Fertility preservation in young patients with cancer

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Virender Suhag

2015-01-01

Full Text Available Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the forefront the potential for fertility preservation in patients being treated for cancer. Many survivors will maintain their reproductive potential after the successful completion of treatment for cancer. However total body irradiation, radiation to the gonads, and certain high dose chemotherapy regimens can place women at risk for acute ovarian failure or premature menopause and men at risk for temporary or permanent azoospermia. Providing information about risk of infertility and possible interventions to maintain reproductive potential are critical for the adolescent and young adult population at the time of diagnosis. There are established means of preserving fertility before cancer treatment; specifically, sperm cryopreservation for men and in vitro fertilization and embryo cryopreservation for women. Several innovative techniques are being actively investigated, including oocyte and ovarian follicle cryopreservation, ovarian tissue transplantation, and in vitro follicle maturation, which may expand the number of fertility preservation choices for young cancer patients. Fertility preservation may also require some modification of cancer therapy; thus, patients' wishes regarding future fertility and available fertility preservation alternatives should be discussed before initiation of therapy.

[Laparoscopic radical trachelectomy for preservation of fertility in early cervical cancer. A case report].

Science.gov (United States)

Isla Ortiz, David; Montalvo-Esquivel, Gonzalo; Chanona-Vilchis, José Gregorio; Herrera Gómez, Ángel; Ñamendys Silva, Silvio Antonio; Pareja Franco, Luis René

2016-01-01

Radical hysterectomy is the standard treatment for patients with early-stage cervical cancer. However, for women who wish to preserve fertility, radical trachelectomy is a safe and viable option. To present the first case of laparoscopic radical trachelectomy performed in the National Cancer Institute, and published in Mexico. Patient, 34 years old, gravid 1, caesarean 1, stage IB1 cervical cancer, squamous, wishing to preserve fertility. She underwent a laparoscopic radical trachelectomy and bilateral dissection of the pelvic lymph nodes. Operation time was 330minutes, and the estimated blood loss was 100ml. There were no intraoperative or postoperative complications. The final pathology reported a tumour of 15mm with infiltration of 7mm, surgical margins without injury, and pelvic nodes without tumour. After a 12 month follow-up, the patient is having regular periods, but has not yet tried to get pregnant. No evidence of recurrence. Laparoscopic radical trachelectomy and bilateral pelvic lymphadenectomy is a safe alternative in young patients who wish to preserve fertility with early stage cervical cancer. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Fertility Preservation for Children Diagnosed with Cancer

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Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult ...

Fertility preservation in young cancer patients

Directory of Open Access Journals (Sweden)

Ariel Revel

2010-01-01

Full Text Available As a result of advances in treatment, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. The increased survival rate of children and adolescents with cancer has resulted in a major interest in the long-term effects of cancer treatment on the possibility for future fertility. Currently established methods for the preservation of fertility are available only for pubertal males and females. Pubertal male cancer patients should be encouraged to freeze numerous sperm samples even when sperm count and motility are poor. In these cases, intracytoplasmic sperm injection is a powerful technique compared with intrauterine insemination since thawed sperm samples with poor parameters can produce relatively high fertilization rates resulting in normal pregnancies and deliveries. Married pubertal women should be proposed ovulation induction, follicular aspiration, and fertilization with husband sperm. Single women could benefit from vitrification of oocytes. This requires a delay of about 3 weeks in the commencement of chemotherapy to enable follicular growth. Fertility preservation for prepubertal patients is more of a problem. Young girls could be offered cryopreservation of gametes in the gonadal tissue. Cryopreservation of testicular tissue was suggested for fertility preservation for young boys, but this method is totally experimental and not currently offered. Discussing future fertility is part of the consultation of young female and male patients facing potentially gonadotoxic cancer therapy. It is the role of reproductive specialists to create various options in their laboratory to preserve fertility potential of cancer patients.

Fertility Preservation Counseling for Pediatric and Adolescent Cancer Patients.

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Campbell, Jessica E; Assanasen, Chatchawin; Robinson, Randal D; Knudtson, Jennifer F

2016-03-01

Fertility preservation for children and young adults with cancer is an important part of comprehensive patient care. In 2013, the American Society of Clinical Oncology (ASCO) released updated clinical practice guidelines addressing fertility preservation. This study aimed to evaluate if pediatric oncologists were performing fertility preservation counseling, if the new guidelines were being adopted, and how reproductive endocrinologists can educate this patient population and their providers. A cross-sectional study was performed from May 26, 2014, to August 26, 2014. An online survey addressing fertility preservation practice patterns was created and provided to the members of the Children's Oncology Group (COG). Thirty-five percent of the 234 respondents reported reading the new 2013 ASCO guidelines. Ninety-five percent of providers reported mentioning fertility preservation options prior to treatment, most commonly including referral to a reproductive endocrinologist (28%), and sperm banking (57%). The most commonly reported barrier to fertility preservation counseling was the cost of treatment. Fertility preservation counseling is being performed by pediatric oncology providers. Familiarity of the ASCO guidelines is limited, revealing that the established methods for fertility preservation in women--embryo and oocyte cryopreservation--may be offered less than experimental methods in this younger patient population. Such differences in apparent practice patterns highlight the need for more education for providers.

Young female cancer patients' experiences with fertility counselling and fertility preservation

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Hoeg, Didde; Schmidt, Lone; Tryde Macklon, Kirsten

2016-01-01

were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how......Introduction: Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment...... in the public Danish health care system. Methods: Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer feel fertility preservation and ... Fertility preservation and adolescent cancer patients: lessons from adult survivors of childhood cancer and their parents. Cancer ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... fertility preservation center closest to you Visit the Pediatric Oncofertility Research Foundation Visit the Patient Navigator Website ... Ginsberg JP. New advances in fertility preservation for pediatric cancer patients. Curr Opin Pediatr. 2010;23:9- ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... fertility preservation is important. These key points can help start the conversation: Cancer and cancer treatment may ... several resources listed on the reverse that can help you locate a fertility preservation specialist to discuss ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... be fertility preservation options available and having your child see a reproductive specialist in a timely manner ... there are options for preserving fertility in your child diagnosed with cancer. You may be focused on ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... JP, Kolon TF. Fertility Preservation in Children and Adolescents With Cancer . Urology. 2016;91:190-6. Loren ... 10. Nieman CL, et al. Fertility preservation and adolescent cancer patients: lessons from adult survivors of childhood ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... available and having your child see a reproductive specialist in a timely manner can improve their future ... Can you refer us to a fertility preservation specialist to discuss my child’s options further? Fertility Preservation - ...

Fertility preservation: a challenge for IVF-clinics

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Dahhan, Taghride; Mol, Femke; Kenter, Gemma G.; Balkenende, Eva M. E.; de Melker, Annemieke A.; van der Veen, Fulco; Dancet, Eline A. F.; Goddijn, Mariëtte

2015-01-01

Acute fertility preservation for women is an interdisciplinary treatment that requires adequate information provision and early referral. This quality management project aimed to improve fertility preservation care by using a practical tool: Strengths, Weaknesses, Opportunities and Threats (SWOT)

Fertility Preservation for Pediatric Patients: Current State and Future Possibilities.

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Johnson, Emilie K; Finlayson, Courtney; Rowell, Erin E; Gosiengfiao, Yasmin; Pavone, Mary Ellen; Lockart, Barbara; Orwig, Kyle E; Brannigan, Robert E; Woodruff, Teresa K

2017-07-01

This review provides an overview of pediatric fertility preservation. Topics covered include the patient populations who could benefit, the current state of fertility preservation options and research, and considerations related to ethics and program development. A broad Embase® and PubMed® search was performed to identify publications discussing investigational, clinical, ethical and health care delivery issues related to pediatric fertility preservation. Relevant publications were reviewed and summarized. Populations who could benefit from fertility preservation in childhood/adolescence include oncology patients, patients with nononcologic conditions requiring gonadotoxic chemotherapy, patients with differences/disorders of sex development and transgender individuals. Peripubertal and postpubertal fertility preservation options are well established and include cryopreservation of oocytes, embryos or sperm. Prepubertal fertility preservation is experimental. Multiple lines of active research aim to develop technologies that will enable immature eggs and sperm to be matured and used to produce a biological child in the future. Ethical challenges include the need for parental proxy decision making and the fact that fertility preservation procedures can be considered not medically necessary. Successful multidisciplinary fertility preservation care teams emphasize partnerships with adult colleagues, prioritize timely consultations and use standardized referral processes. Some aspects of fertility preservation are not covered by insurance and out-of-pocket costs can be prohibitive. Pediatric fertility preservation is an emerging, evolving field. Fertility preservation options for prepubertal patients with fertility altering conditions such as cancer and differences/disorders of sex development are currently limited. However, multiple lines of active research hold promise for the future. Key considerations include establishing a multidisciplinary team to provide

Fertility preservation in patients with haematological disorders: a retrospective cohort study.

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Senapati, Suneeta; Morse, Christopher B; Sammel, Mary D; Kim, Jayeon; Mersereau, Jennifer E; Efymow, Brenda; Gracia, Clarisa R

2014-01-01

This study investigated the factors associated with utilization of fertility preservation and the differences in treatments and outcomes by prior chemotherapy exposure in patients with haematological diseases. This study included all 67 women with haematological diseases seen for fertility preservation consultation at two university hospitals between 2006 and 2011. Of the total, 49% had lymphoma, 33% had leukaemia, 7% had myelodysplastic syndrome and 4% had aplastic anaemia; 46% had prior chemotherapy; and 33% were planning for bone marrow transplantation, 33% pursued ovarian stimulation and 7% used ovarian tissue banking; and 48% of patients did not pursue fertility preservation treatment. All five cycle cancellations were in the post-chemotherapy group: three patients with leukaemia and two with lymphoma. Patients with prior chemotherapy had lower baseline antral follicle count (10 versus 22) and received more gonadotrophins to achieve similar peak oestradiol concentrations, with no difference in oocyte yield (10.5 versus 10) after adjustment for age. Embryo yield was similar between those who had prior chemotherapy and those who had not. Half of the patients with haematological diseases who present for fertility preservation have been exposed to chemotherapy. While ovarian reserve is likely impaired in this group, oocyte yield may be acceptable. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Fertility counseling and preservation practices in youth with lupus and vasculitis undergoing gonadotoxic therapy.

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Nahata, Leena; Sivaraman, Vidya; Quinn, Gwendolyn P

2016-11-01

To assess fertility counseling and preservation practices among children, adolescents, and young adults with rheumatic diseases undergoing cyclophosphamide (CTX) treatment. Retrospective chart review (2006-2016). Academic pediatric center. Male and female patients with systemic lupus erythematosus, Wegener's granulomatosis/granulomatosis with polyangiitis, or other vaculitides, receiving CTX treatment. None. Documentation of fertility counseling and fertility preservation. A total of 58 subjects met the inclusion criteria; 5 were excluded due to incomplete records, thus N = 53. Of these 75% were female (N = 40). Median age was 14 years at diagnosis and 15 years at first CTX treatment. A total of 51% of subjects (69% of males and 45% of females) had no documentation about potential fertility loss before CTX treatment. Among females where fertility counseling was documented, the only fertility preservation option discussed was leuprolide acetate (LA), which was pursued in all of these cases. Of 13 males (77% postpubertal), 3 were offered sperm banking, of whom 2 declined and the other attempted after treatment began and was azoospermic. Of 53 patients, 1 was referred to a fertility specialist. Mean cumulative CTX dose was 9.2 g in males and 8 g in females. Based on these findings, increasing awareness about infertility risk, fertility preservation options, and referral to fertility specialists is needed among pediatric rheumatologists. Prospective studies are needed to assess fertility outcomes in this patient population (including effectiveness of LA with regard to pregnancy rates [PRs]), as well as barriers/facilitators to fertility counseling and fertility preservation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Repair of the threatened feminine identity: experience of women with cervical cancer undergoing fertility preservation surgery.

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Komatsu, Hiroko; Yagasaki, Kaori; Shoda, Rie; Chung, Younghui; Iwata, Takashi; Sugiyama, Juri; Fujii, Takuma

2014-01-01

Fertility preservation is important for women of reproductive age with cervical cancer. The underlying reasons behind suboptimal reproductive results after successful fertility-preserving surgery have not yet been fully revealed. The objective of this study was to explore the experience of fertility preservation with radical trachelectomy from the perspective of women with cervical cancer. We conducted interviews with women with cervical cancer who underwent radical trachelectomy using a Grounded Theory methodology with a theoretical framework of symbolic interactionism. Our findings articulate a process in which feminine identity is first threatened by a diagnosis of cancer, then repaired by fertility preservation with radical trachelectomy, and finally reconstructed after the surgery, through interactions with self, others, and external events in women with cervical cancer. Feeling incomplete as a woman because of the loss of the uterus was a critical factor in the women's feeling that their feminine identity was threatened. Thus, fertility preservation was significant for these women. The meaning of fertility preservation varied among the women, and their life perspectives were therefore distinct after the surgery. Women with cervical cancer who undergo radical trachelectomy experience an identity transformation process, and child bearing is not the only expected outcome of fertility preservation. Nurses should coordinate care through the cancer trajectory. Understanding the identity transformation process helps nurses to assess patients' needs and provide appropriate individual care.

Fertility preservation: a pilot study to assess previsit patient knowledge quantitatively.

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Balthazar, Ursula; Fritz, Marc A; Mersereau, Jennifer E

2011-05-01

To provide a quantitative assessment of patient knowledge about fertility and fertility preservation treatment options before the initial fertility preservation consultation at a university-based fertility preservation center. Prospective pilot survey containing 13 items assessing patient knowledge about fertility preservation, including the available treatment options and their requirements, success rates, and associated risks. University-based IVF center. Women aged 18 to 41 years with illnesses requiring treatments posing a serious threat to future fertility who were referred for fertility preservation consultation between April 2009 and June 2010. None. Knowledge score. Forty-one eligible patients were identified, and all completed surveys before their consultation. A knowledge score was generated for each patient with 1 point awarded for each correct answer. Overall, patients had poor previsit fertility preservation knowledge (mean score 5.9±2.7). Higher knowledge scores were correlated with personal experience with infertility and previous exposure to fertility preservation treatment information. There was no correlation between knowledge score and age, relationship status, pregnancy history, education, or income. Patients seen for fertility preservation consultation at our university-based center generally tend to be in their early 30s, white, well educated, and married. Previsit knowledge about fertility preservation treatment options was poor and did not correlate with age, education, and relationship status. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer.

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Letourneau, Joseph M; Ebbel, Erin E; Katz, Patricia P; Katz, Audra; Ai, Wei Z; Chien, A Jo; Melisko, Michelle E; Cedars, Marcelle I; Rosen, Mitchell P

2012-03-15

The post-treatment quality of life (QOL) impacts of receiving precancer-treatment infertility counseling and of pursuing fertility preservation have not been described in large-scale studies of reproductive age women with cancer. In total, 1041 women who were diagnosed between ages 18 and 40 years responded to a retrospective survey and reported whether they received infertility counseling before cancer treatment and whether they took action to preserve fertility. Five cancer types were included: leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancer. Validated QOL scales were used: the Decision Regret Score, the Satisfaction with Life Scale (SWLS), and the brief World Health Organization QOL questionnaire. Overall, 560 women (61%) who received treatment that potentially could affect fertility were counseled by the oncology team, 45 (5%) were counseled by fertility specialists, and 36 (4%) took action to preserve fertility. Pretreatment infertility counseling by a fertility specialist and an oncologist resulted in lower regret than counseling by an oncologist alone (8.4 vs 11.0; P fertility preservation (6.6 vs 11.0; P fertility specialist counseling (23.0 vs 19.8; P = .09) or preserving fertility (24.0 vs 19.0; P = .05). Receiving specialized counseling about reproductive loss and pursuing fertility preservation is associated with less regret and greater QOL for survivors, yet few patients are exposed to this potential benefit. Women of reproductive age should have expert counseling and should be given the opportunity to make active decisions about preserving fertility. Copyright © 2011 American Cancer Society.

Preservation of Fertility Potential for Gender and Sex Diverse Individuals.

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Johnson, Emilie K; Finlayson, Courtney

2016-01-01

Gender and sex diverse individuals-transgender individuals and those with disorders of sex development (DSD)-both face medical treatments that may impair biological fertility potential. Young DSD patients also often have abnormal gonadal development. Fertility preservation for these populations has historically been poorly understood and rarely addressed. Future fertility should be discussed with gender and sex diverse individuals, particularly given recent advances in fertility preservation technologies and evolving views of fertility potential. Key ethical issues include parental proxy decision-making and uncertainty regarding prepubertal fertility preservation technologies. Many opportunities exist for advancing fertility-related care and research for transgender and DSD patients.

Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review

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Matthews, Michelle L.; Hurst, Bradley S.; Marshburn, Paul B.; Usadi, Rebecca S.; Papadakis, Margaret A.; Sarantou, Terry

2012-01-01

Given the increases in 5-year cancer survival and recent advances in fertility preserving technologies, an increasing number of women with cancer are presenting for discussion of fertility preserving options. This review will summarize the risk of infertility secondary to cancer treatment, available treatment options for fertility preservation, and techniques to reduce future risks for patients. Concerns that will be addressed include the risk of the medications and procedures, the potential ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Online Fertility Preservation Toolkit for Patients and Their Providers Open menu Reprotopia_Main_Menu About SaveMyFertility Provider ... of a clinical study approved by an IRB . Resources For more information about infertility risk and fertility ...

Female fertility preservation in the pediatric and adolescent cancer patient population.

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Algarroba, Gabriela N; Sanfilippo, Joseph S; Valli-Pulaski, Hanna

2018-04-01

The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population. Additionally, the fertility preservation methods for pre- and postpubertal females differ, with only experimental methods available for prepubertal females. We will review the risk of chemotherapy and radiation on female fertility, the approach to fertility preservation in the pediatric and adolescent female population, methods of fertility preservation for both pre- and postpubertal females, barriers to fertility preservation, cost, and psychological and ethical considerations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Fertility Preservation: A Key Survivorship Issue for Young Women with Cancer

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Angarita, Ana Milena; Johnson, Cynae A.; Fader, Amanda Nickles; Christianson, Mindy S.

2016-01-01

Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health-care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women’s age, diagnosis, presence of male partner, time available, and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors’ quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation. PMID:27200291

Fertility preservation: A key survivorship issue for young women with cancer

Directory of Open Access Journals (Sweden)

Ana M Angarita

2016-04-01

Full Text Available Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women’s age, diagnosis, presence of male partner, time available and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors’ quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation.

Fertility preservation in women with borderline ovarian tumors - how does it impact disease outcome? A cohort study.

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Helpman, Limor; Yaniv, Assaf; Beiner, Mario E; Aviel-Ronen, Sarit; Perri, Tamar; Ben-Baruch, Gilad; Hogen Ben-David, Liat; Jakobson-Setton, Ariella; Korach, Jacob

2017-11-01

Borderline ovarian tumors are typically indolent neoplasms. Since many are diagnosed in younger women, fertility conservation is an important consideration and has been advocated based on retrospective data. The objective of this study was to identify features impacting on recurrence and survival in a series of borderline ovarian tumors, and to assess the safety of a fertility-sparing approach. A historical cohort study of consecutive borderline ovarian tumors cases treated at a single institution over 30 years (1981-2011). Data on surgical approach (fertility-sparing or otherwise), disease stage, CA125 levels, histological features, adjuvant treatment and follow-up data were collected. Recurrence and survival were assessed using the Kaplan-Meier method and associations with the variables of interest were evaluated using a multivariate Cox proportional hazards model. 213 patients were included. Of 132 women age 40 years and below at diagnosis, 112 (85%) had a fertility-sparing procedure and 60 (46%) had conservation of an involved ovary. Fifty patients (24%) developed recurrences; fertility preservation (hazard ratio = 2.57; 95% confidence interval 1.1-6; p = 0.029) and advanced stage (hazard ratio = 4.15; 95% confidence interval 2.3-7.6; p Fertility preservation was not associated with compromised survival. Borderline ovarian tumors carry a good prognosis overall. Fertility preservation is associated with a higher risk of disease relapse; however, as most relapses are localized and may be salvaged with surgical treatment, overall survival is not compromised. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available Sorry, you need to enable JavaScript to visit this website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu ...

Fertility Preservation for Children Diagnosed with Cancer

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Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... fertility preservation and the ability to have a future family are important. Understanding there may be fertility ... specialist in a timely manner can improve their future quality of life. Introduction You may not be ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... health. You may feel uncomfortable discussing issues of reproduction with your child. Ask Your Doctor Discussing fertility ... American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Fertil Steril. 2013; 100:1224-31. Chow EJ, et al. Pregnancy after chemotherapy in male and female ... Cancer . Urology. 2016;91:190-6. Loren AW, et al. Fertility preservation for patients with cancer: American ...

Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

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McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

2018-01-01

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such ‘experimental’ procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents’ decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children’s Hospital in Melbourne, Australia. PMID:29084865

Large Conization and Laparoendoscopic Single-Port Pelvic Lymphadenectomy in Early-Stage Cervical Cancer for Fertility Preservation

Directory of Open Access Journals (Sweden)

Polat Dursun

2013-01-01

Full Text Available Fertility preservation in early-stage cervical cancer is a hot topic in gynecologic oncology. Although radical vaginal trachelectomy (RVT is suggested as a fertility preserving approach, there are some serious concerns like cervical stenosis, second trimester loss, preterm delivery in survivors, and lack of residual tumor in the majority of the surgical specimens. Therefore, less radical surgical operations have been proposed in early-stage cervical carcinomas. On the other hand, single-incision laparoscopic surgery (SILS is an evolving endoscopic approach for minimal access surgery. In this report, we present a case with early-stage cervical cancer who wishes to preserve fertility. We successfully performed single-port pelvic lymphadenectomy and large conization to preserve fertility potential of the patient. We think that combination of less radical approach like conization and single-port pelvic lymphadenectomy might be less minimally invasive and is still an effective surgical approach in well-selected cases with cervical carcinomas. Incorporation of single-port laparoscopy into the minimally invasive fertility sparing management of the cervical cancer will improve patients outcome with less complications and better cosmesis. Further studies are needed to reach a clear conclusion.

What to do now? How women with breast cancer make fertility preservation decisions.

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Snyder, Karrie Ann; Tate, Alexandra Lee

2013-07-01

There has been increased attention paid to cancer-related infertility and fertility preservation. However, how cancer patients decide whether or not to pursue fertility preservation has not been fully examined. The data come from 34 interviews with women in the USA diagnosed with breast cancer prior to 40 years of age who contemplated fertility preservation prior to cancer treatment. Fully transcribed interviews were coded through a three-staged inductive process. Three sets of factors that shaped the decision-making process of the respondents regarding fertility preservation treatment options were identified: perceived benefits (e.g. ability to use 'younger' eggs in the future), inhibiting concerns (e.g. success rates) and influential relationships (e.g. physicians, parents and partners). Respondents saw their main fertility preservation decision as choosing whether or not to pursue egg/embryo banking. The decision-making process was complicated and included both health-related and personal considerations, with many respondents reporting a lack of support services for fertility issues. Findings suggest that greater attention needs to be placed on presenting patients with a wider range of options. Those who counsel patients regarding fertility preservation decisions should be aware of the influence of relationship dynamics, broader health care concerns, and fertility histories on these decisions. KEY MESSAGE POINTS: While fertility preservation has garnered greater attention, less is known about how cancer patients make fertility preservation decisions. Despite the range of choices for fertility preservation, respondents identified egg/embryo banking as their primary option. Many factors outside of cancer concerns inhibit and facilitate fertility preservation decisions including fertility history and family relationship dynamics.

Fertility preservation and cancer: How many persons are concerned?

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Le Bihan-Benjamin, Christine; Hoog-Labouret, Natalie; Lefeuvre, Delphine; Carré-Pigeon, Frédérique; Bousquet, Philippe Jean

2018-06-01

A significant proportion of cancer survivors experience chronic health sequelae, one of them being fertility impairment. However, even if many reports, guidelines and positions papers focus on fertility preservation and its needs, access to fertility preservation is not currently offered to all the patients concerned, and the targeted population is not well counted. A cross sectional study was conducted using the French cancer cohort, a cohort covering the whole French population and including around 7 million of cancer patients. Women under the age of 40 and men under the age of 60 included in the cancer cohort in 2013 who had, in the first year, cancer surgery, chemotherapy or radiotherapy were considered. Patients treated by surgery alone for cancers in locations distant from the reproductive organs, or being treated for a cancer the past 3 years were excluded. The number of patients concerned by fertility preservation was estimated at a national and regional level, and by cancer types. 40,000 patients - 30,000 men under the age of 60 years and 10,000 women under the age of 40 years - were identified. A second estimation concerning women under the age of 35 and men under 50 reduced the number of patients to 17,200-10,400 men and 6800 women. The most frequent locations were malignant neoplasm of lymphoid and hematopoietic tissue, lung cancer, cervix uteri, prostate and colorectal cancer. In 2014, around 5 400 persons had a preservation. Around 17,200 cancer patients of reproductive age should be informed about the fertility preservation options available. Medical professionals have to better integrate in their daily practice fertility preservation. Copyright © 2018 Elsevier B.V. All rights reserved.

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013; 100:1224-31. Chow EJ, et al. Pregnancy after chemotherapy in male and female survivors of ...

Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

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McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

2018-01-01

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. 'Fertility preservation' for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such 'experimental' procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents' decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children's Hospital in Melbourne, Australia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available Sorry, you need to enable JavaScript to visit this website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for ... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ...

The Ethics of Fertility Preservation for Paediatric Cancer Patients: From Offer to Rebuttable Presumption.

Science.gov (United States)

McDougall, Rosalind

2015-11-01

Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state. © 2015 John Wiley & Sons Ltd.

The PREgnancy and FERtility (PREFER) study: an Italian multicenter prospective cohort study on fertility preservation and pregnancy issues in young breast cancer patients.

Science.gov (United States)

Lambertini, Matteo; Anserini, Paola; Fontana, Valeria; Poggio, Francesca; Iacono, Giuseppina; Abate, Annalisa; Levaggi, Alessia; Miglietta, Loredana; Bighin, Claudia; Giraudi, Sara; D'Alonzo, Alessia; Blondeaux, Eva; Buffi, Davide; Campone, Francesco; Merlo, Domenico F; Del Mastro, Lucia

2017-05-19

Fertility and pregnancy issues are of key importance for young breast cancer patients. Despite several advances in the field, there are still multiple unmet needs and barriers in discussing and dealing with these concerns. To address the significant challenges related to fertility and pregnancy issues, the PREgnancy and FERtility (PREFER) study was developed as a national comprehensive program aiming to optimize care and improve knowledge around these topics. The PREFER study is a prospective cohort study conducted across several Italian institution affiliated with the Gruppo Italiano Mammella (GIM) group evaluating patterns of care and clinical outcomes of young breast cancer patients dealing with fertility and pregnancy issues. It is composed of two distinctive studies: PREFER-FERTILITY and PREFER-PREGNANCY. The PREFER-FERTILITY study is enrolling premenopausal patients aged 18-45 years, diagnosed with non-metastatic breast cancer, who are candidates to (neo)adjuvant chemotherapy and not previously exposed to anticancer therapies. The primary objective is to obtain and centralize data about patients' preferences and choices towards the available fertility preserving procedures. The success and safety of these strategies and the hormonal changes during chemotherapy and study follow-up are secondary objectives. The PREFER-PREGNANCY study is enrolling survivors achieving a pregnancy after prior history of breast cancer and patients diagnosed with pregnancy-associated breast cancer (PABC). The primary objectives are to obtain and centralize data about the management and clinical outcomes of these women. Patients' survival outcomes, and the fetal, obstetrical and paediatric care of their children are secondary objectives. For both studies, the initial planned recruitment period is 5 years and patients will remain in active follow-up for up to 15 years. The PREFER-FERTILITY study was first activated in November 2012, and the PREFER-PREGNANCY study in May 2013

Male fertility preservation before gonadotoxic therapies

OpenAIRE

Wyns, C.

2010-01-01

Background: Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. Unfortunately, aggressive chemotherapy, radiotherapy and preparative regimens for bone marrow transplantation can severely affect male germ cells, including spermatogonial stem cells (SSCs), and lead to permanent loss of fertility. Different options for fertility preservation are dependent on the pubertal state of the patient. Methods: Relevant studies were identified by an extens...

Male fertility preservation before gonadotoxic therapies.

Science.gov (United States)

Wyns, C

2010-01-01

Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. Unfortunately, aggressive chemotherapy, radiotherapy and preparative regimens for bone marrow transplantation can severely affect male germ cells, including spermatogonial stem cells (SSCs), and lead to permanent loss of fertility. Different options for fertility preservation are dependent on the pubertal state of the patient. Relevant studies were identified by an extensive Medline search of English and French language articles. Sperm cryopreservation prior to gonadotoxic treatment is a well established method after puberty. In case of ejaculation failure by masturbation, assisted ejaculation methods or testicular tissue sampling should be considered. Although no effective gonadoprotective drug is yet available for in vivo spermatogonial stem cell (SSC) protection in humans, current evidence supports the feasibility of immature testicular tissue (ITT) cryopreservation. The different cryopreservation protocols and available fertility restoration options from frozen tissue, i.e. cell suspension transplantation, tissue grafting and in vitro maturation, are presented. RESULTS obtained in humans are discussed in the light of lessons learned from animal studies. Advances in reproductive technology have made fertility preservation a real possibility in young patients whose gonadal function is threatened by gonadotoxic therapies. The putative indications for such techniques, as well as their limitations according to disease, are outlined.

Innovative fertility preservation strategies and programs for young adults with cancer

Directory of Open Access Journals (Sweden)

Johnson RH

2016-01-01

Full Text Available Rebecca H Johnson Division of Pediatric Hematology/Oncology, Department of Pediatrics, Mary Bridge Hospital, MultiCare Health System, Tacoma, WA, USA Abstract: Preservation of fertility is a key issue for young adults newly diagnosed with cancer. Up to 90% of cancer patients under the age of 45 are at risk for fertility impairment following cancer therapy. Cancer patients who are not offered fertility preservation (FP and those who become infertile following therapy may experience long-term psychosocial distress. This review summarizes the numerous effective strategies for preserving fertility, including sperm banking, electroejaculation, and testicular sperm extraction in males and cryopreservation of embryos or oocytes in females. This paper also highlights novel methods currently in development, such as gonadal tissue cryopreservation and in vitro maturation of gametes. In women, anti-Mullerian hormone is emerging as an accurate marker of ovarian reserve, and the use of gonadotropin releasing hormone analogs to protect fertility is increasingly well validated. Although national guidelines mandate FP counseling and referral prior to the start of cancer therapy for patients with reproductive potential, only a minority of young cancer patients in the USA currently take steps to preserve fertility prior to the start of therapy. Some cancer centers across the USA are developing institutional strategies to support FP, resulting in increased utilization of fertility services by newly diagnosed cancer patients. Keywords: young adult, cancer, fertility preservation, program, oocyte, sperm

Fertility preservation in women--a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin's lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT.

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von Wolff, Michael; Montag, Markus; Dittrich, Ralf; Denschlag, Dominik; Nawroth, Frank; Lawrenz, Barbara

2011-08-01

Fertility preservation methods are playing an increasing role in women up to the age of 40 years because of rising survival rates in those affected by cancer. However, balanced practical recommendations concerning all relevant fertility preservation, to support doctors in counselling and treating patients, are still rare. These recommendations were prepared by the network FertiPROTEKT ( http://www.fertiprotect.eu ), a collaboration of around 70 centres in Germany, Switzerland and Austria. The recommendations were developed by specialists in reproductive medicine, reproductive biology and oncology, which gave a comprehensive overview of all named techniques as well as their benefits and risks. Furthermore, practice-orientated recommendations for the individual use of fertility preservation methods for various indications such as breast cancer, Hodgkin's lymphoma and borderline ovarian tumours are given. Various options such as ovarian stimulation and cryopreservation of unfertilised or fertilised oocytes, cryopreservation and transplantation of ovarian tissue, GnRH-agonist administration and transposition of the ovaries can be offered. All the techniques can be performed alone or in combination within a maximum of 2 weeks with low risk and different success rates. Fertility preservation in women has become an option with realistic chances to become pregnant after cytotoxic therapies. The information provided allows a well balanced and realistic counselling and treatment.

Young female cancer patients' experiences with fertility counselling and fertility preservation-a qualitative small-scale study within the Danish health care setting.

Science.gov (United States)

Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T

2016-07-14

Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before initiation of cancer treatment. Participants were interviewed at a place chosen by them, and interviews were recorded and transcribed verbatim. Data were analysed using systematic text condensation developed by Malterud and inspired by Giorgi's phenomenological analysis. None of the participants were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how the possibility of fertility preservation removed a huge concern and enabled them to concentrate on their cancer treatment and on getting better. Overall, the specialized fertility counselling and treatment to preserve fertility was highly valued. The women felt it gave them a choice about their future fertility. The fertility expert presented the various fertility-preserving scenarios, and the women were content that they had an actual choice.

Fertility Preservation for Transgender Adolescents.

Science.gov (United States)

Chen, Diane; Simons, Lisa; Johnson, Emilie K; Lockart, Barbara A; Finlayson, Courtney

2017-07-01

To describe fertility preservation (FP) utilization by transgender adolescents within a pediatric gender clinic between July 2013 and July 2016. A retrospective chart review was conducted to abstract demographic and clinical information among adolescents initiating gender-affirming hormones, including patient age at initial FP consultation, birth-assigned sex, race/ethnicity, and outcome of FP consultation. In our sample of 105 transgender adolescents, a total of 13 (seven transgender men and six transgender women) between the age of 14.2 and 20.6 years were seen in formal consultation for FP before initiating hormones. Of these adolescents, four completed sperm cryopreservation and one completed oocyte cryopreservation. Rates of FP utilization among transgender youth were low, which is consistent with a recently published report of FP utilization among transgender youth at another pediatric institution. Identified barriers to FP in our sample included cost, invasiveness of procedures, and desire not to delay medical transition. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Fertility preservation issues in pediatric hematopoietic stem cell transplantation

DEFF Research Database (Denmark)

Balduzzi, A; Dalle, J-H; Jahnukainen, K

2017-01-01

Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guide...

Management of fertility preservation in young breast cancer patients in a large breast cancer centre.

Science.gov (United States)

Lawrenz, B; Neunhoeffer, E; Henes, M; Lessmann-Bechle, S; Krämer, B; Fehm, Tanja

2010-11-01

The increase of breast cancer in young women under 40 years and the increasing age of women at the time of the birth of their first child underlines the importance to implement counselling for fertility-preserving strategies in the management of breast cancer care. We present the fertility-preserving procedures performed after routine counselling for primary breast cancer patients in a large certified breast cancer centre. Since November 2006, patients aged below 40 years with histologically confirmed breast cancer are routinely counselled on fertility-preserving possibilities before breast surgery and chemotherapy in the fertility centre of the University Women's Hospital in Tuebingen. The recommendations are based on the treatment recommendations of the network FertiPROTEKT. During the last 40 months, 56 primary breast cancer patients were counselled. Forty-one of these patients were hormone receptor positive. Thirty-four patients (63%) underwent fertility-preserving strategies. The majority of the patients (n = 22) decided on ovarian tissue cryopreservation. GnRH protection was performed in 14 patients. In 12 patients an ovarian stimulation protocol was initiated to cryopreserve fertilized or unfertilized oocytes. A combination of different fertility-preserving methods was performed in 12 patients. The preservation of ovarian function and fertility are of great importance to young breast cancer patients. Counselling on fertility-preserving strategies is therefore critical in these patients and should be routinely performed.

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Not an option if there is a high risk of ovarian metastases. Discuss with your doctor. b ... an IRB . Resources For more information about infertility risk and fertility preservation options for children diagnosed with ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... Doctor Information for Patients Many adult survivors of childhood cancer feel fertility preservation and the ability to ... after chemotherapy in male and female survivors of childhood cancer treated between 1970 and 1999: a report ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ... study approved by an IRB . Resources For more information about infertility risk and fertility preservation options for ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... see a reproductive specialist in a timely manner can improve their future quality of life. Introduction You ... Discussing fertility preservation is important. These key points can help start the conversation: Cancer and cancer treatment ...

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... for patients with cancer: American Society of Clinical Oncology clinical practice guideline update . J Clin Oncol. 2013; ... Incorporating fertility preservation into the care of young oncology patients. Cancer. 2010;117:4-10. Download Patient ...

[Chemotherapy and women fertility preservation].

Science.gov (United States)

Gauthier, Tristan; Piver, Pascal; Durand, Lise-Marie; Donadel, Lorène; Pech, Jean-Christophe; Roux, Christophe; Aubard, Yves

2010-01-01

Agressive chemotherapy can lead to premature ovarian failure and loss of fertility in women and children. Embryo cryopreservation is an established clinical procedure of fertility preservation but with several limitations. Others options are available. Cryopreservation ovarian cortex tissu have to be suggested in case of high gonadotoxic treatment. It doesn't require puberty and delay in initiation of chemotherapy. The first birth in France after orthotopic graft of ovarian tissu thawed have been recently described with a promising process. Oocyte cryopreservation is available for women without partner but the experience is limited. Gonadotrophin-releasing hormone (GnRH) agonist therapy as ovarian protectants seem interesting. Follicular growth and maturation in vitro are still experimental. Copyright 2010 Elsevier Masson SAS. All rights reserved.

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... for Patients Many adult survivors of childhood cancer feel fertility preservation and the ability to have a ... treatment and your child’s immediate health. You may feel uncomfortable discussing issues of reproduction with your child. ...

Removal of uterine fibroids by mini-laparotomy technique in women who wish to preserve their uterus and fertility.

Science.gov (United States)

Księżakowska-Łakoma, Kinga; Żyła, Monika; Wilczyński, Jacek

2016-01-01

The minilaparotomy is considered to be a safe and effective alternative to laparoscopy and abdominal laparotomy in myomectomy cases. To perform a retrospective analysis of pre-surgical assessment, surgical course and post-operational parameters in women wishing to preserve their uterus and fertility who underwent myomectomy by minilaparotomy in the Department of Gynecology and Gynecological Oncology at the Polish Mother's Memorial Hospital - Research Institute in Lodz in the years 2008-2014. A total of 76 patients were qualified for minilaparotomy due to a benign gynecological pathology. Only 21 patients with uterine fibroids who wanted to preserve their uterus and fertility were appropriate for this study. Patients' records were analyzed in terms of: epidemiological history, surgical course, postoperative stay and pathological data. All studied patients were asked in 2014 about conception and pregnancy after minilaparotomy. The median age was 35.7 years. The median patient body mass index (BMI) was 24 kg/m(2). The average decrease of hemoglobin was 1.5 g/dl. The size of the myoma was between 1.5 and 15 cm. There were no serious post-surgical complications. The size of the myoma did not correlate significantly with operation time, BMI or blood loss. There was no statistically significant dependence between operation time and average hematocrit and hemoglobin decrease. In our group 7 patients who had undergone myomectomy tried to achieve conception. Four of them succeeded in pregnancy and gave birth to healthy infants. Myomectomy performed via minilaparotomy is a safe procedure for patients willing to preserve their uterus and fertility, and it combines some advantages of both laparotomy and laparoscopy.

Fertility Preservation for Children Diagnosed with Cancer

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Full Text Available ... from adult survivors of childhood cancer and their parents. Cancer Treat Res. 2007;138:201-217. Redig AJ, Brannigan R, Stryker SJ, et al. Incorporating fertility preservation into the care of young oncology patients. Cancer. 2010;117:4- ...

Twenty-five-year-old Woman with Bilateral Borderline Ovarian Tumour Desiring to Preserve Fertility - Case Report and Literature Review on the Current State of Fertility Preservation in Women with Borderline Ovarian Tumours.

Science.gov (United States)

Findeklee, S; Lotz, L; Heusinger, K; Hoffmann, I; Dittrich, R; Beckmann, M W

2016-11-01

Borderline ovarian tumours are semimalignant tumours occurring unilaterally or bilaterally with a peak incidence among women of reproductive age. Since the affected women often wish to preserve fertility, particular precautions must be taken when counselling the patient and obtaining consent prior to planning an individual treatment. Options for preserving fertility include an organ-sparing surgical procedure and cryopreservation of oocytes and/or ovarian tissue. In this article, we report on a 25-year-old patient with a bilateral seromucinous borderline tumour who desired all fertility-preserving options. In order to perform the procedure without delay, we opted to perform luteal phase stimulation prior to oocyte retrieval. We conclude by discussing the current literature on the state of fertility preservation in the treatment of borderline ovarian tumours.

Fertility preservation in young females with non-gynaecologic malignancy: an emerging speciality.

