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Graham ME, Jelin A, Hoon AH, Wilms Floet AM, Levey E, Graham EM. Assisted reproductive technology: Short- and long-term outcomes. Dev Med Child Neurol 2023; 65:38-49. [PMID: 35851656 PMCID: PMC9809323 DOI: 10.1111/dmcn.15332] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/05/2023]
Abstract
Assisted reproductive technology (ART) includes fertility treatment in which either eggs or embryos are handled outside a female's body to promote successful pregnancies and healthy offspring. Current ART procedures encompass in vitro fertilization with or without intracytoplasmic sperm injection. The most common complication of ART is related to the consequences of multiple pregnancy, which can be prevented or minimized by reducing the number of embryos transferred to the uterus, commonly single embryo transfer. ART has been shown to be variably associated with adverse short- and long-term perinatal outcomes, including cerebral palsy, autism, neurodevelopmental imprinting disorders, and cancer. However, there is uncertainty as to whether reported problems are related to the ART procedure itself, to factors related to infertility, to other medical and environmental factors, or a combination thereof. From a pathophysiological perspective, whether ART alters epigenetic mechanisms of gene expression, leading to later developmental, medical, and behavioral disorders, is an area of active investigation. With the meticulously conducted short- and long-term outcome studies completed so far, overall, and after controlling for multiple gestations and preterm delivery, the results suggest that ART is a safe procedure, offering hope to many parent(s) wishing for a healthy child. This paper highlights ART methods and the risk factors and confounders in the interpretation of short- and long-term outcome data, providing the reader with a means to evaluate findings and conclusions of outcome studies. WHAT THIS PAPER ADDS: Assisted reproductive technology (ART) is a relatively safe procedure. Single embryo implantation optimizes outcome. Informed consent, including the risks and benefits of ART, should be required. Ongoing longitudinal studies are necessary to fully understand ART outcomes.
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Affiliation(s)
- Mary Elaine Graham
- College of Arts and Sciences, Washington and Lee University, Lexington, VA, USA
| | - Angie Jelin
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander H. Hoon
- Department of Pediatrics, Division of Developmental Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Anna Maria Wilms Floet
- Department of Pediatrics, Division of Developmental Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA,Center for Development and Learning, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Eric Levey
- Health Services for Children with Special Needs, Washington, DC, USA
| | - Ernest M. Graham
- Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Neuroscience Intensive Care Nursery Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Volatilomics as an Emerging Strategy to Determine Potential Biomarkers of Female Infertility: A Pilot Study. Biomedicines 2022; 10:biomedicines10112852. [DOI: 10.3390/biomedicines10112852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Due to its high prevalence, infertility has become a prominent public health issue, posing a significant challenge to modern reproductive medicine. Some clinical conditions that lead to female infertility include polycystic ovary syndrome (PCOS), endometriosis, and premature ovarian failure (POF). Follicular fluid (FF) is the biological matrix that has the most contact with the oocyte and can, therefore, be used as a predictor of its quality. Volatilomics has emerged as a non-invasive, straightforward, affordable, and simple method for characterizing various diseases and determining the effectiveness of their current therapies. In order to find potential biomarkers of infertility, this study set out to determine the volatomic pattern of the follicular fluid from patients with PCOS, endometriosis, and POF. The chromatographic data integration was performed through solid-phase microextraction (SPME), followed by gas chromatography–mass spectrometry (GC-MS). The findings pointed to specific metabolite patterns as potential biomarkers for the studied diseases. These open the door for further research into the relevant metabolomic pathways to enhance infertility knowledge and diagnostic tools. An extended investigation may, however, produce a new mechanistic understanding of the pathophysiology of the diseases.
