, BREEDJouy‐en‐JosasFrance
- Ecole Nationale Vétérinaire d'Alfort, BREEDMaisons‐AlfortFrance
- Service de Biologie MédicaleCentre Hospitalier de Poissy‐Saint GermainPoissyFrance
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Kumari S, Singh K, Tiwary B, Kumari S, Nishat H. Comprehensive Analysis of the Effect of Maternal and Paternal Demographics and Lifestyle Factors on the Embryo Quality and In Vitro Fertilization Outcomes: A Retrospective Study in North Eastern India. Cureus 2023; 15:e35546. [PMID: 37007407 PMCID: PMC10057698 DOI: 10.7759/cureus.35546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Background Lifestyle habits and demographic characteristics are strongly associated with sperm and oocyte quality and are important co-variates in fertility. However, their effect on the pre-implantation embryo quality in in vitro fertilization (IVF) has not been explored widely. The present retrospective study aimed to explore the effect of maternal and paternal demographic and lifestyle factors on the pre-implantation embryo quality in IVF. Methodology Women in the age group of 21 to 40 years undergoing IVF (n=105) in the Department of Reproductive Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, and their partners were recruited in the study. Maternal and paternal charts were reviewed, and the demographic, lifestyle habit related data, and data related to oocyte retrieval, oocyte quality, and embryo quality were retrieved in a predesigned spreadsheet. Appropriate statistical analysis was conducted using SPSS Version 21 to evaluate the association of the studied maternal and paternal factors with oocyte and embryo quality. P-values less than 0.05 were considered to be significant. Results Maternal factors such as tubal blockage (p=0.02) and residence in an industrial locality (p=0.001) were found to be significantly associated with the quality of oocytes. None of the maternal factors studied were associated with embryo quality; however, day 3 and day 5 embryo quality was significantly associated with educational status of the male partners (p=0.02), smoking (p=0.05), and chewing tobacco (p=0.01). Day 5 embryo quality was also associated with residence in an industrial locality of the male partners (p=0.04). Conclusions Paternal lifestyle habits such as smoking, chewing tobacco, and demographic characteristics such as education and proximity to an industrial area were all related to poor embryo quality. Maternal factors such as tubal blockage and residence of industrial locality were found to be significantly associated with the quality of oocytes.
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Vexø LE, Stormlund S, Landersoe SK, Jørgensen HL, Humaidan P, Bergh C, Englund ALM, Klajnbard A, Bogstad JW, Freiesleben NLC, Zedeler A, Prætorius L, Andersen AN, Løssl K, Pinborg A, Nielsen HS. Low-grade inflammation is negatively associated with live birth in women undergoing IVF. Reprod Biomed Online 2023; 46:302-311. [PMID: 36446681 DOI: 10.1016/j.rbmo.2022.10.004] [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: 07/12/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022]
Abstract
RESEARCH QUESTION Is low-grade inflammation, detected by C-reactive protein (CRP), a marker of IVF outcome addressing both blastocyst quality and pregnancy outcome? DESIGN This sub-study of a multicentre randomized controlled trial included 440 women undergoing IVF treatment with a gonadotrophin-releasing hormone (GnRH) antagonist protocol. Serum CRP was measured on cycle day 2-3 (baseline) and on the day of ovulation triggering. The association between CRP concentrations and reproductive outcomes (number of retrieved oocytes, number of good-quality blastocysts, pregnancy, pregnancy loss and live birth), were analysed, adjusting for relevant confounders. RESULTS A negative association was found between higher baseline CRP concentrations and live birth rate (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.62-0.96, P = 0.02) and higher CRP concentrations at baseline were associated with pregnancy loss among women who conceived (OR 1.37, 95% CI 1.07-1.76, P = 0.01). When testing for a specific cut-off, CRP concentrations above 2.34 (the highest quartile) were more likely to be associated with pregnancy loss (P = 0.02) and a lower chance of live birth (P = 0.04) compared with the lowest quartile. No associations were found between CRP concentrations and pregnancy outcomes on the day of ovulation triggering, and there were no associations between CRP concentrations and the number of good-quality blastocysts. CONCLUSIONS Higher CRP concentrations at cycle day 2-3, before starting ovarian stimulation, are negatively associated with chance of live birth, possibly because of an increased risk of pregnancy loss. No association was found between the number of good-quality blastocysts and CRP concentration. More studies are needed to investigate the impact of low-grade inflammation.
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Affiliation(s)
- Laura Emilie Vexø
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
| | - Sacha Stormlund
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Selma Kloeve Landersoe
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Henrik Løvendahl Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Humaidan
- Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University; Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anne Lis Mikkelsen Englund
- Department of Obstetrics and Gynaecology, Fertility Clinic, Region Zealand University Hospital, Koege, Denmark
| | - Anna Klajnbard
- Fertility Clinic, Department of Obstetrics and Gynaecology, Herlev University Hospital, Copenhagen, Denmark
| | - Jeanette Wulff Bogstad
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Zedeler
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Lisbeth Prætorius
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Anders Nyboe Andersen
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kristine Løssl
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Fertility Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Leung T, Schoenmakers S, Willemsen S, van Rossem L, Dinnyes A, Rousian M, Steegers-Theunissen RP. The Effect of an eHealth Coaching Program (Smarter Pregnancy) on Attitudes and Practices Toward Periconception Lifestyle Behaviors in Women Attempting Pregnancy: Prospective Study. J Med Internet Res 2023; 25:e39321. [PMID: 36719733 PMCID: PMC9929732 DOI: 10.2196/39321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Lifestyle behaviors during the periconception period contribute to achievement of a successful pregnancy. Assessment of attitudes and practices toward these modifiable behaviors can aid in identifying gaps in unhealthy lifestyle behaviors with impact on intervention effectiveness. OBJECTIVE This study investigates the effectiveness of coaching by the eHealth program Smarter Pregnancy during the periconception period on improvement of attitudes and practices toward fruit and vegetable intake and smoking in women attempting pregnancy through assisted reproductive technology (ART) or natural conception. METHODS Women attempting pregnancy through ART (n=1060) or natural conception (n=631) were selected during the periconception period. The intervention groups, conceived through ART or naturally, received Smarter Pregnancy coaching for 24 weeks, whereas the control group conceived through ART and did not receive coaching. Attitudes and practices at baseline and follow-up periods were obtained from self-administered online questionnaire provided by the program. Attitudes were assessed in women with unhealthy behaviors as their intention to increase their fruit and vegetable intake and to quit smoking using a yes/no question. Outcomes on practices, suggesting effectiveness, included daily fruit (pieces) and vegetable (grams) intake, and if women smoked (yes/no). Changes in attitudes and practices were compared at 12 and 24 weeks with baseline between the ART intervention and ART control groups, and within the intervention groups between ART and natural conception. Changes in practices at 12 and 24 weeks were also compared with baseline between women with negative attitude and positive attitude within the intervention groups: ART and natural conception. Analysis was performed using linear and logistic regression models adjusted for maternal confounders and baseline attitudes and practices. RESULTS The ART intervention group showed higher vegetable intake and lower odds for negative attitudes toward vegetable intake after 12 weeks (βadj=25.72 g, P<.001; adjusted odds ratio [ORadj] 0.24, P<.001) and 24 weeks of coaching (βadj=23.84 g, P<.001; ORadj 0.28, P<.001) compared with ART controls. No statistically significant effect was observed on attitudes and practices toward fruit intake (12 weeks: P=.16 and .08, respectively; 24 weeks: P=.16 and .08, respectively) and smoking behavior (12 weeks: P=.87; 24 weeks: P=.92). No difference was observed for the studied attitudes and practices between the ART intervention and natural conception intervention groups. Women with persistent negative attitude toward fruit and vegetable intake at week 12 showed lower fruit and vegetable intake at week 24 compared with women with positive attitude (βadj=-.49, P<.001; βadj=-30.07, P<.001, respectively). CONCLUSIONS The eHealth Smarter Pregnancy program may improve vegetable intake-related attitudes and practices in women undergoing ART treatment. Women with no intention to increase fruit and vegetable intake had less improvement in their intakes. Despite small changes, this study demonstrates again that Smarter Pregnancy can be used to improve vegetable intake, which can complemented by blended care that combines face-to-face and online care to also improve fruit intake and smoking behavior.
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Affiliation(s)
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Andras Dinnyes
- BioTalentum Ltd, Godollo, Hungary.,Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Godollo, Hungary
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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10
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Piquette T, Rydze RT, Pan A, Bosler J, Granlund A, Schoyer KD. The effect of maternal body mass index on embryo division timings in women undergoing in vitro fertilization. F S Rep 2022; 3:324-331. [PMID: 36568924 PMCID: PMC9783148 DOI: 10.1016/j.xfre.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To measure the impact of maternal body mass index (BMI) on the morphokinetics of embryo development as monitored by a time-lapse system. Design A retrospective chart review of in vitro fertilization (IVF) cycles from September 2016 to January 2019. Setting Academic IVF practice. Patients Patients <age 38 years undergoing IVF with their own gametes. Interventions Not applicable. Main outcome measures The primary outcome was to compare embryo division timings between morbidly obese, obese, overweight, and normal-weight patients. A multilevel mixed effects model was performed to investigate the relationships between BMI categories and embryo division timings. Log or square transformation were used to improve fit. Results A total of 366 patients met inclusion criteria, yielding 4,475 embryos: 1,948 embryos from 162 normal-weight women (BMI 18.5-24.9), 1,242 embryos from 96 overweight women (BMI 25.0-29.9), 1,119 embryos from 91 obese women (BMI 30.0-39.9), and 166 embryos from 17 morbidly obese women (BMI ≥40). There were no differences in age, Antimüllerian hormone, or IVF cycle outcomes among the different BMI categories. When comparing embryo division timings based on BMI, controlling for covariates, embryos from obese patients had a shorter time to division to 2 cell embryo (T2) than normal-weight patients. When analyzing BMI as a continuous variable, there was no significant relationship between BMI and embryo division timing. Conclusions Early embryo divisions were accelerated in only certain categories of obesity. This suggests a more complex mechanism for the effect of obesity on embryo development that may not be perceptible through the assessment of cell division timing events.