LENUS (Irish Health Repository)

Smyth, C

2013-06-06

BACKGROUND: As new treatment and research advances continue to improve the prognosis of cancer patients, oncologists and surgeons are increasingly faced with the issue of fertility protection and preservation. Cancer patients are frequently exposed to gonadotoxic chemotherapy and radiation therapy as a component of their treatment regimens. There are currently various anticipatory techniques available to women who wish to retain future reproductive ability, the most successful of which involves oocyte retrieval followed by in vitro fertilisation and embryo cryopreservation. Innovative methods include oocyte cryopreservation, ovarian follicle cryopreservation and oophoropexy. AIM: The aim of this study was to examine our combined experiences at Mayo General Hospital of treating female patients (<30 years) with non-gynaecologic malignancy and requiring referral to the HARI Unit during a 6-year period (2007-2012). Emphasis was placed on reviewing the fertility-preservation options available. METHODS: The hospital inpatient enquiry system was inspected for all cases of non-gynaecologic malignancy referred for fertility preservation from 2007 to 2012. RESULTS: Three cases of non-gynaecologic malignancy in young females, with an intention to protect and preserve future fertility were identified. The primary treatment plan did not initially incorporate input from a gynaecology or fertility specialist. It was after concerted inquiry and reflection by both physician and patient that oncofertility consultation was sought. CONCLUSION: The responsibility is on both physicians and surgeons to consider a more holistic approach to cancer care in young female patients, which focuses not only on the elimination of malignancy but also on preservation of fertility and quality of life.

Fertility preservation in pre-pubertal girls with cancer: the role of ovarian tissue cryopreservation.

Science.gov (United States)

Wallace, W Hamish B; Kelsey, Thomas W; Anderson, Richard A

2016-01-01

With the increasing numbers of survivors of cancer in young people, future fertility and ovarian function are important considerations that should be discussed before treatment commences. Some young people, by nature of the treatment they will receive, are at high risk of premature ovarian insufficiency and infertility. For them, ovarian tissue cryopreservation (OTC) is one approach to fertility preservation that remains both invasive and for young patients experimental. There are important ethical and consent issues that need to be explored and accepted before OTC can be considered established in children with cancer. In this review we have discussed a framework for patient selection which has been shown to be effective in identifying those patients at high risk of premature ovarian insufficiency and who can be offered OTC safely. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Removal of uterine fibroids by mini-laparotomy technique in women who wish to preserve their uterus and fertility

OpenAIRE

Ksi??akowska-?akoma, Kinga; ?y?a, Monika; Wilczy?ski, Jacek

2015-01-01

Introduction The minilaparotomy is considered to be a safe and effective alternative to laparoscopy and abdominal laparotomy in myomectomy cases. Aim To perform a retrospective analysis of pre-surgical assessment, surgical course and post-operational parameters in women wishing to preserve their uterus and fertility who underwent myomectomy by minilaparotomy in the Department of Gynecology and Gynecological Oncology at the Polish Mother's Memorial Hospital ? Research Institute in Lodz in the ...

Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer.

Science.gov (United States)

Letourneau, Joseph M; Smith, James F; Ebbel, Erin E; Craig, Amaranta; Katz, Patricia P; Cedars, Marcelle I; Rosen, Mitchell P

2012-09-15

This study seeks to examine the relation between sociodemographic characteristics and the utilization of fertility preservation services in reproductive age women diagnosed with cancer. A total of 1041 women diagnosed with cancer between the ages of 18 and 40 years responded to a retrospective survey on demographic information and reproductive health history. Five cancer types were included: leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancer. Nine hundred eighteen women reported treatment with potential to affect fertility (chemotherapy, pelvic radiation, pelvic surgery, or bone marrow transplant). Student t test, linear regression, and multivariate logistic regression were used where appropriate to determine the relation between sociodemographic characteristics and the odds of using fertility preservation services. Sixty-one percent of women were counseled on the risk of cancer treatment to fertility by the oncology team. Overall, 4% of women pursued fertility preservation. In multivariate analysis, women who had not attained a bachelor's degree (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.5-0.9) were less likely to be counseled. Trends also suggested possible disparities in access to fertility preservation with age older than 35 years (OR, 0.1; 95% CI, 0.0-1.4) or previous children (OR, 0.3; 95% CI, 0.1-1.1) at diagnosis. Disparities in access to fertility preservation based on ethnicity and sexual orientation were also observed. Sociodemographic health disparities likely affect access to fertility preservation services. Although awareness of fertility preservation has improved in the past decade, an unmet need remains for reproductive health counseling and fertility preservation in reproductive age women diagnosed with cancer. Copyright © 2012 American Cancer Society.

Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer

Science.gov (United States)

Ruddy, Kathryn J.; Gelber, Shari I.; Tamimi, Rulla M.; Ginsburg, Elizabeth S.; Schapira, Lidia; Come, Steven E.; Borges, Virginia F.; Meyer, Meghan E.; Partridge, Ann H.

2014-01-01

Purpose Most research regarding fertility in young women with breast cancer has focused on long-term survivors. Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial cancer diagnosis. Patients and Methods As part of an ongoing prospective multicenter cohort study, we surveyed women with newly diagnosed early-stage breast cancer at age ≤ 40 years. The baseline survey included sociodemographic, medical, and treatment data as well as a modified Fertility Issues Survey, including fertility concern and preservation items. Univariable and multivariable modeling were used to investigate predictors of greater fertility concern. Results Among the first 620 eligible respondents included in this analysis, median age was 37 years (range, 17 to 40 years); 425 women (68%) discussed fertility issues with their physicians before starting therapy, and 319 (51%) were concerned about becoming infertile after treatment. Because of concerns about fertility, four women (1%) chose not to receive chemotherapy, 12 (2%) chose one chemotherapy regimen over another, six (1%) considered not receiving endocrine therapy, 19 (3%) decided not to receive endocrine therapy, and 71 (11%) considered receiving endocrine therapy for < 5 years; 65 (10%) used fertility preservation strategies. Greater concern about fertility was associated with younger age, nonwhite race, not having children, and receipt of chemotherapy. Conclusion Many young women with newly diagnosed breast cancer have concerns about fertility, and for some, these substantially affect their treatment decisions. Only a minority of women currently pursue available fertility preservation strategies in this setting. PMID:24567428

Klinefelter syndrome and fertility: sperm preservation should not be offered to children with Klinefelter syndrome.

Science.gov (United States)

Franik, S; Hoeijmakers, Y; D'Hauwers, K; Braat, D D M; Nelen, W L M; Smeets, D; Claahsen-van der Grinten, H L; Ramos, L; Fleischer, K

2016-09-01

(40-70%). Although spermatogonia can be found by TESE in about half of the peri-pubertal adolescents, there are currently no clinically functional techniques for their future use. Children and adolescents need to be informed that early fertility preservation before the age of 16 cannot guarantee fertility later in life and may even reduce the chances for offspring by removing functional immature germ cells which may possibly develop into spermatozoa after puberty. Furthermore, except for the age of patients with KS, there are no identified factors that can reliably be used as a predictive marker for fertility preservation. Most of the evidence presented in this review is based on studies including a small number of adolescents with KS. Therefore, the studies may have been underpowered to detect clinically significant differences for their various outcomes, especially for potential predictive factors for fertility preservation, such as hormone levels. Furthermore, the population of patients with KS diagnosed during childhood might be different from the adult population with KS where the diagnosis is based on infertility. Results based on comparisons between the two groups must be interpreted with caution. Despite the limitations, this review summarizes the current evidence for managing fertility preservation in patients with KS to provide optimal health care. There was no funding for this study. S.F., Y.H., K.D., W.L.M.N., D.S., H.L.C.-v.d.G. and L.R. declare to have no conflicts of interests. D.D.M.B. reports grants from Merck Serono, grants from Ferring and grants from MSD, outside the submitted work. K.F. reports personal fees from MSD (commercial sponsor), personal fees from Ferring (commercial sponsor), grants from Merck-Serono (commercial sponsor), grants from Ferring (commercial sponsor) and grants from MSD (commercial sponsor), outside the submitted work. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human

Decision-making in female fertility preservation is balancing the expected burden of fertility preservation treatment and the wish to conceive

NARCIS (Netherlands)

Baysal, O.; Bastings, L.; Beerendonk, C.C.M.; Postma, S.A.; Hout, J. in't; Verhaak, C.M.; Braat, D.D.M.; Nelen, W.L.D.M.

2015-01-01

STUDY QUESTION: What are the decisive factors in fertility preservation (FP) decision-making in young women scheduled for gonadotoxic therapy? SUMMARY ANSWER: FP decision-making in young women scheduled for gonadotoxic therapy is mainly based on weighing two issues: the intensity of the wish to

Fertility preservation in young cancer patients--too little, too late?

Science.gov (United States)

Robbins, Helen Louise; Zahoor, Arooba; Jones, Kevin

2015-12-01

Fertility is an important concern for many younger women with cancer; however, evidence suggests that these matters are often inadequately addressed, potentially with long-term implications for quality of life. Increased confidence in discussing fertility-related matters and an emphasis on early discussion and referral are needed to improve current practice. Further work is needed to better assess current practice and to explore how barriers to discussion about fertility preservation may be best overcome.

When to ask male adolescents to provide semen sample for fertility preservation?

OpenAIRE

Dabaja, Ali A.; Wosnitzer, Matthew S.; Bolyakov, Alexander; Schlegel, Peter N.; Paduch, Darius A.

2014-01-01

Background Fertility preservation in adolescents undergoing sterilizing radiation and/or chemotherapy is the standard of care in oncology. The opportunity for patients to provide a semen sample by ejaculation is a critical issue in adolescent fertility preservation. Methods Fifty males with no medical or sexual developmental abnormalities were evaluated. The subjects were screened for evidence of orgasmic, erectile, and ejaculatory dysfunction. A detailed sexual development history was obtain...

Fertility preservation in young women with breast cancer

DEFF Research Database (Denmark)

Klemp, Jennifer R; Kim, S Samuel; Andersen, Claus Yding

2012-01-01

When a young woman is diagnosed with breast cancer, there is often a sense of urgency by the patient and her providers to initiate treatment. This article provides guidelines for incorporating the discussion of fertility preservation with newly diagnosed young women with breast cancer....

Fertility preservation for non-medical reasons: controversial, but increasingly common.

Science.gov (United States)

von Wolff, Michael; Germeyer, Ariane; Nawroth, Frank

2015-01-16

Fertility-preserving measures for women are increasingly being performed for non-medical reasons in Germany. This is now a controversial matter. The authors searched the PubMed database for pertinent publications on the basis of their clinical and scientific experience and evaluated relevant data from the registry of the German FertiPROTEKT network (www.fertiprotekt. com). The various fertility-preserving measures that are available are described and critically discussed. In most cases, the creation of a fertility reserve currently involves the cryopreservation of unfertilized oocytes, rather than of ovarian tissue. Most of the women who decide to undergo this procedure are over 35 years old. According to data from the FertiPROTEKT registry, most such procedures carried out in the years 2012 and 2013 involved a single stimulation cycle. The theoretical probability of childbirth per stimulation is 40% in women under age 35 and 30% in women aged 35 to 39. If the oocytes are kept for use at a later date, rather than at once, the maternal risk is higher, because the mother is older during pregnancy. The risk to the child may be higher as well because of the need for in vitro fertilization (IVF). Pregnancy over age 40 often leads to complications such as gestational diabetes and pre-eclampsia. IVF may be associated with a higher risk of epigenetic abnormalities. Ethicists have upheld women's reproductive freedom while pointing out that so-called social freezing merely postpones social problems, rather than solving them. Fertility preservation for non-medical reasons should be critically discussed, and decisions should be made on a case-by-case basis.

Technical and ethical challenges of fertility preservation in young cancer patients.

Science.gov (United States)

Deepinder, Fnu; Agarwal, Ashok

2008-06-01

As cancer treatment improves, more young men and women survive, but they suffer from infertility as a major sequel of cancer treatment. Gamete and embryo cryopreservation are the only options available to these patients for preserving their fertility. Although cryopreservation of spermatozoa and embryos are already established, oocyte banking is still experimental. The advent of testicular tissue cryopreservation and spermatogonial stem cell transplantation in men, and ovarian tissue cryopreservation and in-vitro follicular maturation in women, has started a frenzy of experiments worldwide trying to demonstrate their potential use in fertility preservation. Although major improvements have been made in tissue cryobanking in the past decade, there are still many unresolved technical issues related to these procedures. Furthermore, the intersection of cancer and fertility preservation in young patients raises ethical, legal and policy issues for oncologists and cancer survivors. Informed consent of minor patients, legal parentage and medical negligence claims are some of the potential legal challenges faced by society and healthcare providers. This review summarizes the technical and ethical challenges of gamete cryopreservation in young cancer patients.

Impact of Radiotherapy on Fertility, Pregnancy, and Neonatal Outcomes in Female Cancer Patients

International Nuclear Information System (INIS)

Wo, Jennifer Y.; Viswanathan, Akila N.

2009-01-01

Purpose: Radiation has many potential long-term effects on cancer survivors. Female cancer patients may experience decreased fertility depending on the site irradiated. Oncologists should be aware of these consequences and discuss options for fertility preservation before initiating therapy. Methods and Materials: A comprehensive review of the existing literature was conducted. Studies reporting the outcomes for female patients treated with cranio-spinal, abdominal, or pelvic radiation reporting fertility, pregnancy, or neonatal-related outcomes were reviewed. Results: Cranio-spinal irradiation elicited significant hormonal changes in women that affected their ability to become pregnant later in life. Women treated with abdomino-pelvic radiation have an increased rate of uterine dysfunction leading to miscarriage, preterm labor, low birth weight, and placental abnormalities. Early menopause results from low-dose ovarian radiation. Ovarian transposition may decrease the rates of ovarian dysfunction. Conclusions: There is a dose-dependent relationship between ovarian radiation therapy (RT) and premature menopause. Patients treated with RT must be aware of the impact of treatment on fertility and explore appropriate options.

Contemporary and future insights into fertility preservation in male cancer patients.

Science.gov (United States)

Agarwal, Ashok; Ong, Chloe; Durairajanayagam, Damayanthi

2014-03-01

In recent years, survival rates of cancer patients have increased, resulting in a shift of focus from quantity to quality of life. A key aspect of quality of life is fertility potential; patients suffering from iatrogenic infertility often become depressed. Since many cancer therapies-chemotherapy, radiotherapy and/or surgery-and even cancer itself have detrimental effects on the male reproductive system, it is important to preserve fertility before any treatment commences. Currently, the only reliable method of male fertility preservation is sperm banking. For patients who are unable to provide semen samples by the conventional method of masturbation, there are other techniques such as electroejaculation, microsurgical epididymal sperm aspiration and testicular sperm extraction that can be employed. Unfortunately, it is presently impossible to preserve the fertility potential of pre-pubertal patients. Due to the increasing numbers of adolescent cancer patients surviving treatment, extensive research is being conducted into several possible methods such as testicular tissue cryopreservation, xenografting, in vitro gamete maturation and even the creation of artificial gametes. However, in spite of its ease, safety, convenience and many accompanying benefits, sperm banking remains underutilized in cancer patients. There are several barriers involved such as the lack of information and the urgency to begin treatment, but various measures can be put in place to overcome these barriers so that sperm banking can be more widely utilized.

Fertility after breast cancer treatment.

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Kasum, Miro; Beketić-Orešković, Lidija; Peddi, Parvin F; Orešković, Slavko; Johnson, Rebecca H

2014-02-01

fertility preservation strategy, providing a 25-35% chance of pregnancy. In addition, oocyte freezing can be considered as an alternative in patients who are single and in those who do not wish a sperm donor. Although ovarian tissue harvesting appears to be safe, experience regarding ovarian transplantation is still limited due to low utilization, so the true value of this procedure remains to be determined. Nevertheless, in clinical situations in which chemotherapy needs to be started in young patients facing premature ovarian failure, ovarian tissue preservation seems to be a promising option for restoring fertility, especially in conjunction with other options like immature oocyte retrieval, in vitro maturation of oocytes, oocyte vitrification, or embryo cryopreservation. It seems that in vitro maturation is a useful strategy because it improves oocyte or cryopreservation outcome in breast cancer patients undergoing ovarian stimulation for fertility preservation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Fertility preservation in women with CNS tumors.

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Tosoni, Alicia; Balestrini, Damiano; Brandes, Alba A

2017-05-01

Fertility impairment due to treatments is a major concern for adolescents and young adult patients who survived cancer. Areas covered: Chemotherapy may determine a detrimental effect on ovary function, leading to infertility, and premature ovarian failure. Embryo and oocyte cryopreservation is a standard strategy for fertility preservation; other strategies, such as gonadal tissue cryopreservation and the use of gonadotropin - releasing hormone agonist, are still considered experimental. There are few data available regarding the effect of pregnancy on glioma, which indicates tumor progression during pregnancy in 33-45% of patients. Expert commentary: Glioma patients need to be advised about the risk of tumor progression during pregnancy, and about the possible, even if not proven, interaction between hormone stimulation and tumor growth.

Fertility preservation in children and young adults undergoing treatment for malignancy

International Nuclear Information System (INIS)

Al-Fozan, Haya M.; Tulandi, Togas

2004-01-01

Advances in cancer therapy have improved the long term survival of young patients suffering from malignancies. However adverse effects of the treatment are sterlity and loss of gonadal function especially in females. Preservation of fertility in males by sperm freezing is more practical and already established. For young women undergoing cancer treatment , the availability of preserving the gonadal function and fertility has just begun.Today we can crypreserve the oocytes, the embryos or rhe ovarian tissue and those undergoing pelvic irradtion, laparascopic can be cnsidered. Because women with non-gynelical malagnencies seek advice from a general surgeon or a medical onconologist, increasing awawreness of physician and general public is recommended. (author)

Cryopreservation of ovarian tissue for fertility preservation in young female oncological patients

DEFF Research Database (Denmark)

Andersen, Claus Yding; Kristensen, Stine Gry; Greve, Tine

2012-01-01

Girls and women suffering from a cancer that requires treatment with gonadotoxic drugs may experience cessation of reproductive function as a side effect due to obliteration of the ovarian pool of follicles. Techniques are now available for fertility preservation, such as cryopreservation of mature...... and growth of follicles, giving rise to menstrual cycles and hormone production for several years. Worldwide, the procedure has resulted in the birth of 15 healthy children. Many cancer patients including girls and young women want fertility preservation, and the techniques are now being further developed...

Increasing awareness of age-related fertility and elective fertility preservation among medical students and house staff: a pre- and post-intervention analysis.

Science.gov (United States)

Anspach Will, Erica; Maslow, Bat-Sheva; Kaye, Leah; Nulsen, John

2017-05-01

To assess medical students' and house staff's knowledge and personal and professional perceptions of age-related fertility and fertility preservation before and after an educational intervention. Pre-/post intervention survey. University-based medical center. Medical students and house staff. An educational session on age-related fertility decline and elective fertility preservation. Knowledge scores and perceptions assessed immediately before and after the intervention. Sixty-five surveys were administered. Of the 53 respondents, 71.7% were married or in a committed relationship; 89.4% reported that they were delaying childbearing, with career and/or education being the most frequently listed reason (85.7%); 39.5% indicated that they had both personal and professional interest in fertility preservation but identified finances (62.5%) and time (59.4%) as barriers; 86.9% indicated previous exposure, with formal education (80.0%) and social media (40.0%) being the most common sources. Mean scores on a six-question knowledge-based assessment improved significantly following the presentation (54.6 ± 19.0% vs. 78.1 ± 16.0%), as did the number of participants who indicated that they might now recommend elective oocyte cryopreservation to others (71.1% vs. 54.3%). After the intervention, 97.8% thought that it was important for medical professionals to be informed about age-related fertility decline and elective oocyte cryopreservation. Despite professional and personal interest, knowledge of age-related fertility decline and elective fertility preservation is limited among medical students and house staff. This study highlights the need for formal education across all levels of training and specialties, with even brief interventions being of potential benefit. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Practical consensus recommendations on fertility preservation in patients with breast cancer

Directory of Open Access Journals (Sweden)

Jyoti Bajpai

2018-01-01

Full Text Available Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Successful survivorship for this group of patients includes maintaining a high quality of life after a cancer diagnosis and treatment; however, lifesaving treatments such as chemotherapy, radiation, and surgery can impact survivors by impairing reproductive and endocrine health. Expert oncologists along with reproductive medicine specialists discuss fertility preservation options in this chapter since fertility preservation is becoming a priority for young women with breast cancer. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.

Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology.

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Lambertini, Matteo; Cinquini, Michela; Moschetti, Ivan; Peccatori, Fedro A; Anserini, Paola; Valenzano Menada, Mario; Tomirotti, Maurizio; Del Mastro, Lucia

2017-01-01

The development of premature ovarian failure and subsequent infertility are possible consequences of chemotherapy use in pre-menopausal women with early-stage breast cancer. Among the available strategies for fertility preservation, pharmacological protection of the ovaries using luteinising hormone-releasing hormone analogues (LHRHa) during chemotherapy has the potential to restore ovarian function and fertility after anticancer treatments; however, the possible efficacy and clinical application of this strategy has been highly debated in the last years. Following the availability of new data on this controversial topic, the Panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guideline on fertility preservation in cancer patients decided to apply the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology around the relevant and current question on the clinical utility of temporary ovarian suppression with LHRHa during chemotherapy as a strategy to preserve ovarian function and fertility in breast cancer patients. To answer this question, preservation of ovarian function and fertility were judged as critical outcomes for the decision-making. Three possible outcomes of harm were identified: LHRHa-associated toxicities, potential antagonism between concurrent LHRHa and chemotherapy, and lack of the prognostic impact of chemotherapy-induced premature ovarian failure. According to the GRADE evaluation conducted, the result was a strong positive recommendation in favour of using this option to preserve ovarian function and fertility in breast cancer patients. The present manuscript aims to update and summarise the evidence for the use of this strategy in light of the new data published up to January 2016, according to the GRADE process. Copyright © 2016 Elsevier Ltd. All rights reserved.

Current state and controversies in fertility preservation in women with breast cancer.

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Taylan, Enes; Oktay, Kutluk H

2017-06-10

On average, over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States. Because an increasing number of young women delay childbearing to later life for various reasons, a growing population of women experience breast cancer before completing childbearing. In this context, preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care. In this review, we will outline the currently available fertility preservation options for women with breast cancer of reproductive age, discuss the controversy behind hormonal suppression for gonadal protection against chemotherapy and highlight the importance of timely referral by cancer care providers.

The Pathways fertility preservation decision aid website for women with cancer: development and field testing.

Science.gov (United States)

Woodard, Terri L; Hoffman, Aubri S; Covarrubias, Laura A; Holman, Deborah; Schover, Leslie; Bradford, Andrea; Hoffman, Derek B; Mathur, Aakrati; Thomas, Jerah; Volk, Robert J

2018-02-01

To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14). Field-testing (n = 20 survivors) assessed post-decision aid scores on the Fertility Preservation Knowledge Scale, feasibility of assessing women's decision-making values while using the website, and website usability/acceptability ratings. Iterative stakeholder engagement optimized the Pathways decision aid website to meet survivors' and providers' needs, including providing patient-friendly information and novel features such as interactive value clarification exercises, testimonials that model shared decision making, financial/referral resources, and a printable personal summary. Survivors scored an average of 8.2 out of 13 (SD 1.6) on the Fertility Preservation Knowledge Scale. They rated genetic screening and having a biological child as strong factors in their decision-making, and 71% indicated a preference for egg freezing. Most women (> 85%) rated Pathways favorably, and all women (100%) said they would recommend it to other women. The Pathways decision aid is a usable and acceptable tool to help women learn about fertility preservation. The Pathways decision aid may help women make well-informed values-based decisions and prevent future infertility-related distress.

Progestin treatment of atypical hyperplasia and well-differentiated adenocarcinoma of the endometrium to preserve fertility.

Science.gov (United States)

Koskas, Martin; Azria, Elie; Walker, Francine; Luton, Dominique; Madelenat, Patrick; Yazbeck, Chadi

2012-03-01

To evaluate the outcome of a cohort of young women treated with progestin for fertility-sparing management of endometrial atypical hyperplasia (AH) and endometrial carcinoma (EC). This retrospective multicentre cohort study included women under the age of 40 years treated conservatively for AH and EC to preserve fertility using progestin for at least 3 months. Four inclusion criteria were defined: (i) the presence of AH or grade 1 EC confirmed by two pathologists (including a reference pathologist); (ii) the use of conservative management for fertility sparing; (iii) adequate radiological examination before conservative management; and (iv) a minimal follow-up time of one year. Twenty-two patients fulfilled the inclusion criteria (8 had EC, and 14 had AH). After progestin treatment, 17 patients responded. Among the 17 patients who experienced remission, three also experienced disease relapse. One patient initially diagnosed with AH experienced progression of her disease to stage IIIA EC. Ten pregnancies were achieved in eight patients. Fertility-sparing management using progestin offers the opportunity to fulfil maternal desires in young patients diagnosed with AH and EC. However, progression of the disease is possible and close follow-up is needed.

Cryopreservation: a cold look at technology for fertility preservation.

Science.gov (United States)

Gosden, Roger

2011-08-01

To outline the history of cryopreservation technology and its contributions to reproductive medicine, including fertility preservation. A search of the relevant literature using Medline and other online tools. Research and laboratory protocol development. The biology of preserving cells at low temperatures is complex and still being unraveled. Principles were first established more than half a century ago, with progress being driven empirically and often by trial and error. The protocols vary widely, and practice is still heavily dependent on operator skill, accounting for wide differences in the success rates between centers. No single protocol fits all specimen types, and differential vulnerability to cryoinjury remains a major obstacle. Nevertheless, semen cryopreservation has long been established, embryo banking is now highly effective, and vitrification appears to overcome problems with oocytes. Protocols in the future, although specific to the cell type and tissue, are likely to evolve toward generally acknowledged standards. But heterogeneity between patients and even within samples implies that each cell may have its own peculiar optimum for minimizing cryoinjury; because protocols are therefore compromises, "perfect" preservation may be unattainable. Cryopreservation has become a mainstay in the assisted reproduction laboratory and underpins fertility preservation for patients with cancer and other conditions. The practice is currently evolving from slow freezing methods toward more vitrification, and future technology is likely to reduce dependence on operator skill, which should raise success rates to higher, more uniform levels. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Fertility preservation for social indications: a cost-based decision analysis.

Science.gov (United States)

Hirshfeld-Cytron, Jennifer; Grobman, William A; Milad, Magdy P

2012-03-01

Age-related infertility remains a problem that assisted reproductive techniques (ART) have limited ability to overcome. Correspondingly, because an increasing number of women are choosing to delay childbearing, fertility preservation strategies, initially intended for patients undergoing gonadotoxic therapies, are being applied to this group of healthy women. Studies supporting the effectiveness of this practice are lacking. Decision analytic techniques. We compared the cost-effectiveness of three strategies for women planning delayed childbearing until age 40: oocyte cryopreservation at age 25, ovarian tissue cryopreservation (OTC) at age 25, and no assisted reproduction until spontaneous conception had been attempted. Not applicable. Not applicable. Cost-effectiveness, which was defined as the cost per live birth. In this analysis, the strategy of foregoing fertility preservation at age 25 and then choosing ART only after not spontaneously conceiving at age 40 was the most cost-effective option. OTC was dominated by the other strategies. Sensitivity analyses demonstrated the robustness of the model; no analysis existed in which OTC was not dominated by oocyte cryopreservation. Increasing the cost of an IVF cycle beyond $22,000 was the only situation in which oocyte cryopreservation was the most preferred strategy. Neither oocyte cryopreservation nor OTC appear to be cost-effective under current circumstances for otherwise healthy women planning delayed childbearing. This analysis should give pause to the current practice of offering fertility preservation based only on the desire for delayed childbearing. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Knowledge regarding fertility preservation in cancer patients: a population-based survey among Brazilian people during the Pink October awareness event.

Science.gov (United States)

Chehin, Mauricio B; Bonetti, Tatiana Cs; Serafini, Paulo C; Motta, Eduardo LA

2017-06-01

The aim of this study was to assess the knowledge about the risk of infertility in cancer patients after treatment, and the options for fertility preservation based on a survey carried out during the 2013 Pink October campaign. This survey was carried out during the 2013 Pink October event in the most important public park of São Paulo, Brazil. Approximately 900 people expressed interest in learning about breast cancer prevention and fertility preservation by participating in workshops, and 242 people filled out a questionnaire. Most of the respondents (78.5%) were women, and one-fourth (25%) had at least one relative with gynecological cancer. Among women over 40 years of age, 86.3% had been screened for breast cancer at some point. However, few participants (34.0%) were aware that cancer treatment can lead to infertility or had heard about fertility preservation options (22.0%). Having a relative with cancer did not influence their knowledge about fertility preservation (22.4% versus 21.3%; p=0.864). However, a higher educational level was significantly associated with more knowledge about the effects of cancer on fertility and options for fertility preservation. The majority of participants did not have knowledge about the impact of oncologic treatment on fertility and did not know that there are options to preserve fertility in cancer patients. Awareness of infertility risk factors is an essential first step to safeguard future fertility, and therefore, more educational initiatives are needed to spread knowledge about oncofertility.

Contemporary and future insights into fertility preservation in male cancer patients

OpenAIRE

Agarwal, Ashok; Ong, Chloe; Durairajanayagam, Damayanthi

2014-01-01

In recent years, survival rates of cancer patients have increased, resulting in a shift of focus from quantity to quality of life. A key aspect of quality of life is fertility potential; patients suffering from iatrogenic infertility often become depressed. Since many cancer therapies?chemotherapy, radiotherapy and/or surgery?and even cancer itself have detrimental effects on the male reproductive system, it is important to preserve fertility before any treatment commences. Currently, the onl...

[IVF and endometriosis, oocyte donation and fertility preservation].

Science.gov (United States)

d'Argent, Emmanuelle Mathieu; Antoine, Jean-Marie

2017-12-01

Endometriosis is a common condition, causing pain and infertility. In infertile woman with superficial peritoneal endometriosis and patent tubes, laparoscopy is recommended, followed by ovarian stimulation alone or in combination with intrauterine inseminations. In case of ovarian or deep endometriosis, the indications of surgery and assisted reproductive technologies remain to be defined precisely. In vitro fertilization is generally proposed after the failure of up to three inseminations, directly for ovarian or deep endometriosis, or in case of an associated factor of infertility, mainly male. Before ovarian stimulation in view to in vitro fertilization, a pretreatment by GnRH agonist for 2 to 6 months or combined contraceptive for 6 to 8 weeks would improve the pregnancy rate. Egg donation is effective in patients with advanced ovarian failure or lack of ovarian response to stimulation. Fertility preservation, especially by oocytes vitrified, must be proposed preventively to women with endometriosis at risk of ovarian failure, without close wish to be pregnant. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Fertility and obstetric outcome after conservative management of placenta accreta.

Science.gov (United States)

Provansal, Magali; Courbiere, Blandine; Agostini, Aubert; D'Ercole, Claude; Boubli, Léon; Bretelle, Florence

2010-05-01

To determine the fertility and obstetric outcomes after conservative management of placenta accreta. A retrospective observational cohort study of all identified cases of placenta accreta from 1993 to 2007 in 2 tertiary university hospitals in France. For patients treated conservatively, maternal and fetal morbidity, reproductive function, fertility, and subsequent pregnancies were recorded. During the study period, 46 patients were treated by conservative management; 6 patients underwent a secondary hysterectomy. Of the remaining 40 patients, 35 were followed up for a median of 65 months (range 18-156 months). Patients resumed their menstrual cycles after a median of 130 days (range 48-176 days). Menses were irregular in 11 patients (31%), but none had amenorrhea. Twelve of the 14 patients desiring another pregnancy achieved a total of 15 pregnancies; 2 patients had recurrent placenta accreta. Five spontaneous abortions and 1 termination of pregnancy occurred during the first trimester. The median term at delivery was 37 weeks (range, 35-40 weeks). Four patients delivered prematurely. Conservative management of placenta accreta can preserve fertility, although the risk of recurrent placenta accreta appears to be high. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Young female cancer patients? experiences with fertility counselling and fertility preservation?a qualitative small-scale study within the Danish health care setting

OpenAIRE

Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T.

2016-01-01

Introduction Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Methods Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselli...

Fertility Preservation for Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

Science.gov (United States)

Loren, Alison W.; Mangu, Pamela B.; Beck, Lindsay Nohr; Brennan, Lawrence; Magdalinski, Anthony J.; Partridge, Ann H.; Quinn, Gwendolyn; Wallace, W. Hamish; Oktay, Kutluk

2013-01-01

Purpose To update guidance for health care providers about fertility preservation for adults and children with cancer. Methods A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language. Results There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials. After review of the new evidence, the Update Panel concluded that no major, substantive revisions to the 2006 American Society of Clinical Oncology recommendations were warranted, but clarifications were added. Recommendations As part of education and informed consent before cancer therapy, health care providers (including medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, and surgeons) should address the possibility of infertility with patients treated during their reproductive years (or with parents or guardians of children) and be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Although patients may be focused initially on their cancer diagnosis, the Update Panel encourages providers to advise patients regarding potential threats to fertility as early as possible in the treatment process so as to allow for the widest array of options for fertility preservation. The discussion should be documented. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. Other fertility preservation methods should be considered investigational and should be performed by providers with the necessary expertise. PMID:23715580

Recommendations for fertility preservation in patients with lymphoma, leukemia, and breast cancer

DEFF Research Database (Denmark)

Kim, S Samuel; Donnez, Jacques; Barri, Pedro

2012-01-01

Fertility issues should be addressed to all patients in reproductive age before cancer treatment. In men, cryopreservation of sperm should be offered to all cancer patients in reproductive age regardless of the risk of gonadal failure. In women, the recommendation of fertility preservation should...... be individualized based on multiple factors such as the urgency of treatment, the age of the patient, the marital status, the regimen and dosage of cancer treatment....

Random-start GnRH antagonist for emergency fertility preservation: a self-controlled trial

Directory of Open Access Journals (Sweden)

Checa MA

2015-02-01

Full Text Available Miguel A Checa,1,2 Mario Brassesco,2 Margalida Sastre,1 Manuel Gómez,2 Julio Herrero,3 Laura Marque,3 Arturo Brassesco,2 Juan José Espinós3 1Department of Obstetrics and Gynecology, Parc de Salut Mar, Universitat Autònoma de Barcelona, 2Centro de Infertilidad y Reproducción Humana (CIRH, 3Centro de Reproducción Asistida Sagrada Familia, Clínica Sagrada Familia, Barcelona, Spain Abstract: The aim of this study is to evaluate the feasibility and safety of random-start controlled ovarian hyperstimulation (COH for emergency fertility preservation, regardless of the phase of the menstrual cycle. A self-controlled pilot clinical trial (NCT01385332 was performed in an acute-care teaching hospital and in two private reproductive centers in Barcelona, Spain. Eleven egg donors participated in the study. Two random-start gonadotropin-releasing hormone (GnRH antagonist protocols were assessed in which ganirelix was initiated on either day 10 (protocol B or on day 20 (protocol C of the menstrual cycle and was continued until estradiol levels were below 60 pg/dL. These protocols were compared with a standard protocol (protocol A. The main outcome of interest was the number of metaphase 2 oocytes retrieved. Results from this study show that the number of mature oocytes retrieved was comparable across the different protocols (14.3±4.6 in the standard protocol versus 13.0±9.1 and 13.2±5.2 in protocols B and C, respectively; values expressed as mean ± standard deviation. The mean number of days needed for a GnRH antagonist to lower estradiol levels, as well as the ongoing pregnancy rates, were also similar when protocols B (stimulation in follicular phase and C (stimulation on luteal phase were compared with protocol A (standard stimulation. GnRH antagonists can be effectively used for random-start controlled ovarian hyperstimulation with an ovarian response similar to that of standard protocols, and the antagonists appear suitable for emergency

Freezing the biological clock: a viable fertility preservation option for young Singapore women?

Science.gov (United States)

Blyth, Eric; Yee, Samantha; Lee, Geok Ling

2013-09-01

In March 2012, an article in The Straits Times entitled 'Freezing eggs could reverse falling birth rate' suggested that employing the latest oocyte cryopreservation techniques could both foster individual women's reproductive autonomy and impact Singapore's fertility rate, which in recent years has consistently been among the world's lowest. The article cited both local and international fertility specialists' approval of elective oocyte cryopreservation for young women wishing to protect their reproductive potential against ageing and as a potential antidote to the contemporary 'delay and defer' model of family-building. Later in 2012, the Ministry of Health announced a review of oocyte cryopreservation policy taking into account related medical, scientific and ethical issues, while the Singapore College of Obstetricians and Gynaecologists endorsed oocyte cryopreservation as an "important, safe and efficient technology". This paper outlines and analyses the arguments and empirical evidence used both to support and oppose offering elective oocyte cryopreservation as a routine fertility service, before concluding that this remains unjustifiable on the basis of insufficient evidence of its clinical efficacy and safety as regards either pregnancy rates or birth outcomes. If it is to be made available at all for these reasons in Singapore, it should be subjected to rigorous clinic-specific evaluation in accordance with accepted clinical and ethical norms.

Prevalence and Predictors of Sperm Banking in Adolescents Newly Diagnosed With Cancer: Examination of Adolescent, Parent, and Provider Factors Influencing Fertility Preservation Outcomes.

Science.gov (United States)

Klosky, James L; Wang, Fang; Russell, Kathryn M; Zhang, Hui; Flynn, Jessica S; Huang, Lu; Wasilewski-Masker, Karen; Landier, Wendy; Leonard, Marcia; Albritton, Karen H; Gupta, Abha A; Casillas, Jacqueline; Colte, Paul; Kutteh, William H; Schover, Leslie R

2017-12-01

Purpose To estimate the prevalence of sperm banking among adolescent males newly diagnosed with cancer and to identify factors associated with banking outcomes. Patients and Methods A prospective, single-group, observational study design was used to test the contribution of sociodemographic, medical, psychological/health belief, communication, and developmental factors to fertility preservation outcomes. At-risk adolescent males (N = 146; age 13.00 to 21.99 years; Tanner stage ≥ 3), their parents, and medical providers from eight leading pediatric oncology centers across the United States and Canada completed self-report questionnaires within 1 week of treatment initiation. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% CIs for specified banking outcomes (collection attempt v no attempt and successful completion of banking v no banking). Results Among adolescents (mean age, 16.49 years; standard deviation, 2.02 years), 53.4% (78 of 146) made a collection attempt, with 43.8% (64 of 146) successfully banking sperm (82.1% of attempters). The overall attempt model revealed adolescent consultation with a fertility specialist (OR, 29.96; 95% CI, 2.48 to 361.41; P = .007), parent recommendation to bank (OR, 12.30; 95% CI, 2.01 to 75.94; P = .007), and higher Tanner stage (OR, 5.42; 95% CI, 1.75 to 16.78; P = .003) were associated with an increased likelihood of a collection attempt. Adolescent history of masturbation (OR, 5.99; 95% CI, 1.25 to 28.50; P = .025), banking self-efficacy (OR, 1.23; 95% CI, 1.05 to 1.45; P = .012), and parent (OR, 4.62; 95% CI, 1.46 to 14.73; P = .010) or medical team (OR, 4.26; 95% CI, 1.45 to 12.43; P = .008) recommendation to bank were associated with increased likelihood of sperm banking completion. Conclusion Although findings suggest that banking is underutilized, modifiable adolescent, parent, and provider factors associated with banking outcomes were identified and should be targeted in future

Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines.

Science.gov (United States)

Oktay, Kutluk; Bedoschi, Giuliano; Berkowitz, Karen; Bronson, Richard; Kashani, Banafsheh; McGovern, Peter; Pal, Lubna; Quinn, Gwendolyn; Rubin, Karen

2016-10-01

In this article we review the existing fertility preservation options for women diagnosed with Turner syndrome and provide practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in women, occurring in approximately 1 in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency and infertility. Although approximately 70%-80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder might possess a small residual of ovarian follicles at birth or early childhood. The present challenge is to identify these women as early in life as is possible, to allow them to benefit from a variety of existing fertility preservation options. To maximize the benefits of fertility preservation, all women with Turner syndrome should be evaluated by an expert as soon as possible in childhood because the vast majority will have their ovarian reserve depleted before adulthood. Cryopreservation of mature oocytes and embryos is a proven fertility preservation approach, and cryopreservation of ovarian tissue is a promising technique with a growing number of live births, but remains investigational. Oocyte cryopreservation has been performed in children with Turner syndrome as young as 13 years of age and ovarian tissue cryopreservation in affected prepubertal children. However, current efficacy of these approaches is unknown in this cohort. For those who have already lost their ovarian reserve, oocyte or embryo donation and adoption are strategies that allow fulfillment of the desire for parenting. For those with Turner syndrome-related cardiac contraindications to pregnancy, use of gestational surrogacy allows the possibility of biological parenting using their own oocytes. Alternatively, gestational surrogacy can serve to carry pregnancy resulting from the use of donor oocytes or embryos, if needed. Copyright © 2016 North American Society for Pediatric and

Fertility Preservation in Females with Turner Syndrome: A Comprehensive Review and Practical Guidelines

Science.gov (United States)

Oktay, K; Bedoschi, G; Berkowitz, K; Bronson, R; Kashani, B; McGovern, P; Pal, L; Quinn, G; Rubin, K

2016-01-01

This article reviews the existing fertility preservation options for females diagnosed with Turner syndrome and provides practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in females, occurring in approximately one in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency (POI) and infertility. Although about 70–80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder may possess a small residual of ovarian follicles at birth or early childhood. The present challenge is to identify these women as early in life as is possible, so as to allow them to benefit from a variety of existing fertility preservation options. To maximize the benefits of fertility preservation, all women with Turner syndrome should be evaluated by an expert as soon as possible in childhood as the vast majority will have their ovarian reserve depleted before adulthood. Cryopreservation of mature oocytes and embryos is a proven fertility preservation approach, while cryopreservation of ovarian tissue is a promising technique with a growing number of live births, but remain investigational. Oocyte cryopreservation has been performed in children with Turner syndrome as young as 13 and ovarian tissue cryopreservation in prepubertal children affected. However, current efficacy of these approaches is unknown in this cohort.. For those who have already lost their ovarian reserve, oocyte or embryo donation and adoption are strategies that allow fulfillment of desire for parenting. For those with Turner syndrome related cardiac contraindications to pregnancy, utilization of gestational surrogacy allows the possibility of biological parenting by using their own oocytes. Alternatively, gestational surrogacy can serve to carry pregnancy resulting from the use of donor oocytes or embryos, if needed. PMID:26485320

[Fertility preservation in boys: spermatogonial stem cell transplantation and testicular grafting].

