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Xu S, Zhao W, Zhang Y, Qiang C, Zhang C. The effect of previous induced abortion history on the assisted reproduction outcomes. Arch Gynecol Obstet 2024; 309:469-474. [PMID: 36708427 DOI: 10.1007/s00404-023-06928-7] [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: 10/12/2022] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE To study whether the history of induced abortion has an effect on the assisted reproduction outcomes in patients undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS 3045 patients who underwent IVF-ET in the Department of Human Reproductive Center of Renmin Hospital from January 2017 to June 2021. They were divided into two groups according to whether there was a history of induced abortion in the past, and the outcomes were compared between the two groups. RESULTS The clinical pregnancy rate in the group with induced abortion history was lower than that in the group without induced abortion history (63.1% vs 67.1%), but the difference was not statistically significant (P = 0.059). The spontaneous abortion rate in the group with induced abortion history was higher than that in the group without induced abortion history (14.9% vs 11.2%) (P = 0.044). The live birth rate in the group with induced abortion history was lower than that in the group without induced abortion history (52.8% vs 59.0%) (P = 0.006). Stepwise logistic regression analysis showed that endometrial thickness (OR = 0.928, 95% CI = 0.886 ~ 0.972, P = 0.002) and live birth rate (OR = 0.682, 95% CI = 0.495 ~ 0.939, P = 0.019) were negatively correlated with induced abortion history. The rate of spontaneous abortion (OR = 1.452, 95% CI = 1.042 ~ 2.024, P = 0.028) was positively correlated with the history of induced abortion. CONCLUSIONS The previous history of induced abortion is related to the outcomes of IVF /ICSI-ET, the endometrial thickness on HCG trigger day decreased, the risk of spontaneous abortion increased and the live birth rate decreased in patients with induced abortion history when undergoing IVF/ICSI-ET.
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Affiliation(s)
- Shaoyuan Xu
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
| | - Wenxian Zhao
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
| | - Ying Zhang
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
| | - Cancan Qiang
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
| | - Changjun Zhang
- Department of Human Reproductive Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, China
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Abdullah AA, Ahmed M, Oladokun A. Characterization and risk factors for unexplained female infertility in Sudan: A case-control study. World J Methodol 2023; 13:98-117. [PMID: 37456975 PMCID: PMC10348085 DOI: 10.5662/wjm.v13.i3.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/08/2023] [Accepted: 03/15/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Female infertility with unknown causes (unexplained) remains one of the mysteries in the reproductive health field, where the diagnostic evidence is still weak and the proposed treatments still work with unknown methods. However, several studies have proposed some possible causes and risk factors for unexplained female infertility.
AIM To characterize and identify factors associated with unexplained infertility in Sudanese women.
METHODS A matched (age and body mass index) case-control study was conducted from March 2021 to February 2022. The study samples were 210 women with unexplained infertility (UI) and 190 fertile women of reproductive age who were attending the maternity hospitals and fertility clinics in Khartoum, Sudan. The risk factors of unexplained infertility were identified using a structured, pre-tested questionnaire containing information on socio-demographic variables, anthropometrics, clinical diagnosis of infertility, behavioral factors, physical activity assessment, diversity, and consumption of different food groups by the study participants.
RESULTS The results showed a higher proportion of women diagnosed with UI were residents of rural areas than controls (21.4% vs 11.1%, P < 0.05), and previous miscarriages and/or abortions were more common in fertile women compared with infertile women (13.16% vs 5.71%, P < 0.05). Additionally, infertile women had a significantly (P < 0.05) higher proportion of family history of infertility (explained and unexplained) compared with controls. Finally, after controlling for the effects of potentially confounding variables using multivariable logistic regression analysis, only marital status, family history of infertility, use of modern contraceptives, smoking, caffeine consumption, physical activity level, meals consumed, other vitamin-A-rich fruits and vegetables, and other vegetables were found to be significant (P < 0.05) factors associated with unexplained infertility among Sudanese women.
CONCLUSION Married women with a family history of infertility who smoke and consume a high amount of caffeine, who live a sedentary lifestyle, and who consume more than two meals free of vitamin-A-rich fruits and/or vegetables and/or other vegetables per day are at the highest risk of developing unexplained infertility.