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Harpe J, Bernstein C, Harriott A. Migraine and infertility, merging concepts in women's reproductive health: A narrative review. Headache 2022; 62:1247-1255. [PMID: 36200786 DOI: 10.1111/head.14402] [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: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective is to examine issues around treating infertility in patients with migraine. BACKGROUND Women outnumber men in migraine diagnosis with a 3:1 ratio; the disease is commonly expressed in women of child-bearing age and is influenced by changes in circulating hormones. Infertility is also common, and the use of treatment options, such as assisted reproductive technology, have expanded exponentially in recent years. METHODS We summarized the literature around the effect of infertility treatments on headache in the general population and migraine population. We also discuss sociobehavioral, economic, and biological factors affecting fertility in patients with migraine, describe infertility protocols, and propose areas of focus for future research. We searched PubMed for the combined key terms in vitro fertilization or assisted reproductive technology AND migraine, or headache. The search included all dates and specified English-language results only. RESULTS Migraine may negatively influence family planning and fertility. Patients face obstacles stemming from the impact of migraine on social relationships and the interference of preventive medications on pregnancy. Migraine may also be associated with an increased prevalence of endocrine disorders which in turn affect fertility. Moreover, infertility treatments are associated with mild headache as a side effect. In addition, we found only one retrospective study demonstrating an increase in headache frequency during in vitro fertilization in the migraine population. CONCLUSIONS We determined that there is little research focused specifically on migraine headache exacerbation and other migraine-associated health outcomes with infertility treatment. This topic merits further interdisciplinary exploration.
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Affiliation(s)
- Jasmin Harpe
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, USA
| | - Carolyn Bernstein
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, USA
| | - Andrea Harriott
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Rababa’h AM, Matani BR, Yehya A. An update of polycystic ovary syndrome: causes and therapeutics options. Heliyon 2022; 8:e11010. [PMID: 36267367 PMCID: PMC9576888 DOI: 10.1016/j.heliyon.2022.e11010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/19/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by menstrual irregularities, chronic anovulation, hirsutism, androgenic alopecia, and acne. At diagnosis, patients can with different manifestations according to the disease phenotype, patient’s age, and lifestyle. However, most patients pursue medical care because of the clinical symptoms of PCOS, such as hyperandrogenism, menstrual irregularities and infertility. Recent studies have shown that PCOS is associated with 80% of anovulatory infertility; however, the precise mechanism of PCOS-induced anovulation is still undetermined. The treatment strategies of PCOS are symptomatic depending mainly on the desired goals and clinical benefits. Life style intervention is still the first line treatment option for overweight females seeking pregnancy. In addition, there are many pharmacological agents that could be added to induce ovulation such as metformin, and clomiphene citrate. Nowadays, many patients preferred to use some herbal medicine that was proved to have potential therapeutic benefits in many studies in the management of PCOS. The purpose of this review was to discuss PCOS-induced infertility and the available therapeutic options as well as the impact of COVID-19 infection on the success of fertility attempts. To address this purpose, Pubmed, Scopus, EMBASE and Google databases were searched for studies discussing PCOS-induced infertility. The literature search revealed the proper therapeutic plans to treat PCOS-induced infertility, and that treatment should be modified according to patient’s complaints, reproductive desires, and disease phenotypes. In conclusion, the use of specific therapeutic agents and patients’ adherence to lifestyle interventions could help patients recover their reproductive and metabolic health.
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Affiliation(s)
- Abeer M. Rababa’h
- Department of Clinical Pharmacy; College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- Corresponding author.