Science.gov (United States)

Goossens, E; Tournaye, H

2013-09-01

Spermatogonial stem cells (SSC) are the founder cells of spermatogenesis and are responsible for the lifelong production of spermatozoa. The cryopreservation and transplantation of these cells has been proposed as a fertility preservation strategy for young boys at risk for stem cell loss, i.e. patients undergoing chemotherapy for cancer or as a conditioning treatment for bone marrow transplantation. To prevent lifelong sterility in boys, two fertility restoration strategies are being developed: the injection of SSC and the grafting of testicular tissue containing SSC. Depending on the disease of the patient one of these two approaches will be applicable. Grafting has the advantage that SSC can reside within their natural niche, preserving the interactions between germ cells and their supporting cells and may therefore be regarded as the first choice strategy. However, in cases where the risk for malignant contamination of the testicular tissue is real, e.g. leukemia, transplantation of SSC by injection is preferable over grafting. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Cryopreservation of ovarian tissue for fertility preservation in young female oncological patients.

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Andersen, Claus Yding; Kristensen, Stine Gry; Greve, Tine; Schmidt, Kirsten Tryde

2012-05-01

Girls and women suffering from a cancer that requires treatment with gonadotoxic drugs may experience cessation of reproductive function as a side effect due to obliteration of the ovarian pool of follicles. Techniques are now available for fertility preservation, such as cryopreservation of mature oocytes, embryos or ovarian cortical tissue. Whereas collection of mature oocytes and embryos requires at least a 2-week period, ovarian tissue may on short notice be frozen prior to treatment and can be transplanted back into women with ovarian failure. Transplanted frozen/thawed tissue supports survival and growth of follicles, giving rise to menstrual cycles and hormone production for several years. Worldwide, the procedure has resulted in the birth of 15 healthy children. Many cancer patients including girls and young women want fertility preservation, and the techniques are now being further developed and implemented in several centers.

Update on fertility preservation in young women undergoing breast cancer and ovarian cancer therapy.

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Lambertini, Matteo; Ginsburg, Elizabeth S; Partridge, Ann H

2015-02-01

The purpose of the article is to review the available options for fertility preservation in patients with breast and ovarian cancer, and the special issues faced by BRCA mutation carriers. Future fertility is an important consideration for many young patients with cancer. There are both experimental and standard available strategies for patients with breast and ovarian cancer to preserve fertility, and each has potential advantages and disadvantages. Embryo cryopreservation is widely available with a highly successful track record. Improvements in laboratory techniques have led to oocyte cryopreservation recently being recategorized as nonexperimental. Conservative gynecologic surgery is a standard consideration for patients with stage I ovarian cancer who desire future fertility. Ovarian tissue cryopreservation as well as ovarian suppression with luteinizing hormone-releasing hormone analogs during chemotherapy are considered experimental methods at this time, although recent data suggest both safety and efficacy for the use of luteinizing hormone-releasing hormone analogs in women receiving (neo)adjuvant chemotherapy for breast cancer. Special issues should be considered for women with BRCA mutations because of the need to undergo preventive surgery at young age. Multidisciplinary teams and well functioning relationships between the oncology and reproductive units are crucial to manage the fertility issues of young women with cancer.

Association between induced abortion history and later in vitro fertilization outcomes.

Science.gov (United States)

Wang, Yao; Sun, Yun; Di, Wen; Kuang, Yan-Ping; Xu, Bing

2018-06-01

To establish an effective and safe clinical fertility strategy by investigating the relationship between abortion history and pregnancy outcomes of in vitro fertilization (IVF) treatment. In the present retrospective cohort study, data from IVF treatment cycles performed at a reproductive center in China between October 1, 2014, and October 31, 2015, were assessed. Outcomes were compared between women with a history of induced abortion and those without. There were 1532 IVF treatment cycles included; 454 patients had a history of induced abortion and 1078 did not. The spontaneous abortion rate was significantly higher (30/170 [17.6%] vs 41/420 [9.8%]; P=0.002) and the endometrium was significantly thinner (8.8 ± 1.8 vs 9.7 ± 1.8 cm; P=0.001) among patients with a history of induced abortion compared with those without. In a subgroup analysis of patients with a history of induced abortion, women who had undergone surgical abortions had a lower live delivery rate compared with medical abortions (29/76 [38%] vs 101/378 [27%]; P=0.039). Further, women who had a history of more than two surgical abortions had lower live delivery and clinical pregnancy rates (both Pabortion was associated with worse IVF outcomes, especially a history of more than two surgical abortions. © 2018 International Federation of Gynecology and Obstetrics.

Sperm banking for fertility preservation: a 20-year experience.

Science.gov (United States)

Johnson, Matrika D; Cooper, Amber R; Jungheim, Emily S; Lanzendorf, Susan E; Odem, Randall R; Ratts, Valerie S

2013-09-01

Sperm banking is an effective method to preserve fertility, but is not universally offered to males facing gonadotoxic treatment in the United States. We compared the disposition and semen parameters of cryopreserved sperm from individuals referred for sperm banking secondary to a cancer diagnosis to those of sperm from men banking for infertility reasons. We performed a retrospective cohort study that reviewed 1118 records from males who presented to bank sperm at Washington University between 1991 and 2010. We collected and analyzed demographics, semen parameters, and disposition of banked sperm. Four hundred and twenty-three men with cancer and 348 banking for infertility reasons attempted sperm cryopreservation in our unit during the specified time period. The most prevalent cancers in our cohort were testicular (32%), lymphoma (25%), and leukemia (11%). Patients with leukemia had the lowest pre-thaw counts and motility. Most cancer patients (57%) who banked elected to use, transfer to another facility, or keep their specimens in storage. The remaining samples were discarded electively (34%) or following death (8%). Overall semen parameters were similar between the cancer and infertility groups, but demographics, ability to bank a sample, azoospermia rates, length of storage, current banking status, and use of banked sperm differed significantly between the two groups. The majority of cancer patients who banked survived their cancer and chose to continue storage of banked samples. Cancer patients were more likely than infertility patients to use or continue storage of banked samples. Our study provides evidence that sperm banking is a utilized modality of fertility preservation in patients with a myriad of cancer diagnoses and should be offered to all men facing gonadotoxic therapies. Further work is needed to determine where disparities in access to sperm banking exist to improve the potential for future fertility in these males. Copyright © 2013 Elsevier

Knowledge, attitudes and awareness regarding fertility preservation among oncologists and clinical practitioners in Lebanon.

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Ghazeeri, Ghina; Zebian, Dina; Nassar, Anwar H; Harajly, Sally; Abdallah, Alain; Hakimian, Stephanie; Skaiff, Bassem; Abbas, Hussein A; Awwad, Johnny

2016-06-01

Fertility preservation (FP) aims to help individuals overcome the infertility associated with cancer treatments such as chemotherapy and radiation. The objective of this study was to assess the awareness, attitudes and knowledge of oncologists' and clinical practitioners' (CPs) about fertility preservation and its options in Lebanon. This was a cross-sectional study with surveys carried out between March 2012 and February 2013 on CPs at the American University of Beirut Medical Centre and Saint Jude's Children Cancer Centre as well as all registered oncologists in Lebanon. Ninety percent of CPs (n = 88) and 94% of oncologists (n = 53) agreed that fertility preservation should be discussed with patient before their cancer treatment. Our data showed a gender bias in relation to patients being informed of their FP options, as well as conflicting knowledge of FP options available in Lebanon among oncologists. The CPs were more likely to have accurate knowledge of FP options and treatment than oncologists. A proactive approach is required to: (1) increase the awareness and knowledge of FP; (2) improve attitudes towards FP; and (3) encourage its communication between CPs, oncologists and patients in Lebanon. Increased education programs, awareness campaigns and development of dedicated FP centres are needed.

Preservação de fertilidade Fertility preservation

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Ana Carolina Japur de Sá Rosa e Silva

2006-06-01

Full Text Available Com a evolução dos recursos terapêuticos e o aumento das taxas de sobrevida dos pacientes oncológicos, as repercussões tardias destas terapias, que antes eram infreqüentes, hoje assumem um papel importante quando se fala em qualidade de vida. Dentre estas complicações tardias está a perda da função ovariana. Segundo as recomendações da Sociedade Americana de Oncologia Clínica (American Society of Clinical Oncology recentemente publicadas, os métodos comprovadamente eficazes para preservação da fertilidade feminina disponíveis hoje são: o congelamento de embriões, a cirurgia ginecológica conservadora e a ooforopexia para os casos de radioterapia localizada. Todas as demais técnicas existentes, tais como a supressão ovariana medicamentosa e a criopreservação de tecido ovariano e de oócitos, embora apresentem resultados promissores, ainda são consideradas experimentais. A escolha da melhor técnica para preservação de fertilidade aplicável em cada caso vai depender da idade da paciente, do tipo de tratamento, da existência ou não de parceiro com quem deseje constituir prole, do tempo disponível até o início da quimioterapia e do potencial do câncer em produzir metástase ovariana. Neste artigo as técnicas disponíveis e experimentais para a preservação da fertilidade são revisadas e discutidas.As therapeutic approaches for oncologic diseases are being improved and an increase in the survival rates are being achieved, long-term complications of these therapies, initially infrequent, assume these days an important place when considering life quality. Among the long term repercussions appears the premature ovarian failure. According to the recommendations of the American Society of Clinical Oncology recently published, the only procedures available nowadays considered to be effective for female fertility preservation are: embryo cryopreservation, conservative gynecological surgery and oophoropexy in cases of

Ovarian failure due to cancer treatment and fertility preservation options

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Soheila Aminimoghaddam

2016-04-01

Full Text Available Primary ovarian insufficiency (POI, commonly referred to premature ovarian failure, is defined as ovarian failure before the age of 40 years. It is the loss of ovarian function caused by a process directly affecting ovaries. Cancer therapy which includes surgery, radiotherapy, and chemotherapy influence ovarian function, leading to premature menopause and loss of fertility. POI is idiopathic in most cases (74-90%. The known causes, in addition to anticancer treatment, are other processes like chromosomal abnormalities, autoimmunity, and natural aging can result in secondary ovarian failure, which is detected by an increase in serum gonadotropin levels (FSH and LH. There are evident risks of POI in women treated for cancer. Those who receive anticancer treatments have an increased risk of developing POI. There by, anticancer drugs and radiation therapy are considered as the most common toxins of ovaries. Although cancer incidence rates in women less than 50 years old continue to increase during recent years, mortality rates are dramatically decreasing due to modern advances in treatment. Increasing numbers of survivors are now confronted with the long-term consequences of exposure to these treatments. The pool of primordial follicles in the ovary is fixed and any injury to the ovary can potentially reduce this ovarian reserve, effectively advancing the patient’s reproductive age, thus narrowing the window of reproductive opportunity. Ovarian failure occurs in a significant percentage of childhood cancer survivors and many of them will seek care for reproductive dysfunction. Nevertheless, Embryo cryopreservation, oocyte cryopreservation, ovary tissue cryopreservation, ovarian suppression and oophoro-pexy are some options to preserve fertility in these groups. As a result, having foreknowledge of potential treatment related ovarian failure will allow the physician to give a better counsel to patients and their family regarding the importance and

Vitrification of in vitro matured oocytes collected from surplus ovarian medulla tissue resulting from fertility preservation of ovarian cortex tissue

DEFF Research Database (Denmark)

Yin, Huiqun; Jiang, Hong; Kristensen, Stine Gry

2016-01-01

PURPOSE: The aim of the study was to investigate the maturation rate of immature oocytes collected from ovarian medulla tissue normally discarded during preparation of ovarian cortical tissue for fertility preservation. Further we evaluated survival of derived MII oocytes following vitrification...... and warming. METHODS: 36 patients aged from 8 to 41 years who had one ovary excised for fertility preservation were included. Oocytes were collected from the medulla tissue and matured in vitro 44-48 h followed by vitrification. Number of oocytes collected, the rates of maturation and post-warming survival...... of cortical tissue may pose a risk of relapse, but the IVM approach is currently too inefficient to be the only method used for fertility preservation....

Random Start Ovarian Stimulation for Oocyte or Embryo Cryopreservation in Women Desiring Fertility Preservation Prior to Gonadotoxic Cancer Therapy.

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Danis, Rachel B; Pereira, Nigel; Elias, Rony T

2017-11-10

Women of reproductive age diagnosed with cancer are often interested in preserving gametes or reproductive tissue that would allow for future genetic parenthood. Preservation of fertility is often accomplished in young cancer patients via ovarian stimulation followed by oocyte or embryo cryopreservation. Conventional stimulation protocols, however, require 2-4 weeks to complete ovarian stimulation, oocyte retrieval and possible fertilization. Such a strategy may not be feasible in patients requiring urgent cancer treatment. Recent studies have highlighted that random start ovarian stimulation can be initiated irrespective of the phase of the menstrual cycle and is an attractive alternative to conventional ovarian stimulation. The primary aim of the current review is to discuss the feasibility and success of random start ovarian stimulation for oocyte or embryo cryopreservation in women desiring fertility preservation prior to gonadotoxic cancer therapy. We performed a systematic review of medical literature published between January 2000 to June 2017 reporting the utility of random start ovarian stimulation for fertility preservation. Search terms included "fertility preservation," "cancer," "ovarian stimulation," "random-start ovarian stimulation," "embryo cryopreservation, and" "oocyte cryopreservation." Publications were included in this review only if patients underwent random start ovarian stimulation prior to cancer therapy. Nineteen publications were identified and perused by the authors. Most publications described the utility of random start ovarian stimulation in the setting of breast cancer. Radom-start stimulation was associated with a reduced time interval between ovarian stimulation initiation and oocyte or embryo cryopreservation. The yield of mature oocytes and their developmental potential into embryos was comparable between conventional and random-start protocols, albeit with higher gonadotropin doses in the latter. The current review suggests

Low Fertility Preservation Utilization Among Transgender Youth.

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Nahata, Leena; Tishelman, Amy C; Caltabellotta, Nicole M; Quinn, Gwendolyn P

2017-07-01

Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy. The purpose of this study was to examine the rates of fertility counseling and utilization of FP among a cohort of adolescents with gender dysphoria seen at a large gender clinic. An Institutional Review Board-approved retrospective review of electronic medical records was conducted of all patients with ICD-9/10 codes for gender dysphoria referred to Pediatric Endocrinology for hormone therapy (puberty suppression and/or cross-sex hormones) from January 2014 to August 2016. Seventy-eight patients met inclusion criteria. Five children were prepubertal, no hormone therapy was considered, and they were therefore excluded. Of the remaining 73 patients, 72 had documented fertility counseling prior to initiation of hormone therapy and 2 subjects attempted FP; 45% of subjects mentioned a desire or plan to adopt, and 21% said they had never wanted to have children. Utilization rates of FP are low among transgender adolescents. More research is needed to understand parenthood goals among transgender youth at different ages and developmental stages and to explore the impact of gender dysphoria on decision-making about FP and parenthood. Discussions about infertility risk, FP, and other family building options should be prioritized in this vulnerable adolescent population. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Ethical, moral, and theological insights into advances in male pediatric and adolescent fertility preservation.

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Ramstein, J J; Halpern, J; Gadzinski, A J; Brannigan, R E; Smith, J F

2017-07-01

The successful treatment of boys with cancer has led to increasing attention to preserving their quality of life after completing cancer therapy. One of the top priorities for living a full life is keeping open the opportunity to have children. While sperm banking for males facing sterilizing cancer treatment can be effective, this approach requires subsequent use of reproductive procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI) to achieve a pregnancy. Advances in fertility preservation techniques may allow pre-pubertal boys to conceive using advanced stem cell technologies and stem cell transplantation in the future. This review summarizes the ethical positions of leading medical societies and explores the religious and moral stances of major religious institutions regarding these options. © 2017 American Society of Andrology and European Academy of Andrology.

Fertility desires and fertility outcomes.

Science.gov (United States)

Bracher, M; Santow, G

1991-05-01

An Australian 1-in-1000 national probability sample conducted in 1986 yielded 2547 women aged 20-59 who provided detailed life histories on marital unions, childbearing, and contraception. Age specific fertility rates, desired family size, differentials in desired family size, desired fertility and achieved fertility, and sequential family building are examined. The results indicate that the desired family size at 1st marriage has declined only slightly over the past 30 years. 3 children are generally desired, and ver few desire 2. The constance of fertility desires in contrasted with the fertilitydecline to below replacement levels. Several reasons are suggested for the desired family size: the desire is for a family size within the family tradition and modified by the desire to have 1 of each sex, the desire reflects less on intentions but more on normative pressure to become a parent. Marrying is self selecting on the desire for a traditional family of at least 2 children. There is a rising age at marriage as well as a decline in marriages. Desired family size exceeds completed fertility. Period factors and personal circumstances affect fertility intentions. Future inquires should explore the multiple factors relating to fertility, rather than in comparing fertility desires and actual fertility. The data collected on age specific fertility were comparable to official estimates. The fertility decline was evidenced in all groups except teenagers. The decline was nearly 50% for those 20-24 years between the 1050's-80's, 33% for ages 25-29. Marriage patterns explain this decline in part. Between 1971-76, women aged 20-25 were married 37 months out of 60 months in 1971-76 versus 25 out of 60 months in 1981-86. Within the 25 year age group, marital fertility has declined and unmarried fertility, which is low, has risen, Women in a marital union of any kind has remained stable. Fertility within de facto unions, which is lower than within marriage, is higher than

Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe

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Alexandra S. Rashedi

2017-06-01

Full Text Available Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale. Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services. Results: Sixty-three responses were received (response rate, 25%, and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75% showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61% stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding. Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements.

Clear cell carcinoma of the uterine cervix: clinical characteristics and feasibility of fertility-preserving treatment

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Jiang X

2014-01-01

Full Text Available Xiang Jiang, Ying Jin, Yan Li, Hui-Fang Huang, Ming Wu, Keng Shen, Ling-Ya Pan Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China Abstract: The objective of this retrospective study was to analyze the clinical characteristics and prognosis of clear cell adenocarcinoma (CCA in the post-diethylstilbestrol (DES era and to evaluate the feasibility of fertility-preserving treatment. The records of 32 patients with CCAs who were treated at Peking Union Medical College Hospital from August 1986 to June 2012 were retrospectively reviewed. Three of the patients had undergone fertility-preserving treatment. The incidence of CCA among cervical adenocarcinomas was 15.2%. The median age was 38 years: 11 patients (34.4% were diagnosed before 30 years of age and two (6.3% after 70 years of age. Ten patients (31.2% were nulliparous. No patient had been exposed to DES. Twenty-nine patients (90.6% presented with obvious symptoms, and the cervix appeared abnormal in 26 patients (81.3%. Cervical Papanicolaou (Pap tests were abnormal in all four patients in whom they were performed (three had high-grade squamous intraepithelial lesions and one had atypical squamous cells of undetermined significance. The distribution by stage was 56.3% stage I, 34.4% stage II, 6.3% stage III, and 3.1% stage IV. Treatments mainly included surgery for patients with stage I to IIA CCA and radiochemotherapy for patients with advanced CCA. The overall 5-year progression-free survival was 72.2%. Patients with stage I to IIA CCA had better 5-year progression-free survival than did patients with stage IIB to IV CCA (81.5% versus 40.0%, P=0.003. The three patients who had undergone fertility-preserving treatment had no recurrences. CCA may also affect adolescents and children without prior DES exposure, who are often misdiagnosed as having functional uterine

Extended safe preservation period of foods of plant origin through combined technological methods

International Nuclear Information System (INIS)

Miteva, D.; Nacheva, I.; Dzhakova, A.; Tsvetkov, Tsv.

2008-01-01

The sublimation drying of fruits as an innovative technology for preservation their composition and enzyme activity is applied to various fruits: apricots, strawberries, plumbs, peaches and apples. The authors present the main methods of lyophilization as an original biotechnology for cryopreservation of fruits and afterwards are subjected to cold sterilization with 1.5 and 3 kGy doses of gamma irradiation. The combined application of both technologies provides safe and extended preservation of fresh fruits with high content of vitamins, mineral salts, maximum preserved enzyme system, aroma-tasty complex and microbiological purity

Fertility-preservation counselling and treatment for medical reasons: data from a multinational network of over 5000 women.

Science.gov (United States)

von Wolff, Michael; Dittrich, Ralf; Liebenthron, Jana; Nawroth, Frank; Schüring, Andreas N; Bruckner, Thomas; Germeyer, Ariane

2015-11-01

Fertility-preservation techniques for medical reasons are increasingly offered in national networks. Knowledge of the characteristics of counselled patients and techniques used are essential. The FertiPROTEKT network registry was analysed between 2007 and 2013, and included up to 85 university and non-university centres in Germany, Austria and Switzerland; 5159 women were counselled and 4060 women underwent fertility preservation. In 2013, fertility-preservation counselling for medical reasons increased significantly among nullipara and women aged between 21 and 35 years (n = 1043; P years predominantly opted for GnRH agonists and ovarian tissue cryopreservation; women aged between 20 and 40 years underwent a variety of techniques; and women over 40 years opted for GnRH agonists. The average number of aspirated oocytes per stimulation cycle decreased as age increased (years: 12.9; 31-35 years: 12.3; 36-46: 9.0; > 41 years: 5.7). For ovarian tissue cryopreservation, removal and cryopreservation of fewer than one ovary was preferred and carried out in 97% of cases in 2013. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Patients’ Perception of Patient–Provider Communication in Fertility Preservation Decision Making Among Young Women With Cancer

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Aakrati Mathur

2013-09-01

Full Text Available Fertility preservation (FP for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to be directive when referring to the fertility clinic. Later in the process, they expect a supportive style of communication from providers. Patient-accessible language, supportive and reassuring styles of communication, and an existing relationship with providers may enhance well-being of the patients.

Variability in the practice of fertility preservation for patients with cancer.

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Kasey A Reynolds

Full Text Available Fertility is important to women and men with cancer. While options for fertility preservation (FP are available, knowledge regarding the medical application of FP is lacking. Therefore we examined FP practices for cancer patients among reproductive endocrinologists (REs. A 36 item survey was sent to board-certified REs. 98% of respondents reported counseling women with cancer about FP options. Oocyte and embryo cryopreservation were universally offered by these providers, but variability was noted in reported management of these cases-particularly for women with breast cancer. 86% of the respondents reported using letrozole during controlled ovarian stimulation (COS in patients with estrogen receptor positive (ER+ breast cancer to minimize patient exposure to estrogen. 49% of respondents who reported using letrozole in COS for patients with ER+ breast cancer reported that they would also use letrozole in COS for women with ER negative breast cancer. Variability was also noted in the management of FP for men with cancer. 83% of participants reported counseling men about sperm banking with 22% recommending against banking for men previously exposed to chemotherapy. Overall, 79% of respondents reported knowledge of American Society for Clinical Oncology FP guidelines-knowledge that was associated with providers offering gonadal tissue cryopreservation (RR 1.82, 95% CI 1.14-2.90. These findings demonstrate that RE management of FP in cancer patients varies. Although some variability may be dictated by local resources, standardization of FP practices and communication with treating oncologists may help ensure consistent recommendations and outcomes for patients seeking FP.

Long-term outcomes of fertility-sparing treatment of atypical polypoid adenomyoma with medroxyprogesterone acetate.

Science.gov (United States)

Nomura, Hidetaka; Sugiyama, Yuko; Tanigawa, Terumi; Matoda, Maki; Kanao, Hiroyuki; Kondo, Eiji; Takeshima, Nobuhiro

2016-01-01

Our objective was to analyze the long-term oncologic outcomes of fertility-preserving hormonal treatment with medroxyprogesterone acetate (MPA) in patients with APA. In a retrospective chart review, we identified patients with APA who were treated with MPA for fertility preservation at our hospital between 2001 and 2011. Eighteen patients with histologically diagnosed APA were identified. Clinical data including treatment, obstetrical, and oncologic outcomes were recorded. The mean observation period was 77.6 months (median 73.5, range 22-142), and the mean age was 33.6 years. Four patients also developed well-differentiated endometrial carcinoma. After the treatment, 14 patients (77.8 %) achieved either a complete response or partial response. Eight patients experienced recurrence, while four experienced persistent disease. Ten patients (55.6 %) eventually underwent hysterectomy. The median time to hysterectomy was 40.3 months (range 24-68). Nine patients progressed to endometrial cancer, and one experienced persistent APA. Among younger patients (years of age), four out of five patients who were married could have children. Seven patients (38.9 %) showed no evidence of the disease during the observation period (median 60 months, range 22-117 months). No one died because of the disease during the observation period. MPA yields a high response rate in APA, and if only younger patients are considered, a favorable pregnancy rate can be obtained. However, because recurrence rate is high, long-term follow-up under supervision of a trained gynecologic oncologist is required. To confirm MPA's utility, multi-center collaboration would be warranted.

[Current situation on fertility preservation in cancer patients in Spain: Level of knowledge, information, and professional involvement].

Science.gov (United States)

Garrido-Colino, Carmen; Lassaletta, Alvaro; Vazquez, María Ángeles; Echevarria, Aizpea; Gutierrez, Ignacio; Andión, Maitane; Berlanga, Pablo

2017-07-01

The estimated risks of infertility in childhood cancer due to radiation, chemotherapy and surgery are well known. The involvement of professionals and advances in the different methods of preservation are increasing. However, many patients do not receive information or perform any method of preservation. Questionnaires to paediatric onco-haematology institutions throughout Spain. The questionnaire consisted of 22 questions assessing their usual practices and knowledge about fertility preservation. Fifty members of the Spanish Society of Paediatric Haematology and Oncology, representing 24 of 43 centres, responded. These represented 82% of centres that treated higher numbers of patients. The effect of treatment on fertility was known by 78% of those who responded, with 76% admitting not knowing any guideline on fertility in children or adolescents. As for the ideal time and place to inform the patient and/or family, only 14% thought it should be done in the same cancer diagnosis interview. In clinical practice, 12% of those surveyed never referred patients to Human Reproduction Units, another 12% only did so if the patients showed interest, and 38% only refer patients in puberty. Just over one-third (34%) of those referrals were going to receive highly gonadotoxic treatment. There are clear differences between pre-puberty and puberty patients. The frequency with which some method of fertility preservation is performed in patients is low. All respondents believe that the existence of national guidelines on the matter would be of interest. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Ovarian tissue cryopreservation and transplantation among alternatives for fertility preservation in the Nordic countries

DEFF Research Database (Denmark)

Rodriguez-Wallberg, Kenny A; Tanbo, Tom; Tinkanen, Helena

2016-01-01

cryopreservation to be experimental. In Iceland, embryo cryopreservation is the only option for fertility preservation. Most centers use slow-freezing methods for ovarian tissue cryopreservation. Most patients selected for ovarian tissue cryopreservation were newly diagnosed with cancer and the tissue...

Fertility preservation in reproductive age women with cancer.

Science.gov (United States)

Kovacs, Peter

2014-12-01

Cancer may be detected at any age and could affect children, and reproductive age women as well. In recent years, cancer treatment has become less destructive and more specific. As a result, survival rates and quality of life following successful treatment have continuously improved. Cancer treatment typically involves surgery, chemo- or radiation therapy, or the combinations of these. These interventions often adversely affect the function of the reproductive organs. Chemo- and radiation therapy are known to be gonadotoxic. Survivors of oncologic therapy are typically rendered infertile primarily due to the loss of ovarian function. There are, however, several medical, surgical, and assisted reproductive technology options that could be and should be offered to those diagnosed with cancer and wish to maintain their fertility. Embryo cryopreservation has been available for decades and has been successfully applied for fertility preservation in women diagnosed with cancer. Recent advances in cryobiology have increased the efficacy of not just embryo but even oocyte and ovarian tissue freezing-thawing. Oocyte vitrification just like embryo cryopreservation requires the use of stimulation but does not require the patient to be in a stable relationship or accept the use of donor sperm. Ovarian tissue cryopreservation does not require stimulation and, following successful transplantation, provides the patient with the most eggs but is currently still considered experimental. This paper summarizes the various fertility-sparing medical, surgical and assisted reproductive technology options. It reviews the current status of embryo, oocyte, and ovarian tissue cryopreservation and discusses their risks and benefits.

Parental attitudes toward fertility preservation in boys with cancer: context of different risk levels of infertility and success rates of fertility restoration

NARCIS (Netherlands)

Sadri-Ardekani, Hooman; Akhondi, Mohammad-Mehdi; Vossough, Parvaneh; Maleki, Haleh; Sedighnejad, Shirin; Kamali, Koorosh; Ghorbani, Behzad; van Wely, Madelon; van der Veen, Fulco; Repping, Sjoerd

2013-01-01

To measure the parental attitudes toward fertility preservation in boys with cancer. Retrospective cohort study. Questionnaire survey via regular mail. A total of 465 families whose sons were already treated for cancer. The questionnaire was designed for two groups based on child's age at the time

Biobanking efforts and new advances in male fertility preservation for rare and endangered species

Directory of Open Access Journals (Sweden)

Pierre Comizzoli

2015-01-01

Full Text Available Understanding and sustaining biodiversity is a multi-disciplinary science that benefits highly from the creation of organized and accessible collections of biomaterials (Genome Resource Banks. Large cryo-collections are invaluable tools for understanding, cataloging, and protecting the genetic diversity of the world′s unique animals and plants. Specifically, the systematic collection and preservation of semen from rare species has been developed significantly in recent decades with some biobanks now being actively used for endangered species management and propagation (including the introduction of species such as the black-footed ferret and the giant panda. Innovations emerging from the growing field of male fertility preservation for humans, livestock species, and laboratory animals are also becoming relevant to the protection and the propagation of valuable domestic and wild species. These new approaches extend beyond the "classical" methods associated with sperm freezing to include testicular tissue preservation combined with xenografting or in vitro culture, all of which have potential for rescuing vast amounts of unused germplasm. There also are other options under development that are predicted to have a high impact within the next decade (stem cell technologies, bio-stabilization of sperm cells at ambient temperatures, and the use of genomics tools. However, biobanking efforts and new fertility preservation strategies have to expand the way beyond mammalian species, which will offer knowledge and tools to better manage species that serve as valuable biomedical models or require assistance to reverse endangerment.

Biobanking efforts and new advances in male fertility preservation for rare and endangered species.

Science.gov (United States)

Comizzoli, Pierre

2015-01-01

Understanding and sustaining biodiversity is a multi-disciplinary science that benefits highly from the creation of organized and accessible collections of biomaterials (Genome Resource Banks). Large cryo-collections are invaluable tools for understanding, cataloging, and protecting the genetic diversity of the world's unique animals and plants. Specifically, the systematic collection and preservation of semen from rare species has been developed significantly in recent decades with some biobanks now being actively used for endangered species management and propagation (including the introduction of species such as the black-footed ferret and the giant panda). Innovations emerging from the growing field of male fertility preservation for humans, livestock species, and laboratory animals are also becoming relevant to the protection and the propagation of valuable domestic and wild species. These new approaches extend beyond the "classical" methods associated with sperm freezing to include testicular tissue preservation combined with xenografting or in vitro culture, all of which have potential for rescuing vast amounts of unused germplasm. There also are other options under development that are predicted to have a high impact within the next decade (stem cell technologies, bio-stabilization of sperm cells at ambient temperatures, and the use of genomics tools). However, biobanking efforts and new fertility preservation strategies have to expand the way beyond mammalian species, which will offer knowledge and tools to better manage species that serve as valuable biomedical models or require assistance to reverse endangerment.

Fertility in female childhood cancer survivors

DEFF Research Database (Denmark)

De Bruin, Marie L; Van Dulmen-den Broeder, Eline; Van den Berg, Marleen H

2009-01-01

chemotherapy and radiotherapy may have an adverse effect on ovarian function, ovarian reserve and uterine function, clinically leading to sub-fertility, infertility, premature menopause and/or adverse pregnancy outcomes. Here we will first address normal female fertility and methods to detect decreased...... fertility. Hence we will focus on direct effects as well as late fertility-related adverse effects caused by chemotherapy and radiotherapy, and we will conclude with a summary of current options for fertility preservation in female childhood cancer survivors.......Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly enlarging group of childhood cancer survivors. There is much concern, however, about the effects of treatment on reproductive potential. In women there is evidence that both...

Fertility intentions and outcomes: Implementing the Theory of Planned Behavior with graphical models.

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Mencarini, Letizia; Vignoli, Daniele; Gottard, Anna

2015-03-01

This paper studies fertility intentions and their outcomes, analyzing the complete path leading to fertility behavior according to the social psychological model of Theory Planned Behavior (TPB). We move beyond existing research using graphical models to have a precise understanding, and a formal description, of the developmental fertility decision-making process. Our findings yield new results for the Italian case which are empirically robust and theoretically coherent, adding important insights to the effectiveness of the TPB for fertility research. In line with TPB, all intentions' primary antecedents are found to be determinants of the level of fertility intentions, but do not affect fertility outcomes, being pre-filtered by fertility intentions. Nevertheless, in contrast with TPB, background factors are not fully mediated by intentions' primary antecedents, influencing directly fertility intentions and even fertility behaviors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Current state and controversies in fertility preservation in women with breast cancer

OpenAIRE

Taylan, Enes; Oktay, Kutluk H

2017-01-01

On average, over 25000 women are diagnosed with breast cancer under the age of 45 annually in the United States. Because an increasing number of young women delay childbearing to later life for various reasons, a growing population of women experience breast cancer before completing childbearing. In this context, preservation of fertility potential of breast cancer survivors has become an essential concept in modern cancer care. In this review, we will outline the currently available fertilit...

Hair mercury concentrations and in vitro fertilization (IVF) outcomes among women from a fertility clinic

Science.gov (United States)

Ehrlich, Shelley; Smith, Kristen; Williams, Paige L.; Chavarro, Jorge E.; Batsis, Maria; Toth, Thomas L.; Hauser, Russ

2015-01-01

Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) treatment and the association with prospectively collected IVF outcomes (229 IVF cycles) was evaluated. Hair Hg levels (median=0.62 ppm, range: 0.03-5.66 ppm) correlated with fish intake (r=0.59), and exceeded the recommended EPA reference of 1ppm in 33% of women. Generalized linear mixed models with random intercepts accounting for within-woman correlations across treatment cycles were used to evaluate the association of hair Hg with IVF outcomes adjusted for age, body mass index, race, smoking status, infertility diagnosis, and protocol type. Hair Hg levels were not related to ovarian stimulation outcomes (peak estradiol levels, total and mature oocyte yields) or to fertilization rate, embryo quality, clinical pregnancy rate or live birth rate. PMID:25601638

Assessing in vivo fertilizing capacity of liquid-preserved boar semen according to the 'Hanover gilt model'.

Science.gov (United States)

Ardón, F; Döhring, A; Le Thi, X; Weitze, K F; Waberski, D

2003-04-01

The goal of this study was to determine the ability of the Hanover gilt model to assess in vivo fertilizing capacity of preserved sperm and to consider whether any modifications to this model were needed. This model evaluates the fertilizing capacity of semen based on the fertilization rate, the rate of normal embryos and the accessory sperm count of 3-5-day embryos. Its distinguishing characteristics are the use of one-time insemination of sperm in reduced numbers, of spontaneously ovulating gilts and of ovulation detection through ultrasound examination of ovaries. Reduced sperm numbers allow for an accurate evaluation of the fertilizing potential of different semen treatments, thereby avoiding the compensatory effect of doses calibrated to maximize fertility. The model's usefulness was assessed in a trial run designed to compare the fertilizing capacity of liquid boar semen diluted into two different extenders. The diluent, the boar and the backflow, had no significant effect on any of the parameters studied. Gilts inseminated less than 24 h before ovulation had a significantly higher (p semen), while using relatively few gilts and little time.

Effect of applying wheat stubble on preservation and utilization of n-fertilizer by 15N trace technique

International Nuclear Information System (INIS)

Xu Xinyu; Zhang Yumei; Xiang Hua; Hu Jisheng

1991-10-01

By using 15 N trace technique, the effect of applying wheat stubble on the preservation and utilization rate of 15 N- ammonium sulphate have been studied. The abundance of ( 15 NH 4 ) 2 SO 4 fertilizer was 8.92%. After three years pot test and field plot test, the results showed that the yields with ' 15 N+mulching' and ' 15 N+incorporating' treated were increased by 5.4∼30.0% for spring wheat and millet(pot test), and 18∼23% for winter wheat and summer corn(field plot test), as compared with only ' 15 N' treatment. The results of 15 N-fertilizer labelled tests showed that the utilization rates of 15 N-fertilizer treated by ' 15 N+mulching' for cropping seasons were 57.8%, 65.8%, 36.6% and 8.5% respectively. These were increased 3.7%, 10.2%, 21.5% and 2.8% as compared with only ' 15 N' treatment. Comparing with only ' 15 N'treatment, the N leached off by percolation water was decreasing 50%, the loss of N caused by volatilization was decreasing 30.3% and the N in humus was increasing 21.1%. All of these proved that the applying of wheat stubble in different mode would adjust and control the activation of microbe in the soil, and the preservation and utilization rate of fertilizer in the soul would be increased

Dairy intake in relation to in vitro fertilization outcomes among women from a fertility clinic.

Science.gov (United States)

Afeiche, M C; Chiu, Y-H; Gaskins, A J; Williams, P L; Souter, I; Wright, D L; Hauser, R; Chavarro, J E

2016-03-01

Is dairy food consumption associated with live birth among women undergoing infertility treatment? There was a positive association between total dairy food consumption and live birth among women ≥35 years of age. Dairy food intake has been previously related to infertility risk and measures of fertility potential but its relation to infertility treatment outcomes are unknown. Our study population comprised a total of 232 women undergoing 353 in vitro fertilization (IVF) treatment cycles between February 2007 and May 2013, from the Environment and Reproductive Health study, an ongoing prospective cohort. Diet was assessed before assisted reproductive technology (ART) treatment using a validated food frequency questionnaire. Study outcomes included ovarian stimulation outcomes (endometrial thickness, estradiol levels and oocyte yield), fertilization rates, embryo quality measures and clinical outcomes (implantation, clinical pregnancy and live birth rates). We used generalized linear mixed models with random intercepts to account for multiple ART cycles per woman while simultaneously adjusting for age, caloric intake, BMI, race, smoking status, infertility diagnosis, protocol type, alcohol intake and dietary patterns. The age- and calorie-adjusted difference in live birth between women in the highest (>3.0 servings/day) and lowest (Switzerland and completed this work while at the Harvard School of Public Health. The other authors declare no conflicts of interest. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Selective Regulation of Oocyte Meiotic Events Enhances Progress in Fertility Preservation Methods

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Onder Celik

2015-01-01

Full Text Available Following early embryonic germ cell migration, oocytes are surrounded by somatic cells and remain arrested at diplotene stage until luteinizing hormone (LH surge. Strict regulation of both meiotic arrest and meiotic resumption during dormant stage are critical for future fertility. Intercellular signaling system between the somatic compartment and oocyte regulates these meiotic events and determines the follicle quality. As well as the collected number of eggs, their qualities are also important for in vitro fertilization (IVF outcome. In spontaneous and IVF cycles, germinal vesicle (GV–stage oocytes, premature GV breakdown, and persistence of first meiotic arrest limit the reproductive performance. Likewise, both women with premature ovarian aging and young cancer women are undergoing chemoradiotherapy under the risk of follicle loss because of unregulated meiotic events. Understanding of oocyte meiotic events is therefore critical for the prevention of functional ovarian reserve. High levels of cyclic guanosine monophophate (cGMP, cyclic adenosine monophophate (cAMP and low phosphodiesterase (PDE 3A enzyme activity inside the oocyte are responsible for maintaining of meiotic arrest before the LH surge. cGMP is produced in the somatic compartment, and natriuretic peptide precursor C (Nppc and natriuretic peptide receptor 2 (Npr2 regulate its production. cGMP diffuses into the oocyte and reduces the PDE3A activity, which inhibits the conversion of cAMP to the 5′AMP, and cAMP levels are enhanced. In addition, oocyte itself has the ability to produce cAMP. Taken together, accumulation of cAMP inside the oocyte induces protein kinase activity, which leads to the inhibition of maturation-promoting factor and meiotic arrest also continues. By stimulating the expression of epidermal growth factor, LH inhibits the Nppc/Npr2 system, blocks cGMP synthesis, and initiates meiotic resumption. Oocytes lacking the functional of this pathway may lead to

Is ridge preservation/augmentation at periodontally compromised extraction sockets safe? A retrospective study.