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Affiliation(s)
- Theresa Piquette
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Robert T. Rydze
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Amy Pan
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jayme Bosler
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Amy Granlund
- Reproductive Medicine Center, Froedtert Hospital, North Hills Health Center, Menomonee Falls, Wisconsin
| | - Kate D. Schoyer
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin,Reprint requests: Kate D. Schoyer, M.D., Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 W. Watertown Plank Rd, Milwaukee, Wisconsin; 53226.
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11
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Lean SC, Candia AA, Gulacsi E, Lee GCL, Sferruzzi-Perri AN. Obesogenic diet in mice compromises maternal metabolic physiology and lactation ability leading to reductions in neonatal viability. Acta Physiol (Oxf) 2022; 236:e13861. [PMID: 35880402 PMCID: PMC9787084 DOI: 10.1111/apha.13861] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 01/29/2023]
Abstract
AIMS Diets containing high-fat and high sugar (HFHS) lead to overweight/obesity. Overweight/obesity increases the risk of infertility, and of the pregnant mother and her child for developing metabolic conditions. Overweight/obesity has been recreated in mice, but most studies focus on the effects of chronic, long-term HFHS diet exposure. Here, we exposed mice to HFHS from 3 weeks prior to pregnancy with the aim of determining impacts on fertility, and gestational and neonatal outcomes. METHODS Time-domain NMR scanning was used to assess adiposity, glucose, and insulin tolerance tests were employed to examine metabolic physiology, and morphological and proteomic analyses conducted to assess structure and nutrient levels of maternal organs and placenta. RESULTS Fertility measures of HFHS dams were largely the same as controls. HFHS dams had increased adiposity pre-pregnancy, however, exhibited exacerbated lipolysis/hyper-mobilization of adipose stores in late pregnancy. While there were no differences in glucose or insulin tolerance, HFHS dams were hyperglycemic and hyperinsulinemic in pregnancy. HFHS dams had fatty livers and altered pancreatic islet morphology. Although fetuses were hyperglycemic and hyperinsulinemic, there was no change in fetal growth in HFHS dams. There were also reductions in placenta formation. Moreover, there was increased offspring loss during lactation, which was related to aberrant mammary gland development and milk protein composition in HFHS dams. CONCLUSIONS These findings are relevant given current dietary habits and the development of maternal and offspring alterations in the absence of an increase in maternal weight and adiposity during pregnancy, which are the current clinical markers to determine risk across gestation.
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Affiliation(s)
- Samantha C Lean
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Alejandro A Candia
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.,Department for the Woman and Newborn Health Promotion, Universidad de Chile, Santiago, Chile
| | - Edina Gulacsi
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Giselle C L Lee
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Amanda N Sferruzzi-Perri
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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12
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Association of infertility cause with perinatal outcomes in a freeze-all policy: an analysis including 10,151 singleton newborns. AJOG GLOBAL REPORTS 2022; 3:100098. [DOI: 10.1016/j.xagr.2022.100098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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13
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He B, Zhang Q, Guo Y, Ao Y, Tie K, Xiao H, Chen L, Xu D, Wang H. Prenatal smoke (Nicotine) exposure and offspring's metabolic disease susceptibility in adulthood. Food Chem Toxicol 2022; 168:113384. [PMID: 36041661 DOI: 10.1016/j.fct.2022.113384] [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: 01/24/2022] [Revised: 08/06/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
Exposure to smoking (nicotine) during pregnancy not only directly affects fetal development, but also increases susceptibility to metabolic diseases in adulthood, but the mechanism of action remains unclear. Here, we review epidemiological and laboratory studies linking these relationships. In addition to the direct effect of nicotine on the fetus, intrauterine neuroendocrine-metabolic programming mediated by maternal glucocorticoid overexposure also plays an important role, involving glucocorticoid-insulin-like growth factor 1 (GC-IGF1) axis, hypothalamic-pituitary-adrenal (HPA) axis, renin-angiotensin system (RAS) and other endocrine systems. Epigenetics is involved in intrauterine neuroendocrine-metabolic programming, metabolic disease susceptibility and multigenerational inheritance. There are "two programming" and "two strikes" mechanisms for the occurrence of fetal-originated metabolic diseases in adulthood. These innovative research summaries and academic viewpoints provide experimental and theoretical basis for systematically elucidating the occurrence and development of fetal-originated metabolic diseases.
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Affiliation(s)
- Bo He
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, 650500, China
| | - Qi Zhang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Yu Guo
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Ying Ao
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Kai Tie
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Hao Xiao
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Liaobin Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China
| | - Dan Xu
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China; Department of Pharmacy, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
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14
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Chen Y, Duan F, Liu L, Chen G, He Z, Huang H, Wang H. Sex differences and heritability of adrenal steroidogenesis in offspring rats induced by prenatal nicotine exposure. J Steroid Biochem Mol Biol 2022; 221:106102. [PMID: 35367371 DOI: 10.1016/j.jsbmb.2022.106102] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/28/2022]
Abstract
The epidemiological investigation has suggested prenatal nicotine exposure (PNE) induces multiorgan developmental toxicity and increases the risk of metabolic diseases in offspring. Our previous study found that the occurrence of fetal-originated diseases was associated with abnormal adrenal development in offspring. However, the long-term harmful effects on adrenal development in offspring induced by PNE remain unclear. Pregnant Wistar rats were injected subcutaneously with nicotine (2 mg/kg·d) from gestation day (GD) 9 to GD20 to obtain the adrenal gland from fetal and adult offspring rats of F1 and F2 generations. We found that the adrenal insulin-like growth factor 1 (IGF1) signaling pathway and steroidogenic function were increased in male while decreased in female of PNE fetal rats, which could extend into adulthood. Furthermore, the primary adrenal cells of fetal rats were treated with nicotine to observe the phenomena and clarify the possible mechanism of the sex difference. The results suggested that there are sex differences in IGF1 signaling pathway and steroidogenic function induced by PNE, which may be associated with sex differences in nAChRβ1 expression. In addition, the adrenal steroidogenic function was reduced in F2 offspring of F1 PNE female rats (regardless of mating with control or Male PNE rats). Therefore, the decrease of adrenal steroidogenic function in female offspring rats induced by PNE has maternal heritability. In conclusion, PNE could lead to sex differences and heritability of adrenal steroidogenic function in offspring rats.
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Affiliation(s)
- Yawen Chen
- Department of Pharmacology, Basic Medical College of Wuhan University, Wuhan 430071, China
| | - Fangfang Duan
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Lian Liu
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China; Department of Pharmacology, Medical College of Yangtze University, Jingzhou 434023, China
| | - Guanghui Chen
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Zheng He
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Hegui Huang
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Hui Wang
- Department of Pharmacology, Basic Medical College of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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15
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Value of Ethnicity or Race in More Accurate Prediction of Future Outcome in Couples with Recurrent Miscarriages. Reprod Sci 2022; 29:2079-2080. [PMID: 35484465 PMCID: PMC9287212 DOI: 10.1007/s43032-022-00942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/09/2022] [Indexed: 11/05/2022]
Abstract
This special issue of Reproductive Sciences is focusing on ethnic health disparity and its impact on (fe)male reproduction. Indeed, studies regarding underlying mechanisms, interventions and prognosis in reproduction are underexposed for the non-White male and female. Here, we call for documentation of race and ethnicity in the analysis and management of couples with recurrent pregnancy loss.
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16
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Comparison of Machine Learning model with Cox regression for prediction of cumulative live birth rate after assisted reproductive techniques: An internal and external validation. Reprod Biomed Online 2022; 45:246-255. [DOI: 10.1016/j.rbmo.2022.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 11/21/2022]
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17
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Stanford JB, Carpentier PA, Meier BL, Rollo M, Tingey B. Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study. BMC Pregnancy Childbirth 2021; 21:495. [PMID: 34233646 PMCID: PMC8265110 DOI: 10.1186/s12884-021-03946-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are highly suitable for primary care practice. We studied the outcomes amongst couples who received restorative reproductive medicine treatment for infertility in a primary care setting. METHODS Two family physicians in Massachusetts trained in a systematic approach to RRM (natural procreative technology, or NaProTechnology) treated couples with infertility. We retrospectively reviewed the characteristics, diagnoses, treatments, and outcomes for all couples treated during the years 1989 to 2014. We compared pregnancy and live birth by clinical characteristics using Kaplan-Meier analysis. We employed the Fleming-Harrington weighted Renyi test or the logrank test to compare the cumulative proportion with pregnancy or with live birth. RESULTS Among 370 couples beginning treatment for infertility, the mean age was 34.8 years, the mean prior time trying to conceive was 2.7 years, and 27% had a prior live birth. The mean number of diagnoses per couple was 4.9. Treatment components included fertility tracking with the Creighton Model FertilityCare System (80%); medications to enhance cervical mucus production (81%), to stimulate ovulation (62%), or to support the luteal phase (75%); and referral to female laparoscopy by a surgeon specializing in endometriosis (46%). The cumulative live birth rate at 2 years was 29% overall; this was significantly higher for women under age 35 (34%), and for women with body mass index < 25 (40%). There were 2 sets of twins and no higher-order multiple gestations. Of the 63 births with data available, 58 (92%) occurred at term. CONCLUSIONS Family physicians can provide a RRM approach for infertility to identify underlying causes and promote healthy term live births. Younger women and women with body mass index < 25 are more likely to have a live birth.