| | - Bayan R. Matani
- Department of Clinical Pharmacy; College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Alaa Yehya
- Department of Department of Clinical Pharmacy and Pharmacy Practice Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
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Balkrishna A, Nain P, Joshi M, Kumar B, Varshney A. Super-critical fluid extract of Bryonopsis laciniosa (Shivlingi) seeds restores fertility in zebrafish models through revival of cytological and anatomical features. J Ovarian Res 2022; 15:46. [PMID: 35477469 PMCID: PMC9044614 DOI: 10.1186/s13048-022-00982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background The Ayurvedic system of medicine mentions the use of seeds of Bryonopsis laciniosa (L.) Naud. (also known as Shivlingi due to their unique structure resembling a ‘Shivling’) for treating sexual dysfunction, impaired fertility, and as a general virility-booster in both males and females. To investigate the scientific basis for such claims, the current study was designed for the chemical characterization of the super critical fluid extracted Shivlingi seed oil (SLSO), and subsequent evaluation of its reproductive fecundity in the zebrafish model of N-ethyl-N-nitrosourea induced infertility. Results Linoleic and linolenic acids were the major fatty acids in the SLSO, with trace amounts of β-sitosterol and stigmasterol. Both male and female zebrafish, when fed orally with the SLSO infused pallets, showed a dose-dependent increase in fertility and fecundity rates. Microscopic observations revealed recovery in the gross ovarian anatomy and consequential improvement in egg production in infertile female zebrafish. Similarly, cytological studies exhibited increased sperm counts and motility in male zebrafish. SLSO exhibited effects similar to the human equivalent dose of Letrozole. Conclusion Taken together, these observations demonstrated the fertility-boosting potentials of SLSO comparable to the widely used infertility drugs. As a whole, this research work has provided scientific evidence for the rationale behind the use of Shivlingi seeds in Ayurvedic treatment for infertility in humans. Finally, but importantly, this study warrants further scientific investigations into different aspects of SLSO on human reproductive health.
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Affiliation(s)
- Acharya Balkrishna
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, 249 405, Uttarakhand, India.,Department of Allied and Applied Sciences, University of Patanjali, Patanjali Yog Peeth, Roorkee-Haridwar Road, Haridwar, 249 405, Uttarakhand, India
| | - Pradeep Nain
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, 249 405, Uttarakhand, India
| | - Monali Joshi
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, 249 405, Uttarakhand, India
| | - Brijesh Kumar
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, 249 405, Uttarakhand, India
| | - Anurag Varshney
- Drug Discovery and Development Division, Patanjali Research Institute, NH-58, Haridwar, 249 405, Uttarakhand, India. .,Department of Allied and Applied Sciences, University of Patanjali, Patanjali Yog Peeth, Roorkee-Haridwar Road, Haridwar, 249 405, Uttarakhand, India. .,Special Centre for Systems Medicine, Jawaharlal Nehru University, New Delhi, India.
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6
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Zymperdikas CF, Zymperdikas VF, Mastorakos G, Grimbizis G, Goulis DG. Assisted reproduction technology outcomes in women with infertility and preexisting diabetes mellitus: a systematic review. Hormones (Athens) 2022; 21:23-31. [PMID: 34668169 DOI: 10.1007/s42000-021-00329-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/11/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess maternal and neonatal outcomes in women with or without preexisting diabetes mellitus (DM) undergoing assisted reproduction technology (ART) treatment. METHODS Prospective or retrospective controlled trials reporting on women with or without preexisting DM undergoing ART treatment were considered eligible. Twelve electronic databases were systematically searched up to December 2020. The risk of bias was assessed by the Cochrane Risk OF Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Each primary outcome was extracted and pooled as maternal- or neonatal-related. RESULTS Two studies were included in the systematic review, reporting on both maternal- and neonatal-related parameters after ART treatment. Due to the limited data, no meta-analysis was conducted. Preterm birth, placenta previa, and excessive bleeding during pregnancy were observed more often in pregnancies complicated by preexisting DM conceived by ART compared with pregnancies without DM. There was no difference in the risk for placental abruption between the groups. Regarding the neonatal outcomes, large-for-gestational-age (LGA) embryos and neonatal intensive care unit (NICU) admission were more commonly reported for women with preexisting DM. In one study, preexisting DM was marginally associated with infant mortality. CONCLUSIONS Despite the scarce data, preexisting DM in pregnancies conceived by ART is associated with increased risk for maternal and neonatal complications. TRIAL REGISTRATION Registered in PROSPERO (registration number: 143187).