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Kim, Jung-Ju; Ben Amara, Heithem; Schwarz, Frank; Kim, Hae-Young; Lee, Jung-Won; Wikesjö, Ulf M E; Koo, Ki-Tae

2017-10-01

This study aimed to evaluate the safety of ridge preservation/augmentation procedures when performed at compromised extraction sockets. Patients subject to ridge preservation/augmentation at periodontally compromised sockets at Seoul National University Dental Hospital (SNUDH) were evaluated in a chart review. Tooth extractions due to acute infection were not included in our study as chronically formed lesions are the only lesions that can be detected from radiographic images. If inflammatory symptoms persisted following ridge preservation/augmentation and antimicrobial and anti-inflammatory therapy, the patient was categorized as a re-infection case and implanted biomaterial removed. Of 10,060 patients subject to tooth extractions at SNUDH, 2011 through 2015, 297 cases meeting inclusion criteria were reviewed. The severity and type of lesions were not specific because extracting data was only done by radiographic images and chart records. The review identified eight patients exhibiting inflammatory symptoms that required additional antimicrobial and anti-inflammatory therapy. Within this group, re-infection occurred in two patients requiring biomaterials removal. The final safety rate for the ridge preservation/augmentation was 99.3%. None of the demographic factors, systemic conditions or choice of biomaterial affected the safety of ridge preservation/augmentation. Alveolar ridge preservation/augmentation at periodontally compromised sockets appears safe following thorough removal of infectious source. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sexuality and fertility in men with hypospadias; improved outcome.

Science.gov (United States)

Örtqvist, L; Fossum, M; Andersson, M; Nordenström, A; Frisén, L; Holmdahl, G; Nordenskjöld, A

2017-03-01

The aim of this study was to investigate sexual function and fertility in adult men born with hypospadias. Patients born with hypospadias, age-matched controls, and a group of circumcised men completed a questionnaire constructed to reflect their psychosexual situation and fertility. Core gender identity, sexual orientation, and gender role behavior was also assessed. 167 patients [63% distal, 24% mid shaft and 13% proximal, mean age 34 (19-54) years], 169 controls from the general population [mean age 33 (19-48) years] and 47 controls circumcised because of phimosis (mean age 26 [19-44]) participated and completed the questionnaire. There were no differences in having a partner, reported fertility, age at sexarche (mean age 17.8), number of sex partners or sexual interest between the patients and controls. More patients than controls reported anejaculation. Reported glanular sensitivity was lower in hypospadias patients and circumcised controls compared with non-circumcised controls. The odds of being satisfied with their sexual life increased with a higher penile perception score in patients (OR = 1.54, p = 0.01). There was no association with penile length. Sexual orientation, core gender identity and gender role behavior were sex-typical in both patients and controls. Patients with proximal hypospadias had a lower reported fertility, experienced anejaculation more often, and were less satisfied with their sexual life. Men born with hypospadias have a good long-term outcome concerning sexual function and fertility. Men born with proximal hypospadias have a more impaired outcome concerning both sexual function and fertility. As satisfaction with genital appearance is important for sexual life satisfaction, clinical, and psychological follow-up into adulthood is especially important in boys born with proximal hypospadias. © 2016 American Society of Andrology and European Academy of Andrology.

Preserving fertility in the hypogonadal patient: an update

Directory of Open Access Journals (Sweden)

Ranjith Ramasamy

2015-04-01

Full Text Available An increasing number of young and middle-aged men are seeking treatment for symptoms related to deficient levels of androgens (hypogonadism including depression, loss of libido, erectile dysfunction, and fatigue. The increase in prevalence of testosterone supplementation in general and anabolic steroid-induced hypogonadism specifically among younger athletes is creating a population of young men who are uniquely impacted by the testicular end-organ negative consequences of exogenous steroid use. Exogenous testosterone therapy can alter the natural regulation of the hypothalamic-pituitary-gonadal axis leading to impaired spermatogenesis with azoospermia being a serious possible result, thus rendering the individual infertile. For men of reproductive age who suffer from hypogonadal symptoms, preservation of fertility is an important aspect of their treatment paradigm. Treatment with human chorionic gonadotropin (hCG has shown the ability not only to reverse azoospermia brought on by testosterone supplementation therapy but also to help maintain elevated intratesticular testosterone levels. In addition, selective estrogen receptor modulators, often used with hCG have been shown both to elevate total testosterone levels and to maintain spermatogenesis in hypogonadal men.

Developmental competence of oocytes isolated from surplus medulla tissue in connection with cryopreservation of ovarian tissue for fertility preservation

DEFF Research Database (Denmark)

Wilken-Jensen, Helle N; Kristensen, Stine G; Jeppesen, Janni V

2014-01-01

OBJECTIVE: Evaluating the developmental competence of immature oocytes collected from surplus medulla tissue in connection with ovarian tissue cryopreservation for fertility preservation. DESIGN: Cohort comparative study. SETTING: University laboratory in Denmark from 2011-2012. POPULATION: 69...

Preserving children's fertility: two tales about children's right to an open future and the margins of parental obligations.

Science.gov (United States)

Cutas, Daniela; Hens, Kristien

2015-05-01

The sources, extent and margins of parental obligations in taking decisions regarding their children's medical care are subjects of ongoing debates. Balancing children's immediate welfare with keeping their future open is a delicate task. In this paper, we briefly present two examples of situations in which parents may be confronted with the choice of whether to authorise or demand non-therapeutic interventions on their children for the purpose of fertility preservation. The first example is that of children facing cancer treatment, and the second of children with Klinefelter syndrome. We argue that, whereas decisions of whether to preserve fertility may be prima facie within the limits of parental discretion, the right to an open future does not straightforwardly put parents under an obligation to take actions that would detect or relieve future infertility in their children-and indeed in some cases taking such actions is problematic.

Fertility preservation after chemotherapy for Hodgkin lymphoma

NARCIS (Netherlands)

van der Kaaij, Marleen A. E.; van Echten-Arends, Jannie; Simons, Arnold H. M.; Kluin-Nelemans, Hanneke C.

2010-01-01

Treatment for Hodgkin lymphoma can negatively affect fertility. This review summarizes data on fertility after chemotherapy in adult patients. Alkylating chemotherapy, especially if containing procarbazine and/or cyclophosphamide, is most harmful to gonadal functioning. Alkylating regimens cause

Preserving Fertility while Battling Cancer

Science.gov (United States)

Some oncologists neglect to discuss the possibility of treatment-related infertility with patients of reproductive age. Researchers are developing decision aids to help patients make an informed, carefully considered decision about fertility.

Emergency IVF for embryo freezing to preserve female fertility: a French multicentre cohort study.

Science.gov (United States)

Courbiere, B; Decanter, C; Bringer-Deutsch, S; Rives, N; Mirallié, S; Pech, J C; De Ziegler, D; Carré-Pigeon, F; May-Panloup, P; Sifer, C; Amice, V; Schweitzer, T; Porcu-Buisson, G; Poirot, C

2013-09-01

What are the outcomes of French emergency IVF procedures involving embryo freezing for fertility preservation before gonadotoxic treatment? Pregnancy rates after emergency IVF, cryopreservation of embryos, storage, thawing and embryo transfer (embryo transfer), in the specific context of the preservation of female fertility, seem to be similar to those reported for infertile couples undergoing ART. A French retrospective multicentre cohort study initiated by the GRECOT network-the French Study Group for Ovarian and Testicular Cryopreservation. We sent an e-mail survey to the 97 French centres performing the assisted reproduction technique in 2011, asking whether the centre performed emergency IVF and requesting information about the patients' characteristics, indications, IVF cycles and laboratory and follow-up data. The response rate was 53.6% (52/97). Fourteen French centres reported that they performed emergency IVF (56 cycles in total) before gonadotoxic treatment, between 1999 and July 2011, in 52 patients. The patients had a mean age of 28.9 ± 4.3 years, and a median length of relationship of 3 years (1 month-15 years). Emergency IVF was indicated for haematological cancer (42%), brain tumour (23%), sarcoma (3.8%), mesothelioma (n = 1) and bowel cancer (n = 1). Gynaecological problems accounted for 17% of indications. In 7.7% of cases, emergency IVF was performed for autoimmune diseases. Among the 52 patients concerned, 28% (n = 14) had undergone previous courses of chemotherapy before beginning controlled ovarian stimulation (COS). The initiation of gonadotoxic treatment had to be delayed in 34% of the patients (n = 19). In total, 56 cycles were initiated. The mean duration of stimulation was 11.2 ± 2.5 days, with a mean peak estradiol concentration on the day on which ovulation was triggered of 1640 ± 1028 pg/ml. Three cycles were cancelled due to ovarian hyperstimulation syndrome (n = 1), poor response (n = 1) and treatment error (n = 1). A mean of 8

Young female cancer patients’ experiences with fertility counselling and fertility preservation—a qualitative small-scale study within the Danish health care setting

Science.gov (United States)

Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T.

2016-01-01

Introduction Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Methods Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before initiation of cancer treatment. Participants were interviewed at a place chosen by them, and interviews were recorded and transcribed verbatim. Data were analysed using systematic text condensation developed by Malterud and inspired by Giorgi’s phenomenological analysis. Results None of the participants were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how the possibility of fertility preservation removed a huge concern and enabled them to concentrate on their cancer treatment and on getting better. Conclusion Overall, the specialized fertility counselling and treatment to preserve fertility was highly valued. The women felt it gave them a choice about their future fertility. The fertility expert presented the various fertility-preserving scenarios, and the women were content that they had an actual choice. PMID:27413812

Male Fertility Issues

Science.gov (United States)

Fertility issues are common in boys and men getting cancer treatment. Fertility preservation options include sperm banking, testicular shielding, testicular sperm extraction (TESE), and testicular tissue freezing. Support and clinical trials are listed.

Modern possibilities of cryobiology in the treatment of infertility, preservation and restoration of fertility

Directory of Open Access Journals (Sweden)

N. V. Avramenko

2013-12-01

Full Text Available Actuality Today, the points of cryotechnology application in assisted reproductive technologies (ART are cryopreservation of semen, embryos, oocytes, ovaries. Research objective Overview of world and national literature displayed a common purpose is a historical fact cryopreservation of biological reproductive material - the formation cryosperm bank , embryos and oocytes banking. In the review of existing methods of cryopreservation. Thus, according to the above meta-analyzes and systematic reviews, the positive outcomes of ART programs have been observed when using vitrification as a method of cryopreservation. The results of the research Due to the high survival rate of embryos after vitrification, to date, ART approach to the problem of the breakdown of the implantation of the embryo in the superovulation stimulation cycles , preimplantation genetic diagnosis of the problems with the definition of a complete set of chromosomes of the embryo, as well as inherited monogenic diseases , problems of multiple pregnancy , prevention of severe ovarian hyperstimulation syndrome. Effective technology for vitrification of oocytes allows modern women of reproductive age to plan the timing of their reproductive potential. Also indicated is the best method of method of preserving fertility in women with cancer , an aggressive course of autoimmune diseases , as well as endometriosis. The successes of modern oncology have led to improved survival after cancer treatment , requiring ART methods for conservation and restoration of fertility. In a world of rapidly developing new areas cryotechnology , including cryopreservation of ovarian tissue. The procedure is eksperimetalnoy , but there are positive impressive results. Conclusions From the review of the current literature on the application of cryotechnology in the field of assisted reproduction , it can be concluded that the cryopreservation became an integral part of achieving high performance - birth to a

Fertility preservation in females with malignant disease-1: causes, clinical needs and indications

Directory of Open Access Journals (Sweden)

Murat Sönmezer

2009-09-01

Full Text Available Cancer incidence is progressively increasing in parallel with an increase in the rate of cancer survivors with the help of advanced treatment modalities. By the year 2010, it is estimated that one in every 250 persons will have survived a childhood malignancy. The increased rates of survival bring about complications related to reproductive health. Cytotoxic treatments due to chemo- and radiotherapy or bone marrow transplantation suppress or irreversibly harm not only female ovarian reserve but also male testicular sperm production. In this review, cryopreservation of gametes and gonads with fertility preservation options and indications prior to cancer treatments are discussed.

Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

Science.gov (United States)

Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

2014-05-01

To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study

Directory of Open Access Journals (Sweden)

Maria de Lourdes de Souza

Full Text Available ABSTRACT Objective: analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods: a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. Results: differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; p<0.001, have an infant with low birthweight (OR:1.1; CI:1.10-1.15; p<0.001 and low Apgar score at 5 minutes (OR:1.4; CI:1.34-1.45; p<0.001 than mothers ≥20 years, with the odds for adverse outcomes greater for those aged 10-14 years. Conclusion: this study provides evidence of fertility rates among adolescents remaining higher in regions of social and economic deprivation. Adolescent mothers and their infants more likely to experience adverse perinatal outcomes. Nurses, public health practitioners, health and social care professionals and educators need to work collaboratively to better target strategies for adolescents at greater risk; to help reduce fertility rates and improve outcomes.

When to ask male adolescents to provide semen sample for fertility preservation?

Science.gov (United States)

Dabaja, Ali A; Wosnitzer, Matthew S; Bolyakov, Alexander; Schlegel, Peter N; Paduch, Darius A

2014-03-01

Fertility preservation in adolescents undergoing sterilizing radiation and/or chemotherapy is the standard of care in oncology. The opportunity for patients to provide a semen sample by ejaculation is a critical issue in adolescent fertility preservation. Fifty males with no medical or sexual developmental abnormalities were evaluated. The subjects were screened for evidence of orgasmic, erectile, and ejaculatory dysfunction. A detailed sexual development history was obtained under an Institutional Review Board (IRB)-approved protocol. Fifty males, aged 18-65 years (mean 39±16.03 years) volunteered to be part of this study. The mean reported age for the onset of puberty was 12.39 years (95% CI, 11.99-12.80 years), 13.59 years (95% CI, 13.05-14.12 years) for the first ejaculation, 12.56 years (95% CI, 11.80-13.32 years) for the start of masturbation, and 17.26 years (95% CI, 16.18-18.33 years) for the first experienced intercourse. Seventy-five percent of the cohort reached puberty by the age of 13.33, experienced masturbation by 14.5, first ejaculated by the age of 14.83, and had intercourse at age of 19.15 years. The first experienced ejaculation fell 1.5 years after the onset of puberty in 80% present of the cohort, and 84% starts masturbation 1.5 years after the onset of puberty. The mean response between the younger and the older subject was not statistical significance. It is appropriate to consider a request for semen specimens by masturbation from teenagers at one year and six months after the onset of puberty; the onset age of puberty plus 1.5 years is an important predictor of ejaculation and sample collection for cryopreservation.

Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study

OpenAIRE

Souza, Maria de Lourdes de; Lynn, Fiona Ann; Johnston, Linda; Tavares, Eduardo Cardoso Teixeira; Brüggemann, Odaléa Maria; Botelho, Lúcio José

2017-01-01

ABSTRACT Objective: analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods: a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. Results: differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 ye...

Fertility preservation with ovarian stimulation and time to treatment in women with stage II-III breast cancer receiving neoadjuvant therapy.

Science.gov (United States)

Chien, A Jo; Chambers, Julia; Mcauley, Fiona; Kaplan, Tessa; Letourneau, Joseph; Hwang, Jimmy; Kim, Mi-Ok; Melisko, Michelle E; Rugo, Hope S; Esserman, Laura J; Rosen, Mitchell P

2017-08-01

To determine whether fertility preservation with ovarian stimulation (OS) results in treatment delay in breast cancer (BC) patients receiving neoadjuvant therapy (NAT). This is a retrospective study of women screened for the prospective neoadjuvant ISPY2 trial at the University of California San Francisco. All patients were years old, p = 0.06), and more likely to be childless (79.4 vs 31.2%, p 40 days, with no significant difference between STIM and control groups (mean 39.8 days vs 40.9 days, p = 0.75). Mean time from diagnosis to fertility consultation was 16.3 days. With median follow-up of 79 months, 16 (19.5%) patients have recurred or died from BC. Rates of pCR, recurrence, and death were similar in both groups. Six of 34 STIM patients have undergone embryo transfer, resulting in one patient with two live births. Fertility preservation with OS can be performed in the neoadjuvant setting without delay in initiation of systemic therapy and should be discussed with all early-stage BC patients of reproductive age.

Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe

Directory of Open Access Journals (Sweden)

Alexandra S. Rashedi

2017-06-01

Full Text Available Purpose: In the accompanying article, “Analysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients.

Decision-making in female fertility preservation is balancing the expected burden of fertility preservation treatment and the wish to conceive.

Science.gov (United States)

Baysal, Ö; Bastings, L; Beerendonk, C C M; Postma, S A E; IntHout, J; Verhaak, C M; Braat, D D M; Nelen, W L D M

2015-07-01

What are the decisive factors in fertility preservation (FP) decision-making in young women scheduled for gonadotoxic therapy? FP decision-making in young women scheduled for gonadotoxic therapy is mainly based on weighing two issues: the intensity of the wish to conceive a child in the future and the expected burden of undergoing FP treatment. Future fertility is of importance for young cancer patients whose reproductive function is being threatened by oncological therapy. To prevent or reduce severe psychological effects of infertility as well as feelings of regret about their FP decision after cancer treatment, the quality of fertility preservation counselling (FPC) should be improved. To improve care, those issues forming a decisive factor in FP decision-making for patients should be clarified, as these issues deserve extensive discussion during FPC. Until now, decisive factors have not been isolated from the complex interplay of all aspects of FP that women contemplate during FP decision-making. By using a mixed methods methodology, a questionnaire developed after qualitative research involving a selected group of five women who previously received FPC was retrospectively sent to eligible patients (n = 143) who had received FPC (1999 - July 2013) and to whom at least one FP option was offered. Patients had received FPC at a university hospital in the Netherlands, in a setting where financial factors do not play a role in FP. They were aged ≥16 years and were scheduled for gonadotoxic treatment. The relationship between patients' baseline characteristics, their attributed importance to 28 relevant importance items and their FP choices was investigated. After five interviews, 28 importance items for FP decision-making were identified and included in our questionnaire. Of these 28 importance items, 24 items could be clustered into seven importance themes. A total of 87 patients (61%) responded to our questionnaire. After performing a multivariable logistic

Ultrasound-Guided Percutaneous Catheter Drainage of Large Breast Abscesses in Lactating Women: How to Preserve Breastfeeding Safely.

Science.gov (United States)

Falco, Giuseppe; Foroni, Monica; Castagnetti, Fabio; Marano, Luigi; Bordoni, Daniele; Rocco, Nicola; Marchesi, Vanessa; Iotti, Valentina; Vacondio, Rita; Ferrari, Guglielmo

2016-12-01

Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess. A pigtail catheter was inserted into the fluid collection using the Seldinger technique under US guide and connected to a three stop way to allow drainage and irrigation of the cavity until its resolution. All procedures have been found safe and well tolerated. No recurrence was observed and breastfeeding was never interrupted. The described technique allows to avoid surgery and to preserve breastfeeding in well-selected patients with a safe, well-tolerated and cost-effective procedure.

Onco-testicular sperm extraction: birth of a healthy baby after fertility preservation in synchronous bilateral testicular cancer and azoospermia.

Science.gov (United States)

Roque, M; Sampaio, M; Salles, P G de Oliveira; Geber, S

2015-05-01

Testicular germ cell tumours (TGCT) represent 1%-1.5% of all male neoplasms, and they have the highest prevalence among men between 15 and 35 years old. Synchronous bilateral disease is a rare presentation, and the ratio of metachronous to synchronous bilateral disease is about 4 : 1. Several studies have suggested a correlation between male infertility and testicular cancer, with a 20-fold increase in the incidence of testicular cancer in infertile patients compared with the general population. At the time of diagnosis, 50%-75% of patients with unilateral TGCT present with subfertility; almost 13% of the patients are azoospermic before treatment, and up to two-thirds of patients become azoospermic following adjuvant cancer therapies. Therefore, fertility preservation should be considered in all oncological treatments. The only available option to preserve the reproductive potential in azoospermic patients with testicular cancer is to perform an onco-testicular sperm extraction (onco-TESE) before cancer treatment. In this paper, we describe a rare case of a patient with synchronous bilateral testicular cancer and azoospermia who was submitted to onco-TESE, sperm cryopreservation, and which was followed by the delivery of a healthy baby after intracytoplasmic sperm injection (ICSI), emphasising the importance of fertility preservation in oncology patients. © 2014 Blackwell Verlag GmbH.

Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy - a systematic literature review.

Science.gov (United States)

Pareja, René; Rendón, Gabriel J; Sanz-Lomana, Carlos Millán; Monzón, Otto; Ramirez, Pedro T

2013-10-01

Radical trachelectomy is a standard treatment for selected patients with early-stage cervical cancer. Outcomes are well established for vaginal radical trachelectomy (VRT), but not for abdominal radical trachelectomy (ART). We searched MEDLINE, EMBASE, and CINAHL (October 1997 through October 2012) using the terms: uterine cervix neoplasms, cervical cancer, abdominal radical trachelectomy, vaginal radical trachelectomy, fertility sparing, and fertility preservation. We included original articles, case series, and case reports. Excluded were review articles, articles with duplicate patient information, and articles not in English. We identified 485 patients. Ages ranged from 6 to 44 years. The most common stage was IB1 (331/464; 71%), and the most common histologic subtype was squamous cell carcinoma (330/470; 70%). Operative times ranged from 110 to 586 min. Blood loss ranged from 50 to 5568 mL. Three intraoperative complications were reported. Forty-seven patients (10%) had conversion to radical hysterectomy. One hundred fifty-five patients (35%) had a postoperative complication. The most frequent postoperative complication was cervical stenosis (n=42; 9.5%). The median follow-up time was 31.6 months (range, 1-124). Sixteen patients (3.8%) had disease recurrence. Two patients (0.4%) died of disease. A total of 413 patients (85%) were able to maintain their fertility. A total of 113 patients (38%) attempted to get pregnant, and 67 of them (59.3%) were able to conceive. ART is a safe treatment option in patients with early-stage cervical cancer interested in preserving fertility. Copyright © 2013 Elsevier Inc. All rights reserved.

Laparoscopic tubal sterilization reversal and fertility outcomes

Directory of Open Access Journals (Sweden)

K Jayakrishnan

2011-01-01

Full Text Available Purpose: The purpose of the study was two-fold. Firstly it was to assess the suitability for tubal recanalization and factors predicting successful laparoscopic recanalization. Secondly, it was to analyze the fertility outcomes and factors affecting the pregnancy rate following laparoscopic tubal recanalization. Materials and Methods: A retrospective chart review of prospectively followed-up 29 women at a tertiary care center seeking tubal sterilization reversal between May 2005 and February 2010 were included. Results: In 14 (48.3% women unilateral tubes were suitable and in only 3 women (10.3% bilateral tubes were suitable. All cases with laparoscopic tubal sterilization were suitable, whereas all cases with fimbriectomy were unsuitable for recanalization. In 6 (20.7% cases salphingostomy was performed as an alternative procedure to tubal reanastomosis. The overall pregnancy rate was 58.8%. In cases with sterilization by Pomeroy′s method, 4 out of 10 (40% conceived, whereas for laparoscopic tubal ligation cases 6 out of 7 (85.7% conceived (P=0.32. None of the patients with final tubal length <5 cm conceived (P=0.03. Comparing the age at recanalization, in women ≤30 years, 71.4% conceived, as compared with 50% when age of women was more than 30 years (P=0.37. Conclusions: The important factors determining the success of recanalization are technique of sterilization and the remaining length of the tube after recanalization. The gynecologist must use an effective technique of sterilization to minimize the failure rates, but at the same time, which causes minimal trauma, and aim at preserving the length of the tube so that reversal is more likely to be successful, should the patient′s circumstances change.

Subfertility in Women With Rheumatoid Arthritis and the Outcome of Fertility Assessments.

Science.gov (United States)

Brouwer, Jenny; Fleurbaaij, Rosalie; Hazes, Johanna M W; Dolhain, Radboud J E M; Laven, Joop S E

2017-08-01

Subfertility is frequently encountered among female rheumatoid arthritis (RA) patients and has been associated with disease activity and antirheumatic drugs. However, little is known about the results of the fertility assessments in these women. Our aim was to study the outcome of fertility assessments in subfertile women with RA. A cross-sectional study was performed in a nationwide cohort of female RA patients who were pregnant or trying to conceive between 2002 and 2010 (Pregnancy-Induced Amelioration of Rheumatoid Arthritis Study). Patients who had given consent for future contact (n = 260) received a questionnaire on reproductive history, fertility examinations, and fertility treatments. Medical files were obtained from attending gynecologists. A completed questionnaire was returned by 178 women (68%), of whom 96% had ended their efforts to conceive. Eighty-two subjects (46%) had at least 1 subfertile episode, and for 61 women a diagnosis for subfertility was available. Unexplained subfertility (48%) and anovulation (28%) were the most common gynecologic diagnoses, and both occurred more often in RA patients than reported in the general population. Women with unexplained subfertility more often used nonsteroidal antiinflammatory drugs (NSAIDs) during the periconceptional period. Seventeen percent of all pregnancies were conceived after fertility treatments. Fertility treatments had equal or higher pregnancy rates in RA compared to other subfertile populations. Unexplained subfertility is more often diagnosed in subfertile female RA patients than in the general population, and is related to periconceptional NSAID use. Despite the higher incidence of subfertility in women with RA, the outcome of fertility treatments in these women appears favorable. © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study.

Science.gov (United States)

Raj, Anita; Saggurti, Niranjan; Balaiah, Donta; Silverman, Jay G

2009-05-30

Child marriage is a substantial barrier to social and economic development in India, and a primary concern for women's health. We assessed the prevalence of child marriage-ie, before 18 years of age-in young adult women in India, and the associations between child marriage and women's fertility and fertility-control outcomes. Data from the National Family Health Survey-3 (2005-06) were limited to a sample of Indian women aged 20-24 years (n=22 807), of whom 14 813 had been or were presently married (ever-married). Prevalence of child marriage was estimated for the whole sample. We used regression models adjusted for demographics, and models adjusted for demographics and duration of marriage to estimate odds ratios (ORs) for the associations between child marriage and both fertility and fertility-control outcomes, in the ever-married subsample. 44.5% of women aged 20-24 years were married before age 18 years, 22.6% were married before age 16 years, and 2.6% were married before age 13 years. Child marriage was significantly associated with no contraceptive use before first childbirth (adjusted OR 1.37 [95% CI 1.22-1.54]), high fertility (three or more births) (7.40 [6.45-8.50]), a repeat childbirth in less than 24 months (3.00 [2.74-3.29]), multiple unwanted pregnancies (2.36 [1.90-2.94]), pregnancy termination (1.48 [1.34-1.63]), and female sterilisation (6.68 [5.78-7.60]). The association between child marriage and high fertility, a repeat childbirth in less than 24 months, multiple unwanted pregnancies, pregnancy termination, and sterilisation all remained significant after controlling for duration of marriage. Increased enforcement of existing policies is crucial for prevention of child marriage. Improved family-planning education, access, and support are urgently needed for women married as children, their husbands, and their families to reduce the high fertility and poor fertility-control outcomes of this practice. US National Institutes of Health and Indian

Fertility considerations in young women with hematological malignancies

DEFF Research Database (Denmark)

Jadoul, Pascale; Kim, S Samuel; Andersen, Claus Yding

2012-01-01

The need for practice guidelines for fertility preservation in young women with hematological malignancies has been increased. To develop recommendations, publications relevant to fertility preservation and hematological cancers were identified through a PubMed database search and reviewed...

Random-start IVF treatment: An emergent fertility preservation technique between cytotoxic treatment courses and stem-cell transplantation in acute myelocytic leukemia

Directory of Open Access Journals (Sweden)

Ghada Hussein

2015-12-01

Conclusions: Although it is still experimental, emergency IVF treatment considered as a novel approach for fertility preservation in cancer patients not only before the start of chemotherapy but even between the treatment courses if the patient’s physical and psychological conditions are stable and acceptable.

Myomectomy to conserve fertility: seven-year follow-up.

Science.gov (United States)

Sangha, Roopina; Strickler, Ronald; Dahlman, Marisa; Havstad, Suzanne; Wegienka, Ganesa

2015-01-01

To observe the occurrence of pregnancy in women undergoing minimally invasive and open myomectomy for symptoms attributed to uterine fibroids and who desire future pregnancy. We performed a retrospective chart review of women who had undergone myomectomy at least two years previously within the Henry Ford Health System in Detroit, MI. We reviewed the subsequent fertility outcomes according to the fertility goals identified by each woman. During the seven-year observation window, 310 women underwent myomectomy and 124 (40%) of these women desired pregnancy. Forty-nine women desiring pregnancy (40%) conceived, and 30 (61% of those who conceived) delivered a viable infant from their first pregnancy. In addition, two women had a live birth after a miscarriage, and one had a live birth after an ectopic pregnancy. Five women had a second live-born baby. There were no differences in the occurrence of pregnancy or pregnancy outcome according to surgical approach, patient age or race, number of uterine incisions, or whether the endometrial cavity was entered. In addition, five of 186 women who did not have a fertility goal (3%) conceived, and one woman delivered two babies. Myomectomy performed to preserve fertility resulted in approximately one in four women having a live birth, independent of surgical technique.

Fertility concerns and preservation in younger women with breast cancer.

Science.gov (United States)

Anchan, Raymond Manohar; Ginsburg, Elizabeth Sarah

2010-06-01

Nearly 30% of breast cancer cases present in women younger than 50 years old. While newer treatment regimens employed are less gonadotoxic, regimens still consist of combination medications that include cyclophosphamide, known to deplete the number of primordial follicles, thereby potentially leading to infertility. For common regimens such as adriamycin/cytoxan (AC), the risk of premature ovarian failure was thought to be largely dependent on patient age, with the risk of complete ovarian failure women women >40 (Hortobagyi et al. (1986) [1]); however recent studies indicate that AC is considered to have intermediate risk for gonadotoxicity in women >40 years age. This review examines major strides in the field of reproductive medicine over the past 20 years including the use of leuprolide acetate, embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking. We also discuss the role of gestational carriers and adoption in establishing families as a viable option for many of these cancer patients who may be unable to avail themselves of other alternatives to fertility preservation. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Fertility preservation in the male pediatric population: factors influencing the decision of parents and children.

Science.gov (United States)

Wyns, C; Collienne, C; Shenfield, F; Robert, A; Laurent, P; Roegiers, L; Brichard, B

2015-09-01

How can the decision process for fertility preservation (FP) in adolescents and prepubertal boys be improved based on patient and parent feelings about FP counseling? The content of information given to patients and parents and hope for future parenthood appeared to positively impact on the decision to preserve fertility in the pediatric population and, therefore, deserves special attention to improve FP care. A vast body of literature on adult cancer patients shows that reproductive capacity is a major quality-of-life issue. Patients also have a strong desire to be informed of available FP options with a view to future parenthood of their own genetic child, considering that parents were able to make an informed and voluntary decision for their prepubertal sons despite the heavy emotional burden at the time of diagnosis, there is so far very limited information on patient expectations regarding FP. A lack of awareness often equates to suboptimal care by oncologists and FP specialists, and poor access to FP, therefore improving knowledge and identifying the expectations of pediatric patients and their parents are crucial for optimizing multidisciplinary collaborative care pathways (MCCPs), including counseling and access to FP methods, in the youngest population. A questionnaire survey was posted to an eligible population between May 2005 and May 2013. A total of 348 prepubertal boys and adolescents aged 0-18 years, diagnosed with cancer in a university hospital setting, were eligible. Three different questionnaires for two age groups of children (parents were established based on information from focus groups. Questions were subsequently reviewed by the institutional ethics board before being sent. Of the 348 eligible patients, 44 died and 14 were lost to follow-up. Thus, 290 patients (77 aged 12-18 years and 213 aged questionnaire. In total, 120 questionnaires were recovered, 45.5% (n = 35/77) from adolescents and 39.9% (n = 85/213) from children. FP acceptance

Hybrid Food Preservation Program Improves Food Preservation and Food Safety Knowledge

Science.gov (United States)

Francis, Sarah L.

2014-01-01

The growing trend in home food preservation raises concerns about whether the resulting food products will be safe to eat. The increased public demand for food preservation information led to the development of the comprehensive food preservation program, Preserve the Taste of Summer (PTTS). PTTS is a comprehensive hybrid food preservation program…

Fertility outcomes in asthma

DEFF Research Database (Denmark)

Gade, Elisabeth Juul; Thomsen, Simon Francis; Lindenberg, Svend

2016-01-01

Evidence is increasing of an association between asthma and aspects of female reproduction. However, current knowledge is limited and furthermore relies on questionnaire studies or small populations. In a prospective observational cohort study to investigate whether time to pregnancy, the number...... of fertility treatments, and the number of successful pregnancies differ significantly between women with unexplained infertility with and without asthma.245 women with unexplained infertility (aged 23-45 years) underwent questionnaires and asthma and allergy testing while undergoing fertility treatment. 96...... women entering the study had either a former doctor's diagnosis of asthma or were diagnosed with asthma when included. After inclusion they were followed for a minimum of 12 months in fertility treatment, until they had a successful pregnancy, stopped treatment, or the observation ended.The likelihood...

[Mechanism of nutrient preservation and supply by soil and its regulation. IV. Fertility regulation and improvement of brown earth type vegetable garden soil and their essence].

Science.gov (United States)

Chen, L; Zhou, L

2000-08-01

Pot experiment studies on the fertility regulation and improvement of fertile and infertile brown earth type vegetable garden soils and their functionary essence show that under conditions of taking different soil fertility improvement measures, the nutrient contents in fertile and infertile soils were not always higher than the controls, but the aggregation densities of soil microaggregates were increased, and the proportion of different microaggregates was more rational. There was no significant relationship between soil productivity and soil microaggregates proportion. It is proved that the essence of soil fertility improvement consists in the ultimate change of the preservation and supply capacities of soil nutrients, and the proportion of soil microaggregates could be an integrative index to evaluate the level of soil fertility and the efficiency of soil improvement.

Improving Access to Standardized Fertility Preservation Information for Older Adolescents and Young Adults with Cancer: Using a User-Centered Approach with Young Adult Patients, Survivors, and Partners to Refine Fertility Knowledge Transfer.

Science.gov (United States)

Tam, Seline; Puri, Natasha; Stephens, Derek; Mitchell, Laura; Giuliani, Meredith; Papadakos, Janet; Gupta, Abha A

2016-09-27

Adolescent and young adult (AYA) cancer patients under 40 should be made aware of their fertility risks and preservation options throughout their care. However, discussions on fertility preservation (FP) do not routinely occur. With a dearth of FP resources, oncology providers may lack knowledge around FP. Thus, informational needs can be unmet, leading to anxiety and distress in patients. Provision of pertinent and timely information can help patients cope better with their diagnosis. FP pamphlets were developed for men and women with cancer. A cross-sectional in-house survey, using convenience sampling, evaluated the pamphlets' effectiveness and measured ease of understanding, acceptability, and perceived utility. Patients and partners were also asked to provide recommendations and complete the Short Test of Functional Health Literacy in Adults (S-TOFHLA) measuring health literacy level. This helps determine if health literacy influences perception of pamphlet effectiveness. All participants (n = 56) reviewed both pamphlets. Fifty-four participants (96 %) found the pamphlet for men useful, while 29 participants (52 %) improved their male fertility knowledge. The pamphlet for women was useful for 52 participants (93 %) and improved knowledge in 35 (63 %) of them. Although the majority of participants had adequate health literacy (98 %), there was insufficient sample diversity to determine if health literacy influenced the pamphlet's effectiveness. Participants indicated preference in receiving verbal (73 %) and written (66 %) information over watching videos or in-class education. They recommended including fertility clinics, financial resources, and statistics in the brochures. These FP pamphlets were concluded as effective in supporting patients in making FP decisions.

Psychological distress and in vitro fertilization outcome.

Science.gov (United States)

Pasch, Lauri A; Gregorich, Steven E; Katz, Patricia K; Millstein, Susan G; Nachtigall, Robert D; Bleil, Maria E; Adler, Nancy E

2012-08-01

To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Prospective cohort study over an 18-month period. Five community and academic fertility practices. Two hundred two women who initiated their first IVF cycle. Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up. IVF cycle outcome and psychological distress. In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma.

Science.gov (United States)

Hu, Jun; Zhu, Li-rong; Liang, Zhi-qing; Meng, Yuan-guang; Guo, Hong-yan; Qu, Peng-peng; Ma, Cai-ling; Xu, Cong-jian; Yuan, Bi-bo

2011-10-01

To assess the clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma (EOC). A retrospective study of young EOC inpatients (≤40 years old) was performed during January 1994 and December 2010 in eight institutions. Data were analyzed from 94 patients treated with fertility-sparing surgery with a median follow-up time of 58.7 months. As histologic grade increased, overall survival (OS) and disease-free survival (DFS) of patients receiving fertility-sparing surgery declined. Neither staging surgery nor laparoscopy of early stage EOC with conservative surgery had a significant effect on OS or DFS. Normal menstruation recommenced after chemotherapy in 89% of the fertility-sparing group. Seventeen pregnancies among twelve patients were achieved by the end of the follow-ups. Fertility-sparing treatment for patients with EOC Stage I Grade 1 could be cautiously considered for young patients. The surgical procedure and surgical route might not significantly influence the prognosis. Standard chemotherapy is not likely to have an evident impact on ovarian function or fertility in young patients.

Preservation of food products by irradiation

International Nuclear Information System (INIS)

McGivney, W.T.

1988-01-01

The use of irradiation to preserve food has the potential to significantly enhance our capacity to maximize the quality and quantity of the food we consume. In a world in which distribution of food occurs across continents and in which malnourished populations are in dire need of basic food products, any safe, effective, and efficient means of preserving food is more than welcome. Irradiation, as a method for food preservation, has been studied for more than 30 years. This discussion focuses on this most recent method for the preservation of food with particular emphasis on its effects on the safety, nutritive, and aesthetic values of the food preserved by irradiation. The use of ionizing radiation as a method to preserve foods is one that has been demonstrated to be effective for a variety of food classes. Irradiation offers a means to decontaminate, disinfest, and retard the spoilage of the food supply. At the same time, it appears that the wholesomeness of these food products is maintained. Nutritive value can be sustained by use of effective doses of radiation. Concerns over the safety of irradiated food are rooted in questions regarding the potential induction of radioactivity, harmful radiolytic products, and pathogenic radiation-resistant or mutant strains of microorganisms. Research findings have allayed concerns over safety. However, more research is necessary to conclusively resolve these safety issues. Food irradiation is a promising technology that has and will contribute to our ability to feed the people of this world. This technology is but one of many available ways to preserve our greatest natural resource, the food supply. Enhancement of the ability to preserve food by irradiation will facilitate the distribution of food from fertile developed regions to the malnourished peoples of underdeveloped countries. 21 references

Lippia origanoides essential oil: an efficient and safe alternative to preserve food, cosmetic and pharmaceutical products.

Science.gov (United States)

Hernandes, C; Pina, E S; Taleb-Contini, S H; Bertoni, B W; Cestari, I M; Espanha, L G; Varanda, E A; Camilo, K F B; Martinez, E Z; França, S C; Pereira, A M S

2017-04-01

The aim of this work was to evaluate the efficacy and safety of Lippia origanoides essential oil as a preservative in industrial products. The composition, antimicrobial activity, mutagenic and toxic potential of L. origanoides were determined. Then, the effect of essential oil as a preservative in food, cosmetics and pharmaceutical products was evaluated. The essential oil of L. origanoides consisted mainly of oxygenated monoterpenes (38·13%); 26·28% corresponded to the compound carvacrol. At concentrations ranging from 0·312 to 1·25 μl ml -1 and in association with polysorbate 80, the essential oil of L. origanoides inhibited the growth of all the tested micro-organisms. The medium lethal dose in mice was 3·5 g kg -1 , which categorizes it as nontoxic according to the European Union criteria, and negative results in the Ames test indicated that this oil was not mutagenic. In combination with polysorbate 80, the essential oil exerted preservative action on orange juice, cosmetic and pharmaceutical compositions, especially in the case of aqueous-based products. Lippia origanoides essential oil is an effective and safe preservative for orange juice, pharmaceutical and cosmetic products. This study allowed for the complete understanding of the antimicrobial action and toxicological potential of L. origanoides essential oil. These results facilitate the development of a preservative system based on L. origanoides essential oil. © 2017 The Society for Applied Microbiology.

Fertility in Women of Reproductive Age After Breast Cancer Treatment: Practice Patterns and Outcomes.

Science.gov (United States)

McCray, Devina K S; Simpson, Ashley B; Flyckt, Rebecca; Liu, Yitian; O'Rourke, Colin; Crowe, Joseph P; Grobmyer, Stephen R; Moore, Halle C; Valente, Stephanie A

2016-10-01

Breast cancer is the most frequently occurring cancer in women of reproductive age, and systemic treatments may adversely affect childbearing plans. Use of assisted reproductive technologies and therapies for ovarian protection improve fertility prospects. We evaluated whether patients had a documented fertility discussion (FD) with their oncology physician prior to therapy, what options were chosen, and if pregnancy was achieved. A retrospective chart review from 2006 to 2014 was performed to evaluate women aged 40 years and younger who were diagnosed with breast cancer and treated with chemotherapy and/or antihormonal therapy. Patient demographics, treatment regimens, presence or absence of FD, in vitro fertilization (IVF) consultation, gonadotropin-releasing hormone (GnRH) agonist use, and subsequent successful pregnancy were analyzed. Among 303 patients meeting the inclusion criteria, 80 (26 %) had an FD with their physician documented; 71 of these 80 women (89 %) sought further fertility consultation and options. Sixteen (20 %) women were prescribed a GnRH agonist only for ovarian protection during chemotherapy, 50 (63 %) underwent IVF consultation only, and 5 (6 %) had both a GnRH agonist prescribed and an IVF consultation. The overall pregnancy rate was 7 % at a mean of 3 years post breast cancer treatment. Pregnancy after treatment was more common among those pursuing IVF consultation or prescribed a GnRH agonist. In treating young breast cancer patients, it is important to assess fertility desire, discuss treatment risks relating to fertility, and discuss preservation options. Although not every woman in this group desired pregnancy, 71/80 (89 %) women having a documented FD sought further fertility consultation and options.