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Affiliation(s)
- Joseph B Stanford
- Office of Cooperative Reproductive Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA. .,International Institute for Restorative Reproductive Medicine, London, UK.
| | - Paul A Carpentier
- International Institute for Restorative Reproductive Medicine, London, UK.,Gianna of Long Island Center for Women's Health and Fertility, New York, USA.,In His Image Family Medicine, Gardner, MA, USA
| | - Barbara L Meier
- International Institute for Restorative Reproductive Medicine, London, UK.,Gianna of Long Island Center for Women's Health and Fertility, New York, USA.,In His Image Family Medicine, Gardner, MA, USA.,Reliant Medical Group, Fitchburg, MA, USA
| | - Mark Rollo
- International Institute for Restorative Reproductive Medicine, London, UK.,Reliant Medical Group, Fitchburg, MA, USA
| | - Benjamin Tingey
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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18
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Bosselut H, Paulmyer-Lacroix O, Gnisci A, Bretelle F, Perrin J, Courbiere B. [Prognostic factors of live-birth after in vitro fertilization for unexplained infertility: A cohort study]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:601-607. [PMID: 33434750 DOI: 10.1016/j.gofs.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES For 15 to 30% of infertile couples, no etiology can be found, leading to the diagnosis of "unexplained infertility". The aim of our study was to identify prognostic factors for live birth following in vitro fertilization (IVF) for these couples. METHODS A retrospective, monocentric study on a cohort of couples undergoing IVF for unexplained infertility with the woman aged≤40 years old. Primary analysis compared couples with a live birth following IVF versus childless couples following IVF. RESULTS Between January 2014 and December 2018, 104 couples were included, 196 transvaginal oocyte pickup were performed, followed by 234 embryo transfers (fresh or cryopreserved) which resulted in 43 deliveries. The cumulative live birth rate was 40.4% per couple. Before IVF attempts, no clinical or paraclinical prognostic factors between the two groups was observed. However, multivariate analysis showed several biological factors of good prognosis in course of treatment, such as a higher number of mature oocytes and better quality embryos in "live birth" group. CONCLUSIONS For a couple, the chances of having a child following IVF unexplained infertility are 40.4%. However, no clinical characteristic enabled us to identify favourable or unfavourable prognosis factors before starting ART. The prognostic factors identified during IVF cycle are interesting to advise or not to pursue IVF.
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Affiliation(s)
- H Bosselut
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - O Paulmyer-Lacroix
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, département d'histologie et embryologie, Marseille, France
| | - A Gnisci
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France
| | - F Bretelle
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, unité de recherche sur les maladies infectieuses tropicales et émergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France
| | - J Perrin
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, CNRS, IRD, Avignon université, IMBE, Marseille, France
| | - B Courbiere
- Pôle femmes-parents-enfants, centre clinico-biologique d'AMP-CECOS, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix Marseille université, CNRS, IRD, Avignon université, IMBE, Marseille, France
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Xiong Y, Wang J, Huang S, Liu C, Liu Y, Qi Y, Li L, Wang W, Zou K, Tan J, Sun X. Association between maternal prepregnancy body mass index and pregnancy outcomes following assisted reproductive technology: A systematic review and dose-response meta-analysis. Obes Rev 2021; 22:e13219. [PMID: 33554474 DOI: 10.1111/obr.13219] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/05/2021] [Accepted: 01/22/2021] [Indexed: 02/05/2023]
Abstract
This systematic review investigated dose-response relationship between maternal prepregnancy body mass index (BMI) and pregnancy outcomes following assisted reproductive technology, including clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR). We searched four major databases and finally included 105 studies involving more than 271,632 pregnant women. We performed linear or nonlinear dose-response meta-analyses using random effects models. At per-woman level, pooling of unadjusted estimates shown an inverted J-shaped relationship between maternal BMI and CPR; pooling of adjusted estimates showed a linear association, suggesting statistical association between higher maternal BMI and lower CPR (adjusted OR [aOR] for 5-unit increase in BMI: 0.96, 95%CI: 0.94-0.98). At per-cycle level, linear dose-response relationship was found between maternal BMI and CPR (crude relative risk, RR, [cRR] for 5-unit increase in BMI 0.97, 0.96-0.98; aOR 0.96, 0.94-0.99). Linear dose-response relationship was established between maternal BMI and the outcomes of MR or LBR (higher BMI associated with higher MR [cRR 1.15, 1.08-1.22] and lower LBR [cRR 0.91, 0.88-0.94] at per-woman level). Sensitivity analyses showed no significant changes. In conclusion, there is dose-response relationship between maternal BMI and pregnancy outcomes following assisted reproductive technology. Higher BMI values may suggest suboptimal pregnancy outcomes.
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Affiliation(s)
- Yiquan Xiong
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jing Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Shiyao Huang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Chunrong Liu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yanmei Liu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yana Qi
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wen Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Kang Zou
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jing Tan
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
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20
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Guan H, Tang H, Pan L, Song H, Tang L. Pregnancy predictors in unexplained infertility after intrauterine insemination. J Gynecol Obstet Hum Reprod 2021; 50:102071. [PMID: 33486101 DOI: 10.1016/j.jogoh.2021.102071] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/21/2020] [Accepted: 01/14/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Intrauterine insemination (IUI) is a first-line treatment for unexplained infertility (UI). There was a compelling need for the improvement of pregnancy rate in females with UI. OBJECTIVE To explore the pregnancy predictors in cases of UI undergoing IUI. METHOD A total of 212 couples who underwent 446 IUI cycles were involved the study. Different factors were grouped to explore the influencing factors of IUI for UI. RESULT Female age and somking affected pregnancy outcomes. As the number of treatment cycles increased, the pregnancy rate increased. The BMI, treatment regimens, type of infertility, endometrium, and timing insemination have no significant prognostic value. CONCLUSION Apart from the number of treatment cycles, somking, and female age, no other factors had prognostic value. More studies and samples are necessary to evaluate whether other factors affect conception.
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Affiliation(s)
- Huijuan Guan
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Jiangsu, Lianyungang, 222001, China
| | - Huaiyun Tang
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Jiangsu, Lianyungang, 222001, China
| | - Linqing Pan
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Jiangsu, Lianyungang, 222001, China
| | - Hang Song
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Jiangsu, Lianyungang, 222001, China
| | - Lisha Tang
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Jiangsu, Lianyungang, 222001, China.
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Ricci E, Noli S, Ferrari S, La Vecchia I, De Cosmi V, Castiglioni M, Somigliana E, Agostoni C, Cipriani S, Mauri PA, Parazzini F. Pretreatment maternal lifestyle and outcomes of assisted reproduction: an Italian cohort study. BMJ Open 2020; 10:e038837. [PMID: 33243794 PMCID: PMC7692844 DOI: 10.1136/bmjopen-2020-038837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE We investigated whether lifestyle affects assisted reproduction technology (ART) outcomes. DESIGN Cohort study. SETTING Italian fertility unit. PARTICIPANTS From September 2014 to December 2016, women from couples presenting for evaluation and eligible for ART were invited to participate. Information on alcohol intake, current smoking and leisure physical activity (PA) during the year before the interview was collected, using a structured questionnaire. We considered the ART outcomes of the cycle immediately following the interview. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was cumulative pregnancy rate per retrieval. Secondary measures were number of retrieved oocytes, embryo transfer and live birth. RESULTS In 492 women undergoing an ART cycle, 427 (86.8%) underwent embryo transfer, 157 (31.9%) had at least one clinical pregnancy and 121 (24.6%) had live birth. The cumulative pregnancy rate per retrieval was 33.3% (95% CI 28.5% to 38.7%). In women in the third tertile of alcohol intake, adjusted relative risk was 0.97 (95% CI 0.87 to 1.08), 0.90 (95% CI 0.62 to 1.30) and 0.89 (95% CI 0.57 to 1.37) for embryo transfer, clinical pregnancy and live birth, respectively. The corresponding figures in women currently smoking more than 5 cigarettes/day were 1.00 (95% CI 0.88 to 1.16), 0.94 (95% CI 0.60 to 1.48) and 1.14 (95% CI 0.68 to 1.90), and in women with PA ≥5 hours/week were 0.93 (95% CI 0.79 to 1.08), 0.44 (95% CI 0.22 to 0.90) and 0.48 (95% CI 0.22 to 1.05), respectively. CONCLUSION There were no significant differences in in vitro fertilisation outcomes among women who used alcohol or tobacco in the year prior to treatment. Conservatively, all women should be advised to limit substance abuse. Moreover, our study suggested that maintaining a moderate, but not high, level of PA could be beneficial.