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Affiliation(s)
- Christos F Zymperdikas
- Unit of Reproductive Endocrinology, 1St Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.
| | - Vasileios F Zymperdikas
- 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece
- Department of Orthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Mastorakos
- 2Nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Grigorios Grimbizis
- Unit of Reproductive Endocrinology, 1St Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1St Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Hecht LM, Hadwiger A, Patel S, Hecht BR, Loree A, Ahmedani BK, Miller-Matero LR. Disordered eating and eating disorders among women seeking fertility treatment: A systematic review. Arch Womens Ment Health 2022; 25:21-32. [PMID: 34175997 DOI: 10.1007/s00737-021-01156-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this systematic review is to evaluate the prevalence of disordered eating and eating disorders among women seeking fertility treatment.Observational studies were searched in Ovid MEDLINE, Web of Science, Embase, and PsycInfo. Studies published prior to September 2020 when the search was conducted were considered. Inclusion criteria included (1) original and empirical research, (2) published in a peer-reviewed journal, and (3) reported on disordered eating among women seeking fertility treatment in the sample or reported on prevalence of eating disorders among women seeking fertility treatment in the sample. Independent screening of abstracts was conducted by two authors (LH and AH). Ten studies met the inclusion criteria. Sample size, study location, measures, and results for each study in this review were reported.Among women pursuing fertility treatment, rates of current eating disorders ranged from 0.5 to 16.7%, while past eating disorder prevalence rates ranged from 1.4 to 27.5%. Current anorexia nervosa or bulimia nervosa was reported by up to 2% and 10.3% of women, respectively, while history of anorexia nervosa or bulimia nervosa was reported by up to 8.5% and 3.3% of women, respectively. Binge eating disorder or other eating disorders were reported by up to 18.5% and 9.1% of women, respectively. Disordered eating pathology was endorsed by 1.6 to 48% of women seeking fertility treatment. Endorsement of pathological eating attitudes was generally higher among women seeking fertility treatment with current or past eating disorders as compared to community samples, with the exception of dietary restraint. Rates of current and past eating disorders are higher among women seeking fertility treatment than in the general population. Providers treating women with infertility should be cognizant of these prevalence rates and consider screening for eating pathology in their patients as this may contribute to their likelihood of successful conception and/or subsequent pregnancy outcomes.
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Affiliation(s)
- Leah M Hecht
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA.
| | - Ashley Hadwiger
- Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
| | - Shivali Patel
- Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
| | - Bryan R Hecht
- MetroHealth Medical Center, Division of Reproductive Endocrinology, 2500 Metrohealth Dr, Cleveland, OH, 44109, USA
| | - Amy Loree
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA
| | - Brian K Ahmedani
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA.,Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
| | - Lisa R Miller-Matero
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA.,Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
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Rahban R, Rehfeld A, Schiffer C, Brenker C, Egeberg Palme DL, Wang T, Lorenz J, Almstrup K, Skakkebaek NE, Strünker T, Nef S. The antidepressant Sertraline inhibits CatSper Ca2+ channels in human sperm. Hum Reprod 2021; 36:2638-2648. [PMID: 34486673 PMCID: PMC8450872 DOI: 10.1093/humrep/deab190] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/01/2021] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Do selective serotonin reuptake inhibitor (SSRI) antidepressants affect the function of human sperm? SUMMARY ANSWER The SSRI antidepressant Sertraline (e.g. Zoloft) inhibits the sperm-specific Ca2+ channel CatSper and affects human sperm function in vitro. WHAT IS KNOWN ALREADY In human sperm, CatSper translates changes of the chemical microenvironment into changes of the intracellular Ca2+ concentration ([Ca2+]i) and swimming behavior. CatSper is promiscuously activated by oviductal ligands, but also by synthetic chemicals that might disturb the fertilization process. It is well known that SSRIs have