Male and female experiences of having fertility matters raised alongside a cancer diagnosis during the teenage and young adult years.

Science.gov (United States)

Crawshaw, M A; Glaser, A W; Hale, J P; Sloper, P

2009-07-01

Discussion and management of potential reproductive health sequelae of adolescent cancer are essential and challenging components of care for the multidisciplinary team. Despite this, research has been limited to specific experiences (e.g. sperm banking) or fertility-related concerns of adult survivors. This grounded theory study of 38 male and female survivors of adolescent cancer aged 16-30 years drew on in-depth single interviews to map the range of experiences of being advised that treatment might affect fertility. Strong support for being told at around diagnosis was found regardless of gender, age, incapacity or availability of fertility preservation services. Age and life stage appeared less significant for impact than the perceived level of threat to personal and social well-being. Women were more likely to achieve lower levels of comprehension about the physiological impact, to report later distress from lack of fertility preservation services and to revisit more frequently those decisions made by the few offered fertility preservation. Men found decision making about sperm banking straightforward on the whole and reported satisfaction with having the choice regardless of outcome. Findings suggest that young people can cope with this information alongside diagnosis especially when professional and parental support is proportionate to the particular impact on them.

Factors associated with the receipt of fertility preservation services along the decision-making pathway in young Canadian female cancer patients.

Science.gov (United States)

Yee, Samantha

2016-02-01

This study investigated the factors associated with the receipt of fertility preservation (FP) services along the decision-making pathway in young Canadian female cancer patients. The roles of the oncologists were examined. A total of 188 women who were diagnosed with cancer between the ages of 18-39 after the year 2000 and had finished active cancer treatment by the time of the survey (2012-2013) participated in the study. Logistic regression models and Pearson χ (2) tests were used for analyses. The mean ages of participants at diagnosis and at survey time were 30.2 (SD = 3.7) and 33.9 (SD = 5.9). One quarter (n = 45, 23.9 %) did not recall having a fertility discussion with their oncologists. Of the three quarters who had a fertility discussion (n = 143, 76.1 %), discussions were equally initiated by oncologists (n = 71) and patients (n = 72). Of the 49 women (26 %) who consulted a fertility specialist, 17 (9 %) underwent a FP procedure. Fertility concern at diagnosis was the driving force of the receipt of FP services at all decision points. Our findings suggest that not only was the proactive approach of oncologists in initiating a fertility discussion important, the quality of the discussion was equally critical in the decision-making pathway. Oncologists play a pivotal role in the provision of fertility services in that they are not only gate keepers, knowledge brokers, and referral initiators of FP consultation, but also they are catalysts in supporting cancer patients making important FP decision in conjunction with the consultation provided by a fertility specialist.

Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

Science.gov (United States)

Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

2016-08-01

Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review.

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Sukharamwala, Prashant B; Patel, Krishen D; Teta, Anthony F; Parikh, Shailraj; Ross, Sharona B; Ryan, Carrie E; Rosemurgy, Alexander S

2015-09-01

Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief (P = 0.24), endocrine insufficiency (P = 0.15), and perioperative morbidity (P = 0.13) between DPPHR and PPPD. However, quality of life (P insufficiency (P = 0.005), and LOS (P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis.

Proceedings of the Working Group Session on Fertility Preservation for Individuals with Gender and Sex Diversity.

Science.gov (United States)

Finlayson, Courtney; Johnson, Emilie K; Chen, Diane; Dabrowski, Elizabeth; Gosiengfiao, Yasmin; Campo-Engelstein, Lisa; Rosoklija, Ilina; Jacobson, Jill; Shnorhavorian, Margarett; Pavone, Mary Ellen; Moravek, Molly B; Bonifacio, Herbert J; Simons, Lisa; Hudson, Janella; Fechner, Patricia Y; Gomez-Lobo, Veronica; Kadakia, Rachel; Shurba, Angela; Rowell, Erin; Woodruff, Teresa K

2016-01-01

Children and adolescents with gender and sex diversity include (1) gender-nonconforming and transgender individuals for whom gender identity or expression are incongruent with birth-assigned sex (heretofore, transgender) and (2) individuals who have differences in sex development (DSD). Although these are largely disparate groups, there is overlap in the medical expertise necessary to care for individuals with both gender and sex diversity. In addition, both groups face potential infertility or sterility as a result of desired medical and surgical therapies. The Ann & Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) gender and sex development program (GSDP) provides specialized multidisciplinary care for both transgender and DSD patients. In response to patient concerns that recommended medical treatments have the potential to affect fertility, the Lurie Children's GSDP team partnered with experts from the Oncofertility Consortium at Northwestern University to expand fertility preservation options to gender and sex diverse youth. This article summarizes the results of a meeting of experts across this field at the annual Oncofertility Consortium conference with thoughts on next steps toward a unified protocol for this patient group.

Fertility outcome and information on fertility issues in individuals with different forms of disorders of sex development: findings from the dsd-LIFE study.

Science.gov (United States)

Słowikowska-Hilczer, Jolanta; Hirschberg, Angelica Lindén; Claahsen-van der Grinten, Hedi; Reisch, Nicole; Bouvattier, Claire; Thyen, Ute; Cohen Kettenis, Peggy; Roehle, Robert; Köhler, Birgit; Nordenström, Anna

2017-11-01

To investigate fertility outcome in individuals with different forms of disorders of sex development (DSD), if assisted reproductive technology (ART) was used, and the patients' satisfaction with the information they had received. A cross-sectional multicenter study, dsd-LIFE. Not applicable. A total of 1,040 patients aged ≥16 years with different DSD diagnoses participated. A web-based questionnaire was filled out by all participants. The participants could chose to take part in somatic investigations including ultrasonography. Information on partner, number of children, ART, adoption and step-children, general health, presence of gonads and uterus, current education and economic situation, received information on fertility issues, and satisfaction with the information, was collected. In the total cohort, mean age 32 years, 33% lived with a partner, but only 14% reported having at least one child including 7% with ART, 4% adopted. Only 3.5% of the total cohort had been able to reproduce without ART, most frequently women with congenital adrenal hyperplasia, and only 0.7% of participants with other diagnoses. Of the participants, 72% had received information on fertility, but 17% were not satisfied with the information. Fertility outcome is significantly reduced in all types of DSD; however, fertility potential should be assessed individually. The satisfaction with how fertility problems have been discussed can be improved. The care of patients with DSD is complex, should be individualized, and new treatment possibilities incorporated. A close collaboration in multidisciplinary teams is therefore essential to improve the situation for individuals with DSD. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

In vitro fertilization outcome in women with endometriosis & previous ovarian surgery

Directory of Open Access Journals (Sweden)

Sonja Pop-Trajkovic

2014-01-01

Full Text Available Background & objectives: Women with endometriosis often need in vitro fertilization (IVF to concieve. There are conflicting data on the results of IVF in patients with endometriosis. This study was undertaken to elucidate the influence of endometriosis on IVF outcome to give the best counselling for infertile patient with this problem. Methods: The outcome measures in 78 patients with surgically confirmed endometriosis were compared with 157 patients with tubal factor infertility, all of whom have undergone IVF. The groups were matched for age and follicle stimulating hormone (FSH levels. Outcome measures included number of follicles, number of ocytes, peak oestradiol (E2 concentrations and mean number of ampoules of gonadotropins. Cumulative pregnancy, miscarriage and live birth rates were calculated in both the groups. Results: Higher cancelation rates, higher total gonadotropin requirements, lower peak E2 levels and lower oocyte yield were found in women with endometriosis and previous surgery compared with those with tubal factor infertility. However, no differences were found in fertilization, implantation, pregnancy, miscarriage, multiple births and delivery rates between the endometriosis and tubal factor infertility groups. Interpretation & conclusions: The present findings showed that women with endometriosis and previous surgery responded less well to gonadotropins during ovarian stimulation and hence the cost of treatment to achieve pregnancy was higher in this group compared with those with tubal factor infertility. However, the outcome of IVF treatment in patients with endometriosis was as good as in women with tubal factor infertility.

Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation.

Science.gov (United States)

Hunter, Jacob B; Gifford, René H; Wanna, George B; Labadie, Robert F; Bennett, Marc L; Haynes, David S; Rivas, Alejandro

2016-03-01

To evaluate hearing preservation (HP) outcomes in adult cochlear implant recipients with a mid-scala electrode. Tertiary academic center. Adult patients implanted with a mid-scala electrode between May 2013 and July 2015. Cochlear implantation. Age, sex, surgical approach, residual hearing changes post cochlear implantation, HP rates using different published classifications, and speech perception scores. Fifty ears for 47 patients (mean age, 58.2 yr; range, 23-86) were implanted with the electrode. Recognizing that not all patients were true HP candidates and/or underwent generally accepted HP surgical techniques, 39 ears had preoperative low-frequency hearing (audiometric threshold ≤ 85dB HL at 250Hz), 24 preserved acoustic hearing postoperatively (75.0%). Patients who had preserved acoustic hearing were implanted via round window (N = 18), extended round window (N = 4), or via cochleostomy (N = 2) approaches. Mean threshold elevation for low-frequency pure-tone average (125, 250, and 500  Hz) was 20.2  dB after surgery. 43.8% of patients had aidable low-frequency hearing at activation, 30.0% at 6-months postoperatively, and 30.8% 1-year postopera tively. Using a formula outlined by Skarzynski and colleagues, at 6-months postoperatively, 15.0% of patients had complete HP, whereas 40.0% had partial HP. At 1-year, these percentages decreased to 0% and 38.5%, respectively. Age, type of approach, and perioperative steroid use were not correlated with HP outcomes at activation and 6-months postoperatively (p > 0.05). The mid-scala electrode evaluated allows preservation of low-frequency hearing in patients undergoing cochlear implantation at rates and degrees of preservation close to other reports in the cochlear implant literature.

Stimulation of the ovaries in women with breast cancer undergoing fertility preservation : Alternative versus standard stimulation protocols; the study protocol of the STIM-trial

NARCIS (Netherlands)

Dahhan, T.; Balkenende, E.M.; Beerendonk, C. C.M.; Fleischer, K.; Stoop, D.; Bos, A. M.E.; Lambalk, Cornelis B.; Schats, R; van Golde, Ron J T; Schipper, I.; Louwé, L. A.; Cantineau, A. E.P.; Smeenk, Jesper M J; Bruin, Jacob P; Reddy, D N; Kopeika, Y.; van der Veen, F; Wely, M.; Linn, S. C.; Goddijn, M.

2017-01-01

Background Chemotherapy for breast cancer may have a negative impact on reproductive function due to gonadotoxicity. Fertility preservation via banking of oocytes or embryos after ovarian stimulation with FSH can increase the likelihood of a future live birth. It has been hypothesized that elevated

Stimulation of the ovaries in women with breast cancer undergoing fertility preservation: Alternative versus standard stimulation protocols; the study protocol of the STIM-trial

NARCIS (Netherlands)

Dahhan, T.; Balkenende, E. M. E.; Beerendonk, C. C. M.; Fleischer, K.; Stoop, D.; Bos, A. M. E.; Lambalk, C. B.; Schats, R.; van Golde, R. J. T.; Schipper, J.; Louwe, L. A.; Cantineau, A. E. P.; Smeenk, J. M. J.; de Bruin, J. P.; Reddy, N.; Kopeika, Y.; van der Veen, F.; van Wely, M.; Linn, S. C.; Goddijn, M.

2017-01-01

Background Chemotherapy for breast cancer may have a negative impact on reproductive function due to gonadotoxicity. Fertility preservation via banking of oocytes or embryos after ovarian stimulation with FSH can increase the likelihood of a future live birth. It has been hypothesized that elevated

Stimulation of the ovaries in women with breast cancer undergoing fertility preservation: Alternative versus standard stimulation protocols; the study protocol of the STIM-trial

NARCIS (Netherlands)

Dahhan, T.; Balkenende, E.M.E.; Beerendonk, C.C.M.; Fleischer, K.; Stoop, D.; Bos, A.M.; Lambalk, C.B.; Schats, R.; Golde, R.J. van; Schipper, I.; Louwe, L.A.; Cantineau, A.E.P.; Smeenk, J.M.; Bruin, J.P. de; Reddy, N.; Kopeika, Y.; Veen, F. van der; Wely, M. van; Linn, S.C.; Goddijn, M.

2017-01-01

BACKGROUND: Chemotherapy for breast cancer may have a negative impact on reproductive function due to gonadotoxicity. Fertility preservation via banking of oocytes or embryos after ovarian stimulation with FSH can increase the likelihood of a future live birth. It has been hypothesized that elevated

Stimulation of the ovaries in women with breast cancer undergoing fertility preservation : Alternative versus standard stimulation protocols; the study protocol of the STIM-trial

NARCIS (Netherlands)

Dahhan, T.; Balkenende, E. M. E.; Beerendonk, C. C. M.; Fleischer, K.; Stoop, D.; Bos, A. M. E.; Lambalk, C. B.; Schats, R.; van Golde, R. J. T.; Schipper, I.; Louwe, L. A.; Cantineau, A. E. P.; Smeenk, J. M. J.; de Bruin, J. P.; Reddy, N.; Kopeika, Y.; van der Veen, F.; van Wely, M.; Linn, S. C.; Goddijn, M.

2017-01-01

Background: Chemotherapy for breast cancer may have a negative impact on reproductive function due to gonadotoxicity. Fertility preservation via banking of oocytes or embryos after ovarian stimulation with FSH can increase the likelihood of a future live birth. It has been hypothesized that elevated

Fertility Preservation in Girls

Directory of Open Access Journals (Sweden)

Jennia Michaeli

2012-01-01

Full Text Available Children that undergo treatment for cancer are at risk of suffering from subfertility or hormonal dysfunction due to the detrimental effects of radiotherapy and chemotherapeutic agents on the gonads. Cryopreservation of ovarian tissue prior to treatment offers the possibility of restoring gonadal function after resumption of therapy. Effective counseling and management of pediatric patients is crucial for preserving their future reproductive potential. The purpose of this article is to review recent literature and to revise recommendations we made in a 2007 article. Pediatric hemato-oncology, reproductive endocrinology, surgery, anesthesia and bioethics perspectives are discussed and integrated to propose guidelines for offering ovarian cryopreservation to premenarcheal girls with cancer.

Cryopreservation of ovarian tissue for fertility preservation in a large cohort of young girls

DEFF Research Database (Denmark)

Jensen, A K; Rechnitzer, C; Macklon, K T

2017-01-01

STUDY QUESTION: Is there an association between the need for medical puberty induction and the diagnosis or treatment received in girls who have undergone cryopreservation of ovarian tissue for fertility preservation? SUMMARY ANSWER: There was a clear association between the intensity of treatment...... received and requirement for medical puberty induction but no association with the diagnosis. WHAT IS KNOWN ALREADY: Although it cannot be predicted which girls will become infertile or develop premature ovarian insufficiency (POI) following intensive chemotherapy or irradiation, patients who are at high...... the diagnosis and received treatment and the requirement for medical puberty induction was examined. PARTICIPANTS/MATERIALS, SETTING, METHODS: The need for medical puberty induction was assessed in 32 girls who were prepubertal at the time of OTC. MAIN RESULTS AND THE ROLE OF CHANCE: Indications for OTC were...

Fertility Preservation for Children Diagnosed with Cancer

Medline Plus

Full Text Available ... with cancer. You may be focused on cancer treatment and your child’s immediate health. You may feel ... can help start the conversation: Cancer and cancer treatment may affect my child’s fertility. Will my child’s ...

Mental health outcomes of mothers who conceived using fertility treatment.

Science.gov (United States)

Raguz, Nikolett; McDonald, Sheila W; Metcalfe, Amy; O'Quinn, Candace; Tough, Suzanne C

2014-02-28

To compare the proportion of women with self-reported depression and anxiety symptoms at four months postpartum between mothers of singletons who conceived spontaneously and mothers who conceived with the aid of fertility treatment. The sample used for this study was drawn from The "All Our Babies Study", a community-based prospective cohort of 1654 pregnant women who received prenatal care in Calgary, Alberta. This analysis included women utilizing fertility treatment and a randomly selected 1:2 comparison group. The data was collected via three questionnaires, two of which were mailed to the participants during pregnancy and one at four months postpartum. Symptoms of depression and anxiety at four months postpartum were measured using the Edinburg Postnatal Depression Scale and the Spielberger State Anxiety Inventory. Secondary outcomes of parenting morale and perceived stress were also evaluated. Descriptive statistics were used to characterize the population. Chi square tests and in cases of small cell sizes, Fisher Exact Tests were used to assess differences in postpartum mental health symptomatology between groups. Seventy-six participants (5.9%) conceived using a form of fertility treatment. At four months postpartum, no significant differences were observed in the proportions reporting excessive depression symptoms (2.6% vs. 5.3%, p = 0.50), anxiety (8.1% vs. 16.9%, p = 0.08) or high perceived stress scores (7.9% vs. 13.3%, p = 0.23). Women who conceived with fertility treatment were less likely to score low on parenting morale compared to women who conceived spontaneously and this was particularly evident in primiparous women (12.5% vs. 33.8%, p = 0.01). There were no group differences in proportions reporting low parenting morale in multiparous women. This study suggests that at four months postpartum, the proportion of women who experience elevated symptoms of depression, anxiety or perceived stress do not differ between mothers who

Stages of endometriosis: Does it affect in vitro fertilization outcome

Directory of Open Access Journals (Sweden)

Sonja Pop-Trajkovic

2014-06-01

Conclusion: The American Society for Reproductive Medicine classification of endometriosis is useful in predicting IVF outcome. Advanced endometriosis means a worse prognosis for IVF treatment compared to milder stages or tubal factor infertility. The decreased fertilization rate in Stage I/II endometriosis might be a cause of subfertility in these women, as a result of a hostile environment caused by the disease.

Fertility Preservation for Children Diagnosed with Cancer

Medline Plus

Full Text Available ... diagnosed with cancer. You may be focused on cancer treatment and your child’s immediate health. You may feel ... points can help start the conversation: Cancer and cancer treatment may affect my child’s fertility. Will my child’s ...

The Influence of Methotrexate Treatment on Male Fertility and Pregnancy Outcome After Paternal Exposure.

Science.gov (United States)

Grosen, Anne; Kelsen, Jens; Hvas, Christian Lodberg; Bellaguarda, Emanuelle; Hanauer, Stephen B

2017-04-01

Inflammatory bowel disease incidence peaks during the reproductive years. Methotrexate (MTX) is frequently used for inflammatory bowel disease, but its use during pregnancy is contraindicated in women because of teratogenic effects. The aim of this review is to investigate the influence of MTX on male fertility and pregnancy outcomes after paternal MTX exposure. A systematic literature search was performed by applying 2 focus areas, "methotrexate" and "male fertility or pregnancy outcome." Terms and keywords were used both as MeSH terms and free-text searches. Pertinent articles were searched for additional relevant references. In animal studies, MTX induces aberrations in sperm DNA that have not been identified in humans. The effects of MTX on human sperm quality have only been described in case reports. A transient adverse effect on sperm quality with low-dose MTX has been reported, but several other cases have not found harmful effects of MTX. MTX has not been measured in human sperm ejaculates; yet, the risk of a direct toxic effect on the fetus through MTX-contaminated seminal plasma seems negligible. Until now, 284 pregnancies with paternal MTX exposure have been reported. The outcomes were 248 live births and a total of 13 malformations, with no overt indication of MTX embryopathy. This review reveals the lack of studies on the safety of MTX with regard to male reproduction. It is not clear whether MTX transiently influences male fertility and sperm DNA integrity, and more studies are needed. Comparative cohort studies found no increased risk of adverse pregnancy outcomes.

A National Evaluation of Safe Schools/Healthy Students: Outcomes and Influences

Science.gov (United States)

Derzon, James H.; Yu, Ping; Ellis, Bruce; Xiong, Sharon; Arroyo, Carmen; Mannix, Danyelle; Wells, Michael E.; Hill, Gary; Rollison, Julia

2012-01-01

The Safe Schools/Healthy Students (SS/HS) Initiative has awarded over $2 billion in grants to more than 350 school districts in partnership with local mental health, law enforcement, and juvenile justice agencies. To estimate the impact of grantee characteristics, grant operations, and near-term outcomes in reducing violence and substance use,…

Uterine artery embolization angiography and fertility related aspects

Directory of Open Access Journals (Sweden)

Irina A. Horhoianu

2016-05-01

Full Text Available Purpose. Uterine artery embolization is a minimally invasive technique. It applies the principle of targeted anatomical structure devascularisation with utility in fibroid conservative therapy, including for future fertility preserving status. The objective of our paper represents a description and evaluation of angiography utility as a predictive method for fertility maintenance. Material and Methods. The angiography and ultrasound aspects obtained from a prospective study in which selected patients have undergone uterine artery embolization for fertility preservation are detailed. Results. The following angiography aspects have been detected: left- right shunt and utero-ovarian collaterals; these have been compared with the ultrasound aspects related to the fibroid evolution form a volumetric and Doppler ultrasound point of view. The angiographical description predicts the impact on post embolization fibroid evolution and upon fertility. An analysis is made in order to assess the way in which angiography can contribute to fertility alteration. Conclusions. The angiography aspects during embolization and the following ultrasound aspects can represent predictive factors as to fertility evolution after uterine artery embolization.

Development of Domestic Cat Embryo Produced by Preserved Sperms

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KARTINI ERIANI

2008-12-01

Full Text Available The ability to mature and fertilize oocytes of endangered species may allow us to sustain genetic and global biodiversity. Epididymis sperms may be the last chance to ensure preservation of genetic materials after injury or death of a valuable animal. Studies have been conducted to determine wether both epididymis sperms and oocytes can be used to produce viable embryos and offspring. The purpose of this study was to determine how long cats sperms contained in epididymis were remain motile and had intact membranes when preserved at 4 ° C, and to determine whether such those preserved sperms are able to fertilize oocytes. Epididymis was preserved immediately in phosphate buffer saline at 4 ° C for 1, 3, and 6 days. The observation of sperm quality and viability after preservation was performed by vital staining acrosom and Hoechst-Propidium Iodine. Biological functions of sperms were evaluated by in vitro culture technique for fertilization, micro fertilization and embryonic development rate in CR1aa medium. The results showed that average motility of sperms collected from ductus deferens, cauda and corpus epididymis decreased not significantly (P > 0.05 from 0, 1, 3, and 6 days of preservation times (from 83.0%, 80.2%, 79.0%; 80.9%, 75.0%, 75.5%; 52.0%, 63.2%, 55.0% to 34.6%, 34.6%, 33.3%, respectively. The general results showed that sperms from epididymis preserved for 1, 3, and 6 days can be used for IVF. The rate of embryonal cleavage produced by IVF technique using sperms collected from epididymis preserved for 1-, 3- and 6-days were 33.3, 26.7, and 20.0%, respectively and significantly different (p < 0.05 from that of controll (50.0%. In conclusion, sperms contained in epididyimis preserved at 4 ° C in PBS (Phospate Buffer Saline for 1-6 days can be used to IVF and in vitro production of cat embryos.

[Successful pregnancies outcomes with the use of in vitro fertilization after Essure® unilateral hydrossalpinx occlusion].

Science.gov (United States)

Guedes-Martins, Luís; Mesquita-Guimarães, Joana; Barreiro, Márcia

2014-01-01

Since two decades we witnessed the publication of several studies devoted to the study of the influence of the presence of hydrosalpinx on the results of embryo transfer techniques. The aim of this study is to present the results of treatment and pregnancy outcomes in women with a history of infertility associated with unilateral hydrosalpinx, visible on vaginal ultrasound, which were subjected to unilateral occlusion with Essure® and subsequent treatment with in vitro fertilization. We performed a prospective analysis of a sample of 6 women, with a history of infertility and unilateral hydrosalpinx, between April 2010 to May 2013. In all cases we proceeded to unilateral hysteroscopic placement of the Essure® microinsert, prior to performing a cycle for in vitro fertilization. Of the 6 patients undergoing in vitro fertilization, 4 became pregnant (66.7%). Of these, two were uneventful pregnancies until delivery and 2 are still under surveillance, without complications. Of the patients who did not become pregnant after in vitro fertilization (n = 2, 33.3%), 1 conceived spontaneously during the subsequent monitoring. The advancement of hysteroscopy in the treatment of hydrosalpinx using the Essure® microinsert placement is a valid alternative to the laparoscopic approach. This study suggests the effectiveness of unilateral tubal occlusion caused by Essure® microinsert in improving outcomes of in vitro fertilization treatment in cases of infertility associated with unilateral hydrosalpinx, visible in the vaginal ultrasound.

Economic consequences of overweight and obesity in infertility : a framework for evaluating the costs and outcomes of fertility care

NARCIS (Netherlands)

Koning, A. M. H.; Kuchenbecker, W. K. H.; Groen, H.; Hoek, A.; Land, J. A.; Khan, K. S.; Mol, B. W. J.

2010-01-01

Overweight and obesity are an epidemic in Western society, and have a strong impact on fertility. We studied the consequences of overweight and obesity with respect to fecundity, costs of fertility treatment and pregnancy outcome in subfertile women. We searched the literature for systematic reviews

Economic consequences of overweight and obesity in infertility: a framework for evaluating the costs and outcomes of fertility care

NARCIS (Netherlands)

Koning, A. M. H.; Kuchenbecker, W. K. H.; Groen, H.; Hoek, A.; Land, J. A.; Khan, K. S.; Mol, B. W. J.

2010-01-01

Overweight and obesity are an epidemic in Western society, and have a strong impact on fertility. We studied the consequences of overweight and obesity with respect to fecundity, costs of fertility treatment and pregnancy outcome in subfertile women. We searched the literature for systematic reviews

Thermoradiation treatment of sewage sludge to eliminate pathogens for safe use as fertilizer and animal feed supplement

International Nuclear Information System (INIS)

Sivinski, H.D.; Whitfield, W.J.

1975-01-01

This paper describes a research program titled ''Waste Resources Utilization'' using a new technique called thermoradiation to destroy pathogenic organisms in sewage sludge. The thermoradiated sewage sludge will be used to study the feasibility of use for safe land application as fertilizer and soil conditioner and use as a feed supplement for ruminant animals. Experiments to date have shown good results for sludge disinfection of resistant bacteria, viruses, and parasites. Thermoradiation experiments are being carried out at a temperature of 65 0 C combined with 160 krad gamma dose for a total of 2000 pounds of dried treated sludge. The sludge will be shipped to New Mexico State University for the feeding studies and land application studies. (auth)

Effect of pigtail catheter application on obstetric outcomes in in vitro fertilization/intracytoplasmic sperm injection pregnancies following hyperstimulation syndrome.

Science.gov (United States)

Çağlar Aytaç, Pınar; Kalaycı, Hakan; Yetkinel, Selçuk; Alkaş, Didem; Yüksel Şimşek, Seda; Haydardedeoğlu, Bülent; Bulgan Kılıçdağ, Esra

2017-06-01

To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS). This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment. The obstetric reports of 173 patients could be accessed and were examined to investigate the pregnancy outcomes of those with and without catheters. No complications such as infection or vascular or intra-abdominal organ trauma were observed related to the pigtail application. There were no differences in abortus, preterm labor, gestational diabetes mellitus, and preeclampsia ratio between the pigtail and control groups (p>0.05). The rate of readmission to hospital for OHSS was lower in the pigtail group than in the control group although not statistically significant (p=0.08). Pigtail application is a safe and effective method for draining ascites in patients with OHSS after ICSI treatment. The use of pigtail catheters had no adverse effects on the perinatal outcomes of patients hospitalized with OHSS who became pregnant after ICSI treatment. In addition, the percutaneous drainage of ascites via a pigtail catheter helped prevent the readmission of patients with moderate or severe OHSS.

Recommendations for fertility preservation in patients with lymphomas

DEFF Research Database (Denmark)

Schmidt, Kirsten Tryde; Andersen, Claus Yding

2012-01-01

This guideline aims to serve as a reference for fertility specialists and other specialists working with young patients at risk of premature ovarian insufficiency (POI) or testicular dysfunction (TD) due to treatment of Hodgkin or Non-Hodgkin lymphoma....

The value of reproductive tract scoring as a predictor of fertility and production outcomes in beef heifers.

Science.gov (United States)

Holm, D E; Thompson, P N; Irons, P C

2009-06-01

In this study, 272 beef heifers were studied from just before their first breeding season (October 15, 2003), through their second breeding season, and until just after they had weaned their first calves in March, 2005. This study was performed concurrently with another study testing the economic effects of an estrous synchronization protocol using PG. Reproductive tract scoring (RTS) by rectal palpation was performed on the group of heifers 1 d before the onset of their first breeding season. The effect of RTS on several fertility and production outcomes was tested, and the association of RTS with the outcomes was compared with that of other input variables such as BW, age, BCS, and Kleiber ratio using multiple or univariable linear, logistic, or Cox regression. Area under the curve for receiver operating characteristic analysis was used to compare the ability of different input variables to predict pregnancy outcome. After adjustment for BW and age, RTS was positively associated with pregnancy rate to the 50-d AI season (P Reproductive tract scoring was a better predictor of fertility than was Kleiber ratio and similar in its prediction of calf weaning weight. It was concluded from this study that RTS is a predictor of heifer fertility, compares well with other traits used as a predictor of production outcomes, and is likely to be a good predictor of lifetime production of the cow.

Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study.

Science.gov (United States)

Souza, Maria de Lourdes de; Lynn, Fiona Ann; Johnston, Linda; Tavares, Eduardo Cardoso Teixeira; Brüggemann, Odaléa Maria; Botelho, Lúcio José

2017-04-06

analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; ppobreza social y económica. Madres adolescentes y sus bebés tienen mayor probabilidad de efectos perinatales adversos. Enfermeros, trabajadores de salud pública, profesionales de salud y asistencia social y educadores deben colaborar para mejor dirigir estrategias a adolescentes con riesgo superior; para fines de ayudar a reducir las tasas de fertilidad y mejorar los resultados.

A national evaluation of Safe Schools/Healthy Students: outcomes and influences.

Science.gov (United States)

Derzon, James H; Yu, Ping; Ellis, Bruce; Xiong, Sharon; Arroyo, Carmen; Mannix, Danyelle; Wells, Michael E; Hill, Gary; Rollison, Julia

2012-05-01

The Safe Schools/Healthy Students (SS/HS) Initiative has awarded over $2 billion in grants to more than 350 school districts in partnership with local mental health, law enforcement, and juvenile justice agencies. To estimate the impact of grantee characteristics, grant operations, and near-term outcomes in reducing violence and substance use, promoting mental health, and enhancing school safety, logged odds ratios (LORs) were calculated contrasting Year 3 with Baseline performance from grantee-provided data on seven outcome measures. After comparing grantee performance across outcomes and outcomes across grantees, the LORs were entered as dependent variables in a series of meta-regressions in which grantee characteristics, grant operations, and near-term outcomes were tested after controlling for pre-grant characteristics. Findings indicate that the SS/HS Initiative significantly improved most outcomes, that within-grantee performance varied greatly by outcome, and that random-effects meta-regression appreciably decreased the variance available for modeling. The approach demonstrates that the SS/HS Initiative is effective and that locally collected performance data can be used to estimate grantee success in improving youth outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Evaluation of fertilization-to-planting and fertilization-to-harvest intervals for safe use of noncomposted bovine manure in Wisconsin vegetable production.

Science.gov (United States)

Ingham, Steven C; Fanslau, Melody A; Engel, Rebecca A; Breuer, Jeffry R; Breuer, Jane E; Wright, Thomas H; Reith-Rozelle, Judith K; Zhu, Jun

2005-06-01

Fresh bovine manure was mechanically incorporated into loamy sand and silty clay loam Wisconsin soils in April 2004. At varying fertilization-to-planting intervals, radish, lettuce, and carrot seeds were planted; crops were harvested 90, 100, 110 or 111, and 120 days after manure application. As an indicator of potential contamination with fecal pathogens, levels of Escherichia coli in the manure-fertilized soil and presence of E. coli on harvested vegetables were monitored. From initial levels of 4.0 to 4.2 log CFU/g, E. coli levels in both manure-fertilized soils decreased by 2.4 to 2.5 log CFU/g during the first 7 weeks. However, E. coli was consistently detected from enriched soil samples through week 17, perhaps as a result of contamination by birds and other wildlife. In the higher clay silty clay loam soil, the fertilization-to-planting interval affected the prevalence of E. coli on lettuce but not on radishes and carrots. Root crop contamination was consistent across different fertilization-to-harvest intervals in silty clay loam, including the National Organic Program minimum fertilization-to-harvest interval of 120 days. However, lettuce contamination in silty clay loam was significantly (P < 0.10) affected by fertilization-to-harvest interval. Increasing the fertilization-to-planting interval in the lower clay loamy sand soil decreased the prevalence of E. coli on root crops. The fertilization-to-harvest interval had no clear effect on vegetable contamination in loamy sand. Overall, these results do not provide grounds for reducing the National Organic Program minimum fertilization-to-harvest interval from the current 120-day standard.

The Obesity-Fertility Protocol: a randomized controlled trial assessing clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women.

Science.gov (United States)

Duval, Karine; Langlois, Marie-France; Carranza-Mamane, Belina; Pesant, Marie-Hélène; Hivert, Marie-France; Poder, Thomas G; Lavoie, Hélène B; Ainmelk, Youssef; St-Cyr Tribble, Denise; Laredo, Sheila; Greenblatt, Ellen; Sagle, Margaret; Waddell, Guy; Belisle, Serge; Riverin, Daniel; Jean-Denis, Farrah; Belan, Matea; Baillargeon, Jean-Patrice

2015-01-01

Obesity in infertile women increases the costs of fertility treatments, reduces their effectiveness and increases significantly the risks of many complications of pregnancy and for the newborn. Studies suggest that even a modest loss of 5-10 % of body weight can restore ovulation. However, there are gaps in knowledge regarding the benefits and cost-effectiveness of a lifestyle modification program targeting obese infertile women and integrated into the fertility clinics. This study will evaluate clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women. We hypothesize that the intervention will: 1) improve fertility, efficacy of fertility treatments, and health of mothers and their children; and 2) reduce the cost per live birth, including costs of fertility treatments and pregnancy outcomes. Obese infertile women (age: 18-40 years; BMI ≥30 kg/m(2) or ≥27 kg/m(2) with polycystic ovary syndrome) will be randomised to either a lifestyle intervention followed by standard fertility treatments after 6 months if no conception has been achieved (intervention group) or standard fertility treatments only (control group). The intervention and/or follow-up will last for a maximum of 18 months or up to the end of pregnancy. Evaluation visits will be planned every 6 months where different outcome measures will be assessed. The primary outcome will be live-birth rates at 18 months. The secondary outcomes will be sub-divided into four categories: lifestyle and anthropometric, fertility, pregnancy complications, and neonatal outcomes. Outcomes and costs will be also compared to similar women seen in three fertility clinics across Canada. Qualitative data will also be collected from both professionals and obese infertile women. This study will generate new knowledge about the implementation, impacts and costs of a lifestyle management program in obese infertile women. This information

The Effect of Low Carbohydrate Diets on Fertility Hormones and Outcomes in Overweight and Obese Women: A Systematic Review

Science.gov (United States)

McGrice, Melanie; Porter, Judi

2017-01-01

(1) Background: Medical interventions including assisted reproductive technologies have improved fertility outcomes for many sub-fertile couples. Increasing research interest has investigated the effect of low carbohydrate diets, with or without energy restriction. We aimed to systematically review the published literature to determine the extent to which low carbohydrate diets can affect fertility outcomes; (2) Methods: The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42016042669) and followed Preferred Reporting Items For Systematic Reviews and Meta-Analyses guidelines. Infertile women were the population of interest, the intervention was low carbohydrate diets (less than 45% total energy from carbohydrates), compared to usual diet (with or without co-treatments). Four databases were searched from date of commencement until April 2016; a supplementary Google scholar search was also undertaken. Title and abstract, then full text review, were undertaken independently and in duplicate. Reference lists of included studies and relevant systematic reviews were checked to ensure that all relevant studies were identified for inclusion. Quality assessment was undertaken independently by both authors using the Quality Criteria Checklist for Primary Research. Outcome measures were improved fertility outcomes defined by an improvement in reproductive hormones, ovulation rates and/or pregnancy rates; (3) Results: Seven studies fulfilled the inclusion criteria and were included in the evidence synthesis. Interventions were diverse and included a combination of low carbohydrate diets with energy deficit or other co-treatments. Study quality was rated as positive for six studies, suggesting a low risk of bias, with one study rated as neutral. Of the six studies which reported changes in reproductive hormones, five reported significant improvements post intervention; (4) Conclusion: The findings of these

The long-term outcome of 946 consecutive couples visiting a fertility clinic in 2001-2003

NARCIS (Netherlands)

Donckers, Janneke; Evers, Johannes L. H.; Land, Jolande A.

Objective: To describe the outcome of fertility work-up, treatment, and dropout in a cohort of subfertile couples in a well-defined area in Western Europe. Design: Prospective cohort study. Setting: Maastricht University Medical Center. Patient(s): Subfertile couples referred by their general

A comparative study of boar semen extenders with different proposed preservation times and their effect on semen quality and fertility

Directory of Open Access Journals (Sweden)

Marina Anastasia Karageorgiou

2016-01-01

Full Text Available The present study compared the quality characteristics of boar semen diluted with three extenders of different proposed preservation times (short-term, medium-term and long-term. A part of extended semen was used for artificial insemination on the farm (30 sows/extender, while the remaining part was stored for three days (16–18 °C. Stored and used semen was also laboratory assessed at insemination time, on days 1 and 2 after the collection (day 0. The long-term extender was used for a short time, within 2 days from semen collection, with the aim to investigate a possible advantage over the others regarding laboratory or farm fertility indicators at the beginning of the preservation time. Viability, motility, kinetic indicators, morphology and DNA fragmentation were estimated. The results showed reduced viability, higher values for most of the kinetics, and higher immotile spermatozoa from day 1 to day 2 in all extenders; however, the long-term extender was superior compared to the other two on both days. With regard to morphology and chromatin integrity, the percentage of abnormal and fragmented spermatozoa increased on day 2 compared to day 1 for all of the extenders. However, based on the farrowing rate and the number of piglets born alive after the application of conventional artificial insemination within 2 days from semen collection/dilution, it was found that the medium-term diluents were more effective. In conclusion, it seems that the in vivo fertilization process involves more factors than simply the quality of laboratory evaluated sperm indicators, warranting further research.

Anesthetic management for oocyte retrieval: An exploratory analysis comparing outcome in in vitro fertilization cycles with and without pre-implantation genetic diagnosis

Directory of Open Access Journals (Sweden)

Alexander Ioscovich

2013-01-01

Full Text Available Purpose: To date, there has been no comparison of outcomes in women undergoing anesthesia for in vitro fertilization (IVF oocyte retrieval for the purpose of pre-implantation genetic diagnosis (PGD because of their or their partner′s genetic disease relative to the outcome in women requiring IVF because of fertility issues. Materials and Methods: A prospective observational study, wherein all demographic and anesthetic management data were collected from IVF and PGD units′ records for a 6-month period. Descriptive analyses and parametric tests were employed. Results: There were 307 cases IVF and 76 cases PGD: most (97.4% and 99.7%, respectively received general anesthesia with propofol and fentanyl ± dipyrone (90.5% and 93.3%, respectively with no adverse effects. The only statistically significant difference between IVF and PGD groups that was potentially clinically significant was post-procedure recovery time (23.0 ± 20.4 vs. 29.4 ± 35.8 min, respectively; P < 0.0001, but is explainable as greater caution by Anesthesiologists for higher-risk PGD cases having autosomal dominant diseases that may impact anesthesia management (myotonic dystrophy, neurofibromatosis, Marfan′s; two of these cases also recovered in the general post-anesthesia care unit, as a precaution for early diagnosis and treatment of potential post-procedural complication. Conclusions: Results of this first-ever survey of anesthesia for PGD compared with IVF cases imply that propofol-and-fentanyl-based anesthesia is safe and can be recommended, bearing in mind that with patients who have autosomal dominant diseases impacting anesthetic management it is prudent to be more cautious post-recovery.

Fertility and pregnancy outcome in women with systemic sclerosis.