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Affiliation(s)
- Elena Ricci
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Noli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Stefania Ferrari
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Irene La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valentina De Cosmi
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Università di Milano, Milan, Italy
| | - Marta Castiglioni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Edgardo Somigliana
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Sonia Cipriani
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Agnese Mauri
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Fabio Parazzini
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Khunte R, Li M, Behr B, Zhao Q, Baker VL. Blastocyst formation rate for Asians versus Caucasians and within body mass index categories. J Assist Reprod Genet 2020; 37:933-943. [PMID: 32130613 DOI: 10.1007/s10815-020-01706-9] [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: 06/21/2019] [Accepted: 01/30/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE There are well-documented racial and ethnic disparities for in vitro fertilization (IVF) outcomes, including disparities in clinical pregnancy and live birth rate. Obesity has also been associated with an increase in the risk of infertility and reduction in the efficacy of fertility treatment. However, there are limited data regarding the potential effect of race and obesity on in vitro embryo development. The purpose of this study was to determine whether blastocyst formation rates vary with race and body mass index (BMI). METHODS This retrospective analysis included 1134 fresh autologous cycles (N = 8266 embryos), which took place from January 2013 to December 2016. Women were categorized as Caucasian, Asian (not Indian), and Indian (South Asian) and by BMI categories (normal, overweight, and obese). Regression analyses were performed using race and BMI as the primary predictor variables and blastocyst formation as the outcome. RESULTS Compared to Caucasian, the adjusted OR for blastocyst development was 0.85 (95% CI 0.72-1.00) for Asian women and 1.15 (95% CI 0.95-1.38) for Indian women. Women who were overweight (aOR 0.93; 95% CI 0.77-1.12) or obese (aOR 0.92; 95% CI 0.74-1.12) had similar odds of blastocyst formation comparing to women with normal BMI. Furthermore, analyses examining combined effects of race and BMI revealed no differences in blastocyst formation among Asian or Indian women with varied BMI categories compared to Caucasian women with normal BMI. CONCLUSION Blastocyst formation did not differ based on race or BMI.
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Affiliation(s)
- Rucha Khunte
- Odessa Fertility Lab, Odessa Regional Medical Center, Odessa, TX, USA
| | - Mengmeng Li
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Barry Behr
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Stanford University Medical Center, Sunnyvale, CA, USA
| | - Qianying Zhao
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Stanford University Medical Center, Sunnyvale, CA, USA
| | - Valerie Lynn Baker
- Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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23
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Xiong YQ, Liu YM, Qi YN, Liu CR, Wang J, Li L, Zou K, Tan J, Sun X. Association between prepregnancy subnormal body weight and obstetrical outcomes after autologous in vitro fertilization cycles: systematic review and meta-analysis. Fertil Steril 2020; 113:344-353.e2. [DOI: 10.1016/j.fertnstert.2019.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 01/11/2023]
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Salih Joelsson L, Elenis E, Wanggren K, Berglund A, Iliadou AN, Cesta CE, Mumford SL, White R, Tydén T, Skalkidou A. Investigating the effect of lifestyle risk factors upon number of aspirated and mature oocytes in in vitro fertilization cycles: Interaction with antral follicle count. PLoS One 2019; 14:e0221015. [PMID: 31419245 PMCID: PMC6697332 DOI: 10.1371/journal.pone.0221015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 07/30/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION There is evidence demonstrating that certain lifestyle factors have a detrimental effect on fertility. Since such factors often coexist, possible synergistic effects merit further investigation. Thus we aimed to examine the cumulative impact of lifestyle factors on in vitro fertilization (IVF) early reproductive treatment outcomes and their interaction with measures of ovarian reserve. MATERIALS AND METHODS By following women who were starting their first fresh IVF cycle in 2 cohorts, the "Lifestyle study cohort" (hypothesis generating cohort, n = 242) and the "UppSTART study" (validation cohort, n = 432) in Sweden, we identified two significant risk factors acting independently, smoking and BMI, and then further assessed their cumulative effects. RESULTS Women with both these risk factors had an Incidence Rate Ratio (IRR) of 0.75 [(95% CI 0.61-0.94)] regarding the number of aspirated oocytes compared to women without these risk factors. Concerning the proportion of mature oocytes in relation to the total number of aspirated oocytes, the interaction between BMI and Antral Follicle Count (AFC) was significant (p-value 0.045): the lower the value of AFC, the more harmful the effect of BMI with the outcome. CONCLUSIONS Data shows that there is an individual as well as a cumulative effect of smoking and BMI on the number of aspirated and mature oocytes in fresh IVF treatment cycles. AFC might modify associations between BMI and the proportion of mature oocytes in relation to the total number of aspirated oocytes. These results highlight the importance of lifestyle factors on IVF early reproductive outcomes and provide additional evidence for the importance of preconception guidance for the optimization of IVF cycle outcome.
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Affiliation(s)
- Lana Salih Joelsson
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Evangelia Elenis
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Kjell Wanggren
- Department of Clinical Science, Intervention and Technology, Obstetrics and gynecology, Karolinska Institute, Stockholm, Sweden
| | - Anna Berglund
- National Centre for Knowledge on Men's Violence against women (NCK), Uppsala University, Uppsala, Sweden
| | - Anastasia N. Iliadou
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Carolyn E. Cesta
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Sunni L. Mumford
- 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, United States of America
| | | | - Tanja Tydén
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
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Martinez RM, Baccarelli AA, Liang L, Dioni L, Mansur A, Adir M, Bollati V, Racowsky C, Hauser R, Machtinger R. Body mass index in relation to extracellular vesicle-linked microRNAs in human follicular fluid. Fertil Steril 2019; 112:387-396.e3. [PMID: 31146888 PMCID: PMC6663626 DOI: 10.1016/j.fertnstert.2019.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To study whether increased body mass index is associated with altered expression of extracellular vesicle microRNAs (EV-linked miRNAs) in human follicular fluid. DESIGN Cross-sectional study. SETTING Tertiary-care university-affiliated center. PATIENT(S) One hundred thirty-three women undergoing in vitro fertilization (IVF) were recruited from January 2014 to August 2016. INTERVENTIONS(S) None. MAIN OUTCOME MEASURE(S) EV-linked miRNAs were isolated from follicular fluid and their expression profiles were measured with the use of the Taqman Open Array Human miRNA panel. EV-linked miRNAs were globally normalized and inverse-normal transformed. Associations between body mass index (BMI) and EV-linked miRNA outcomes were analyzed by means of multivariate linear regression and principal component analysis. RESULT(S) Eighteen EV-linked miRNAs were associated with an increase in BMI after adjusting for age, ethnicity, smoking status, and batch effects. Hsa-miR-328 remained significant after false discovery rate adjustments. Principal component analyses identified the first principal component to account for 40% of the variation in our EV-linked miRNA dataset, and adjusted linear regression found that the first principal component was significantly associated with BMI after multiple testing adjustments. Using Kyoto Encyclopedia of Genes and Genomes enrichment analyses, we predicted gene targets of EV-linked miRNA in silico and identified PI3K-Akt signaling, ECM-receptor interaction, focal adhesion, FoxO signaling, and oocyte meiosis pathways. CONCLUSION(S) These results show that a 1-unit increase in BMI is associated with altered follicular fluid expression of EV-linked miRNAs that may influence follicular and oocyte developmental pathways. Our findings provide potential insight into a mechanistic explanation for the reduced fertility rates associated with increased BMI.
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Affiliation(s)
- Rosie M Martinez
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Laboratory of Precision Environmental Biosciences, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York
| | - Andrea A Baccarelli
- Laboratory of Precision Environmental Biosciences, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Laura Dioni
- Epidemiology, Epigenetics, and Toxicology Laboratory, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Abdallah Mansur
- Department of Obstetrics and Gynecology, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Ramat-Gan, Israel
| | - Michal Adir
- Department of Obstetrics and Gynecology, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Ramat-Gan, Israel
| | - Valentina Bollati
- Epidemiology, Epigenetics, and Toxicology Laboratory, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Catherine Racowsky
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ronit Machtinger
- Department of Obstetrics and Gynecology, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Ramat-Gan, Israel.
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Di Gregorio LM, Zambrotta E, Di Guardo F, Gulino FA, Musmeci G, Capriglione S, Angioli R, Palumbo M. Effects of Body Mass Index and Biochemical Lipid Levels on Reproductive Outcomes during An Intracytoplasmic Sperm Injection: A Retrospective Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:190-195. [PMID: 31310072 PMCID: PMC6642433 DOI: 10.22074/ijfs.2019.5614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/26/2018] [Indexed: 12/12/2022]
Abstract
Background The aim of this study was to evaluate the impact of body mass index (BMI) and lipid profile on repro-
ductive outcomes of women undergoing intracytoplasmic sperm injection (ICSI) cycles. Materials and Methods This retrospective observational study was conducted in the Center of Human Reproductive
Physiopathology of University of Catania between April 2017 and March 2018 and enrolled 114 couples undergoing
ICSI. Levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-c), high-density lipoprotein-cholesterol
(HDL-c) and triglycerides were determinate and, according to the BMI, samples were divided into the following
groups: group A (BMI: 18.5-24.9 kg/m2); group B (BMI: 25-29.9 kg/m2); and group C (BMI >30 kg/m2). BMI and
lipid profile associations with the number of oocytes and embryos retrieved, the oocytes and embryo quality, the fer-
tilization rate as well as the percentage of miscarriages and pregnancies, were assessed. The statistical analysis was
performed using Shapiro-Wilk test, analysis of variance (ANOVA) and Kruskal -Wallis method. Results Fertilization and pregnancy rates were lower in women with BMI>30 than in women with BMI: 25-29.9 and
BMI: 18.5-24.9, despite the not altered levels of lipoprotein. Conclusion Our results demonstrated that an excess of adipose tissue in women undergoing ICSI was not directly
related with altered biochemical lipid values. However, overweight and obese patients showed poor fertilization and
pregnancy rate despite the not altered values of lipoprotein.