off-target actions on Ca2+, Na+ and K+ channels in somatic cells. Whether SSRIs affect the activity of CatSper is, however, unknown. STUDY DESIGN, SIZE, DURATION We studied the action of the seven drugs belonging to the most commonly prescribed class of antidepressants, SSRIs, on resting [Ca2+]i and Ca2+ influx via CatSper in human sperm. The SSRI Sertraline was selected for in-depth analysis of its action on steroid-, prostaglandin-, pH- and voltage-activation of human CatSper. Moreover, the action of Sertraline on sperm acrosomal exocytosis and penetration into viscous media was evaluated. PARTICIPANTS/MATERIALS, SETTING, METHODS The activity of CatSper was investigated in sperm of healthy volunteers, using kinetic Ca2+ fluorimetry and patch-clamp recordings. Acrosomal exocytosis was investigated using Pisum sativum agglutinin and image cytometry. Sperm penetration in viscous media was evaluated using the Kremer test. MAIN RESULTS AND THE ROLE OF CHANCE Several SSRIs affected [Ca2+]i and attenuated ligand-induced Ca2+ influx via CatSper. In particular, the SSRI Sertraline almost completely suppressed Ca2+ influx via CatSper. Remarkably, the drug was about four-fold more potent to suppress prostaglandin- versus steroid-induced Ca2+ influx. Sertraline also suppressed alkaline- and voltage-activation of CatSper, indicating that the drug directly inhibits the channel. Finally, Sertraline impaired ligand-induced acrosome reaction and sperm penetration into viscous media. LIMITATIONS, REASONS FOR CAUTION This is an in vitro study. Future studies have to assess the physiological relevance in vivo. WIDER IMPLICATIONS OF THE FINDINGS The off-target action of Sertraline on CatSper in human sperm might impair the fertilization process. In a research setting, Sertraline may be used to selectively inhibit prostaglandin-induced Ca2+ influx. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Swiss Centre for Applied Human Toxicology (SCAHT), the Département de l’Instruction Publique of the State of Geneva, the German Research Foundation (CRU326), the Interdisciplinary Center for Clinical Research, Münster (IZKF; Str/014/21), the Innovation Fund Denmark (grant numbers 14-2013-4) and the EDMaRC research grant from the Kirsten and Freddy Johansen’s Foundation. The authors declare that no conflict of interest could be perceived as prejudicing the impartiality of the research reported. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
- Rita Rahban
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland.,Swiss Centre for Applied Human Toxicology, Basel, Switzerland
| | - Anders Rehfeld
- Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Christian Schiffer
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, University of Münster, Münster, Germany
| | - Christoph Brenker
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, University of Münster, Münster, Germany
| | | | - Tao Wang
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, University of Münster, Münster, Germany.,Institute of Life Science and School of Life Science, Nanchang University, Nanchang, Jiangxi, PR China
| | - Johannes Lorenz
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, University of Münster, Münster, Germany
| | - Kristian Almstrup
- Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Niels E Skakkebaek
- Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Timo Strünker
- Centre of Reproductive Medicine and Andrology, University Hospital Münster, University of Münster, Münster, Germany
| | - Serge Nef
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland.,Swiss Centre for Applied Human Toxicology, Basel, Switzerland
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Hinkle M, Dodd J. A Systematic Review of Interventions Targeting Infertility-Related Distress: A Search for Active Ingredients. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:167-193. [PMID: 34493164 DOI: 10.1080/0092623x.2021.1974623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Various psychological interventions have been developed to combat negative mental and physical health effects of infertility. However, it is unknown if there are common elements, or "active ingredients," between interventions. This review examined which active ingredients were present among psychological interventions targeting the impacts of infertility. Using a predetermined search strategy, 72 articles and 22 active ingredients were identified. Relaxation/stress management was found to be the most common treatment element. Future research should investigate which active ingredients are most effective for reducing infertility-related stressors so clinicians and researchers can create and implement treatments that contain essential and effective components.