Science.gov (United States)

Steen, V D; Medsger, T A

1999-04-01

To determine fertility and pregnancy outcome in women with systemic sclerosis (SSc; scleroderma) who had disease onset before age 45 years. All living women with scleroderma who had first been evaluated at the University of Pittsburgh Scleroderma Clinic after January 1, 1972 were sent a detailed self-administered questionnaire in 1986 specifically concerning pregnancy outcomes and infertility. This group was compared with 2 race- and age-matched control groups, one comprising women with rheumatoid arthritis (RA) and one comprising healthy neighborhood women identified by random-digit dialing. We determined the number, history, treatment, and outcome of women who either had never been pregnant or had attempted to become pregnant unsuccessfully for more than 1 year. We also obtained data regarding pregnancy outcomes, including the frequency of miscarriage, premature births, small full-term infants, perinatal deaths, and births of live healthy infants. The study group comprised 214 women with SSc, 167 with RA, and 105 neighborhood controls. There were no significant differences in the overall rates of miscarriage, premature births, small full-term births, or neonatal deaths between the 3 groups. Women with SSc were more likely than those without SSc to have adverse outcomes of pregnancy after the onset of their rheumatic disease, particularly premature births (also seen in RA women after disease onset) and small full-term infants. Although a significantly greater number of women with SSc had never been pregnant, there were no significant differences in the frequency of never having been pregnant or of infertility in the 3 groups after adjustment for contributing factors. This study indicates that women with SSc have acceptable pregnancy outcomes compared with those of women with other rheumatic disease and healthy neighborhood controls. Infertility was not a frequent problem. We believe that there are no excessive pregnancy risks to women with SSc or their infants

21 CFR 178.3800 - Preservatives for wood.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Preservatives for wood. 178.3800 Section 178.3800... Certain Adjuvants and Production Aids § 178.3800 Preservatives for wood. Preservatives may be safely used... to accomplish the technical effect of protecting the wood from decay, mildew, and water absorption...

Totally laparoscopic pylorus-preserving gastrectomy for early gastric cancer in the middle stomach: technical report and surgical outcomes.

Science.gov (United States)

Kumagai, Koshi; Hiki, Naoki; Nunobe, Souya; Sekikawa, Sayuri; Chiba, Takehiro; Kiyokawa, Takashi; Jiang, Xiaohua; Tanimura, Shinya; Sano, Takeshi; Yamaguchi, Toshiharu

2015-01-01

The feasibility, safety, and improved quality of postoperative life following laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with a hand-sewn anastomosis via a mini-laparotomy for early gastric cancer (EGC) have been previously established. Here we describe the surgical procedure of totally laparoscopic pylorus-preserving gastrectomy (TLPPG) using an intracorporeal delta-shaped anastomosis technique, and the short-term surgical outcomes of 60 patients with EGC in the middle stomach are reported. After lymphadenectomy and mobilization of the stomach, intraoperative gastroscopy was performed in order to verify the location of the tumor, and then the distal and proximal transecting lines were established, 5 cm from the pyloric ring and just proximal to Demel's line, respectively. Following transection of the stomach, a delta-shaped intracorporeal gastrogastrostomy was made with linear staplers. There were no intraoperative complications or conversions to open surgery. Mean operation time and blood loss were 259 min and 28 mL, respectively. Twelve patients (20.0%) experienced postoperative complications classified as grade II using the Clavien-Dindo classification, with the most frequent complication being gastric stasis (6 cases, 10.0 %). The incidence of severe complications classified as grade III or above was 1.7%; only one patient required reoperation and intensive care due to postoperative intraabdominal bleeding and subsequent multiple organ failure. TLPPG with an intracorporeal delta-shaped anastomosis was found to be a safe procedure, although it tended to require a longer operating time than the well-established LAPPG with a hand-sewn gastrogastrostomy.

Velocity ratio predicts outcomes in patients with low gradient severe aortic stenosis and preserved EF

DEFF Research Database (Denmark)

Jander, Nikolaus; Hochholzer, Willibald; Kaufmann, Beat A

2014-01-01

OBJECTIVE: To evaluate the usefulness of velocity ratio (VR) in patients with low gradient severe aortic stenosis (LGSAS) and preserved EF. BACKGROUND: LGSAS despite preserved EF represents a clinically challenging entity. Reliance on mean pressure gradient (MPG) may underestimate stenosis severity...... for severe stenosis. We hypothesised that VR may have conceptual advantages over MPG and AVA, predict clinical outcomes and thereby be useful in the management of patients with LGSAS. METHODS: Patients from the prospective Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study with an AVA...≤40 mm Hg and EF≥55% and asymptomatic at baseline were stratified according to VR with a cut-off value of 0.25. Outcomes were evaluated according to aortic valve-related events and cardiovascular death. RESULTS: Of 435 patients with LGSAS, 197 (45%) had VRVR≥0...

Successful long-term preservation of rat sperm by freeze-drying.

Directory of Open Access Journals (Sweden)

Takehito Kaneko

Full Text Available BACKGROUND: Freeze-drying sperm has been developed as a new preservation method where liquid nitrogen is no longer necessary. An advantage of freeze-drying sperm is that it can be stored at 4 °C and transported at room temperature. Although the successful freeze-drying of sperm has been reported in a number of animals, the possibility of long-term preservation using this method has not yet been studied. METHODOLOGY/PRINCIPAL FINDINGS: Offspring were obtained from oocytes fertilized with rat epididymal sperm freeze-dried using a solution containing 10 mM Tris and 1 mM EDTA adjusted to pH 8.0. Tolerance of testicular sperm to freeze-drying was increased by pre-treatment with diamide. Offspring with normal fertility were obtained from oocytes fertilized with freeze-dried epididymal sperm stored at 4 °C for 5 years. CONCLUSIONS AND SIGNIFICANCE: Sperm with -SS- cross-linking in the thiol-disulfide of their protamine were highly tolerant to freeze-drying, and the fertility of freeze-dried sperm was maintained for 5 years without deterioration. This is the first report to demonstrate the successful freeze-drying of sperm using a new and simple method for long-term preservation.

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Science.gov (United States)

Chin, Helen B; Howards, Penelope P; Kramer, Michael R; Mertens, Ann C; Spencer, Jessica B

2016-12-01

To assess which characteristics are associated with failure to receive fertility counseling among a cohort of young women diagnosed with cancer. Population-based cohort study. Not applicable. A total of 1,282 cancer survivors, of whom 1,116 met the inclusion criteria for the analysis. None. The main outcome in this study was whether or not women reported receiving any information at the time of their cancer diagnosis on how cancer treatment might affect their ability to become pregnant. Forty percent of cancer survivors reported that they did not receive fertility counseling at the time of cancer diagnosis. Women were more likely to fail to receive counseling if they had only a high school education or less or if they had given birth. Cancer-related variables that were associated with a lack of counseling included not receiving chemotherapy as part of treatment and diagnosis with certain cancer types. Counseling about the risk of infertility and available fertility preservation options is important to cancer patients. Additionally, counseling can make women aware of other adverse reproductive outcomes, such as early menopause and its associated symptoms. Less-educated women and parous women are at particular risk of not getting fertility-related information. Programs that focus on training not just the oncologist, but also other health care providers involved with cancer care, to provide fertility counseling may help to expand access. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

LH prevents cisplatin-induced apoptosis in oocytes and preserves female fertility in mouse

Science.gov (United States)

Rossi, Valerio; Lispi, Monica; Longobardi, Salvatore; Mattei, Maurizio; Rella, Francesca Di; Salustri, Antonietta; De Felici, Massimo; Klinger, Francesca G

2017-01-01

Premature ovarian failure and female infertility are frequent side effects of anticancer therapies, owing to the extreme sensitivity of the ovarian reserve oocytes to the damaging effects of irradiation and chemotherapy on DNA. We report here a robust protective effect of luteinizing hormone (LH) on the primordial follicle pool of prepubertal ovaries against the cisplatin (Cs)-induced apoptosis. In vitro LH treatment of prepubertal ovarian fragments generated anti-apoptotic signals by a subset of ovarian somatic cells expressing LH receptor (LHR) through cAMP/PKA and Akt pathways. Such signals, reducing the oocyte level of pro-apoptotic TAp63 protein and favoring the repair of the Cs-damaged DNA in the oocytes, prevented their apoptosis. Noteworthy, in vivo administration to prepubertal female mice of a single dose of LH together with Cs inhibited the depletion of the primordial follicle reserve caused by the drug and preserved their fertility in reproductive age, preventing significant alteration in the number of pregnancy and of delivered pups. In conclusion, these findings establish a novel ovoprotective role for LH and further support the very attracting prospective to use physiological 'fertoprotective' approaches for preventing premature infertility and risks linked to precocious menopause in young patients who survived cancer after chemotherapy. PMID:27689876

LH prevents cisplatin-induced apoptosis in oocytes and preserves female fertility in mouse.

Science.gov (United States)

Rossi, Valerio; Lispi, Monica; Longobardi, Salvatore; Mattei, Maurizio; Rella, Francesca Di; Salustri, Antonietta; De Felici, Massimo; Klinger, Francesca G

2017-01-01

Premature ovarian failure and female infertility are frequent side effects of anticancer therapies, owing to the extreme sensitivity of the ovarian reserve oocytes to the damaging effects of irradiation and chemotherapy on DNA. We report here a robust protective effect of luteinizing hormone (LH) on the primordial follicle pool of prepubertal ovaries against the cisplatin (Cs)-induced apoptosis. In vitro LH treatment of prepubertal ovarian fragments generated anti-apoptotic signals by a subset of ovarian somatic cells expressing LH receptor (LHR) through cAMP/PKA and Akt pathways. Such signals, reducing the oocyte level of pro-apoptotic TAp63 protein and favoring the repair of the Cs-damaged DNA in the oocytes, prevented their apoptosis. Noteworthy, in vivo administration to prepubertal female mice of a single dose of LH together with Cs inhibited the depletion of the primordial follicle reserve caused by the drug and preserved their fertility in reproductive age, preventing significant alteration in the number of pregnancy and of delivered pups. In conclusion, these findings establish a novel ovoprotective role for LH and further support the very attracting prospective to use physiological 'fertoprotective' approaches for preventing premature infertility and risks linked to precocious menopause in young patients who survived cancer after chemotherapy.

Preliminary observations on whole-ovary xenotransplantation as an experimental model for fertility preservation.

Science.gov (United States)

Nichols-Burns, Stephanie M; Lotz, Laura; Schneider, Heike; Adamek, Edyta; Daniel, Christoph; Stief, Andrea; Grigo, Christina; Klump, Dorothee; Hoffmann, Inge; Beckmann, Matthias W; Dittrich, Ralf

2014-11-01

Ovarian tissue preservation and retransplantation is a promising strategy to restore fertility in cancer survivors. Ischaemia accompanying ovarian tissue grafting, however, can lead to significant follicle loss. Transplantation of the whole ovary by vascular anastomosis has been considered as an alternative to prevent widespread ischaemic damage. In this study, the feasibility and function of transplanting whole ovary with intact vasculature were evaluated, with the goal of developing a xenograft model for studies using donated human ovaries. Whole-swine ovaries with vascular pedicles were perfused and transplanted as intact ovaries by anastomosis into irradiated ovariectomized nude rats (n = 10). The observation period was between 1 and 4 weeks. Fresh swine ovaries served as controls (n = 10). Ovarian stroma and follicle populations were assessed through histological examination in both transplanted and control ovaries. Most of the transplanted whole ovaries (n = 6) maintained stromal quality and all preantral follicle classes were represented, although follicle numbers decreased compared with fresh control. Four transplanted ovaries were fibrotic after 1-4 weeks within the nude rat. Our results demonstrate transplantation of whole-pig ovary into nude rats is possible and support development of this xenograft model system for human studies. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Outcome of gallbladder preservation in surgical management of primary bile duct stones.

Science.gov (United States)

Tian, Ming-Guo; Shi, Wei-Jin; Wen, Xin-Yuan; Yu, Hai-Wen; Huo, Jing-Shan; Zhou, Dong-Feng

2003-08-01

To evaluate the methods and outcome of gallbladder preservation in surgical treatment of primary bile duct stones. Thirty-five patients with primary bile duct stones and intact gallbladders received stone extraction by two operative approaches, 23 done through the intrahepatic duct stump (RBD-IDS, the RBD-IDS group) after partial hepatectomy and 12 through the hepatic parenchyma by retrograde puncture (RBD-RP, the RBD-RP group). The gallbladders were preserved and the common bile duct (CBD) incisions were primarily closed. The patients were examined postoperatively by direct cholangiography and followed up by ultrasonography once every six months. In the RBD-IDS group, residual bile duct stones were found in three patients, which were cleared by a combination of fibrocholedochoscopic extraction and lithotripsy through the drainage tracts. The tubes were removed on postoperative day 22 (range: 16-42 days). In the RBD-RP group, one patient developed hemobilia and was cured by conservative therapy. The tubes were removed on postoperative day 8 (range: 7-11 days). Postoperative cholangiography showed that all the gallbladders were well opacified, contractile and smooth. During 54 (range: 6-120 months) months of follow-up, six patients had mildly thickened cholecystic walls without related symptoms and further changes, two underwent laparotomies because of adhesive intestinal obstruction and gastric cancer respectively, three died of cardiopulmonary diseases. No stones were found in all the preserved gallbladders. The intact gallbladders preserved after surgical extraction of primary bile duct stones will not develop gallstones. Retrograde biliary drainage is an optimal approach for gallbladder preservation.

Outcome of in vitro fertilization in women with subclinical hypothyroidism.

Science.gov (United States)

Cai, YunYing; Zhong, LanPing; Guan, Jie; Guo, RuiJin; Niu, Ben; Ma, YanPing; Su, Heng

2017-05-25

Previous studies examining associations between subclinical hypothyroidism (SCH) with in vitro fertilization (IVF) outcome indicate some benefits of levothyroxine (LT4) treatment. But IVF outcomes in treated SCH women whose serum Thyroid Stimulating Hormone (TSH) concentration did and did not exceed 2.5 mIU/L before the IVF cycle has not been studied thoroughly. In this study, we performed a prospective cohort study with 270 treated subclinical hypothyroidism patients undergoing their first IVF retrieval cycle at a single cite. SCH in women receiving LT4 replacement with a basal TSH level between 0.2-2.5mIU/L displayed a similar rate of clinical pregnancy (47.4% vs 38.7%, P = .436), miscarriage (7.4% vs 16.7%, P = .379) and live birth (43.9% vs 32.3%, P = .288) compared to women with a basal TSH level between 2.5-4.2 mIU/L. Strictly controlled TSH (less than 2.5 mIU/L) before IVF may have no effect on the pregnancy rate in LT4 treated SCH women.

Sexuality and fertility outcomes after hand sewn versus stapled ileal pouch anal anastomosis for ulcerative colitis.

Science.gov (United States)

Harnoy, Yann; Desfourneaux, Véronique; Bouguen, Guillaume; Rayar, Michel; Meunier, Bernard; Siproudhis, Laurent; Boudjema, Karim; Sulpice, Laurent

2016-01-01

Ileal pouch anal anastomosis (IPAA) may alter sexuality and fertility in women. The laparoscopic approach seems to reduce infertility rates in women after IPAA. However, the impact of hand sewn versus stapled IPAA on sexuality and fertility has never been assessed in patients with ulcerative colitis (UC). The objective of this study was to analyze the impact of the IPAA technique on sexuality and fertility in UC. All UC patients who underwent an IPAA between May 1996 and April 2011 were included. The patients answered mailed questionnaires including sexuality validated questionnaires and fertility questionnaires. The risk factors of sexual dysfunction were explored. A total of 135 patients were included. Eighty-eight patients (65%) answered the questionnaires. Their mean age and follow-up were 37.2 ± 13.4 y and 109.7 ± 57.5 mo. The rates of female and male sexual dysfunction were 50% and 29%, respectively. Intestinal transit disorders were identified as risk factors in both men and women and anastomotic stricture in women sexual dysfunction, in univariate analyses. The IPAA technique did not impact sexual function in women but there was a trend for less erectile dysfunction after hand sewn IPAA (16.7% versus 44.4%). The fertility rate was 47% in women and 75% in men, with a trend for a better fertility in women after hand sewn IPAA (P = 0.07). In this preliminary study, the hand sewn or stapled IPAA technique did not impact the sexuality or fertility outcomes of UC patients, but there was a trend for better female fertility and male erectile function after hand sewn IPAA. Intestinal transit disorders contributed to male and female sexual dysfunction after IPAA. Copyright © 2016 Elsevier Inc. All rights reserved.

Fertility effects of cancer treatment.

Science.gov (United States)

Marsden, Donald E; Hacker, Neville

2003-01-01

Cancer sufferers are a subfertile group, and most treatments have the potential to adversely affect gonadal function. As cancer treatment becomes more effective and survival rates improve there are more cancer survivors in the reproductive age group for whom parenting is an important consideration. This article outlines the effects on fertility of cancer treatments and techniques to minimise the risk of infertility. The overall prospects for younger cancer sufferers to either retain their fertility or have genetic offspring is now better than ever before, due to advances in assisted reproductive technology, the appropriate use of fertility sparing surgery and other techniques to reduce the toxicity of therapy on the reproductive organs. These advances raise new moral and ethical concerns that must be considered before advising cancer sufferers of the options for preserving reproductive capacity.

Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2cm or larger: A literature review and analysis of oncological and obstetrical outcomes.

Science.gov (United States)

Pareja, Rene; Rendón, Gabriel J; Vasquez, Monica; Echeverri, Lina; Sanz-Lomana, Carlos Millán; Ramirez, Pedro T

2015-06-01

Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishing to preserve fertility. Radical trachelectomy can be performed with a vaginal, abdominal, or laparoscopic/robotic approach. Vaginal radical trachelectomy (VRT) is generally not offered to patients with tumors 2cm or larger because of a high recurrence rate. There are no conclusive recommendations regarding the safety of abdominal radical trachelectomy (ART) or laparoscopic radical trachelectomy (LRT) in such patients. Several investigators have used neoadjuvant chemotherapy in patients with tumors 2 to 4cm to reduce tumor size so that fertility preservation may be offered. However, to our knowledge, no published study has compared outcomes between patients with cervical tumors 2cm or larger who underwent immediate radical trachelectomy and those who underwent neoadjuvant chemotherapy followed by radical trachelectomy. We conducted a literature review to compare outcomes with these 2 approaches. Our main endpoints for evaluation were oncological and obstetrical outcomes. The fertility preservation rate was 82.7%, 85.1%, 89%; and 91.1% for ART (tumors larger than >2cm), ART (all sizes), NACT followed by surgery and VRT (all sizes); respectively. The global pregnancy rate was 16.2%, 24% and 30.7% for ART, VRT, and NACT followed by surgery; respectively. The recurrence rate was 3.8%, 4.2%, 6%, 7.6% and 17% for ART (all sizes), VRT (all sizes), ART (tumors>2cm), NACT followed by surgery, and VRT (tumors>2cm). These outcomes must be considered when offering a fertility sparing technique to patients with a tumor larger than 2cm. Copyright © 2015 Elsevier Inc. All rights reserved.

Fertilizers applied to certified organic tomato culture

International Nuclear Information System (INIS)

Martins, T.C.G.; De Nadai Fernandes, E.A.; Ferrari, A.A.; Bacchi, M.A.; Tagliaferro, F.S.

2010-01-01

The tomato culture demands large quantities of mineral nutrients, which are supplied by synthetic fertilizers in the conventional cultivation system. In the organic cultivation system only alternative fertilizers are allowed by the certifiers and accepted as safe for humans and environment. The chemical composition of rice bran, oyster flour, cattle manure and ground charcoal, as well as soils and tomato fruits were evaluated by instrumental neutron activation analysis (INAA). The potential contribution of organic fertilizers to the enrichment of chemical elements in soil and their transfer to fruits was investigated using concentration ratios for fertilizer and soil samples, and also for soil and tomato. Results evidenced that these alternative fertilizers could be taken as important sources of Br, Ca, Ce, K, Na and Zn for the organic tomato culture. (author)

Current status of semen preservation in the ram, boar and stallion.

Science.gov (United States)

Graham, E F; Crabo, B G; Pace, M M

1978-01-01

From the studies cited it was concluded that short and long term preservation of stallion semen has encountered major obstacles. Fertilizing capacity of extended or extended and cooled spermatozoa has been impaired. With the hydrogen ion extenders, the fertility was depressed either with or without glycerol when the semen was inseminated immediately after extension. With the cream-gel extender, fertility was not impaired when inseminated immediately after extension, but was impaired after storage at 5 C for 24 hr or in the presence of glycerol. The fertilizing capacity of extended frozen spermatozoa particularly from some stallions has been more adversely affected than that of others. These studies show that the pregnancy rate range was from 50 to 80% for raw semen from the same stallion used in the frozen studies. Pregnancy rate with this magnitude of difference must be carefully weighed in applying the results from a few stallions to the population. Sufficient information has been generated to suggest that the preservation of stallion spermatozoa is possible but the fertilizing capacity is impaired. Causes of this impairment must be further investigated. When this is accomplished, the number of motile spermatozoa needed per insemination and the frequency of insemination required for optimal fertilization reported in this review must then be reevaluated.

New complex fertilizer 'Suprodit' to obtain safe agricultural productions on contaminated lands.

Science.gov (United States)

Nikolaevich Ratnikov, Alexander; Sergeevich Anisimov, Vyacheslav; Nikoaevna Anisimova, Lidiya; Georgievich Sviridenko, Dmitry; Jurievna Balanova, Olesya

2015-04-01

One of the reclamation techniques to reduce the accumulation of radionuclides and heavy metals in the crop is the use of natural sorbents, industrial deposits of which are located in the contaminated areas or at distances that allows one to organize cheap their delivery to the application site. More promising reclamation technique is the use of new types of complex fertilizers, the main components of which are special sorbents of natural or artificial origin. New complex fertilizer of prolonged action - "SUPRODIT", containing in addition to nutrients highly efficient mineral and organic sorbents, was developed by specialists of the RIRAE. The feedstock for mineral sorbent was Tripoli (finely porous siliceous mineral) from local field (Kaluga region), organic sorbent - peat. The "SUPRODIT"composition: N - 8-11%; P2O5 - 11-13 %; K2O - 11-17%, organic matter and 30-40%, respectively. The effect of a single application of complex fertilizer will be maintained for two or more growing seasons. Received RF patent for the invention "Method of production of complex fertilizer of prolonged action". In a series of field experiments on sod-podzolic sandy loam soil it was shown that the application of "SUPRODIT" at dose of 800 kg/ha to soil contaminated with dehydrated sewage sludge (DSS), significantly reduces heavy metals (Cd, Ni, Pb) content in a crop of oats and barley due to the sorption properties of this fertilizers. Thus, Cd accumulation in the oats grain decreased 1.3 times, barley grain - 1.5 times, Ni - 1.5 times for barley and oats; Pb - 1.8 and 1.7 times respectively opposite to variant where the DSS was applied only. "SUPRODIT" reduces the negative effects of HM on the growth and development of plants, and limits the accumulation of 137Cs and HM in biomass. The 137Cs content in the biomass of barley in the variant of jointly added to soil of 137Cs and "SUPRODIT" decreased by 8.9 times in comparison with control and 4.4 times compared with standard fertilizers (NPK

Stressful life events are associated with a poor in vitro fertilization (IVF) - outcome: a prospective study

DEFF Research Database (Denmark)

Ebbesen, Signe Maria Schneevoigt; Zachariae, Robert; Mehlsen, Mimi Yung

2009-01-01

-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months. METHODS: Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE...... number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end...

New advances in ovarian autotransplantation to restore fertility in cancer patients.

Science.gov (United States)

Salama, Mahmoud; Woodruff, Teresa K

2015-12-01

Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results.

Fertility awareness online: the efficacy of a fertility education website in increasing knowledge and changing fertility beliefs.

Science.gov (United States)

Daniluk, J C; Koert, E

2015-02-01

How effective is online education in increasing knowledge of fertility and assisted reproductive technologies (ART), and changing beliefs about the timing of parenthood? Exposure to an online educational intervention resulted in immediate changes in participants' beliefs about the ideal timing of parenthood, and a significant increase in their knowledge of fertility and ART treatments and options; most of these changes were not sustained over time, particularly for men. Research has identified significant gaps in men's and women's knowledge of fertility and ART, contributing to the trend to delay childbearing. Effective educational programs need to be developed, to support informed fertility and child-timing decisions. Pre-post intervention study of 199 currently childless men and women, and a 6-month follow-up of 110 of these participants. One hundred and ninety-nine childless participants between the ages of 18 and 35 were asked to complete 4 beliefs and 22 knowledge questions prior to, and immediately after, reading 10 online posts related to: fertility testing and preservation, fertility history and lifespan, the effects of health and fitness on fertility, and assisted reproduction. Six months later, 110 of the original sample repeated the 26-item survey. Participants' fertility and ART knowledge scores increased significantly immediately after the intervention, as did their confidence in their fertility and ART knowledge. Participants' beliefs about the ideal and latest age a woman or man should consider producing a child decreased. However, 6 months later, participants' beliefs and knowledge levels largely returned to their pre-intervention levels, particularly for the men in the study. The sample size and the recruitment methods may limit the generalizability of these findings. Previous studies have demonstrated the short-term efficacy of online educational approaches to increase fertility knowledge and support informed family planning decisions. Web

Outcomes after valve-preserving root surgery for patients with Marfan syndrome.

Science.gov (United States)

Kunihara, Takashi; Aicher, Diana; Rodionycheva, Svetlana; Asano, Mitsuru; Tochii, Masato; Sata, Fumihiro; Schäfers, Hans-Joachim

2012-09-01

In patients with Marfan syndrome (MFS), valve reimplantation has been proposed as superior to root remodeling. In the present study, both forms of valve-preserving root repair were applied and mid-term results analyzed in MFS patients compared to a propensity score-matched cohort. Among 604 patients who underwent valve-preserving aortic root surgery between 1995 and 2011 at the authors' institution, 33 MFS patients (16 males, 17 females; mean age 31 +/- 12 years) underwent either remodeling (n=21) or reimplantation (n=12). All patients were followed up echocardiographically, and the outcome with regard to late aortic valve regurgitation (AR) grade EII and reoperation on the aortic valve was compared between MFS patients and the matched cohort (n=33). Baseline characteristics and operative data were similar between the groups. Actuarial freedom from AR > or = II at seven years was 86 +/- 8% in MFS patients and 90 +/- 10% in matched non-MFS patients (p = 0.94). Actuarial freedom from reoperation at seven years was 90 +/- 7% in MFS patients and 100% in non-MFS patients (p = 0.79). In Cox's proportional hazard's model, no independent risk factor, including MFS, was found for recurrent AR or reoperation. Within the MFS patients, remodeling and reimplantation provided an almost identical freedom from late AR > or = II and reoperation up to five years postoperatively (p = 0.55 and 0.99, respectively). The stability of valve-preserving aortic root repair was comparable between patients with or without MFS. Both forms of valve-preserving root repair can provide similar mid-term results for MFS patients, primarily according to their root geometry. However, additional long-term follow up data based on a larger number of patients are required to confirm the evidence obtained to date.

Oocyte vitrification as an efficient option for elective fertility preservation.

Science.gov (United States)

Cobo, Ana; García-Velasco, Juan A; Coello, Aila; Domingo, Javier; Pellicer, Antonio; Remohí, José

2016-03-01

To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP). Retrospective observational multicenter study. Private university-affiliated center. A total of 1,468 women who underwent EFP because of age or having associated a medical condition other than cancer (January 2007 to April 2015). None. Survival and cumulative live birth rate (CLBR) per consumed oocyte. Mean age was higher with EFP due to age versus having an associated medical reason (37.7 y [95% confidence interval (CI) 36.5-37.9] vs. 35.7 y [95% CI 34.9-36.3]). In total, 137 patients (9.3%) returned to use their oocytes. Overall survival rate was 85.2% (95% CI 83.2-87.2). Live birth rate per patient was higher in women ≤35 years old than ≥36 years old (50% [95% CI 32.7-67.3] vs. 22.9% [95% CI 14.9-30.9]). CLBR was higher and increased faster in younger women. The gain in CLBR was sharp from 5 (15.4%, 95% CI -4.2 to 35.0) to 8 oocytes (40.8%, 95% CI 13.2-68.4), with an 8.4% gain per additional oocyte, in the ≤35-year-old group. The increase was slower with 10-15 oocytes, reaching a plateau CLBR of 85.2%. A milder increase (4.9% gain) was observed in the ≥36-year-old group (from 5.1% [95% CI -0.6 to 10.7] to 19.9% [95% CI 8.7-31.1] when 5-8 oocytes were consumed), reaching the plateau with 11 oocytes (CLBR 35.6%). Forty babies were born. At least 8-10 metaphase II oocytes are necessary to achieve reasonable success. Numbers should be individualized in women >36 years old. We suggest encouraging women who are motivated exclusively by a desire to postpone childbearing because of age, to come at younger ages to increase success possibilities. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Differences among nursing homes in outcomes of a safe resident handling program.

Science.gov (United States)

Kurowski, Alicia; Gore, Rebecca; Buchholz, Bryan; Punnett, Laura

2012-01-01

A large nursing home corporation implemented a safe resident handling program (SRHP) in 2004-2007. We evaluated its efficacy over a 2-year period by examining differences among 5 centers in program outcomes and potential predictors of those differences. We observed nursing assistants (NAs), recording activities and body postures at 60-second intervals on personal digital assistants at baseline and at 3-month, 12-month, and 24-month follow-ups. The two outcomes computed were change in equipment use during resident handling and change in a physical workload index that estimated spinal loading due to body postures and handled loads. Potential explanatory factors were extracted from post-observation interviews, investigator surveys of the workforce, from administrative data, and employee satisfaction surveys. The facility with the most positive outcome measures was associated with many positive changes in explanatory factors and the facility with the fewest positive outcome measures experienced negative changes in the same factors. These findings suggest greater SRHP benefits where there was lower NA turnover and agency staffing; less time pressure; and better teamwork, staff communication, and supervisory support. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

Effect of body mass index on in vitro fertilization outcomes in women

Directory of Open Access Journals (Sweden)

Anjali Sathya

2010-01-01

Full Text Available Background :Obesity has become a major health problem across the world. In women, it is known to cause anovulation, subfecundity, increased risk of fetal anomalies and miscarriage rates. However, in women going for assisted reproduction the effects of obesity on egg quality, embryo quality, clinical pregnancy, live birth rates are controversial. Objectives :To assess the effect of women′s body mass index (BMI on the reproductive outcome of non donor In vitro fertilization (IVF/Intracytoplasmic sperm injection (ICSI. The effects of BMI on their gonadotrophin levels (day 2 LH, FSH, gonadotrophin dose required for ovarian stimulation, endometrial thickness and oocyte/embryo quality were looked at, after correcting for age and poor ovarian reserve. Materials and Methods : Retrospective study of medical records of 308 women undergoing non donor IVF cycles in a University affiliated teaching hospital. They were classified into three groups: normal weight (BMI25 30 kg/m 2 . All women underwent controlled ovarian hyper stimulation using long agonist protocol. Results : There were 88 (28.6% in the normal weight group, 147 (47.7% in the overweight and 73 (23.7% in the obese group. All three groups were comparable with respect to age, duration of infertility, female and male causes of infertility. The three groups were similar with respect to day 2 LH/FSH levels, endometrial thickness and gonadotrophin requirements, oocyte quality, fertilization, cleavage rates, number of good quality embryos and clinical pregnancy rates. Conclusion :Increase in body mass index in women does not appear to have an adverse effect on IVF outcome. However, preconceptual counselling for obese women is a must as weight reduction helps in reducing pregnancy-related complications.

Preservation of Ejaculatory and Erectile Function after Radical Cystectomy for Urothelial Malignancy

International Nuclear Information System (INIS)

Salem, H.K.

2005-01-01

Treating cancer patients, sexual issues should not be forgotten. With increasing survival from urologic cancer, quality of life and quality of sexuality have became very important targets in treating those patients. Fertility to those patients who desire fatherhood is sometimes more important than cancer morbidity, especially young patients in the rural areas in our country, to the extent that they may refuse the operation. We describe a new technique to preserve the erectile function and antegrade ejaculation after radical cystectomy. Patients and Methods: Seven potent men with a median age of 40 years (range 35-50) presented with invasive transitional cell carcinoma (TCC) of the lateral or the anterior bladder wall. All patients wished to preserve the ejaculatory function and fertility potential. We described the surgical technique of nerve sparing radical cystectomy with preservation of the vas deferens, seminal vesicles, whole prostate and neurovascular bundles. The follow up period ranged from six months to three years (mean 20 months) to assess recurrence, erectile function and ejaculatory function. Erectile function is normal in all patients with satisfactory sexual intercourse. Antegrade ejaculation was documented in six cases. One of them fathered a child. No local or distant recurrence was detected in the seven patients at the last follow-up. The technique of radical cystectomy (with preservation of the vas deferens, whole prostate and seminal vesicle) is a good option in selected young men with bladder carcinoma in whom preservation of fertility is desirable

Food preservation by irradiation

International Nuclear Information System (INIS)

Kooij, J. van

1981-01-01

Twenty-five years of development work on the preservation of food by irradiation have shown that this technology has the potential to reduce post-harvest losses and to produce safe foods. The technological feasibility has been established but general acceptance of food irradiation by national regulatory bodies and consumers requires attention. The positive aspects of food preservation by irradiation include: the food keeps its freshness and its physical state, agents which cause spoilage (bacteria, etc.) are eliminated, recontamination does not take place, provided packaging materials are impermeable to bacteria and insects. It inhibits sprouting of root crops, kills insects and parasites, inactivates bacteria, spores and moulds, delays ripening of fruit, improves the technological properties of food. It makes foods biologically safe, allows the production of shelf-stable foods and is excellent for quarantine treatment, and generally improves food hygiene. The dose ranges needed for effective treatment are given

Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes

Directory of Open Access Journals (Sweden)

Guilherme Machado de Carvalho

2013-01-01

Full Text Available Background. Electric-acoustic stimulation (EAS is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI surgery. Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience. Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device. Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America.

Unrealized fertility: Fertility desires at the end of the reproductive career

Directory of Open Access Journals (Sweden)

John Casterline

2017-01-01

Full Text Available Background: 'Unrealized fertility' is a failure to achieve desired fertility. Unrealized fertility has been examined in low-fertility societies but, with the exception of research on infertility, has been neglected in research on non-Western societies. Objective: We conduct a multicountry investigation of one form of unrealized fertility, namely a reproductive career which ends with the woman desiring further children. Methods: We analyze 295,854 women aged 44‒48 in 252 surveys (DHS, RHS, PAP conducted in the period 1986-2015 in 78 countries. Two indicators of unrealized fertility are constructed: (i a comparison of ideal versus actual number of children; (ii the desire for another child. We estimate multilevel regressions with covariates at individual and aggregate levels. Results: Unrealized fertility is far more prevalent according to the first indicator than the second. It is more common among women with fewer living children and women whose first birth occurs after age 20, and it is distinctly higher in sub-Saharan Africa and lower in South Asia. The evidence on trend over the course of fertility transition is mixed: for the second indicator but not the first, the net effect is a reduction in the prevalence of unrealized fertility as fertility declines. Conclusions: Unrealized fertility occurs frequently in most societies and therefore deserves more rigorous research, especially on its consequences for emotional, social, economic, and demographic outcomes. Contribution: We provide the first comprehensive documentation of the prevalence of unrealized fertility across a broad set of contemporary non-Western societies.

Alternative food-preservation technologies: efficacy and mechanisms.

Science.gov (United States)

Lado, Beatrice H; Yousef, Ahmed E

2002-04-01

High-pressure processing, ionizing radiation, pulsed electric field and ultraviolet radiation are emerging preservation technologies designed to produce safe food, while maintaining its nutritional and sensory qualities. A sigmoid inactivation pattern is observed in most kinetic studies. Damage to cell membranes, enzymes or DNA is the most commonly cited cause of death of microorganisms by alternative preservation technologies.

Comparison of clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in IVF-ICSI split insemination cycles.

Science.gov (United States)

Lee, Sun Hee; Lee, Jae Hyun; Park, Yong-Seog; Yang, Kwang Moon; Lim, Chun Kyu

2017-06-01

This study aimed to compare the clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling oocytes. Additionally, we evaluated whether the implementation of split insemination contributed to an increase in the number of ICSI procedures. A total of 571 cycles in 555 couples undergoing split insemination cycles were included in this study. Among them, 512 cycles (89.7%) were a couple's first IVF cycle. The patients were under 40 years of age and at least 10 oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI. Total fertilization failure was significantly more common in IVF cycles than in ICSI cycles (4.0% vs. 1.4%, p cycles than in IVF cycles (17.2% vs. 11.4%, p cycle and the second cycle, split insemination or ICSI was performed in 18 of the 95 cycles in which a second IVF cycle was performed. The clinical outcomes did not differ between IVF and ICSI in split insemination cycles. Split insemination can decrease the risk of total fertilization failure. However, unnecessary ICSI is carried out in most split insemination cycles and the use of split insemination might make ICSI more common.

Does the Ovarian Stimulation Phase Length Predict In vitro Fertilization Outcomes?

Directory of Open Access Journals (Sweden)

Angela Baerwald

2011-01-01

Full Text Available Background: Bi-directional communication between the follicle and oocyte is necessary toregulate follicle and oocyte development. Currently, it is not practical to monitor the serial growthof individual follicles during assisted reproduction. The ovarian stimulation phase length (SPLis an indirect measure of mean follicular growth rate. The objective of this study was to test thehypothesis that a short or long SPL would be associated with suboptimal outcomes in womenundergoing in vitro fertilization (IVF.Materials and Methods: A retrospective cohort study was conducted in 140 women who underwentIVF. Follicle development was monitored every 2-3 days during ovarian stimulation usingtransvaginal ultrasonography. Once > 3 follicles reached ≥ 17 mm, human chorionic gonadotropin(hCG was administered. Oocyte retrieval was performed approximately 35 hours after hCG.Oocytes underwent IVF on the day of collection and were evaluated daily thereafter. Embryos weretransferred on days 3 or 5, depending on the number and quality of embryos available. Associationsbetween SPL, age, follicle, oocyte, embryo and pregnancy outcomes were evaluated (SPSS version17.0; SPSS Inc., Chicago, IL, USA.Results: A SPL of 11 days was associated with an optimal number of follicles that developed to≥ 6 mm, ≥ 10 mm and ≥ 15 mm; serum estradiol concentrations; and number of oocytes collected(p0.05. Associations betweenSPL and outcomes were not influenced by age (p>0.05.Conclusion: The ovarian SPL can be used to predict the number of follicles that develop, oocytescollected and serum estradiol concentrations, but not embryo or pregnancy outcomes.

Clinical outcomes from maximum-safe resection of primary and metastatic brain tumors using awake craniotomy.

Science.gov (United States)

Groshev, Anastasia; Padalia, Devang; Patel, Sephalie; Garcia-Getting, Rosemarie; Sahebjam, Solmaz; Forsyth, Peter A; Vrionis, Frank D; Etame, Arnold B

2017-06-01

To retrospectively analyze outcomes in patients undergoing awake craniotomies for tumor resection at our institution in terms of extent of resection, functional preservation and length of hospital stay. All cases of adults undergoing awake-craniotomy from September 2012-February 2015 were retrospectively reviewed based on an IRB approved protocol. Information regarding patient age, sex, cancer type, procedure type, location, hospital stay, extent of resection, and postoperative complications was extracted. 76 patient charts were analyzed. Resected cancer types included metastasis to the brain (41%), glioblastoma (34%), WHO grade III anaplastic astrocytoma (18%), WHO grade II glioma (4%), WHO grade I glioma (1%), and meningioma (1%). Over a half of procedures were performed in the frontal lobes, followed by temporal, and occipital locations. The most common indication was for motor cortex and primary somatosensory area lesions followed by speech. Extent of resection was gross total for 59% patients, near-gross total for 34%, and subtotal for 7%. Average hospital stay for the cohort was 1.7days with 75% of patients staying at the hospital for only 24h or less post surgery. In the postoperative period, 67% of patients experienced improvement in neurological status, 21% of patients experienced no change, 7% experienced transient neurological deficits, which resolved within two months post op, 1% experienced transient speech deficit, and 3% experienced permanent weakness. In a consecutive series of 76 patients undergoing maximum-safe resection for primary and metastatic brain tumors, awake-craniotomy was associated with a short hospital stay and low postoperative complications rate. Copyright © 2017 Elsevier B.V. All rights reserved.

Fertility concerns among child and adolescent cancer survivors and their parents: A qualitative analysis.

Science.gov (United States)

Ellis, Sarah J; Wakefield, Claire E; McLoone, Jordana K; Robertson, Eden G; Cohn, Richard J

2016-01-01

Cancer diagnoses and treatment may have long-term effects on fertility. Semistructured interviews were administered to young cancer survivors (Fertility related concerns were reported by 45 participants (46.4%). Themes included: distress regarding potential infertility; the effect of infertility on future relationships, self-esteem, and miscommunications/confusion about fertility status; access to fertility testing; and preservation options. Parents also reported challenges regarding how and when it was developmentally appropriate to talk to their children about fertility. The development of comprehensive consumer-driven approaches to managing the fertility concerns of young survivors and their families is essential.

Oocyte cryopreservation for fertility preservation in postpubertal female children at risk for premature ovarian failure due to accelerated follicle loss in Turner syndrome or cancer treatments.

Science.gov (United States)

Oktay, K; Bedoschi, G

2014-12-01

To preliminarily study the feasibility of oocyte cryopreservation in postpubertal girls aged between 13 and 15 years who were at risk for premature ovarian failure due to the accelerated follicle loss associated with Turner syndrome or cancer treatments. Retrospective cohort and review of literature. Academic fertility preservation unit. Three girls diagnosed with Turner syndrome, 1 girl diagnosed with germ-cell tumor. and 1 girl diagnosed with lymphoblastic leukemia. Assessment of ovarian reserve, ovarian stimulation, oocyte retrieval, in vitro maturation, and mature oocyte cryopreservation. Response to ovarian stimulation, number of mature oocytes cryopreserved and complications, if any. Mean anti-müllerian hormone, baseline follical stimulating hormone, estradiol, and antral follicle counts were 1.30 ± 0.39, 6.08 ± 2.63, 41.39 ± 24.68, 8.0 ± 3.2; respectively. In Turner girls the ovarian reserve assessment indicated already diminished ovarian reserve. Ovarian stimulation and oocyte cryopreservation was successfully performed in all female children referred for fertility preservation. A range of 4-11 mature oocytes (mean 8.1 ± 3.4) was cryopreserved without any complications. All girls tolerated the procedure well. Oocyte cryopreservation is a feasible technique in selected female children at risk for premature ovarian failure. Further studies would be beneficial to test the success of oocyte cryopreservation in young girls. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment?