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Affiliation(s)
- Luisa Maria Di Gregorio
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Elisa Zambrotta
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Federica Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.Electronic Address:
| | - Ferdinando Antonio Gulino
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Giulia Musmeci
- Department of Pharmaceutical Sciences, University of Catania, Catania, Italy
| | - Stella Capriglione
- Department of Obstetrics and Gynaecology, Campus Bio-Medico, Rome, Italy
| | - Roberto Angioli
- Department of Obstetrics and Gynaecology, Campus Bio-Medico, Rome, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Purewal S, Chapman SCE, van den Akker OBA. A systematic review and meta-analysis of lifestyle and body mass index predictors of successful assisted reproductive technologies. J Psychosom Obstet Gynaecol 2019; 40:2-18. [PMID: 29172958 DOI: 10.1080/0167482x.2017.1403418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Lifestyle (smoking, drinking alcohol) and body mass index (BMI) predictors of successful outcomes in assisted reproductive technology (ART) treatments were examined in this meta-analysis. METHOD A bibliographic search was undertaken using six databases. The review was informed by PRISMA/MOOSE guidelines. Meta-analytic data were analysed using random effects models. RESULTS We included 77 studies examining effects of BMI, smoking and drinking alcohol. Patients with a BMI< =24.9 were significantly more likely to achieve LB/pregnancy than with BMI> =25 OR = 1.219 (95% CI:1.128-1.319, z = 4.971, p < .001; I2 = 53.779%, p = .001). Non-smokers were significantly more likely to achieve a LB or pregnancy than smokers OR = 1.457 (95% CI:1.228-1.727, z = 4.324, p < .001; I2 = 51.883; p = .001). Meta-regression revealed the number of embryos transferred significantly moderated the effects of smoking on ART outcomes, and there was a trend indicating primary infertility and high BMI were also significant moderators. The evidence for drinking alcohol was inconclusive due to the small number of studies. CONCLUSIONS This meta-analysis confirms that ART treatment success can be predicted with lifestyle factors. Further, non-smokers' relative odds of pregnancy/live birth increase as more embryos were transferred but there was a trend that the odds of pregnancy/live birth decrease with primary infertility and high BMI.
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Affiliation(s)
- Satvinder Purewal
- a Institute of Psychology, Faculty of Education, Health and Wellbeing , University of Wolverhampton , Wolverhampton , UK
| | - S C E Chapman
- b Department of Pharmacy & Pharmacology , University of Bath , Bath , UK
| | - O B A van den Akker
- c Department of Psychology, School of Science and Technology , Middlesex University , London , UK
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28
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Slopien R, Horst N, Jaremek JD, Chinniah D, Spaczynski R. The impact of surgical treatment of obesity on the female fertility. Gynecol Endocrinol 2019; 35:100-102. [PMID: 30599791 DOI: 10.1080/09513590.2018.1500536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
As obesity is considered to be a pandemic of the twenty-first century, the bariatric surgery becomes more common through the global population. The adverse effects of obesity on fertility can be reversed through the bariatric surgery procedures. In this review, we presented the effects of bariatric surgery on hypothalamic-pituitary-ovarian axis and fertility, ovarian reserve, and contraception efficacy.
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Affiliation(s)
- Radoslaw Slopien
- a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
| | - Nikodem Horst
- b Department of General of Colorectal Surgery , Poznan University of Medical Sciences , Poznan , Poland
| | | | | | - Robert Spaczynski
- d Department of Infertility and Reproductive Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
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WITHDRAWN: Birth characteristics in men with infertility. Reprod Biomed Online 2018. [DOI: 10.1016/j.rbmo.2018.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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30
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Zhang RP, Zhao WZ, Chai BB, Wang QY, Yu CH, Wang HY, Liu L, Yang LQ, Zhao SH. The effects of maternal cigarette smoking on pregnancy outcomes using assisted reproduction technologies: An updated meta-analysis. J Gynecol Obstet Hum Reprod 2018; 47:461-468. [DOI: 10.1016/j.jogoh.2018.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/05/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022]
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Bazzano MV, Sarrible GB, Martinez N, Berón de Astrada M, Elia EM. Obesity alters the uterine environment before pregnancy. J Nutr Biochem 2018; 62:181-191. [PMID: 30300837 DOI: 10.1016/j.jnutbio.2018.09.009] [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: 05/21/2018] [Revised: 08/03/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022]
Abstract
Obesity is a metabolic disorder that predisposes to numerous diseases and has become a major global public health concern. Cafeteria diet (CAF) is the animal model used for the study of obesity that more closely reflects Western diet habits. Previously, we described that CAF administration for 60 days induces obesity in female rats and their fetuses develop macrosomia. Given that, in our model, rats are not genetically modified and that obese mothers were fed standard chow during pregnancy, the aim of the current study was to test the hypothesis that obesity alters the intrauterine environment prior to pregnancy, and this may explain the exacerbated fetal weight gain. We found that uteri from obese rats during the estrous phase developed insulin resistance through mechanisms that involve the induction of uterine hypoxia and the down-regulation of the insulin receptor gene. Moreover, uterine cell proliferation was induced by obesity concomitantly with the reduction in the uterine contractile response to a β2 AR agonist, salbutamol, and this may be consequence of the down-regulation in the uterine β2 AR expression. We conclude that CAF-induced obesity alters the uterine environment in rats during the estrous phase and may cause the fetal macrosomia previously described by us in obese animals. The lower sensitivity of the uterus to a relaxation stimulus (salbutamol) is not a minor fact given that for implantation to occur the uterus must be relaxed for embryo nidation. Thus, the alteration in the uterine quiescence may impair implantation and, consequently, the foregoing pregnancy.
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Affiliation(s)
- María Victoria Bazzano
- Universidad de Buenos Aires (UBA), Facultad de Ciencias Exactas y Naturales (FCEN), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-UBA-Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE), Buenos Aires, Argentina
| | - Gisela Belén Sarrible
- Universidad de Buenos Aires (UBA), Facultad de Ciencias Exactas y Naturales (FCEN), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-UBA-Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE), Buenos Aires, Argentina; UBA, FCEN, Departamento de Biodiversidad y Bilogía Experimental, Buenos Aires, Argentina
| | - Nora Martinez
- UBA, Facultad de Medicina, Buenos Aires, Argentina; CONICET-UBA- Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO), Buenos Aires, Argentina
| | - Martín Berón de Astrada
- Universidad de Buenos Aires (UBA), Facultad de Ciencias Exactas y Naturales (FCEN), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-UBA-Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE), Buenos Aires, Argentina; UBA, FCEN, Departamento de Fisiología, Biología Molecular y Celular, Buenos Aires, Argentina
| | - Evelin Mariel Elia
- Universidad de Buenos Aires (UBA), Facultad de Ciencias Exactas y Naturales (FCEN), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-UBA-Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE), Buenos Aires, Argentina; UBA, FCEN, Departamento de Biodiversidad y Bilogía Experimental, Buenos Aires, Argentina.
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Budani MC, Fensore S, Di Marzio M, Tiboni GM. Cigarette smoking impairs clinical outcomes of assisted reproductive technologies: A meta-analysis of the literature. Reprod Toxicol 2018; 80:49-59. [PMID: 29906539 DOI: 10.1016/j.reprotox.2018.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/14/2018] [Accepted: 06/05/2018] [Indexed: 12/26/2022]
Abstract
There is convincing evidence that cigarette smoking can impair female reproductive potential. This meta-analysis updates the knowledge regarding the effects of cigarette smoking on clinical outcomes of assisted reproductive technologies (ART). Twenty-six studies were included in this meta-analysis. Results were expressed as odds ratios (OR) with 95% confidence intervals (CI) and statistical heterogeneity between the studies was evaluated with Higgins (I2), Breslow (τ2), Birge's ratio (H2) indices and Chi-square test (χ2). A P-value < 0.05 was considered statistically significant. The analysis showed a significant decrease in live birth rate per cycle for smoking patients (OR 0.59, 95% CI 0.44-0.79; P = 0.0005), a significant lower clinical pregnancy rate per cycle for smoking women (OR 0.53, 95% CI 0.41-0.68; P < 0.0001), and a significant increase in terms of spontaneous miscarriage rate (OR 2.22, 95% CI 1.10-4.48; P = 0.025) for smokers. These findings demonstrate clear negative effects of cigarette smoking on the outcome of ART programs.
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Affiliation(s)
- Maria Cristina Budani
- Dipartimento di Medicina e Scienze dell'Invecchiamento, University "G. d'Annunzio" Chieti-Pescara, Italy.
| | - Stefania Fensore
- Dipartimento di Scienze Filosofiche, Pedagogiche ed Economico-Quantitative, University "G. d'Annunzio" Chieti-Pescara, Italy.
| | - Marco Di Marzio
- Dipartimento di Scienze Filosofiche, Pedagogiche ed Economico-Quantitative, University "G. d'Annunzio" Chieti-Pescara, Italy.
| | - Gian Mario Tiboni
- Dipartimento di Medicina e Scienze dell'Invecchiamento, University "G. d'Annunzio" Chieti-Pescara, Italy.
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Pedro J, Brandão T, Schmidt L, Costa ME, Martins MV. What do people know about fertility? A systematic review on fertility awareness and its associated factors. Ups J Med Sci 2018; 123:71-81. [PMID: 29957086 PMCID: PMC6055749 DOI: 10.1080/03009734.2018.1480186] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/01/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA. METHODS A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e.g. 'awareness' OR 'health knowledge, attitudes, practice' AND 'fertility'; 'fertile period'; 'assisted reprod*'). RESULTS Seventy-one articles met the eligibility criteria and were included. The main results showed that participants report low-to-moderate FA. Higher levels of FA were shown by women, highly educated individuals, people who reported difficulties with conceiving, and those who had planned their pregnancies. Having or desiring to have children was not related to FA level. An inconsistent association between study participant age and FA was observed, with some studies indicating that older participants had higher FA, but others found an opposite result or did not find any association. CONCLUSION The current findings suggest that interventions to increase FA are warranted, especially those targeting men, people with low education, and in family planning settings. Interventions and campaigns should be customized to meet individuals' needs regarding FA. Because of the high heterogeneity regarding the assessment of FA, these conclusions must be interpreted with caution.