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Affiliation(s)
- Abdullah Abdulslam Abdullah
- Reproductive Health Sciences Program, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Biomedical Sciences, Faculty of Veterinary Sciences, University of Gadarif, Al-Gadarif 32211, Sudan
| | - Musa Ahmed
- Reproductive Health Sciences Program, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, AL-Salam University, Al-fula 120, West Kordofan, Sudan
| | - Adesina Oladokun
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 119, Oyo state, Nigeria
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Zeng XW, Bloom MS, Wei F, Liu L, Qin J, Xue L, Wang S, Huang G, Teng M, He B, Mao X, Chu C, Lin S, Dong GH, Tan W. Perfluoroalkyl Acids in Follicular Fluid and Embryo Quality during IVF: A Prospective IVF Cohort in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:27002. [PMID: 36723383 PMCID: PMC9891133 DOI: 10.1289/ehp10857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 10/16/2022] [Accepted: 12/23/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Perfluoroalkyl acids (PFAA) have been measured in ovarian follicular fluid from women using in vitro fertilization (IVF), although associations between follicular fluid PFAA and IVF outcomes have been inconsistent. OBJECTIVES We investigated the association between follicular fluid PFAA and embryo quality in women undergoing IVF. METHODS We prospectively enrolled 729 women undergoing IVF treatment in Guangxi province, China, from July 2018 to December 2018. We measured 32 PFAA, including branched isomers, in follicular fluid using ultra-performance liquid chromatography coupled to tandem mass spectrometry. We applied restricted cubic splines, linear regression, and log-binominal regression models to investigate associations between follicular fluid PFAA and embryo quality, adjusting for confounding variables and investigated oocyte maturity as an intervening variable using causal mediation analysis. We further estimated the overall effect of the PFAA mixture on outcomes using Bayesian kernel machine regression (BKMR). RESULTS We detected 8 of 32 measured PFAA in >85% of follicular fluid samples. Higher PFAA concentrations were associated with fewer high-quality embryos from IVF. The high-quality embryo rates at the 50th percentile of linear perfluoro-1-octanesulfonate acid (n-PFOS), all branched PFOS isomers (Br-PFOS) and linear perfluoro-n-octanoic acid (n-PFOA) were -6.34% [95% confidence interval (CI): -9.45, -3.32%], -16.78% (95% CI: -21.98, -11.58%) and -8.66% (95% CI: -11.88, -5.43%) lower, respectively, than the high quality embryo rates at the reference 10th percentile of PFAA. Oocyte maturity mediated 11.76% (95% CI: 3.18, 31.80%) and 14.28% (95% CI: 2.95, 31.27%) of the n-PFOS and n-PFOA associations, respectively. The results of the BKMR models showed a negative association between the PFAA mixture and the probability of high-quality embryos, with branched PFOS isomers having posterior inclusion probabilities of 1 and accounting for the majority of the association. DISCUSSION Exposure to higher PFAA concentrations in follicular fluid was associated with poorer embryo quality during IVF. Branched PFOS isomers may have a stronger effect than linear PFOS isomers. More studies are needed to confirm these findings and to directly estimate the effects on pregnancy and live-birth outcomes. https://doi.org/10.1289/EHP10857.
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Affiliation(s)
- Xiao-Wen Zeng
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Sun Yat-sen University, Guangzhou, China
| | - Michael S. Bloom
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Fu Wei
- Department of Anatomy and Embryology. Leiden University Medical Center, Leiden, The Netherlands
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Liling Liu
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Jie Qin
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Lintao Xue
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Shikai Wang
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Guolan Huang
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Min Teng
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Bing He
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Xianbao Mao
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Chu Chu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Sun Yat-sen University, Guangzhou, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, 12 Albany, NY, USA
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, 12 Albany, NY, USA
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Sun Yat-sen University, Guangzhou, China
| | - Weihong Tan
- Department of Reproductive Medicine and Genetics Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
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Modarres M, Abunasri M, Alhani F, Ebrahimi E. The Effectiveness of Implementing Family-Centered Empowerment Model on Irrational Thoughts of Iranian Infertile Women: A Randomized Clinical Trial. J Caring Sci 2022; 11:224-231. [PMID: 36483691 PMCID: PMC9720503 DOI: 10.34172/jcs.2022.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 04/03/2021] [Indexed: 08/01/2023] Open
Abstract
Introduction: Infertility is one of the main problems of the family and is one of the factors that determine the identity and personality of Iranian infertile women. Family-centered empowerment model is a step toward increasing the self-efficacy of patients and enabling them to take responsibility of their illness. This study aimed to determine the effectiveness of applying family-centered empowerment model on irrational thoughts of Iranian infertile women. Methods: This study was a randomized clinical trial conducted on 80 infertile women and their husbands that were randomly divided into two intervention and control groups. Irrational Parenthood Cognitions questionnaire was given to the intervention and control groups to complete before and 3 months after the intervention. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, IL, USA). Results: The mean (SD) of irrational thoughts' scores in the control group before and after the study were 33.92 (5.98) and 33.20 (6.83) respectively, and in the intervention group were 34.55 (5.61) and 19.97 (3.52), respectively. The result of independent t-test showed a significant reduction in irrational thoughts of women in the intervention group after the family-centered empowerment model intervention. Conclusion: The family-centered empowerment model after three months of continuous implementation was able to effectively reduce the irrational thoughts about having children in infertile women.