Science.gov (United States)

Jones, Georgina; Hughes, Jane; Mahmoodi, Neda; Smith, Emily; Skull, Jonathan; Ledger, William

2017-07-01

Although fertility preservation (FP) treatment options have increased, the existing evidence suggests that many women with cancer do not feel well supported in making these decisions, but find them stressful and complex and fail to take up fertility care at this crucial time. Whilst existing reviews have all made important contributions to our understanding of the FP decision-making process, none of them examine solely and specifically these processes for women of reproductive age with a diagnosis of any cancer, leaving a gap in the knowledge base. Given the expectation that care is patient-centred, our review aims to address this gap which may be of help to those managing patients struggling to make difficult decisions in the often brief period before potentially sterilizing cancer treatment is started. Underpinning this narrative review was the question 'What factors hinder the decision-making process for women with any cancer and contemplating FP treatment?' Our objectives were to (i) assess and summarize this existing literature, (ii) identify the factors that hinder this decision-making process, (iii) explore to what extent these factors may differ for women choosing different methods of FP and (iv) make recommendations for service delivery and future research. A systematic search of the medical and social science literature from the 1 January 2005 up to the end of January 2016 was carried out using three electronic databases (Web of Science (PubMed), Ovid SP Medline and CINAHL via Ebsco). Included in the review were quantitative, qualitative and mixed-method studies. Reference lists of relevant papers were also hand searched. From the 983 papers identified, 46 papers were included. Quality assessment was undertaken using the Mixed Methods Appraisal Tool and thematic analysis was used to analyse the data. From the analysis, 6 key themes with 15 sub-themes emerged: (i) fertility information provision (lack of information, timing of the information, patient

In high school and pregnant: the importance of educational and fertility expectations for subsequent outcomes.

Science.gov (United States)

Yakusheva, Olga

2011-01-01

This study uses the High School and Beyond data (1980–1992) to examine the importance of educational and fertility expectations in explaining the achievement gap of adolescent mothers for over 5,500 young women from different socioeconomic backgrounds. Using a non-parametric local propensity score regression, the study finds that the economic disadvantage associated with having a child in high school is particularly large in poor socioeconomic environments; however, this disadvantage is a result of preexisting differences in the educational and fertility expectations and is not because of a diminished capacity of the socioeconomic environment to mediate the effect of an unplanned childbirth. The findings suggest that childcare assistance and other policies designed to alleviate the burden of child rearing for young mothers of low means may not produce the desired improvement in their subsequent educational and labor market outcomes. A much earlier policy intervention with a focus on fostering young women's outlook for the future is needed.

Young women's construction of their post-cancer fertility.

Science.gov (United States)

Dryden, Amy; Ussher, Jane M; Perz, Janette

2014-01-01

Younger women diagnosed with cancer often face compromised fertility as a result of their treatment. However, previous research has adopted a biomedical model of fertility and utilised hypothetico-deductive research methods which have not allowed for full exploration of women's subjectivity. This study explored younger women's construction of their fertility post-cancer, and their discussions of fertility with healthcare professionals, from a social constructionist epistemology. Semi-structured one-to-one interviews were conducted with eight women aged 18-26, across a variety of cancer types. Foucaultian Discourse Analysis identified three subject positions associated with fertility concerns: 'Inadequate woman: Accepting the motherhood mandate'; 'Adequate woman: Resisting the motherhood mandate'; and 'Survival of the fittest: Woman as genetically defective'. Implications of these subject positions included feelings of inadequacy, fear and devastation; feeling undesirable to romantic partners; and concern about passing on cancer-positive genes. In describing healthcare professional interactions, women adopted positions of 'Satisfied patient'; 'Passive recipient patient'; or 'Resisting the passive patient position'. Accounts of inadequate information provision were associated with anger and frustration, whereas feeling adequately informed was associated with satisfaction at making decisions about fertility preservation. These results suggest that fertility is of importance to young women cancer survivors, and that compromised fertility can negatively impact subjectivity.

Immunosuppressive drugs and fertility

OpenAIRE

Leroy, Clara; Rigot, Jean-Marc; Leroy, Maryse; Decanter, Christine; Le Mapihan, Kristell; Parent, Anne-Sophie; Le Guillou, Anne-Claire; Yakoub-Agha, Ibrahim; Dharancy, Sébastien; Noel, Christian; Vantyghem, Marie-Christine

2015-01-01

Immunosuppressive drugs are used in the treatment of inflammatory and autoimmune diseases, as well as in transplantation. Frequently prescribed in young people, these treatments may have deleterious effects on fertility, pregnancy outcomes and the unborn child. This review aims to summarize the main gonadal side effects of immunosuppressants, to detail the effects on fertility and pregnancy of each class of drug, and to provide recommendations on the management of patients who are seen prior ...

Endothelial cell preservation at hypothermic to normothermic conditions using clinical and experimental organ preservation solutions

NARCIS (Netherlands)

Post, Ivo C. J. H.; de Boon, Wadim M. I.; Heger, Michal; van Wijk, Albert C. W. A.; Kroon, Jeffrey; van Buul, Jaap D.; van Gulik, Thomas M.

2013-01-01

Endothelial barrier function is pivotal for the outcome of organ transplantation. Since hypothermic preservation (gold standard) is associated with cold-induced endothelial damage, endothelial barrier function may benefit from organ preservation at warmer temperatures. We therefore assessed

Dry Preserving the Green Sea Urchin.

Science.gov (United States)

Stimson, Cheryl D.

1987-01-01

Describes a project for junior high and senior high school students designed to safely preserve hard-bodied marine invertebrates. Details the materials and procedures used in this technique. Stresses the use of non-toxic solutions and producing a lifelike specimen. (CW)

Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

Directory of Open Access Journals (Sweden)

Marius Dettmer

2015-01-01

Full Text Available Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS from a young group of patients (n=52, age 48.9 ± 6.1 years who had received hip resurfacing (HR with a cohort of patients (n=73, age 48.2 ± 6.6 years who had received neck-preserving, short-stem implant total hip arthroplasty (THA. Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year in both groups (p<0.0001, η2=0.69; there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8 than MiniHip surgery (62.5 min ± 14.8, U=85.0, p<0.0001, η2=0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs.

Effects of Cancer Treatment on Fertility (For Parents)

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... Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Effects of Cancer Treatment on Fertility KidsHealth / For Parents / Effects of Cancer Treatment on ...

A method for safely resecting anterior butterfly gliomas: the surgical anatomy of the default mode network and the relevance of its preservation.

Science.gov (United States)

Burks, Joshua D; Bonney, Phillip A; Conner, Andrew K; Glenn, Chad A; Briggs, Robert G; Battiste, James D; McCoy, Tressie; O'Donoghue, Daniel L; Wu, Dee H; Sughrue, Michael E

2017-06-01

OBJECTIVE Gliomas invading the anterior corpus callosum are commonly deemed unresectable due to an unacceptable risk/benefit ratio, including the risk of abulia. In this study, the authors investigated the anatomy of the cingulum and its connectivity within the default mode network (DMN). A technique is described involving awake subcortical mapping with higher attention tasks to preserve the cingulum and reduce the incidence of postoperative abulia for patients with so-called butterfly gliomas. METHODS The authors reviewed clinical data on all patients undergoing glioma surgery performed by the senior author during a 4-year period at the University of Oklahoma Health Sciences Center. Forty patients were identified who underwent surgery for butterfly gliomas. Each patient was designated as having undergone surgery either with or without the use of awake subcortical mapping and preservation of the cingulum. Data recorded on these patients included the incidence of abulia/akinetic mutism. In the context of the study findings, the authors conducted a detailed anatomical study of the cingulum and its role within the DMN using postmortem fiber tract dissections of 10 cerebral hemispheres and in vivo diffusion tractography of 10 healthy subjects. RESULTS Forty patients with butterfly gliomas were treated, 25 (62%) with standard surgical methods and 15 (38%) with awake subcortical mapping and preservation of the cingulum. One patient (1/15, 7%) experienced postoperative abulia following surgery with the cingulum-sparing technique. Greater than 90% resection was achieved in 13/15 (87%) of these patients. CONCLUSIONS This study presents evidence that anterior butterfly gliomas can be safely removed using a novel, attention-task based, awake brain surgery technique that focuses on preserving the anatomical connectivity of the cingulum and relevant aspects of the cingulate gyrus.

Economic crisis promotes fertility decline in poor areas: Evidence from Colombia

OpenAIRE

Eleonora Davalos; Leonardo Fabio Morales

2017-01-01

Background: The effects of an economic recession extend beyond financial spheres and spill over into present and future family decisions via income restrictions and expectations. Hardly any research on the effects of economic recession on fertility outcomes has taken place in developing countries. Objective: This study seeks to explain the effects of economic cycles on fertility outcomes in poor areas. Methods: This paper analyzes fertility trends from the third largest economy in Latin...

Meticulous Overview on the Controlled Release Fertilizers

Directory of Open Access Journals (Sweden)

Siafu Ibahati Sempeho

2014-01-01

Full Text Available Owing to the high demand for fertilizer formulations that will exhaust the possibilities of nutrient use efficiency (NUE, regulate fertilizer consumption, and lessen agrophysicochemical properties and environmental adverse effects instigated by conventional nutrient supply to crops, this review recapitulates controlled release fertilizers (CRFs as a cutting-edge and safe way to supply crops’ nutrients over the conventional ways. Essentially, CRFs entail fertilizer particles intercalated within excipients aiming at reducing the frequency of fertilizer application thereby abating potential adverse effects linked with conventional fertilizer use. Application of nanotechnology and materials engineering in agriculture particularly in the design of CRFs, the distinctions and classification of CRFs, and the economical, agronomical, and environmental aspects of CRFs has been revised putting into account the development and synthesis of CRFs, laboratory CRFs syntheses and testing, and both linear and sigmoid release features of CRF formulations. Methodical account on the mechanism of nutrient release centring on the empirical and mechanistic approaches of predicting nutrient release is given in view of selected mathematical models. Compositions and laboratory preparations of CRFs basing on in situ and graft polymerization are provided alongside the physical methods used in CRFs encapsulation, with an emphasis on the natural polymers, modified clays, and superabsorbent nanocomposite excipients.

Ovulation monitoring and fertility knowledge: Their relationship to fertility experience in a cross-sectional study.

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Righarts, Antoinette; Dickson, Nigel P; Parkin, Lianne; Gillett, Wayne R

2017-08-01

Various aspects of fertility knowledge, including the timing of the fertile window, have consistently been found to be poor. Limited evidence also suggests ovulation monitoring to time intercourse could be common. However, there have been no studies that compare these two aspects of fertility and women's fertility/infertility experiences. To examine the frequency of ovulation monitoring and its relationship with fertility knowledge and experience. A cross-sectional study of women aged 25-50 years resident in southern New Zealand was undertaken in 2011. Randomly selected women were asked to complete a fertility questionnaire. Outcome prevalence measures were calculated with 95% confidence intervals (CI) and associations investigated using χ 2 tests and Poisson regression. Ovulation monitoring was common, having ever been undertaken by 31.4% (95% CI: 28.5-34.3%) of the 1034 participants. However, knowledge was poor, particularly regarding the fertile window. More women who had ever monitored ovulation correctly identified the fertile window, although the proportion was still very low (18.4 vs 13.1% in those who had not, P = 0.027). Regression modelling showed ovulation monitoring was independently associated with seeking medical help to conceive, education and fertility experience, but not with knowledge. This study confirms ovulation monitoring was commonly undertaken. However, many women, including those who had monitored their ovulation, had poor fertility knowledge and failed to identify the fertile window. Poor fertility knowledge needs to be addressed, especially among women intending to conceive. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Outcome of Cesarean Myomectomy: Is it a Safe Procedure?

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Senturk, Mehmet Baki; Polat, Mesut; Doğan, Ozan; Pulatoğlu, Çiğdem; Yardımcı, Oğuz Devrim; Karakuş, Resul; Tayyar, Ahter Tanay

2017-11-01

Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p  0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p  0.05). This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.

Tennessee Valley Authority National Fertilizer and Environmental Research Center

International Nuclear Information System (INIS)

Gautney, J.

1991-01-01

The National Fertilizer and Environmental Research Center (NFERC) is a unique part of the Tennessee Valley Authority (TVA), a government agency created by an Act of Congress in 1933. The Center, located in Muscle Shoals, Alabama, is a national laboratory for research, development, education and commercialization for fertilizers and related agricultural chemicals including their economic and environmentally safe use, renewable fuel and chemical technologies, alternatives for solving environmental/waste problems, and technologies which support national defense- NFERC projects in the pesticide waste minimization/treatment/disposal areas include ''Model Site Demonstrations and Site Assessments,'' ''Development of Waste Treatment and Site Remediation Technologies for Fertilizer/Agrichemical Dealers,'' ''Development of a Dealer Information/Education Program,'' and ''Constructed Wetlands.''

Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: A retrospective study

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Yan, Jia-Fei; Xu, Xiao-Wu; Jin, Wei-Wei; Huang, Chao-Jie; Chen, Ke; Zhang, Ren-Chao; Harsha, Ajoodhea; Mou, Yi-Ping

2014-01-01

AIM: To describe the clinical characteristics, technical procedures, and outcomes of patients undergoing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for benign and malignant pancreatic neoplasms. METHODS: The clinical data of 38 patients who underwent LSPDP in the Sir Run Run Shaw Hospital between January 2003 and August 2013 were analyzed retrospectively. Surgical techniques for LSPDP included preservation of the splenic artery and vein (Kimura’s technique) and ligation of the splenic pedicle with preservation of the short gastric vessels (Warshaw’s technique). RESULTS: There were no conversions to open surgery in the 38 patients. Splenic vessels were conserved during spleen-preserving pancreatectomy, except in two patients who underwent resection of the splenic vessels and preservation only of the short gastric vessels. The mean operation time was 123.2 ± 52.4 min, the mean intraoperative blood loss was 78.2 ± 39.5 mL, and the mean postoperative hospital stay was 7.6 ± 2.9 d. The overall rate of postoperative complications was 18.4% (7/38), and the rate of clinical pancreatic fistula was 13.2% (5/38). All postoperative complications were treated conservatively. The postoperative pathological diagnoses were 22 cases of benign pancreatic disease and 16 cases of borderline or low-grade malignant lesions. During a median follow-up of 38 mo (range: 5-133 mo), no recurrence was observed. CONCLUSION: LSPDP is a safe, feasible and effective procedure for the treatment of benign and low-grade malignant tumors of the distal pancreas. PMID:25320534

Can simple trachelectomy or conization show comparable survival rate compared with radical trachelectomy in IA1 cervical cancer patients with lymphovascular space invasion who wish to save fertility? A systematic review and guideline recommendation.

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Shim, Seung-Hyuk; Lim, Myong Cheol; Kim, Hyun Jung; Lee, Maria; Nam, Eun Ji; Lee, Jung Yun; Lee, Yoo-Young; Lee, Kwang Beom; Park, Jeong Yeol; Kim, Yun Hwan; Ki, Kyung Do; Song, Yong Jung; Chung, Hyun Hoon; Kim, Sunghoon; Lee, Jeong-Won; Kim, Jae-Weon; Bae, Duk-Soo; Lee, Jong-Min

2018-01-01

This study aims to analyze the published literatures on the effect of less radical fertility-preserving procedures, such as conization or simple trachelectomy, on oncological outcomes in IA1 cervical cancer patients with lymphovascular space invasion (LVSI) through a systematic-review. The EMBASE and MEDLINE databases and Cochrane Library were searched for published studies reporting the oncological outcomes of conization/simple trachelectomy in these patients, through April 2017. The endpoints were recurrence and mortality rates. Data were presented as per the Meta-analysis Of Observational Studies in Epidemiology checklist. Practice guidelines were generated via the Grading of Recommendation, Assessment, Development and Evaluation system. From 6,755 records, 94 full-texts articles were reviewed for eligibility, and five studies were included in this systematic review. All included studies were nonrandomized studies: two case-control studies comparing conization (n = 14) with hysterectomy (n = 24), and the other three were interrupted time series including conization (n = 20) and simple vaginal trachelectomy (n = 59). During the median follow-up duration of 43 months, no recurrence was reported in both conization and simple trachelectomy groups in IA1 patients with LVSI. From three studies reporting the fertility outcomes, the rates of pregnancy, live birth, preterm delivery, and second-trimester miscarriage were 73% (35/48), 64% (32/50), 10% (5/48), and 6% (3/48), respectively. Results suggest that simple trachelectomy or conization could be performed for IA1 cervical cancer patients with LVSI who want to preserve fertility, although these results are only based on a small number of nonrandomized studies (recommendation grade 2 = weak; evidence level D = very low). Further randomized trials with long-term study period are needed to address this issue.

Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

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Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

2014-07-21

Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

Toward theoretical understanding of the fertility preservation decision-making process: examining information processing among young women with cancer.

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Hershberger, Patricia E; Finnegan, Lorna; Altfeld, Susan; Lake, Sara; Hirshfeld-Cytron, Jennifer

2013-01-01

Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. The purpose of this article is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Using a grounded theory approach, 27 women with cancer participated in individual, semistructured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by 5 dimensions within the Contemplate phase of the decision-making process framework. In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Better understanding of theoretical underpinnings surrounding women's information processes can facilitate decision support and improve clinical care.

Modern High Technology Solutions for Quality and Longterm Vegetable Preservation

International Nuclear Information System (INIS)

Nacheva, I.; Miteva, D.; Todorov, Y.; Loginovska, K.; Tsvetkov, Ts.

2012-01-01

In the publication the authors present the results of the applying of two modern technologies for long term and safe vegetable preservation – freeze-drying and gamma sterilization. The freeze-dried vegetables feature minimum moisture – from 2 – 5% and taste-aroma complex preserved to the highest degree. The carried out gamma sterilization ensures a high microbial purity of the vegetables and guarantees for their long term preservation - up to 5 years in polymer packing, under usual conditions

Ranking of healthcare programmes based on health outcome, health costs and safe delivery of care in hospital pharmacy practice.

Science.gov (United States)

Brisseau, Lionel; Bussières, Jean-François; Bois, Denis; Vallée, Marc; Racine, Marie-Claude; Bonnici, André

2013-02-01

To establish a consensual and coherent ranking of healthcare programmes that involve the presence of ward-based and clinic-based clinical pharmacists, based on health outcome, health costs and safe delivery of care. This descriptive study was derived from a structured dialogue (Delphi technique) among directors of pharmacy department. We established a quantitative profile of healthcare programmes at five sites that involved the provision of ward-based and clinic-based pharmaceutical care. A summary table of evidence established a unique quality rating per inpatient (clinic-based) or outpatient (ward-based) healthcare programme. Each director rated the perceived impact of pharmaceutical care per inpatient or outpatient healthcare programme on three fields: health outcome, health costs and safe delivery of care. They agreed by consensus on the final ranking of healthcare programmes. A ranking was assigned for each of the 18 healthcare programmes for outpatient care and the 17 healthcare programmes for inpatient care involving the presence of pharmacists, based on health outcome, health costs and safe delivery of care. There was a good correlation between ranking based on data from a 2007-2008 Canadian report on hospital pharmacy practice and the ranking proposed by directors of pharmacy department. Given the often limited human and financial resources, managers should consider the best evidence available on a profession's impact to plan healthcare services within an organization. Data are few on ranking healthcare programmes in order to prioritize which healthcare programme would mostly benefit from the delivery of pharmaceutical care by ward-based and clinic-based pharmacists. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Fertility awareness-based mobile application for contraception

Science.gov (United States)

Berglund Scherwitzl, Elina; Gemzell Danielsson, Kristina; Sellberg, Jonas A.; Scherwitzl, Raoul

2016-01-01

Abstract Objectives: The aim of the study was to retrospectively evaluate the effectiveness of a fertility awareness-based method supported by a mobile-based application to prevent unwanted pregnancies as a method of natural birth control. Methods: In a retrospective analysis, the application’s efficiency as a contraceptive method was examined on data from 4054 women who used the application as contraception for a total of 2085 woman-years. Results: The number of identified unplanned pregnancies was 143 during 2053 woman-years, giving a Pearl Index of 7.0 for typical use. Ten of the pregnancies were due to the application falsely attributing a safe day within the fertile window, producing a perfect-use Pearl Index of 0.5. Calculating the cumulative pregnancy probability by life-table analysis resulted in a pregnancy rate of 7.5% per year (95% confidence interval 5.9%, 9.1% per year). Conclusions: The application appears to improve the effectiveness of fertility awareness-based methods and can be used to prevent pregnancies if couples consistently protect themselves on fertile days. PMID:27003381

Regulation of fertilization and early seed development.

Science.gov (United States)

Dresselhaus, Thomas; Doughty, James

2014-04-01

Plant reproduction meetings often deal either with pre-fertilization processes such as flowering and pollen biology or post-fertilization processes such as embryogenesis and seed development. The Biochemical Society Focused Meeting entitled 'Regulation of Fertilization and Early Seed Development' was organized to close this gap and to discuss mechanistic similarities and future research directions in the reproductive processes shortly before, during and after fertilization. As an outcome of the workshop, invited speakers and a few selected oral communication presenters contributed focused reviews and technical articles for this issue of Biochemical Society Transactions. We provide here a short overview of the contents and highlights of the various articles.

Rudiments of recent fertility decline in Hungary: Postponement, educational differences, and outcomes of changing partnership forms

Directory of Open Access Journals (Sweden)

Zsolt Spéder

2006-10-01

Full Text Available Our study describes fundamental changes in childbearing behavior in Hungary. It documents current postponement of entry into motherhood (first birth and uncovers signs of delay in second birth. We place the behavioral modifications into historical time and reveal the basic role of the political, economic, and societal transformation of Hungary that started in 1989-1990 in these modifications. We document postponement as well as differentiation, and mothers' highest level of education will represent the structural position of individuals. We shed light on the different speed of postponement and support the assumption of behavioral differences according to the highest level of education. Particular attention will be paid to changing partnership relations: Fertility outcomes remain to be strongly associated with the type of partnership and its development; profound changes in partnership formation, namely the proliferation of cohabitation and the increasing separation rate of first partnerships, may therefore facilitate fertility decline in Hungary. The analysis is based on the first wave of the Hungarian panel survey "Turning points of the life course" carried out in 2001/2002.

Histology of Testicular Biopsies Obtained for Experimental Fertility Preservation Protocol in Boys with Cancer.

Science.gov (United States)

Pietzak, Eugene J; Tasian, Gregory E; Tasian, Sarah K; Brinster, Ralph L; Carlson, Claire; Ginsberg, Jill P; Kolon, Thomas F

2015-11-01

Cryopreservation of testicular tissue with subsequent reimplantation after therapy has the potential to preserve fertility for prepubertal boys with cancer. We present the histology and feasibility of testicular tissue procurement for this novel approach. We performed a prospective cohort study of boys at significant risk for treatment associated gonadotoxicity who were eligible for an experimental research protocol between 2008 and 2011. Open testicular biopsy was performed while the patients were anesthetized for another treatment related procedure. Half of the specimen was reserved for cryopreservation, while the other half was used for research purposes. Semithin sections of the biopsy specimens were evaluated for histological features and compared to age adjusted reference values. A total of 34 boys underwent biopsy between March 2008 and October 2011. Of the patients 29 had solid tumors and 5 underwent hematopoietic stem cell transplantation for benign disease. A total of 27 patients had adequate tissue for histological analysis. Median patient age was 8.7 years (IQR 2.2 to 11.5). All children had either normal (81.5% of patients) or increased (18.5%) numbers of germ cells per tubule for their age. However, 5 of 26 patients (19%) older than 6 months had no evidence of adult dark spermatogonia and 9 of 16 (56%) older than 6 years had no evidence of primary spermatocytes on biopsy, which would be expected based on age norms. These findings are suggestive of abnormal germ cell maturation. The preliminary histological findings of abnormal spermatogenesis maturation in the testes of prepubertal boys with cancer warrants further investigation. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Goserelin with chemotherapy to preserve ovarian function in pre-menopausal women with early breast cancer: menstruation and pregnancy outcomes.

Science.gov (United States)

Wong, M; O'Neill, S; Walsh, G; Smith, I E

2013-01-01

Premature ovarian failure and infertility following chemotherapy in early breast cancer (EBC) are major concerns for young women. The role of gonadotrophin-releasing hormone (GnRH) agonists with chemotherapy in EBC in reducing the incidence of chemotherapy-induced early menopause remains uncertain, and long-term data on the recovery of fertility are sparse. We report an audit of our experience with the GnRH agonist, goserelin (Zoladex®), used with chemotherapy to preserve ovarian function and maintain fertility. Pre-menopausal women were given goserelin subcutaneously every 28 days during chemotherapy, starting 0-14 days before treatment. The main clinical end point was recovery of menstruation after chemotherapy. The other end points were rate of successful conception and median time to recovery of menses. About 84% of 125 women recovered menstruation with the median time to recovery of 6 months (1-43 months), including 76% of 71 patients aged over 35. Of the 42 patients who attempted pregnancy, 71% (n=30) managed to achieve pregnancies. At the time of analysis, there were 42 pregnancies and 30 healthy deliveries. The GnRH agonist, goserelin, given with chemotherapy for EBC is associated with a low risk of long-term chemotherapy-induced amenorrhoea and a high chance of pregnancy. Further randomised trials are needed.

A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

NARCIS (Netherlands)

van Heesch, M.M.J.; Evers, J.L.H.; Dumoulin, J.C.M.; van der Hoeven, M.A.H.B.; van Beijsterveldt, C.E.M.; Bonsel, G.J.; Dykgraaf, R.H.M.; van Goudoever, J.B.; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; van Zonneveld, P.; Dirksen, C.D.

2014-01-01

Objective To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

NARCIS (Netherlands)

Heesch, M.M. van; Evers, J.L.H.; Dumoulin, J.C.; Hoeven, M.A. van der; Beijsterveldt, C.E. van; Bonsel, G.J.; Dykgraaf, R.H.; Goudoever, J.B. van; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; Zonneveld, P. van; Dirksen, C.D.

2014-01-01

OBJECTIVE: To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

Ovarian preservation in locally advanced cervical cancer undergoing neoadjuvant chemotherapy and radical surgery: our experience and analysis of the literature.

Science.gov (United States)

Signorelli, Mauro; Bogani, Giorgio; Chiappa, Valentina; Ditto, Antonino; Scaffa, Cono; Martinelli, Fabio; Lorusso, Domenica; Raspagliesi, Francesco

2018-03-30

The aim of this study was to estimate the rate of ovarian metastases and recurrences among patients affected by locally advanced stage cancer patients (LACC), undergoing neoadjuvant chemotherapy (NACT) and radical surgery with conservation of ovaries. Retrospective evaluation of consecutive patients affected by LACC (stage IB2- IIB), treated by NACT followed by radical surgery at National Cancer Institute, Milan, Italy, between 1990-2015. Overall, 331 patients were included. Stage at presentation included stage IB2, IIA and IIB in 120 (36.3%), 63 (19%) and 148 (44.7%) patients, respectively. Main histotype was squamous cell carcinoma (n=265, 80.1%) followed by adenocarcinoma/adenosquamous (n=51, 15.4%), and more than half of patients had a grade 3 carcinoma . Overall, 102 (30.8%) women had at least one ovary preserved during surgery, while 229 (69.2%) had bilateral salpingo-oophorectomy. Comparing patients who had ovarian preservation with patients who had not, we observed that the two groups were comparable in terms of baseline characteristics. Survival outcomes were not influenced by ovarian preservation (disease-free (p=0.93) and overall (p=0.65) survivals). One (1%) woman had a localized ovarian recurrence. Our data suggest that ovarian preservation at the time of surgery is a safe option among women with LACC after NACT with no detrimental impact on oncologic outcome. Further prospective studies are warranted.

The impact of freedom on fertility decline.

Science.gov (United States)

Campbell, Martha M; Prata, Ndola; Potts, Malcolm

2013-01-01

Although fertility decline often correlates with improvements in socioeconomic conditions, many demographers have found flaws in demographic transition theories that depend on changes in distal factors such as increased wealth or education. Human beings worldwide engage in sexual intercourse much more frequently than is needed to conceive the number of children they want, and for women who do not have access to the information and means they need to separate sex from childbearing, the default position is a large family. In many societies, male patriarchal drives to control female reproduction give rise to unnecessary medical rules constraining family planning (including safe abortion) or justifying child marriage. Widespread misinformation about contraception makes women afraid to adopt modern family planning. The barriers to family planning can be so deeply infused that for many women the idea of managing their fertility is not considered an option. Conversely, there is evidence that once family planning is introduced into a society, then it is normal consumer behaviour for individuals to welcome a new technology they had not wanted until it became realistically available. We contend that in societies free from child marriage, wherever women have access to a range of contraceptive methods, along with correct information and backed up by safe abortion, family size will always fall. Education and wealth can make the adoption of family planning easier, but they are not prerequisites for fertility decline. By contrast, access to family planning itself can accelerate economic development and the spread of education.

A safe and accurate method to perform esthetic mandibular contouring surgery for Far Eastern Asians.

Science.gov (United States)

Hsieh, A M-C; Huon, L-K; Jiang, H-R; Liu, S Y-C

2017-05-01

A tapered mandibular contour is popular with Far Eastern Asians. This study describes a safe and accurate method of using preoperative virtual surgical planning (VSP) and an intraoperative ostectomy guide to maximize the esthetic outcomes of mandibular symmetry and tapering while mitigating injury to the inferior alveolar nerve (IAN). Twelve subjects with chief complaints of a wide and square lower face underwent this protocol from January to June 2015. VSP was used to confirm symmetry and preserve the IAN while maximizing the surgeon's ability to taper the lower face via mandibular inferior border ostectomy. The accuracy of this method was confirmed by superimposition of the perioperative computed tomography scans in all subjects. No subjects complained of prolonged paresthesia after 3 months. A safe and accurate protocol for achieving an esthetic lower face in indicated Far Eastern individuals is described. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Economic crisis promotes fertility decline in poor areas: Evidence from Colombia

Directory of Open Access Journals (Sweden)

Eleonora Davalos

2017-09-01

Full Text Available Background: The effects of an economic recession extend beyond financial spheres and spill over into present and future family decisions via income restrictions and expectations. Hardly any research on the effects of economic recession on fertility outcomes has taken place in developing countries. Objective: This study seeks to explain the effects of economic cycles on fertility outcomes in poor areas. Methods: This paper analyzes fertility trends from the third largest economy in Latin America - Colombia - from 1998 to 2013. We estimate a panel data regression model with state and year fixed effects. Results: On average, periods of recession are associated with fertility decline in poor areas and fertility growth in well-off areas. During an economic crisis, fertility in poor states decreases by 0.002 children per woman, while in well-off states fertility increases by 0.007 children per woman. Conclusions: The impact of an economic crisis on fertility varies depending on poverty. Poor states have procyclical responses while well-off states tend to have countercyclical reactions to economic downturns. Contribution: This study illuminates the procyclical and countercyclical debate, showing that within a country there can be two different responses to an economic downturn.

Digital Preservation Tools for Repository Managers 2: institutional and lifecycle preservation costs

OpenAIRE

Hitchcock, Steve; Beagrie, Neil; Hole, Brian

2010-01-01

The 5-module JISC KeepIt course on Digital Preservation Tools for Repository Managers was designed by repository managers. Each module consists of a mix of short presentations and hands-on exercises to learn about the basics and gain practice with each of the tools covered. Module 2 covers lifecycle costs for managing digital objects, based on the LIFE approach, and institutional costs. Tools include Keeping Research Data Safe (KRDS) a model, method and survey for assessing the institutional ...

Spleen-preserving distal pancreatectomy in trauma.

Science.gov (United States)

Schellenberg, Morgan; Inaba, Kenji; Cheng, Vincent; Bardes, James M; Lam, Lydia; Benjamin, Elizabeth; Matsushima, Kazuhide; Demetriades, Demetrios

2018-01-01

Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. All patients who underwent distal pancreatectomy (January 1, 2007, to December 31, 2014) were identified from the National Trauma Data Bank. Patients with concomitant splenic injury and those who underwent partial splenectomy were excluded. Demographics, clinical data, procedures, and outcomes were collected. Study groups were defined by surgical procedure: distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy. Baseline characteristics between groups were compared with univariate analysis. Multivariate analysis was performed with logistic and linear regression to examine differences in outcomes. Over the 8-year study period, 2,223 patients underwent distal pancreatectomy. After excluding 1,381 patients with concomitant splenic injury (62%) and 8 (pancreatectomy and splenectomy, those who underwent spleen-preserving distal pancreatectomy were younger (p pancreatectomy (p = 0.017). Complications, mortality, and intensive care unit LOS were not significantly different. In young patients after blunt trauma who are not severely injured, a spleen-preserving distal pancreatectomy should be considered to allow for conservation of splenic function and a shorter hospital LOS. In all other patients, the surgeon should not hesitate to remove the spleen with the distal pancreas. Therapy, level IV.

Mlh1 is required for female fertility in Drosophila melanogaster: An outcome of effects on meiotic crossing over, ovarian follicles and egg activation.

Science.gov (United States)

Vimal, Divya; Kumar, Saurabh; Pandey, Ashutosh; Sharma, Divya; Saini, Sanjay; Gupta, Snigdha; Ravi Ram, Kristipati; Chowdhuri, Debapratim Kar

2018-03-01

Mismatch repair (MMR) system, a conserved DNA repair pathway, plays crucial role in DNA recombination and is involved in gametogenesis. The impact of alterations in MMR family of proteins (bacterial MutS and MutL homologues) on mammalian fertility is well documented. However, an insight to the role of MMR in reproduction of non-mammalian organisms is limited. Hence, in the present study, we analysed the impact of mlh1 (a MutL homologue) on meiotic crossing over/recombination and fertility in a genetically tractable model, Drosophila melanogaster. Using mlh1 e00130 hypomorphic allele, we report female specific adverse reproductive outcome for reduced mlh1 in Drosophila: mlh1 e00130 homozygous females had severely reduced fertility while males were fertile. Further, mlh1 e00130 females contained small ovaries with large number of early stages as well as significantly reduced mature oocytes, and laid fewer eggs, indicating discrepancies in egg production and ovulation. These observations contrast the sex independent and/or male specific sterility and normal follicular development as well as ovulation reported so far for MMR family proteins in mammals. However, analogous to the role(s) of mlh1 in meiotic crossing over and DNA repair processes underlying mammalian fertility, ovarian follicles from mlh1 e00130 females contained significantly increased DNA double strand breaks (DSBs) and reduced synaptonemal complex foci. In addition, large proportion of fertilized eggs display discrepancies in egg activation and fail to proceed beyond stage 5 of embryogenesis. Hence, reduction of the Mlh1 protein level leads to defective oocytes that fail to complete embryogenesis after fertilization thereby reducing female fertility. Copyright © 2017 Elsevier GmbH. All rights reserved.

A Multinomial Model of Fertility Choice and Offspring Sex-Ratios in India

OpenAIRE

Rubiana Chamarbagwala; Martin Ranger

2007-01-01

Fertility decline in developing countries may have unexpected demographic consequences. Although lower fertility improves nutrition, health, and human capital investments for surviving children, little is known about the relationship between fertility outcomes and female-male offspring sex-ratios. Particularly in countries with a cultural preference for sons, like India and China, fertility decline may deteriorate the already imbalanced sex-ratios. We use the fertility histories of over 90,00...

Toward theoretical understanding of the fertility preservation decision-making process: Examining information processing among young women with cancer

Science.gov (United States)

Hershberger, Patricia E.; Finnegan, Lorna; Altfeld, Susan; Lake, Sara; Hirshfeld-Cytron, Jennifer

2014-01-01

Background Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. Objective The purpose of this paper is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Methods Using a grounded theory approach, 27 women with cancer participated in individual, semi-structured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by five dimensions within the Contemplate phase of the decision-making process framework. Results In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Conclusion Better understanding of theoretical underpinnings surrounding women’s information processes can facilitate decision support and improve clinical care. PMID:24552086

Outcome of Radical Surgical Resection for Craniopharyngioma with Hypothalamic Preservation: A Single-Center Retrospective Study of 1054 Patients.

Science.gov (United States)

Shi, Xiang'en; Zhou, Zhongqing; Wu, Bin; Zhang, Yongli; Qian, Hai; Sun, Yuming; Yang, Yang; Yu, Zaitao; Tang, Zhiwei; Lu, Shuaibin

2017-06-01

A retrospective review of the surgical outcome for patients with craniopharyngioma (CP) treated in a single neurosurgical center with surgical resection using visualization to ensure hypothalamic preservation. The study included 1054 patients. Before 2003, a pterional cranial approach was preferred for 78% of patients; after 2004, the unifrontal basal interhemispheric approach was performed in 79.1% of patients. Complete tumor resection was achieved in 89.6% of patients; vision improved in 47.1% of patients who had preoperative vision impairment. However, diabetes insipidus worsened in 70.4% of patients and new-onset diabetes insipidus occurred in 29.7% of the remaining patients. Pituitary stalk preservation occurred in 48.9% of cases. There were 89.6% of patients with total tumor removal; 13.3% of patients showed tumor recurrence within an average of 2.8 years. Of 69 follow-up patients with a subtotal or partial resection, 94.2% showed tumor recurrence within an average of 4.3 months. Of the total patients, 82.3% fully recovered. This study has shown that radical surgical resection of CP using microsurgical excision can be effective with a good patient outcome without more limitations on each individual tumor of distinct features despite the impact of recent endoscopic techniques on CP surgery. The surgical approach depends on a direct and wider visualization of CP located in the midline with preserving hypothalamic structures by identifying some hypothalamic landmark structures. After surgery, most patients can resume their normal activities even after aggressive tumor removal, although patients require postoperative hormonal replacement. Copyright © 2017 Elsevier Inc. All rights reserved.

Outcome and Impact of Aortic Valve Replacement in Patients With Preserved LVEF and Low-Gradient Aortic Stenosis.

Science.gov (United States)

Dayan, Victor; Vignolo, Gustavo; Magne, Julien; Clavel, Marie-Annick; Mohty, Dania; Pibarot, Philippe

2015-12-15

Low mean transvalvular gradient (gradient (LG) AS and preserved left ventricular ejection fraction, including paradoxical low-flow (i.e., stroke volume index gradient (LF-LG) and normal-flow, low-gradient (NF-LG), and those with high-gradient (≥ 40 mm Hg) AS or moderate AS. Studies published between 2005 and 2015 were analyzed. Primary outcome was the survival benefit associated with AVR. Secondary outcome was overall mortality regardless of treatment. Eighteen studies were included in the analysis. Patients with LF-LG AS have increased mortality compared with patients with moderate AS (hazard ratio [HR]: 1.68; 95% confidence interval [CI]: 1.31 to 2.17), NF-LG (HR: 1.80; 95% CI: 1.29 to 2.51), and high-gradient (HR: 1.67; 95% CI: 1.16 to 2.39) AS. AVR was associated with reduced mortality in patients with LF-LG (HR: 0.44; 95% CI: 0.25 to 0.77). Similar benefit occurred with AVR in patients with NF-LG (HR: 0.48; 95% CI: 0.28 to 0.83). Compared with patients with high-gradient AS, those with LF-LG were less likely to be referred to AVR (odds ratio: 0.32; 95% CI: 0.21 to 0.49). Patients with paradoxical LF-LG AS and NF-LG AS have increased risk of mortality compared with other subtypes of AS with preserved left ventricular ejection fraction, and improved outcome with AVR. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Multivariate Cholesky models of human female fertility patterns in the NLSY.

Science.gov (United States)

Rodgers, Joseph Lee; Bard, David E; Miller, Warren B

2007-03-01

Substantial evidence now exists that variables measuring or correlated with human fertility outcomes have a heritable component. In this study, we define a series of age-sequenced fertility variables, and fit multivariate models to account for underlying shared genetic and environmental sources of variance. We make predictions based on a theory developed by Udry [(1996) Biosocial models of low-fertility societies. In: Casterline, JB, Lee RD, Foote KA (eds) Fertility in the United States: new patterns, new theories. The Population Council, New York] suggesting that biological/genetic motivations can be more easily realized and measured in settings in which fertility choices are available. Udry's theory, along with principles from molecular genetics and certain tenets of life history theory, allow us to make specific predictions about biometrical patterns across age. Consistent with predictions, our results suggest that there are different sources of genetic influence on fertility variance at early compared to later ages, but that there is only one source of shared environmental influence that occurs at early ages. These patterns are suggestive of the types of gene-gene and gene-environment interactions for which we must account to better understand individual differences in fertility outcomes.