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Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Tânia Brandão
- Centre for Research in Psychology (CIP-UAL), Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria E. Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana V. Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
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Hamirah NK, Kamsani YS, Mohamed Nor Khan NA, Ab Rahim S, Rajikin MH. Effects of Nicotine and Tocotrienol-Rich Fraction Supplementation on Cytoskeletal Structures of Murine Pre-Implantation Embryos. Med Sci Monit Basic Res 2017; 23:373-379. [PMID: 29217815 PMCID: PMC5731215 DOI: 10.12659/msmbr.905447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Cytoskeletal structures, in particular actin and tubulin, provide a fundamental framework in all cells, including embryos. The objective of this study was to evaluate the effects of nicotine, which is a source of oxidative stress, and subsequent supplementation with Tocotrienol-rich fraction (TRF) on actin and tubulin of 2- and 8-cell murine embryos. Material/Methods Thirty female Balb/C mice were divided into 4 groups: Group 1 received: subcutaneous (sc) injection of 0.9% NaCl; Group 2 received sc injection of 3.0 nicotine mg/kg bw/day; Group 3 received 3.0 sc injection of nicotine mg/kg bw/day +60 mg/kg bw/day TRF; and Group 4 received 60 sc injection of TRF mg/kg bw/day for 7 consecutive days. The animals were superovulated with 5 IU PMSG followed by 5 IU hCG 48 h later. Animals were cohabited with fertile males overnight and euthanized through cervical dislocation at 24 h post coitum. Embryos at the 2- and 8-cell stages were harvested, fixed, and stained to visualize actin and tubulin distributions by using CLSM. Results Results showed that at 2-cell stage, actin intensities were significantly reduced in the nicotine group compared to that of the control group (p<0.001). In Group 3, the intensity of actin significantly increased compared to that of the nicotine group (p<0.001). At 8-cell stage, actin intensity of the nicotine group was significantly lower than that of the control group (p<0.001). The intensities of actin in Group 3 were increased compared to that of nicotine treatment alone (p<0.001). The same trend was seen in tubulin at 2- and 8-cell stages. Interestingly, both actin and tubulin structures in the TRF-treated groups were enhanced compared to the control. Conclusions This study suggests that TRF prevents the deleterious effects of nicotine on the cytoskeletal structures of 2- and 8-cell stages of pre-implantation mice embryos in vitro.
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Affiliation(s)
- Nurul Kamsani Hamirah
- Institute of Medical Molecular Biotechnology, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Yuhaniza Shafinie Kamsani
- Institute of Medical Molecular Biotechnology, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.,Maternofetal and Embryo Research Group (MatE), Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia
| | - Nor-Ashikin Mohamed Nor Khan
- Institute of Medical Molecular Biotechnology, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.,Maternofetal and Embryo Research Group (MatE), Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia
| | - Sharaniza Ab Rahim
- Institute of Medical Molecular Biotechnology, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Mohd Hamim Rajikin
- Institute of Medical Molecular Biotechnology, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.,Maternofetal and Embryo Research Group (MatE), Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh, Malaysia
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Healthy preconception nutrition and lifestyle using personalized mobile health coaching is associated with enhanced pregnancy chance. Reprod Biomed Online 2017; 35:453-460. [PMID: 28688924 DOI: 10.1016/j.rbmo.2017.06.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/08/2017] [Accepted: 06/08/2017] [Indexed: 01/13/2023]
Abstract
Periconceptional nutrition and lifestyle are essential in pathogenesis and prevention of most reproductive failures, pregnancy outcome and future health. We aimed to investigate whether personalized mobile health (mHealth) coaching empowers couples contemplating pregnancy to increase healthy behaviour and chances of pregnancy. A survey was conducted among 1053 women and 332 male partners who received individual coaching using the mHealth programme 'Smarter Pregnancy' to change poor nutrition and lifestyle for 26 weeks, depending on pregnancy state and gender. Poor behaviours were translated into a total risk score (TRS) and Poisson regression analysis was performed to estimate associations with the chance of pregnancy adjusted for fertility status, age and baseline body mass index expressed as adjusted hazard ratio (aHR) and 95% confidence interval (95% CI). A lower (a)HR suggests a higher chance of achieving pregnancy. A higher TRS was significantly associated with a lower chance of pregnancy in all women (aHR 0.79, 95% CI 0.72-0.85) and (a)HR was lowest in women whose male partner participated (aHR 0.75, 95% CI 0.61-0.91). This survey shows that empowerment of couples in changing poor nutrition and lifestyle using personalized mHealth coaching is associated with an enhanced pregnancy chance in both infertile and fertile couples.
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36
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Mice endometrium receptivity in early pregnancy is impaired by maternal hyperinsulinemia. Mol Med Rep 2017; 15:2503-2510. [PMID: 28447735 PMCID: PMC5428841 DOI: 10.3892/mmr.2017.6322] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/07/2017] [Indexed: 12/20/2022] Open
Abstract
Previous studies have investigated the lower embryo implantation rates in women with polycystic ovary syndrome, obesity and type 2 diabetes, and specifically the association between the abnormal oocyte and embryo and hyperinsulinemia. The importance of hyperinsulinemia on maternal endometrium receptivity remains to be elucidated. The present study used a hyperinsulinemic mouse model to determine whether hyperinsulinemia may affect endometrial receptivity. An insulin intervention mouse model was first established. The serum levels of insulin, progesterone and estradiol were subsequently detected by ELISA assay analysis. The number of implantation sites was recorded using Trypan blue dye and the morphology of mice uteri was investigated using hematoxylin and eosin staining. The expression levels of molecular markers associated with endometrial receptivity were detected by reverse transcription‑quantitative polymerase chain reaction, western blotting and immunohistochemistry analyses. Finally, the importance of mechanistic target of rapamycin (mTOR) expression following insulin treatment was determined. Mice treated with insulin developed insulin resistance and hyperinsulinemia. The number of implantation sites following insulin treatment did not differ between the control and insulin‑treated groups. Additionally, no significant morphological alterations in mice uteri between control and insulin‑treated groups were observed. However, the expression levels of estrogen receptor (Esr) 1, Esr2, progesterone receptor and homeobox A10 associated with endometrial receptivity, were imbalanced during endometrium receptivity when maternal hyperinsulinemia was induced. Western blot analysis revealed that expression levels of endometrial phosphorylated (p)‑mTOR and p‑ribosomal protein S6 kinase β‑1 were significantly greater in the insulin‑treated group. These results demonstrated that although an embryo may implant into endometrium, mice endometrium receptivity in early pregnancy may be impaired by maternal hyperinsulinemia. In addition, mTOR signaling may be involved in this process. The present study provides preliminary results demonstrating that female reproduction may be compromised during hyperinsulinemia, which requires further investigation in future studies.
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37
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Shin JJ, Jee BC, Kim H, Kim SH. Major Disease Prevalence and Menstrual Characteristics in Infertile Female Korean Smokers. J Korean Med Sci 2017; 32:321-328. [PMID: 28049245 PMCID: PMC5220000 DOI: 10.3346/jkms.2017.32.2.321] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/30/2016] [Indexed: 12/03/2022] Open
Abstract
We investigated the prevalence of smoking and factors associated with smoking in infertile Korean women. Smoking status, education, occupation, personal habits, past medical history, current illness, stress level, and menstrual characteristics were collected from self-report questionnaires. The Beck Depression Inventory (BDI) was used to assess the degree of depression. Data on the causes of infertility and levels of six reproductive hormones were collected from medical records. Among 785 women less than 42 years of age, the prevalence of current, secondhand, past, and never smokers were 12.7%, 45.7%, 0.9%, and 40.6%, respectively. Primary infertility was more frequent in secondhand smokers. Causes of infertility were similar among current, secondhand, and never smokers. Current smokers were less educated (P < 0.001) and more likely to consume alcohol than secondhand or never smokers (P < 0.001). Secondhand smokers slept less than current smokers (P = 0.041). Among several major diseases, only the prevalence of diabetes mellitus (4.0%) was significantly higher in current smokers than in secondhand smokers (0.0%, P = 0.002) or never smokers (0.6%, P = 0.031). The self-reported prevalence of depression, and the degree of depression were similar among women with different smoking statuses. There were no differences in menstrual characteristics or serum levels of six reproductive hormones between current, secondhand, and never smokers, even after excluding women with polycystic ovary syndrome. In conclusion, education/employment status, alcohol drinking, and the prevalence of primary infertility and diabetes mellitus were significantly different according to smoking status among infertile women.
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Affiliation(s)
- Jae Jun Shin
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
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Comstock IA, Diaz-Gimeno P, Cabanillas S, Bellver J, Sebastian-Leon P, Shah M, Schutt A, Valdes CT, Ruiz-Alonso M, Valbuena D, Simon C, Lathi RB. Does an increased body mass index affect endometrial gene expression patterns in infertile patients? A functional genomics analysis. Fertil Steril 2016; 107:740-748.e2. [PMID: 27919438 DOI: 10.1016/j.fertnstert.2016.11.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/25/2016] [Accepted: 11/09/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the transcriptomic profile of endometrial gene alterations during the window of implantation in infertile obese patients. DESIGN Multicenter, prospective, case-control study. SETTING Three academic medical centers for reproductive medicine. PATIENT(S) Infertile patients, stratified into body mass index (BMI) categories according to the World Health Organization guidelines, were included in the study. INTERVENTION(S) Endometrial samples were obtained from women undergoing standardized estrogen and P replacement cycles after 5 days of vaginal P supplementation. MAIN OUTCOME MEASURE(S) To identify endometrial gene expression alterations that occur during the window of implantation in infertile obese patients as compared with infertile normal-weight controls using a microarray analysis. RESULT(S) XCL1, XCL2, HMHA1, S100A1, KLRC1, COTL1, COL16A1, KRT7, and MFAP5 are significantly dysregulated during the window of implantation in the receptive endometrium of obese patients. COL16A1, COTL1, HMHA1, KRCL1, XCL1, and XCL2 were down-regulated and KRT7, MFAP5, and S100A1 were up-regulated in the endometrium of obese patients. These genes are mainly involved in chemokine, cytokine, and immune system activity and in the structural extracellular matrix and protein-binding molecular functions. CONCLUSION(S) Obesity is associated with significant endometrial transcriptomic differences as compared with non-obese subjects. Altered endometrial gene expression in obese patients may contribute to the lower implantation rates and increased miscarriage rates seen in obese infertile patients. CLINICAL TRIAL REGISTRATION NUMBER NCT02205866.