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Affiliation(s)
- Madison Hinkle
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Julia Dodd
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
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10
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Effect of probiotics on vaginal Ureaplasma parvum in women suffering from unexplained infertility. Reprod Biomed Online 2021; 43:503-514. [PMID: 34315695 DOI: 10.1016/j.rbmo.2021.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 12/12/2022]
Abstract
RESEARCH QUESTION Does oral probiotic supplementation influence the relative abundance of different vaginal microbiota in women experiencing infertility? DESIGN A prospective, monocentric randomized controlled trial. To study the influence of probiotics on infertility, 80 patients with primary or secondary infertility were included. Patients were assigned to either a probiotic treatment or a control group. Participants in the treatment group (n = 40) took one sachet (2 g) a day of a defined probiotic supplement limiting Lactobacillus strains. Patients in the control group did not receive any additional probiotic supplements. Vaginal samples were taken on day 20 of the menstrual cycle and 4 weeks later, on day 20, of the consecutive cycle. Subsequently, 16s rRNA gene analysis of the vaginal samples was conducted. RESULTS After the intervention phase, no effects on alpha diversity resulting from treatment could be observed. The between sample diversity of different women (beta diversity) at baseline had no effects of age, treatment group or body mass index. Primary or secondary sterility, however, had a significant effect on community. Three clusters (Lactobacillus crispatus, Lactobacillus iners and Lactobacillus gasseri) were identified as the leading representatives. Furthermore, patients treated with probiotics showed limited growth of Ureaplasma parvum compared with the control group (P = 0.021). CONCLUSIONS This study points to a possible protective effect of probiotic supplements on the vaginal microbiota. It is tempting to speculate that this effect assists in containing the growth of non-beneficial bacteria and helps to prevent or cure a dysbiotic vaginal flora.
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11
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Vasta FN, Girelli R. An Epistemological Perspective of Integrated Multidisciplinary Treatment When Dealing With Infertile Women With a Parenthood Goal: The Importance of Matterpsychic Perspective. Front Psychol 2021; 12:634028. [PMID: 33763003 PMCID: PMC7982840 DOI: 10.3389/fpsyg.2021.634028] [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: 11/26/2020] [Accepted: 02/05/2021] [Indexed: 11/28/2022] Open
Abstract
This article proposes a multidisciplinary work perspective on couples who undergo assisted reproductive technology (ART) treatments, with particular attention paid to the treatment of women. The epistemological references underlying a vision of infertility and sterility that respect the psyche–soma unity of the person are illustrated: the biopsychosocial model and the psychoneuroimmunology and psychosomatic contemporary models of health and illness. Based on clinical experience in a private and institutional setting, different steps in the course of treatment are described with the related areas of psychological work: from the search for pregnancy to the choice of adhering to an ART treatment, to conception, up to delivery and beyond. The implications of the work are targeted at a better qualification of psychological interventions in this specific multidisciplinary area.
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Affiliation(s)
- Francesca Natascia Vasta
- Confederation of Italian Organizations for Analytical Research on Groups - Research Board, Rome, Italy
| | - Raffaella Girelli
- Confederation of Italian Organizations for Analytical Research on Groups, Rome, Italy
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12
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Zhang F, Feng Q, Yang L, Liu X, Su L, Wang C, Yao H, Sun D, Feng Y. Analysis of the etiologies of female infertility in Yunnan minority areas. BMC WOMENS HEALTH 2021; 21:88. [PMID: 33648484 PMCID: PMC7923498 DOI: 10.1186/s12905-021-01216-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/09/2021] [Indexed: 11/24/2022]
Abstract