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Affiliation(s)
- Maryam Modarres
- Department of Reproductive Health Midwifery, School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Maryam Abunasri
- Department of Reproductive Health Midwifery, School of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran
| | - Fatemeh Alhani
- School of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Elham Ebrahimi
- Department of Reproductive Health Midwifery, School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Science, Tehran, Iran
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Abstract
IMPORTANCE The number of children born through the use of assisted reproductive technology (ART) has been increasing. These children may have higher risks for epigenetic alteration and adverse perinatal outcomes, which may be associated with childhood cancers. OBJECTIVE To determine the associations between different modes of conception and childhood cancers and potential mediation by preterm birth and low birth weight. DESIGN, SETTING, AND PARTICIPANTS This nationwide, population-based cohort study included registry data from 2 308 016 eligible parents-child triads in Taiwan from January 1, 2004, to December 31, 2017. A total of 1880 children with incident childhood cancer were identified. Data were analyzed between September 1, 2020, and June 30, 2022. EXPOSURE Mode of conception, defined as (1) natural conception, (2) subfertility and non-ART (ie, infertility diagnosis but no ART-facilitated conception), or (3) ART (ie, infertility diagnosis and ART-facilitated conception). MAIN OUTCOMES AND MEASURES Diagnosis of childhood cancer according to the International Classification of Childhood Cancers, Third Edition. RESULTS The mean (SD) paternal and maternal ages were 33.28 (5.07) and 30.83 (4.56) years, respectively. Of the 2 308 016 children, 52.06% were boys, 8.16% were born preterm, and 7.38% had low birth weight. During 14.9 million person-years of follow-up (median, 6 years [IQR, 3-10 years]), ART conception was associated with an increased risk of any type of childhood cancers compared with natural conception (hazard ratio, 1.58; 95% CI, 1.17-2.12) and subfertility with non-ART conception (hazard ratio, 1.42; 95% CI, 1.04-1.95). The increased cancer risk of children conceived with ART was mainly owing to leukemia and hepatic tumor. The increased cancer risk associated with ART conception was not mediated by preterm birth or low birth weight. CONCLUSIONS AND RELEVANCE In this cohort study, children conceived via ART had a higher risk of childhood cancers than those conceived naturally and those born to parents with an infertility diagnosis did not use ART. The increased risk could not be explained by preterm birth or low birth weight.
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Affiliation(s)
- Shiue-Shan Weng
- Institute of Public Health, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei City, Taiwan
| | - Yen-Tsung Huang
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Yi-Ting Huang
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Yi-Ping Li
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei City, Taiwan
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Zou L, Hong M, Dai Z, Zhu J, Peng Q, Wang W. The association between previous induced abortion and in vitro fertilization outcomes: A retrospective cohort study in Hefei, China. Eur J Obstet Gynecol Reprod Biol 2021; 262:124-128. [PMID: 34015639 DOI: 10.1016/j.ejogrb.2021.05.020] [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: 11/21/2019] [Revised: 02/14/2021] [Accepted: 05/08/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the association between previous induced abortion and in vitro fertilization (IVF) outcomes among Chinese women. STUDY DESIGN In this retrospective cohort study, a total of 1436 infertility patients treated with IVF for the first time in the reproductive centre of Anhui Province Maternity and Child Health Hospital from February 2014 to April 2018 were selected as the study population, and 95 (6.6 %) had a history of induced abortion. Data were assessed from the hospital electronic database and medical records in the reproductive centre. RESULTS In total, 818 women (57.0 %) achieved clinical pregnancy, and 501 (34.9 %) achieved live birth. After adjustments for a series of potential confounding factors, women with a history of induced abortion had a significantly decreased probability of clinical pregnancy per transfer (OR: 0.71, 95 % CI: 0.53, 0.95, p = 0.037) and live birth per pregnancy (OR: 0.52, 95 % CI: 0.30, 0.90, p = 0.021) and a higher risk of miscarriage per pregnancy (OR: 1.89, 95 % CI: 1.24, 2.88, p = 0.009) than those without. Because relevant information was unavailable, the impacts of different types of previous induced abortion were not assessed. CONCLUSIONS Previous induced abortion may have an adverse effect on IVF outcomes among infertility patients.
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Affiliation(s)
- Linbing Zou
- Reproductive Medicine Centre, Anhui Province Maternity and Child Health Hospital, 15 Yimin Road, Hefei, Anhui, 230001, PR China
| | - Mingyun Hong
- Reproductive Medicine Centre, Anhui Province Maternity and Child Health Hospital, 15 Yimin Road, Hefei, Anhui, 230001, PR China
| | - Zhijun Dai
- Reproductive Medicine Centre, Anhui Province Maternity and Child Health Hospital, 15 Yimin Road, Hefei, Anhui, 230001, PR China
| | - Jiansheng Zhu
- Reproductive Medicine Centre, Anhui Province Maternity and Child Health Hospital, 15 Yimin Road, Hefei, Anhui, 230001, PR China
| | - Qingmei Peng
- Department of Obstetrics and Gynecology, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, PR China
| | - Weiye Wang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinggangshan University, 28 Xueyuan Road, Ji'an, Jiangxi, 343009, PR China; Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong, 266021, PR China.
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