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Affiliation(s)
- Ioanna A Comstock
- Stanford University Clinic for Reproductive Medicine, Sunnyvale, California.
| | | | - Sergio Cabanillas
- Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain
| | - Jose Bellver
- Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain
| | | | - Meera Shah
- Stanford University Clinic for Reproductive Medicine, Sunnyvale, California
| | - Amy Schutt
- Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas
| | - Cecilia T Valdes
- Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas
| | | | | | - Carlos Simon
- Stanford University Clinic for Reproductive Medicine, Sunnyvale, California; Valencia University/Instituto Valenciano de Infertilidad, Valencia, Spain; Baylor Family Fertility Center, Texas Children's Hospital Pavilion for Women, Houston, Texas; Igenomix, Valencia, Spain
| | - Ruth B Lathi
- Stanford University Clinic for Reproductive Medicine, Sunnyvale, California
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Kaya Y, Kizilkaya Beji N, Aydin Y, Hassa H. The effect of health-promoting lifestyle education on the treatment of unexplained female infertility. Eur J Obstet Gynecol Reprod Biol 2016; 207:109-114. [PMID: 27838534 DOI: 10.1016/j.ejogrb.2016.10.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 07/23/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to reveal the 1) awareness, 2) improvements of a health-promoting lifestyle on women with unexplained infertility having at least one of the risk factors that have been indicated to negatively affect fertility (smoking, body mass index lower than 18.5kg/m2 and more than 25kg/m2, over-exercising or not exercising at all, alcohol consumption, caffeine consumption of more than 300mg/day, and high levels of stress) by means of health-promoting lifestyle education, 3) the effect of this improvement on the result of assisted-reproduction treatment in terms of clinical pregnancy. STUDY DESIGN 64 women diagnosed with unexplained infertility were divided into a group receiving Health-Promoting Lifestyle (HPL) education and a control group. 1) Risk Factors Questionnaire (BMI, Smoking, Alcohol, Stress, Exercise, Caffeine), 2) Depression, Anxiety and Stress Scale, 3) Health-Promoting Lifestyle Profile II. The health promoting lifestyle was given to the education group. The Risk Factors Questionnaire; Depression, Anxiety, Stress Scale and Healthcare-Promoting Lifestyle Profile II were also administered after the first-second-third month of education but before ART treatment. RESULTS A statistically significant decrease was found in the average levels of four variables as; BMI (p<0.001)-stress (p<0.001)-caffeine consumption (p<0.001)-lower exercise levels (p<0.001). Moreover, the total number of risk factors that females had between the first and third interview decreased significantly. Clinical pregnancy rate after ART was 12 (46.1%) and 5 (19.2%) in education and control group consequently (p=0.02). CONCLUSION Health-promoting lifestyle education was found to be effective in reducing the lifestyle risk factors for infertility and increasing the success rates of assisted reproduction treatment by correcting these risk factors.
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Affiliation(s)
- Yeliz Kaya
- Eskişehir Osmangazi University, Faculty of Health Sciences, Department of Nursing, Eskişehir, Turkey.
| | - Nezihe Kizilkaya Beji
- Biruni University, Faculty of Health Sciences, Department of Nursing, Istanbul, Turkey
| | - Yunus Aydin
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Gynecology and Obstetrics, Reproductive Endocrinology and Infertility, Eskişehir, Turkey
| | - Hikmet Hassa
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Gynecology and Obstetrics, Reproductive Endocrinology and Infertility, Eskişehir, Turkey
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Rossi BV, Bressler LH, Correia KF, Lipskind S, Hornstein MD, Missmer SA. Lifestyle and in vitro fertilization: what do patients believe? FERTILITY RESEARCH AND PRACTICE 2016; 2:11. [PMID: 28620538 PMCID: PMC5424337 DOI: 10.1186/s40738-016-0026-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 09/16/2016] [Indexed: 11/22/2022]
Abstract
Background Patients have many beliefs regarding lifestyle factors and IVF outcomes. Methods Observational study of 208 IVF patients at an academic infertility center. Main outcome measures were perceived influence of various lifestyle factors assessed by multivariable logistic regression and p-value tests for linear trend (Pt). Results A majority of participants believed that there were many women’s lifestyle choices that were influential, compared to fewer male factors (cessation of tobacco (72 %), alcohol (69 %), caffeine (62 %), and use of vitamins (88 %)). Compared to participants with less education, participants with a higher education level were less likely to believe vitamins were helpful and some alcohol use was not harmful. As income decreased, participants were less likely to consider dietary factors contributory to IVF success, such as women (p-trend, p = 0.02) and men (p-trend, p = 0.009) consuming a full-fat dairy diet. Participants’ beliefs were most commonly influenced by physicians (84 %) and the internet (71 %). Conclusions Patients believed many lifestyle factors are associated with IVF success. Understanding patients’ assumptions regarding the effect of lifestyle factors on IVF success may better allow physicians to counsel patients about IVF outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s40738-016-0026-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brooke V Rossi
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA.,University Hospitals Fertility Center, Kathy Risman Pavilion, Suite 310, 1000 Auburn Dr, Beachwood, OH 44122 USA
| | - Leah Hawkins Bressler
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Katharine F Correia
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Shane Lipskind
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Mark D Hornstein
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Stacey A Missmer
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA.,Department of Epidemiology, Harvard School of Public Health, Boston, MA USA
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41
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Nouri M, Aghadavod E, Khani S, Jamilian M, Amiri Siavashani M, Ahmadi S, Asemi Z. Association between BMI and gene expression of anti-Müllerian hormone and androgen receptor in human granulosa cells in women with and without polycystic ovary syndrome. Clin Endocrinol (Oxf) 2016; 85:590-5. [PMID: 27163385 DOI: 10.1111/cen.13098] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/31/2016] [Accepted: 05/04/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) is one of the most reliable markers of ovarian reserve. There is evidence which suggests that BMI may be associated with gene expression of AMH, AMH type II receptor (AMHR-II) and androgen receptor (AR) in human granulosa cells (GC) in women with and without polycystic ovary syndrome (PCOS). OBJECTIVE To investigate the association between BMI and gene expression of AMH, AMHR-II and AR in human GC in women with and without PCOS. DESIGN, PATIENTS AND MEASUREMENTS In a cross-sectional study, hormonal profiles were measured among 38 patients with PCOS and 38 subjects without PCOS aged 18-40. AMH, AMHR-II and AR mRNA levels were quantified in cumulus GC. Pearson correlation and multiple linear regressions were used to assess the relationships. RESULTS Quantitative RT-PCR demonstrated that AMH and AMHR-II expression were negatively correlated with BMI (r = -0·39, P < 0·001 for AMH and r = -0·49, P < 0·001 for AMHR-II), whereas AR expression was positively correlated with BMI (r = 0·46, P < 0·001). CONCLUSIONS There is a negative association between AMH, AMHR-II expression and BMI, and a positive association between AR expression and BMI in the GC of PCOS and non-PCOS women.
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Affiliation(s)
- Mohammad Nouri
- Women's Reproductive Health Research Center, Tabriz, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
| | - Sajad Khani
- Research Center for Pharmaceutical Nanotechnology, Research and Development Complex, Tabriz, Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mehrnush Amiri Siavashani
- Department of Gynecology and Obstetrics, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shahnaz Ahmadi
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Gynecology and Obstetrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
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42
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Affiliation(s)
- Mark D. Hornstein
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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43
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Wang X, Hao J, Zhang F, Li J, Kong H, Guo Y. Effects of female and male body mass indices on the treatment outcomes and neonatal birth weights associated with in vitro fertilization/intracytoplasmic sperm injection treatment in China. Fertil Steril 2016; 106:460-6. [DOI: 10.1016/j.fertnstert.2016.04.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/23/2016] [Accepted: 04/14/2016] [Indexed: 10/21/2022]
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Predictors of treatment failure in young patients undergoing in vitro fertilization. J Assist Reprod Genet 2016; 33:1001-7. [PMID: 27154866 DOI: 10.1007/s10815-016-0725-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The purpose of the study was to evaluate whether routinely collected clinical factors can predict in vitro fertilization (IVF) failure among young, "good prognosis" patients predominantly with secondary infertility who are less than 35 years of age. METHODS Using de-identified clinic records, 414 women <35 years undergoing their first autologous IVF cycle were identified. Logistic regression was used to identify patient-driven clinical factors routinely collected during fertility treatment that could be used to model predicted probability of cycle failure. RESULTS One hundred ninety-seven patients with both primary and secondary infertility had a failed IVF cycle, and 217 with secondary infertility had a successful live birth. None of the women with primary infertility had a successful live birth. The significant predictors for IVF cycle failure among young patients were fewer previous live births, history of biochemical pregnancies or spontaneous abortions, lower baseline antral follicle count, higher total gonadotropin dose, unknown infertility diagnosis, and lack of at least one fair to good quality embryo. The full model showed good predictive value (c = 0.885) for estimating risk of cycle failure; at ≥80 % predicted probability of failure, sensitivity = 55.4 %, specificity = 97.5 %, positive predictive value = 95.4 %, and negative predictive value = 69.8 %. CONCLUSION If this predictive model is validated in future studies, it could be beneficial for predicting IVF failure in good prognosis women under the age of 35 years.