Background The present study aims to provide a comparative analysis of the etiologies of female infertility between Dehong, on the Yunnan Frontier, and Kunming. Methods A retrospective study, which included 941 infertile females in Kunming who were treated in the First People’s Hospital of Yunnan Province and infertile females who were treated in the local hospital in Dehong from January 2016 to November 2018, was conducted. A comparative analysis of the etiologies of infertility in the two regions was then carried out. Results In patients with primary infertility, ovulation disorder (15.03%) was the main cause of infertility in Kunming, and pelvic inflammatory disease (25.59%) was the main cause in Dehong. With regard to secondary infertility, although pelvic inflammatory disease was the main cause of infertility in both regions, the incidence of intrauterine adhesions in Kunming was significantly higher than in Dehong. Conclusions The etiology of infertility showed different epidemiological characteristics depending on the region, hence individualized treatment should be given accordingly
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Affiliation(s)
- Fen Zhang
- Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, No. 157 of Jinbi Road, Xishan District, Kunming, 650032, China.,Medical School of Kunming University of Science and Technology, Kunming, 650500, China
| | - Qing Feng
- Kunming Dianchi Lake Evironmental Protection Collaborative Research Center, Kunming University, Kunming, 650214, China
| | - Linna Yang
- Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, No. 157 of Jinbi Road, Xishan District, Kunming, 650032, China.,Medical School of Kunming University of Science and Technology, Kunming, 650500, China
| | - Xuelian Liu
- Department of Gynecology, Dehong Hospital of Traditional Chinese Medicine, Mangshi, 678400, China
| | - Lingyun Su
- Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, No. 157 of Jinbi Road, Xishan District, Kunming, 650032, China.,Medical School of Kunming University of Science and Technology, Kunming, 650500, China
| | - Chunyan Wang
- Department of Gynecology, The Second People's Hospital of Baoshan City, Baoshan, 678000, China
| | - Huimei Yao
- Department of Obstetrics and Gynecology, Cangyuan Wa Autonomous County People's Hospital, Cangyuan, 677400, China
| | - Dawei Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (Dongdan Campus), No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, China.
| | - Yun Feng
- Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, No. 157 of Jinbi Road, Xishan District, Kunming, 650032, China. .,Medical School of Kunming University of Science and Technology, Kunming, 650500, China.
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Courbiere B, Lacan A, Grynberg M, Grelat A, Rio V, Arbo E, Solignac C. Psychosocial and professional burden of Medically Assisted Reproduction (MAR): Results from a French survey. PLoS One 2020; 15:e0238945. [PMID: 32970695 PMCID: PMC7514013 DOI: 10.1371/journal.pone.0238945] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate the impact of infertility and Medically Assisted Reproduction (MAR) throughout all aspects of life among infertile women and men. MATERIALS AND METHODS An online survey included 1 045 French patients (355 men, 690 women) who were living or had lived the experience of infertility and MAR. The questionnaire included 56 questions on several domains: global feelings, treatment burden, rapport with medical staff, psychosocial impact, sexual life and professional consequences. RESULTS Respondents had experienced an average of 3.6 (95% CI: 3.3-3.9) MAR cycles: 5% (n = 46) were pregnant, 4% (n = 47) were waiting to start MAR, 50% (n = 522) succeeded in having a live birth following MAR, 19% (n = 199) were currently undergoing ART, and 21% (n = 221) dropped out of the MAR process without a live birth. Satisfaction rates regarding the received medical care were above 80%, but 42% of patients pointed out the lack of information about non-medical support. An important impact on sexual life was reported, with 21% of patients admitted having not had intercourse for several weeks or even several months. Concerning the impact on professional life, 63% of active workers currently in an MAR program (n = 185) considered that MAR had strong repercussions on the organization of their working life with 49% of them reporting a negative impact on the quality of their work, and 46% of them reporting the necessity to lie about missing work during their treatment. CONCLUSION Despite a high overall level of satisfaction regarding medical care, the burden of infertility and MAR on quality of life is strong, especially on sexuality and professional organization. Clinical staff should be encouraged to develop non-medical support for all patients at any stage of infertility treatment. Enterprises should be warned about the professional impact of infertility and MAR to help their employees reconcile personal and professional life.
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Affiliation(s)
- Blandine Courbiere
- Pôle Femmes-Parents-Enfants–Centre Clinico-Biologique d’AMP, AP-HM La Conception, Marseille, France
- CNRS, IRD, Aix Marseille Univ, Avignon Université, IMBE, Marseille, France
- * E-mail:
| | - Arnaud Lacan
- Kedge Business School, AMSE, CNRS, EHESS, UMR 7316, Marseille, France
| | - Michael Grynberg
- Department of Reproductive Medicine & Fertility Preservation, Hôpital Antoine Beclère, Clamart, France
| | - Anne Grelat
- Centre Mistral, Clinique Pasteur, Guilherand-Granges, France
| | - Virginie Rio
- Collectif bAMP, Association de patients de l’AMP et de personnes infertiles, Quincy sous Sénart, France
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Selective Serotonin Reuptake Inhibitors and Fertility: Considerations for Couples Trying to Conceive. Harv Rev Psychiatry 2020; 27:108-118. [PMID: 30676405 DOI: 10.1097/hrp.0000000000000204] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression and anxiety are prevalent disorders and are often treated with selective serotonin reuptake inhibitors (SSRIs). Infertility is also common among couples, and rates of depression and anxiety are elevated in this population, but the impact of SSRIs on fertility has received modest attention. This review explores the literature available on SSRIs, fertility, and infertility-treatment outcomes to assist clinicians in better counseling their patients. METHODS A literature search was performed using the search terms infertility, fertility, antidepressants, and SSRIs to identify studies that investigated the relationship between SSRI use and fertility or infertility-treatment outcomes. RESULTS Twenty relevant articles were identified, 16 of which were original research studies. The studies varied in design, quality, and outcome measures, limiting meta-analysis. The prevalence of antidepressant use ranged from 3.5%-10% in reproductive-age women, with infertile populations reporting less use. The two studies examining the impact of SSRIs in fertile women had conflicting results. Six of the seven studies in infertility patients found no significant association between SSRIs and treatment outcomes; three observed a trend, however, toward reduced fecundability or negatively influenced fertility biomarkers. One study found treatment increased pregnancy rates. In males, most studies were of relatively poor quality, though six of the seven studies found SSRIs to have an adverse effect on semen parameters. CONCLUSIONS There is insufficient evidence at present to propose that SSRIs reduce fertility or influence infertility-treatment outcomes. SSRIs may have an adverse impact on sperm quality, but further research is warranted.
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Öztekin Ü, Hacimusalar Y, Gürel A, Karaaslan O. The Relationship of Male Infertility with Somatosensory Amplification, Health Anxiety and Depression Levels. Psychiatry Investig 2020; 17:350-355. [PMID: 32252512 PMCID: PMC7176565 DOI: 10.30773/pi.2019.0248] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/07/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the relationship between infertility and factors such as anxiety, health anxiety, depression, and somatosensory amplification in male patients presenting with infertility. METHODS In this study, we evaluated 198 patients (infertile group: 130, control group: 68). Patients that fit the inclusion criteria were informed about the aim and method of the study and filled out sociodemographic data collection form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), The Somatosensory Amplification Scale (SSAS), and Health Anxiety Inventory (HAI) questionnaires. RESULTS The mean scores for SSAS, HAI, BAI, and BDI were significantly higher in the infertility group compared to the control group (p<0.001 for all comparisons). Moreover, the mean scores of the patients in the primary infertile group (n=107) were significantly higher than in the secondary infertile group (n=23) (p<0.05 for all comparisons). Logistic regression analysis revealed that infertility had a significant effect on age, HAI and BDI. CONCLUSION Psychiatric evaluation of infertile patients may contribute to more efficient use of health services, may reduce the negative effects of anxiety and depression on fertility, and in turn, increase the success of infertility treatment. Therefore, we recommend that each patient presenting with infertility undergoes psychiatric evaluation as part of their treatment.
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Affiliation(s)
- Ünal Öztekin
- Department of Urology, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
| | - Yunus Hacimusalar
- Department of Psychiatry, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
| | - Abdullah Gürel
- Department of Urology, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
| | - Ozgul Karaaslan
- Department of Psychiatry, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
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