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45
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Sarais V, Pagliardini L, Rebonato G, Papaleo E, Candiani M, Viganò P. A Comprehensive Analysis of Body Mass Index Effect on in Vitro Fertilization Outcomes. Nutrients 2016; 8:109. [PMID: 26907340 PMCID: PMC4808839 DOI: 10.3390/nu8030109] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/05/2016] [Accepted: 02/18/2016] [Indexed: 02/05/2023] Open
Abstract
The effect of a raised body mass index (BMI) on the outcome of assisted reproduction technology (ART) still represents a controversial issue. Even less clear is whether BMI acts with a potential detrimental effect on IVF outcomes via a deleterious effect on innate quality of oocytes or on the environmental milieu within the uterus. With the aim to better understand the mechanisms underlying the potential deleterious effect of an increased BMI on IVF outcomes, we have evaluated the effects of female BMI on number and quality of retrieved oocytes, fertilization rate, embryo score and incidences of ongoing pregnancy and live births among couples undergoing IVF in an Italian population. Data from 1602 women who underwent their first IVF cycle were retrospectively analyzed. A significantly reduced percentage of mature oocytes when comparing obese (BMI ≥ 30 kg/m2) and normal-weight patients (BMI = 18.50–24.99 kg/m2) was found. After adjusting for maternal age and other confounders, odds for ongoing pregnancy rate showed no differences across different BMI categories. However, a significant increased odds ratio (OR) could be observed for miscarriage rate in patients with BMI ≥ 25 (OR = 2.5; p = 0.04). These results should be taken into account in order to define optimal strategies for overweight and obese patients referring to ART procedures.
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Affiliation(s)
- Veronica Sarais
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Luca Pagliardini
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Giorgia Rebonato
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Enrico Papaleo
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Paola Viganò
- Division of Genetics and Cell Biology, San Raffaele Scientific Institute, 20132 Milano, Italy.
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Humphries LA, Chang O, Humm K, Sakkas D, Hacker MR. Influence of race and ethnicity on in vitro fertilization outcomes: systematic review. Am J Obstet Gynecol 2016; 214:212.e1-212.e17. [PMID: 26363483 DOI: 10.1016/j.ajog.2015.09.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/19/2015] [Accepted: 09/01/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We conducted a systematic review to evaluate the influence of race and ethnicity on clinical pregnancy and live birth outcomes after in vitro fertilization (IVF). STUDY We searched PubMed, EMBASE, Web of Science, CINAHL, POPLINE, and Cochrane Central, and hand-searched relevant articles published through July 22, 2015. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers independently evaluated abstracts to identify studies that compared clinical pregnancy rates and live birth rates for ≥2 racial and/or ethnic groups after nondonor IVF cycles. RESULTS Twenty-four studies were included. All 5 US registry-based studies showed that black, Hispanic, and Asian women had lower clinical pregnancy rates and/or live birth rates after IVF, compared with white women. Similarly, most clinic-specific studies reported significant disparities in these primary outcomes, potentially attributable to differences in infertility diagnosis, spontaneous abortion, and obesity. Studies varied with respect to definitions of race/ethnicity, inclusion of first cycles vs multiple cycles for individual women, and collected covariates. Most studies were limited by sample size, inadequate adjustment for confounding, selection bias, and extensive missing data. CONCLUSIONS Although current evidence points to race and ethnicity, especially black race, as strong predictors of poorer outcomes after IVF, the utility of results is constrained by the limitations described.
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Affiliation(s)
- Leigh A Humphries
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
| | - Olivia Chang
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
| | - Kathryn Humm
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA; Boston IVF, Waltham, MA
| | | | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA.
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Firns S, Cruzat VF, Keane KN, Joesbury KA, Lee AH, Newsholme P, Yovich JL. The effect of cigarette smoking, alcohol consumption and fruit and vegetable consumption on IVF outcomes: a review and presentation of original data. Reprod Biol Endocrinol 2015; 13:134. [PMID: 26669322 PMCID: PMC4681150 DOI: 10.1186/s12958-015-0133-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/09/2015] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Lifestyle factors including cigarette smoking, alcohol consumption and nutritional habits impact on health, wellness, and the risk of chronic diseases. In the areas of in-vitro fertilization (IVF) and pregnancy, lifestyle factors influence oocyte production, fertilization rates, pregnancy and pregnancy loss, while chronic, low-grade oxidative stress may underlie poor outcomes for some IVF cases. METHODS Here, we review the current literature and present some original, previously unpublished data, obtained from couples attending the PIVET Medical Centre in Western Australia. RESULTS During the study, 80 % of females and 70 % of male partners completed a 1-week diary documenting their smoking, alcohol and fruit and vegetable intake. The subsequent clinical outcomes of their IVF treatment such as quantity of oocytes collected, fertilization rates, pregnancy and pregnancy loss were submitted to multiple regression analysis, in order to investigate the relationship between patients, treatment and the recorded lifestyle factors. Of significance, it was found that male smoking caused an increased risk of pregnancy loss (p = 0.029), while female smoking caused an adverse effect on ovarian reserve. Both alcohol consumption (β = 0.074, p < 0.001) and fruit and vegetable consumption (β = 0.034, p < 0.001) had positive effects on fertilization. CONCLUSION Based on our results and the current literature, there is an important impact of lifestyle factors on IVF clinical outcomes. Currently, there are conflicting results regarding other lifestyle factors such as nutritional habits and alcohol consumption, but it is apparent that chronic oxidative stress induced by lifestyle factors and poor nutritional habits associate with a lower rate of IVF success.
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Affiliation(s)
- Sarah Firns
- School of Biomedical Sciences, CHIRI Biosciences Research Precinct, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia
| | - Vinicius Fernandes Cruzat
- School of Biomedical Sciences, CHIRI Biosciences Research Precinct, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia
| | - Kevin Noel Keane
- School of Biomedical Sciences, CHIRI Biosciences Research Precinct, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia.
- Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia.
| | - Karen A Joesbury
- Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia
- PIVET Medical Centre, 166-168 Cambridge Street, Leederville, Perth, WA, 6007, Australia
| | - Andy H Lee
- Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia
| | - Philip Newsholme
- School of Biomedical Sciences, CHIRI Biosciences Research Precinct, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia
| | - John L Yovich
- School of Biomedical Sciences, CHIRI Biosciences Research Precinct, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia.
- PIVET Medical Centre, 166-168 Cambridge Street, Leederville, Perth, WA, 6007, Australia.
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Braga DPAF, Setti AS, Iaconelli A, Taitson PF, Borges E. Racial and ethnic differences in assisted reproduction treatment outcomes: the benefit of racial admixture. HUM FERTIL 2015; 18:276-81. [PMID: 26646392 DOI: 10.3109/14647273.2015.1080862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The goal of the present study was to determine whether racial and ethnic differences affect the outcomes of assisted reproductive technology in the Brazilian population. 1497 patients undergoing intracytoplasmic sperm injection (ICSI) cycles were split into groups according to the patient's ethnicity: Caucasian (n = 2131), Mestizo (n = 358), Asian (n = 174), Black (n = 115) and Indian (n = 260). ICSI outcomes were compared among the groups. Body mass index was highest in the Black group, followed by the Mestizo, Indian, Caucasian and Asian groups (p > 0.001). The FSH dose (p > 0.001) was highest among Indians, followed by Asians and Caucasians, and the dose was lowest among Blacks and Mestizos. In contrast, the oocyte yield was highest among Mestizos, followed by Indians, Blacks and Caucasians, and lowest among Asians (p = 0.005). The fertilisation rate was highest among Mestizos, followed by Blacks, Indians and Caucasians, whereas Asians had the lowest fertilisation rate (p = 0.004). Pregnancy and implantation rates were also highest among Mestizos, followed by Blacks, Indians and Caucasians, whereas the Asian patients had the lowest rates (p = 0.008 and p > 0.001, respectively). In conclusion, our evidence suggests a possible beneficial effect of racial admixture on ICSI outcomes.
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Affiliation(s)
- Daniela Paes Almeida Ferreira Braga
- a Fertility - Medical Group, Av. Brigadeiro Luis Antônio , São Paulo , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , Rua Vieira Maciel, São Paulo , Brazil.,c Disciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo. - UNIFESP , Rua Embaú, São Paulo , Brazil
| | - Amanda S Setti
- a Fertility - Medical Group, Av. Brigadeiro Luis Antônio , São Paulo , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , Rua Vieira Maciel, São Paulo , Brazil
| | - Assumpto Iaconelli
- a Fertility - Medical Group, Av. Brigadeiro Luis Antônio , São Paulo , Brazil
| | - Paulo Franco Taitson
- d Pontifícia Universidade Católica de Minas Gerais, Instituto de Ciências Biológicas e da Saúde , Av. Dom José Gaspar, Belo Horizonte - MG - Brazil
| | - Edson Borges
- a Fertility - Medical Group, Av. Brigadeiro Luis Antônio , São Paulo , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , Rua Vieira Maciel, São Paulo , Brazil
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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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Domar AD, Rooney KL, Milstein M, Conboy L. Lifestyle habits of 12,800 IVF patients: Prevalence of negative lifestyle behaviors, and impact of region and insurance coverage. HUM FERTIL 2015; 18:253-7. [DOI: 10.3109/14647273.2015.1071881] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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