The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET outcome

Directory of Open Access Journals (Sweden)

Al-Rejjal Rafat

2008-09-01

Full Text Available Abstract Background To evaluate the relationship between endometrial thickness on day of human chorionic gonadotrophin administration (hCG and pregnancy outcome in a large number of consecutive in vitro fertilization and embryo transfer (IVF-ET cycles. Methods A retrospective cohort study including all patients who had IVF-ET from January 2003–December 2005 conducted at a tertiary center. Results A total of 2464 cycles were analysed. Pregnancy rate (PR was 35.8%. PR increased linearly (r = 0.864 from 29.4% among patients with a lining of less than or equal to 6 mm, to 44.4% among patients with a lining of greater than or equal to 17 mm. ROC showed that endometrial thickness is not a good predictor of PR, so a definite cut-off value could not be established (AUC = 0.55. Conclusion There is a positive linear relationship between the endometrial thickness measured on the day of hCG injection and PR, and is independent of other variables. Hence aiming for a thicker endometrium should be considered.

Child-rearing ability and the provision of fertility services: an Ethics Committee opinion.

Science.gov (United States)

2017-12-01

Fertility programs may withhold services from prospective patients on the basis of well-grounded reasons that those patients will be unable to provide minimally adequate or safe care for offspring. This document was reviewed and updated; this version replaces the previous version of this document, last published July 2013 (Fertil Steril 2013;100:50-53). Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

First production of larvae using cryopreserved sperm: Effects of preservation temperature and cryopreservation on European eel sperm fertilization capacity

DEFF Research Database (Denmark)

Asturiano, J.F.; Sørensen, Sune Riis; Perez, L.

2016-01-01

Sperm cryopreservation is a useful tool in captive fish reproduction management, that is to synchronize gamete production, especially in the case of species as the European eel, where the time of female spawning readiness is unpredictable. Several protocols to cryopreserve sperm of this species....... Fertilization of two egg batches was attempted. Diluted sperm caused a similar percentage of fertilized eggs and a similar number of embryos and larvae, independently of storage temperature (4 or 20°C). The cryopreserved sperm resulted in a lower percentage of fertilized eggs, but embryos developed and a few...... larvae ('cryolarvae') were obtained 55 h after fertilization in one of the two egg batches. This result evidences that the tested cryopreservation protocol is applicable for eel reproduction management, although improvements will be required to enhance fertilization success...

Essential Oils: Sources of Antimicrobials and Food Preservatives

Science.gov (United States)

Pandey, Abhay K.; Kumar, Pradeep; Singh, Pooja; Tripathi, Nijendra N.; Bajpai, Vivek K.

2017-01-01

Aromatic and medicinal plants produce essential oils in the form of secondary metabolites. These essential oils can be used in diverse applications in food, perfume, and cosmetic industries. The use of essential oils as antimicrobials and food preservative agents is of concern because of several reported side effects of synthetic oils. Essential oils have the potential to be used as a food preservative for cereals, grains, pulses, fruits, and vegetables. In this review, we briefly describe the results in relevant literature and summarize the uses of essential oils with special emphasis on their antibacterial, bactericidal, antifungal, fungicidal, and food preservative properties. Essential oils have pronounced antimicrobial and food preservative properties because they consist of a variety of active constituents (e.g., terpenes, terpenoids, carotenoids, coumarins, curcumins) that have great significance in the food industry. Thus, the various properties of essential oils offer the possibility of using natural, safe, eco-friendly, cost-effective, renewable, and easily biodegradable antimicrobials for food commodity preservation in the near future. PMID:28138324

Strategies for safe motherhood.

Science.gov (United States)

Chatterjee, A

1995-02-01

The Safe Motherhood Initiative was launched in 1988 as a global effort to halve maternal mortality and morbidity by the year 2000. The program uses a combination of health and nonhealth strategies to emphasize the need for maternal health services, extend family planning services, and improve the status of women. The maternal mortality rate (per 100,000 live births) is 390 for the world, 20-30 for developed countries, 450 for developing countries, and 420 for Asia. This translates into 308,000 maternal deaths in Asia, of which 100,000 occur in India. The direct causes of maternal mortality include sepsis, hemorrhage, eclampsia, and ruptured uterus. Indirect causes occur when associated medical conditions, such as anemia and jaundice, are exacerbated by pregnancy. Underlying causes are ineffective health services, inadequate obstetric care, unregulated fertility, infections, illiteracy, early marriage, poverty, malnutrition, and ignorance. India's Child Survival and Safe Motherhood Program seeks to achieve immediate improvements by improving health care. Longterm improvements will occur as nutrition, income, education, and the status of women improve. Improvements in health care will occur in through the provision of 1) essential obstetric care for all women (which will be essentially designed for low-risk women), 2) early detection of complications during pregnancy and labor, and 3) emergency services. Services will be provided to pregnant women at their door by field staff, at a first referral hospital, perhaps at maternity villages where high risk cases can be housed in the latter part of their pregnancies, and through the continual accessibility of government vehicles. In addition, family planning services will be improved so that fertility regulation can have its expected beneficial effect on the maternal mortality rate. The professional health organizations in India will also play a vital role in the success of this effort to reduce maternal mortality.

Evaluating Cost-Effectiveness of Interventions that Affect Fertility and Childbearing: How Health Effects are Measured Matters

Science.gov (United States)

Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

2015-01-01

Background Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Objective To characterize current practices for counting such health outcomes. Design We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on QALYs associated with fertility and childbearing. Results We reviewed 108 studies, identifying seven themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies employed multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations The review was targeted rather than systematic. Conclusions Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased towards the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our

5 Steps to Food Preservation Program Meets the Needs of Idaho Families

Science.gov (United States)

Dye, Lorie; Hoffman, Katie

2014-01-01

University of Idaho FCS Extension Educators in southeastern Idaho developed a five-lesson condensed version of safe food preservation classes, driven by participants' interest to meet the needs of everyday home preservers. A post-test survey revealed that participants took the course to be self-reliant, use their own produce, and be in control of…

Organ Preservation Using Contact Radiotherapy for Early Rectal Cancer: Outcomes of Patients Treated at a Single Centre in the UK.

Science.gov (United States)

Dhadda, A S; Martin, A; Killeen, S; Hunter, I A

2017-03-01

Contact radiotherapy for early rectal cancer uses 50 kV X-rays to treat rectal cancers under direct vision. We present data of a series of patients treated at a single centre with prospective follow-up and functional assessment. All patients were treated at the Queen's Centre for Oncology, Hull, UK between September 2011 and October 2015. Patients received a biopsy, magnetic resonance imaging (MRI) of the liver/pelvis, computed tomography of the chest and endorectal ultrasound. Patients were deemed to be either unfit for radical surgery or refused it due to the need for a permanent stoma. Follow-up consisted of 3 monthly flexible sigmoidoscopy and MRI of the liver/pelvis and 12 monthly computed tomography of the chest. In total, 42 patients were treated with contact radiotherapy ± external beam chemo/radiotherapy without any primary surgical excision. The median age was 78 years (range 50-94 years). Local recurrence-free survival was 88%, disease-free survival was 86% and overall survival was 88% with a median follow-up of 24 months (range 5-54 months). The median time to recurrence was 12 months (range 4-14 months). The estimated 30 day surgical mortality for this cohort with radical surgery was 12%. Mortality from the contact radiotherapy procedure was 0%. Functional outcomes as investigated by the Low Anterior Resection Syndrome (LARS) score were good, with 65% having no LARS. Contact radiotherapy for early rectal cancer is a safe, well-tolerated outpatient procedure, allowing organ preservation, with excellent oncological and functional outcomes. For elderly co-morbid patients with suitable rectal cancers this should be considered as a standard of care. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Urinary Phthalate Metabolite Concentrations and Reproductive Outcomes among Women Undergoing in Vitro Fertilization: Results from the EARTH Study.

Science.gov (United States)

Hauser, Russ; Gaskins, Audrey J; Souter, Irene; Smith, Kristen W; Dodge, Laura E; Ehrlich, Shelley; Meeker, John D; Calafat, Antonia M; Williams, Paige L

2016-06-01

Evidence from both animal and human studies suggests that exposure to phthalates may be associated with adverse female reproductive outcomes. We evaluated the associations between urinary concentrations of phthalate metabolites and outcomes of assisted reproductive technologies (ART). This analysis included 256 women enrolled in the Environment and Reproductive Health (EARTH) prospective cohort study (2004-2012) who provided one to two urine samples per cycle before oocyte retrieval. We measured 11 urinary phthalate metabolites [mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monoethyl phthalate (MEP), monocarboxyisooctyl phthalate (MCOP), monocarboxyisononyl phthalate (MCNP), and mono(3-carboxypropyl) phthalate (MCPP)]. We used generalized linear mixed models to evaluate the association of urinary phthalate metabolites with in vitro fertilization (IVF) outcomes, accounting for multiple IVF cycles per woman. In multivariate models, women in the highest as compared with lowest quartile of MEHP, MEHHP, MEOHP, MECPP, ΣDEHP (MEHP + MEHHP + MEOHP + MECPP), and MCNP had lower oocyte yield. Similarly, the number of mature (MII) oocytes retrieved was lower in the highest versus lowest quartile for these same phthalate metabolites. The adjusted differences (95% CI) in proportion of cycles resulting in clinical pregnancy and live birth between women in the fourth versus first quartile of ΣDEHP were -0.19 (-0.29, -0.08) and -0.19 (-0.28, -0.08), respectively, and there was also a lower proportion of cycles resulting in clinical pregnancy and live birth for individual DEHP metabolites. Urinary concentrations of DEHP metabolites were inversely associated with oocyte yield, clinical pregnancy, and live birth following ART. Hauser R, Gaskins AJ, Souter I, Smith

Usefulness of radionuclide scintiphotography to evaluate preserved kidney viability

International Nuclear Information System (INIS)

Sato, Koshi; Yokota, Kazuhiko; Uchida, Hisanori

1987-01-01

GAMMA imaging of the renal cortical microcirculation is a safe and non-invasive method for assessment of kidney viability before transplantation. We used trifluoperazine (TFP), urokinase and verapamil from 24 to 120 hour kidney preservation in dogs. For these preserved kidneys, we used radionuuclide scintiphotography to evaluate kidney viability. After preservation, these kidneys were perfused with technitium -99m labeled microspheres, and imaging of the renal vasculature was obtained by scintigraphy. The distribution of the microspheres was assessed visually and by computer analysis. Modified Collins' solution perfused kidneys show very poor cortical uptake with marked increase in uptake in the hilar region after preservation. In contrast, cortical flow remained relatively well preserved in kidneys perfused and preserved by use of modified Collins' solotion with TFP, urokinase and urokinase + verapamil. There was a direct correlation between these results and the capacity of kidneys treated in the same fashion to sustain life after retransplantation into the original host. (author)

Safe Anesthesia For Every Tot

DEFF Research Database (Denmark)

Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G

2015-01-01

PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus...... on the safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

Methodological Issues and Evidence of Malfeasance in Research Purporting to Show Thimerosal in Vaccines Is Safe

Directory of Open Access Journals (Sweden)

Brian Hooker

2014-01-01

Full Text Available There are over 165 studies that have focused on Thimerosal, an organic-mercury (Hg based compound, used as a preservative in many childhood vaccines, and found it to be harmful. Of these, 16 were conducted to specifically examine the effects of Thimerosal on human infants or children with reported outcomes of death; acrodynia; poisoning; allergic reaction; malformations; auto-immune reaction; Well’s syndrome; developmental delay; and neurodevelopmental disorders, including tics, speech delay, language delay, attention deficit disorder, and autism. In contrast, the United States Centers for Disease Control and Prevention states that Thimerosal is safe and there is “no relationship between [T]himerosal[-]containing vaccines and autism rates in children.” This is puzzling because, in a study conducted directly by CDC epidemiologists, a 7.6-fold increased risk of autism from exposure to Thimerosal during infancy was found. The CDC’s current stance that Thimerosal is safe and that there is no relationship between Thimerosal and autism is based on six specific published epidemiological studies coauthored and sponsored by the CDC. The purpose of this review is to examine these six publications and analyze possible reasons why their published outcomes are so different from the results of investigations by multiple independent research groups over the past 75+ years.

Father absence and reproduction-related outcomes in Malaysia, a transitional fertility population.

Science.gov (United States)

Sheppard, Paula; Snopkowski, Kristin; Sear, Rebecca

2014-06-01

Father absence is consistently associated with children's reproductive outcomes in industrialized countries. It has been suggested that father absence acts as a cue to particular environmental conditions that influence life history strategies. Much less is known, however, about the effects of father absence on such outcomes in lower-income countries. Using data from the 1988 Malaysian Family Life Survey (n = 567), we tested the effect of father absence on daughters' age at menarche, first marriage, and first birth; parity progression rates; and desired completed family size in Malaysia, a country undergoing an economic and fertility transition. Father absence during later childhood (ages 8 to 15), although not during earlier childhood, was associated with earlier progressions to first marriage and first birth, after controlling for other confounders. Father absence does not affect age at menarche, desired family size, or progression from first to second birth. The patterns found in this transitional population partly mirror those in developed societies, where father absence accelerates reproductive events. There is, however, a notable contrast between the acceleration in menarche for father-absent girls consistently found in developed societies and the lack of any association in our findings. The mechanisms through which father absence affects reproduction may differ in different ecological contexts. In lower-income contexts, direct paternal investment or influence may be of more importance in determining reproductive behavior than whether fathers act as a cue to environmental conditions.

Resobio. Management of forest residues: preserving soils and biodiversity

International Nuclear Information System (INIS)

Rantien, Caroline; Charasse, Laurent; Wlerick, Lise; Landmann, Guy; Nivet, Cecile; Jallais, Anais; Augusto, Laurent; Bigot, Maryse; Thivolle Cazat, Alain; Bouget, Christophe; Brethes, Alain; Boulanger, Vincent; Richter, Claudine; Cornu, Sophie; Rakotoarison, Hanitra; Ulrich, Erwin; Deleuze, Christine; Michaud, Daniel; Cacot, Emmanuel; Pousse, Noemie; Ranger, Jacques; Saint-Andre, Laurent; Zeller, Bernd; Achat, David; Cabral, Anne-Sophie; Akroume, Emila; Aubert, Michael; Bailly, Alain; Fraysse, Jean-Yves; Fraud, Benoit; Gardette, Yves-Marie; Gibaud, Gwenaelle; Helou, Tammouz-Enaut; Pitocchi, Sophie; Vivancos, Caroline

2014-03-01

The Resobio project (management of forest slash: preservation of soils and biodiversity) aimed at updating knowledge available at the international level (with a focus on temperate areas) on the potential consequences of forest slash sampling on fertility and on biodiversity, and at identifying orientations for recommendations for a revision of the ADEME guide of 2006 on wise collecting of forest slash. The first part of this report is a synthesis report which gives an overview of results about twenty issues dealing with the nature of wood used for energy production and the role of slash, about the consequences of this type of collecting for soil fertility and species productivity, and about impacts on biodiversity. Based on these elements, recommendations are made for slash management and for additional follow-up and research. The second part contains five scientific and technical reports which more deeply analyse the issue of fertility, and technical documents on slash management (guides) published in various countries

Biochar for soil fertility and natural carbon sequestration

Science.gov (United States)

Rostad, C.E.; Rutherford, D.W.

2011-01-01

Biochar is charcoal (similar to chars generated by forest fires) that is made for incorporation into soils to increase soil fertility while providing natural carbon sequestration. The incorporation of biochar into soils can preserve and enrich soils and also slow the rate at which climate change is affecting our planet. Studies on biochar, such as those cited by this report, are applicable to both fire science and soil science.

Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

DEFF Research Database (Denmark)

Klit, Jakob

2014-01-01

, hip OA is associated with FAI covering three fundamentally different hip deformities, including acetabular dysplasia; all hypothesized to initiates OA development. Where PAO is used worldwide as a joint-preserving procedure in acetabular dysplasia, TKA and THA are the treatment of choice of end stage......BACKGROUND: Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma...... information prior to PAO, TKA and THA surgery. MATERIAL AND METHODS: This PhD thesis is based on three studies. Study I is a cross-sectional survey of preserved hip joints with a mean follow-up of ten years after PAO. One hundred patients (121 PAO's) were eligible for inclusion. An inquiry to the National...

Age at First Birth, Fertility, and Contraception in Tanzania

OpenAIRE

Ngalinda, Innocent

1998-01-01

The first visible outcome of the fertility process is the birth of the first child. The first birth marks a woman's transition into motherhood. It plays a significant role in the future life of each individual woman and has a direct relationship with fertility. The age at which child bearing begins influences the number of children a woman bears throughout her reproductive period in the absence of any active fertility control. For countries in sub-Saharan Africa, where contraceptive use is re...

Fertility Intentions, Career Considerations and Subsequent Births: The Moderating Effects of Women's Work Hours.

Science.gov (United States)

Shreffler, Karina M; Johnson, David R

2013-09-01

Prior research indicates a negative relationship between women's labor force participation and fertility at the individual level in the United States, but little is known about the reasons for this relationship beyond work hours. We employed discrete event history models using panel data from the National Survey of Families and Households ( N = 2,411) and found that the importance of career considerations mediates the work hours/fertility relationship. Further, fertility intentions and the importance of career considerations were more predictive of birth outcomes as women's work hours increase. Ultimately, our findings challenge the assumption that working more hours is the direct cause for employed women having fewer children and highlight the importance of career and fertility preferences in fertility outcomes.

Preservation and conservation of electronic information resources of ...

African Journals Online (AJOL)

The major holdings of the broadcast libraries of the Nigerian Television Authority (NTA) are electronic information resources; therefore, providing safe places for general management of these resources have aroused interest in the industry in Nigeria for sometimes. The need to study the preservation and conservation of ...

Transgender men's experiences of fertility preservation: a qualitative study.

Science.gov (United States)

Armuand, G; Dhejne, C; Olofsson, J I; Rodriguez-Wallberg, K A

2017-02-01

How do transgender men experience fertility preservation (FP) by cryopreservation of oocytes? The procedures required prior to oocyte cryopreservation, such as hormonal ovarian stimulation and transvaginal ultrasound (TVS), have a negative impact on gender dysphoria as they are closely linked to the men's female assigned sex at birth, which is incompatible with their current status. Transgender persons often have high dissatisfaction with assigned sex-specific body features, such as the genital organs and androgen/oestrogen-responsive features. Thus, undergoing FP that requires genital-specific examinations, aimed at obtaining oocytes to cryopreserve, could be distressing. As no previous studies have investigated transgender men's experiences of FP involving cryopreservation of oocytes, little is known about their experience of the procedures. This is a prospective study among adult transgender men referred for FP between March 2014 and December 2015. Individual in-depth qualitative interviews were conducted shortly after FP treatment. The interviews lasted between 62 and 111 min (mean 81 min) and were digitally recorded and transcribed verbatim. Participants were recruited on their first visit to the assisted reproduction clinic for reproductive counseling. There were 15 men, scheduled for FP, who chose to participate in the study (age 19-35); none had given birth and eight had a partner. Data were analyzed by thematic content analysis. The analysis resulted in three main categories: the journey to FP, reactions to the FP proceedings and strategies for coping. The referral for FP was an important part of the assessment and diagnosis and sometimes lined with frustrating waits and doubts. The reaction to the FP proceedings revealed that the genital examinations and the physical changes associated with discontinuation of testosterone or hormonal stimulation treatment triggered gender incongruence and dysphoria. However, for some, the negative expectations were not

Radioactive waste facility as environmental preservation factor

International Nuclear Information System (INIS)

Heilbron Filho, P.F.L.; Xavier, Ana Maria

1997-01-01

The objective of this article is to show, in a resumed way, the many aspects involved in the selection, licensing and construction of a repository for the safe disposal of low and intermediate radioactive level wastes in Brazil where from we conclude that a repository is for sure an agent of environmental preservation. (author)

Preserving the memory of waste disposal centres for the future generations; Preserver la memoire des centre de stockage pour les generations futures

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

Radioactive waste disposal and storage facilities are designed to be intrinsically safe (lowest possible impact) for a duration depending on the lifetime of wastes. The French national agency of waste management (ANDRA) wishes to preserve as long as possible the memory of its waste facilities taking into account a possible loss of this memory beyond the legal monitoring period. For this reason, the ANDRA has analyzed the means that have permitted the preservation of the historical heritage through the centuries. The conclusions show that it is possible to preserve with a good confidence a patrimony during long time scales providing some organizing and structuring of this memory (archiving on numerical media and on permanent paper). (J.S.)

Cardiovascular Risk Following Fertility Therapy: Systematic Review and Meta-Analysis.

Science.gov (United States)

Dayan, Natalie; Filion, Kristian B; Okano, Marisa; Kilmartin, Caitlin; Reinblatt, Shauna; Landry, Tara; Basso, Olga; Udell, Jacob A

2017-09-05

The longer term cardiovascular effects of fertility therapy are unknown. The aim of this study was to summarize data linking fertility therapy with subsequent cardiovascular outcomes. We systematically searched published reports for studies addressing the question "does fertility therapy increase the risk of longer term cardiovascular outcomes?" We included: 1) human studies; 2) case control, cohort, or randomized designs with 3) exposure to fertility therapy and 4) cardiovascular outcomes clearly reported; 5) presence of comparison group; 6) minimum 1-year follow-up; and 7) adjustment for age. Two independent reviewers screened abstracts, titles, and full texts, and assessed study quality. We used the DerSimonian and Laird random-effects models to pool hazard ratios (HRs) with 95% confidence intervals (CIs) of the following outcomes: acute cardiac event; stroke; venous thromboembolism; hypertension; and diabetes mellitus, comparing women who received fertility therapy with those who did not. Six observational studies met inclusion criteria including 41,910 women who received fertility therapy and 1,400,202 women who did not. There was no increased risk of a cardiac event (pooled HR: 0.91; 95% CI: 0.67 to 1.25; I 2  = 36.6%), or diabetes mellitus (pooled HR: 0.93; 95% CI: 0.87 to 1.001; I 2  = 0%). Results were not pooled for hypertension (I 2  = 95.0%) and venous thromboembolism (I 2  = 82.3%). There was a trend toward higher risk of stroke (pooled HR: 1.25; 95% CI: 0.96 to 1.63; I 2  = 0%). The small number of studies and significant heterogeneity precludes definitive reassurance about the longer term cardiovascular safety of these treatments, particularly stroke. Future studies are needed to address ongoing knowledge gaps in this area. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Fertility in female survivors of Hodgkin's lymphoma

Directory of Open Access Journals (Sweden)

Irene Biasoli

2012-01-01

Full Text Available Currently, Hodgkin's lymphoma is one of the most curable types of cancer. Patients are often young and so the long-term morbidities of treatment have become of increasing concern. Among these, infertility is one of the most challenging consequences for patients in reproductive age. Premature ovarian failure in premenopausal women is a serious long-term sequel of the toxicity of chemotherapy. The main consequence of this syndrome is infertility, but women also present other symptoms related to estrogen deprivation. Different rates of impaired gonadal function are reported, depending on the patient's age, stage of disease, dose and intensity of chemotherapy and the use of radiation therapy. The most established strategy in female infertility is cryopreservation of embryos after in vitro fertilization. Additionally, the use of oral contraceptives or gonadotropinreleasing hormone analogs (GnRH-a during treatment is under study. This review will provide a general overview of the main studies conducted to evaluate the infertility rate among female Hodgkin's lymphoma survivors and risk factors associated to treatment, different end-point definitions for evaluating fertility and also a brief description of the available strategies for fertility preservation.

Combined-modality treatment and organ preservation in bladder cancer. Do molecular markers predict outcome?

International Nuclear Information System (INIS)

Weiss, C.; Roedel, F.; Wolf, I.; Sauer, R.; Roedel, C.; Papadopoulos, T.; Engehausen, D.G.; Schrott, K.M.

2005-01-01

Purpose: in invasive bladder cancer, several groups have reported the value of organ preservation by a combined-treatment approach, including transurethral resection (TUR-BT) and radiochemotherapy (RCT). As more experience is acquired with this organ-sparing treatment, patient selection needs to be optimized. Clinical factors are limited in their potential to identify patients most likely to respond to RCT, thus, additional molecular markers for predicting treatment response of individual lesions are sorely needed. Patients and methods: the apoptotic index (AI) and Ki-67 index were evaluated by immunohistochemistry on pretreatment biopsies of 134 patients treated for bladder cancer by TUR-BT and RCT. Expression of each marker as well as clinicopathologic factors were then correlated with initial response, local control and cancer-specific survival with preserved bladder in univariate and multivariate analysis. Results: the median AI for all patients was 1.5% (range 0.2-7.4%). The percentage of Ki-67-positive cells in the tumors ranged from 0.2% to 85% with a median of 14.2%. A significant correlation was found for AI and tumor differentiation (G1/2: AI = 1.3% vs. G3/4: AI = 1.6%; p = 0.01). A complete response at restaging TUR-BT was achieved in 76% of patients. Factors predictive of complete response included T-category (p < 0.0001), resection status (p = 0.02), lymphovascular invasion (p = 0.01), and Ki-67 index (p = 0.02). For local control, AI (p = 0.04) and Ki-67 index (p = 0.05) as well as T-category (p = 0.005), R-status (p = 0.05), and lymphatic vessel invasion (p = 0.05) reached statistical significance. Out of the molecular markers only high Ki-67 levels were associated to cause-specific survival with preserved bladder. On multivariate analysis, T-category was the strongest independent factor for initial response, local control and cancer-specific survival with preserved bladder. Conclusion: The indices of pretreatment apoptosis and Ki-67 predict a

Effect of Hurdle Technology in Food Preservation: A Review.

Science.gov (United States)

Singh, Shiv; Shalini, Rachana

2016-01-01

Hurdle technology is used in industrialized as well as in developing countries for the gentle but effective preservation of foods. Hurdle technology was developed several years ago as a new concept for the production of safe, stable, nutritious, tasty, and economical foods. Previously hurdle technology, i.e., a combination of preservation methods, was used empirically without much knowledge of the governing principles. The intelligent application of hurdle technology has become more prevalent now, because the principles of major preservative factors for foods (e.g., temperature, pH, aw, Eh, competitive flora), and their interactions, became better known. Recently, the influence of food preservation methods on the physiology and behavior of microorganisms in foods, i.e. their homeostasis, metabolic exhaustion, stress reactions, are taken into account, and the novel concept of multi-target food preservation emerged. The present contribution reviews the concept of the potential hurdles for foods, the hurdle effect, and the hurdle technology for the prospects of the future goal of a multi-target preservation of foods.

Fertility Intentions, Career Considerations and Subsequent Births: The Moderating Effects of Women’s Work Hours

Science.gov (United States)

Johnson, David R.

2014-01-01

Prior research indicates a negative relationship between women’s labor force participation and fertility at the individual level in the United States, but little is known about the reasons for this relationship beyond work hours. We employed discrete event history models using panel data from the National Survey of Families and Households (N = 2,411) and found that the importance of career considerations mediates the work hours/fertility relationship. Further, fertility intentions and the importance of career considerations were more predictive of birth outcomes as women’s work hours increase. Ultimately, our findings challenge the assumption that working more hours is the direct cause for employed women having fewer children and highlight the importance of career and fertility preferences in fertility outcomes. PMID:25506189

Preservation of autophagy should not direct nutritional therapy

NARCIS (Netherlands)

McClave, S.A.; Weijs, P.J.M.

2015-01-01

PURPOSE OF REVIEW: Recent reports in the literature have proposed that forced mandatory feeding should be avoided in the first week of critical illness to preserve autophagy, in order to maximize responses to oxidative stress, preserve organ function, and improve outcomes. RECENT FINDINGS: Autophagy

Comparing serum basal and follicular fluid levels of anti-Mullerian hormone as a predictor of in vitro fertilization outcomes in patients with and without polycystic ovary syndrome

International Nuclear Information System (INIS)

Somayeh Arabzadeh; Ghamartaj Hossein

2010-01-01

The prediction of in vitro fertilization (IVF) outcomes by anti-Mullerian hormone (AMH) measurement is getting increasing attention from clinicians. This study compares the relationship between serum or intrafollicular AMH levels and IVF outcomes in women with and without polycystic ovary syndrome (PCOS).This prospective study was carried out in two university-based fertility clinics. Serum samples were collected on cycle day 3 and follicular fluid (FF) was collected on the day of oocyte retrieval from 26 women with PCOS and 42 normo-ovulatory controls. AMH levels were measured in the samples using immunoenzymatic assay. The relationship between serum or FF AMH levels and IVF outcomes, including number of oocytes retrieved, oocyte maturation rate, fertilization rate, implantation rate, high quality grade embryo rate, and biochemical and clinical pregnancy rates were further assessed.Median serum basal AMH and FF AMH levels were significantly higher in the PCOS group as compared to controls, the values being 14.2 ng/mL vs. 3.2 ng/mL (P<.001) and 8.2 ng/g protein vs. 4.7 ng/g protein (P<.01), respectively. In both groups, serum basal AMH levels showed a positive correlation with number of oocytes retrieved (r=0.323; P=.037 in control vs. r=0.529; P=.005 in PCOS). In the control group, there was a positive relationship between serum basal AMH levels and percentage of matured oocytes (r = 0.331; P=.032) and implantation rate (r=0.305; P=.05).Serum basal, and not intrafollicular, AMH levels may be a good predictive factor for quantitative and qualitative IVF outcomes in normo-ovulatory, but not in PCOS patients (Author).

Soils, Crops and Fertilizer Use. A What, How and Why Guide. Appropriate Technologies for Development. Reprint R-8.

Science.gov (United States)

Leonard, David

This manual, prepared for use by Peace Corps volunteers in developing countries, has been designed as an on-the-job reference for soil management and fertilizer use at the small farmer level. It provides information on yield-boosting techniques, especially in the areas of soil conservation, organic and chemical fertilizer use, and the safe and…

Low diastolic blood pressure and adverse outcomes in heart failure with preserved ejection fraction.

Science.gov (United States)

Tsujimoto, Tetsuro; Kajio, Hiroshi

2018-07-15

It remains unknown whether a low diastolic blood pressure (DBP) increases the risks of cardiovascular events and death in patients with heart failure with preserved ejection fraction (HFpEF). We used data from the TOPCAT trial. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure. Hazard ratios (HRs) were analyzed for DBPs of <60, 60-69, 70-79, and ≥90 mm Hg in comparison with a DBP of 80-89 mm Hg using multivariable Cox proportional hazard models. This study included 3417 patients with HFpEF who had a controlled blood pressure. In the mean follow-up period of 3.0 years, 881 patients experienced at least one confirmed primary outcome event. Compared with patients with a DBP of 80-89 mm Hg, the adjusted HRs for primary outcome events were significantly higher in those with DBPs of <60 mm Hg (HR: 2.19 [95% confidence interval,1.72-2.78]) and 60-69 mm Hg (HR: 1.52 [1.23-1.87]). Similarly, the adjusted HRs for all-cause death, major cardiovascular events, and hospitalization for heart failure, but not stroke, were significantly higher in patients with a DBP of <70 mm Hg. A relationship between a low DBP and adverse outcomes was found in HFpEF patients with a systolic blood pressure of ≥120 mm Hg; however, a low systolic blood pressure with a DBP of ≥70 mm Hg was not associated with these event risks. A low DBP increased the risks of adverse outcomes in patients with HFpEF. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures.

Science.gov (United States)

Klit, Jakob

2014-04-01

Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma, hip OA is associated with FAI covering three fundamentally different hip deformities, including acetabular dysplasia; all hypothesized to initiates OA development. Where PAO is used worldwide as a joint-preserving procedure in acetabular dysplasia, TKA and THA are the treatment of choice of end stage OA. Traditional main outcomes are clinically objective surgeon-reported endpoints. Patient perceived outcomes are known to differ from these and PROMs are now recommended as the core set of outcomes. When evaluating the outcome in younger patients, this high demanding group can show ceiling-effects of the scores. The overall aim of this thesis was to investigate the consequences of PAO, TKA, and THA in younger patients evaluated by alternative outcomes in relation to satisfaction, fulfillment of expectations, symptoms of depression, the socioeconomic effects, and abilities in sex-life; to improve patient information prior to PAO, TKA and THA surgery. This PhD thesis is based on three studies. Study I is a cross-sectional survey of preserved hip joints with a mean follow-up of ten years after PAO. One hundred patients (121 PAO's) were eligible for inclusion. An inquiry to the National Patient registry identified 36 of PAO's (in 35 patients) being converted to THA. The 61 remaining patients (80 preserved hip joints) were asked to participate in this questionnaire based follow-up. Fifty-five patients (70 preserved hip-joints) accepted and constituted the study population. All patients received a questionnaire concerning aspects of functional ability, patient satisfaction, expectations, and quality of life following PAO. Both Study II and Study III are prospective multicenter cohort

Pathways: patient-centred decision counselling for women at risk of cancer-related infertility: a protocol for a comparative effectiveness cluster randomised trial.

Science.gov (United States)

Woodard, Terri Lynn; Hoffman, Aubri S; Crocker, Laura C; Holman, Deborah A; Hoffman, Derek B; Ma, Jusheng; Bassett, Roland L; Leal, Viola B; Volk, Robert J

2018-02-21

National guidelines recommend that all reproductive-age women with cancer be informed of their fertility risks and offered referral to fertility specialists to discuss fertility preservation options. However, reports indicate that only 5% of patients have consultations, and rates of long-term infertility-related distress remain high. Previous studies report several barriers to fertility preservation; however, initial success has been reported using provider education, patient decision aids and navigation support. This protocol will test effects of a multicomponent intervention compared with usual care on women's fertility preservation knowledge and decision-making outcomes. This cluster-randomised trial will compare the multicomponent intervention (provider education, patient decision aid and navigation support) with usual care (consultation and referral, if requested). One hundred newly diagnosed English-speaking women of reproductive age who are at risk of cancer-related infertility will be recruited from four regional oncology clinics.The Pathways patient decision aid website provides (1) up-to-date evidence and descriptions of fertility preservation and other family-building options, tailored to cancer type; (2) structured guidance to support personalising the information and informed decision-making; and (3) a printable summary to help women prepare for discussions with their oncologist and/or fertility specialist. Four sites will be randomly assigned to intervention or control groups. Participants will be recruited after their oncology consultation and asked to complete online questionnaires at baseline, 1 week and 2 months to assess their demographics, fertility preservation knowledge, and decision-making process and quality. The primary outcome (decisional conflict) will be tested using Fisher's exact test. Secondary outcomes will be assessed using generalised linear mixed models, and sensitivity analyses will be conducted, as appropriate. The University of

Association of basal serum testosterone levels with ovarian response and in vitro fertilization outcome

Directory of Open Access Journals (Sweden)

Sun Mei

2011-01-01

Full Text Available Abstract Background To evaluate basal testosterone (T levels during follicular phase of the menstrual cycle as a predictor for ovarian response and in vitro fertilization (IVF outcome. Method We analyzed data retrospectively from hospital-based IVF center including one thousand two hundred and sixty Chinese Han women under their first IVF cycle reached the ovum pick-up stage, without polycystic ovary syndrome (PCOS or endometriosis undergoing long IVF protocol. Patients were divided into 2 groups. Group 1: patients with diminished ovarian reserve (basal FSH >10 IU/L (n = 187; Group 2: patients with normal ovarian reserve (basal FSH Results Basal T levels were markly different between pregnant and non-pregnant women in Group 1; whereas not in Group 2. A testosterone level of 47.85 ng/dl was shown to predict pregnancy outcome with a sensitivity of 52.8% and specificity of 65.3%; and the basal T was correlated with the numbers of large follicles (> 14 mm on HCG day in Group 1. Significantly negative correlations were observed between basal T, days of stimulation and total dose of gonadotropins after adjusting for confounding factors in both groups. Conclusion In women with diminished ovarian reserve, basal T level was a predictor for the number of large follicles on HCG day and pregnancy outcome; but could not in those with normal serum FSH. Basal T levels were associated with both days of stimulation and total dose of gonadotropins, indicating that lower level of T might relate with potential ovarian poor response.

Slow fertilization of stickleback eggs: the result of sexual conflict?

Directory of Open Access Journals (Sweden)

Frommen Joachim G

2006-05-01

Full Text Available Abstract Background The fertilization success in sperm competition in externally fertilizing fish depends on number and quality of sperm. The time delay between sequential ejaculations may further influence the outcome of sperm competition. Such a time interval can load the raffle over fertilization if fertilization takes place very fast. Short fertilization times are generally assumed for externally fertilizing fish such as the three-spined stickleback (Gasterosteus aculeatus. In this pair-spawning fish, territorial males often try to steal fertilizations in nests of neighbouring males. This sneaking behaviour causes sperm competition. Sneakers will only get a share of paternity when eggs are not fertilized immediately after sperm release. Contrary to males, females may be interested in multiple paternity of their clutch of eggs. There thus may be a sexual conflict over the speed of fertilization. Results In this study we used two different in vitro fertilization experiments to assess how fast eggs are fertilized in sticklebacks. We show that complete fertilization takes more than 5 min which is atypically long for externally fertilizing fishes. Conclusion This result suggests that the time difference does not imply high costs to the second stickleback male to ejaculate. Slow fertilization (and concomitant prolonged longevity of sperm may be the result of sexual conflict in which females aimed at complete fertilization and/or multiple paternity.

Evaluation of influence of fertilizers in radium concentration from tomato culture

International Nuclear Information System (INIS)

Lauria, Dejanira C.; Ribeiro, Fernando C.A.; Alleluia, Irene B.; Perez, Daniel V.

2001-01-01

The fertilizer contribution to radio uptake by tomato plants was assessed. Tomato and soil samples from four different plantations were analyzed: two using organic fertilizer and two using phosphate fertilizer. The Ra concentrations in eight of the most used tomato fertilizers were determined. The concentration values ranged from 14 to 221 Bq/kg of Ra-226 and from 25 to 176 Bq/kg of Ra-228. Owing to the low Ra concentration and to the used fertilizer quantities, the fertilizers would not increase significantly the Ra soil concentration. However, the highest soil to plant concentration ratios were found in the plantations using phosphate fertilizers. This outcome pointed out the higher Ra availability in the phosphate fertilizer plantations than in the organic fertilizer plantations, showing a possible positive influence of phosphate fertilizers for the tomato Ra uptake. Due to the phosphate fertilizer used, the dose could increase from 0,05 Sv/year to 0,24 Sv/year. However this increase is not significant face the ingestion average worldwide effective dose. (author)

Effect of magnetized extender on sperm membrane integrity and development of oocytes in vitro fertilized with liquid storage boar semen.

Science.gov (United States)

Lee, Sang-Hee; Park, Choon-Keun

2015-03-01

The objective of this study was to evaluate the effect of a magnetized extender on sperm membrane damage and development of oocytes in vitro fertilized with liquid storage boar semen. Before semen dilution, extender was flowed through a neodymium magnet (0, 2000, 4000 and 6000G) for 5min and collected semen was preserved for 168h at 18°C. In results, plasma membrane integrity with live sperm was significantly higher in semen treated with extenders magnetized at 4000G than sperm treated with extenders magnetized at 0G during semen preservation for 120-168h (psemen treated with extenders magnetized at 4000 and 6000G compared to 0 and 2000G during semen preservation for 168h (psemen treated with extenders magnetized at 2000G than other groups during semen preservation for 168h. The ability of semen to achieve successful in vitro fertilization was also not significantly different among the groups during preservation. However, when the semen was preserved for 168h, the blastocyst formation rates were significantly higher at 6000G compared to 0 and 2000G (psemen extender could protect the sperm membrane from damage, and improve the ability of rates of in vitro blastocyst development and magnetized semen diluter is beneficial for long liquid preservation of boar semen. Copyright © 2014 Elsevier B.V. All rights reserved.

The changing contexts of fertility outcomes: case studies from a remote village in Bali, Indonesia.

Science.gov (United States)

Withers, Mellissa; Browner, Carole H

2012-01-01

In the context of ready access to contraceptives, we sought to determine which individual and socio-cultural factors were most important in the dramatic fertility decline seen in an impoverished rural Balinese community. The study built on a 2002 longitudinal survey of 1528 Balinese reproductive-age married women that four years later found a significant proportion did not meet their expressed fertility aspirations. Four case studies of women whose expressed fertility intentions evolved over the study period are described. Culturally specific contextual factors (notably son preference), in interaction with increasing poverty, helped explained when and why their expressed fertility intentions changed. Moreover, many categorized in the second survey as not having meet their previously reported fertility aspirations were, in fact, intentionally spacing births. Although many women opted for smaller families than they actually wanted, and a decades-long, aggressive, two-child government campaign helped make them socially acceptable, contraception enabled the women to engage in strategic birth planning. We conclude that it is unrealistic to expect women in such settings, or indeed any setting, to give meaningful answers to questions in demographic surveys regarding future fertility aspirations.

Immunocontraceptives: New Approaches to Fertility Control

Directory of Open Access Journals (Sweden)

Kiranjeet Kaur

2014-01-01

Full Text Available The rapidly increasing global population has bowed the attention of family planning and associated reproductive health programmes in the direction of providing a safe and reliable method which can be used to limit family size. The world population is estimated to exceed a phenomenal 10 billion by the year 2050 A.D., thus presenting a real jeopardy of overpopulation with severe implications for the future. Despite the availability of contraceptive methods, there are over one million elective abortions globally each year due to unintended pregnancies, having devastating impact on reproductive health of women worldwide. This highlights the need for the development of newer and improved contraceptive methods. A novel contraceptive approach that is gaining substantial attention is “immunocontraception” targeting gamete production, gamete outcome, or gamete function. Amongst these, use of sperm antigens (gamete function seems to be an exciting and feasible approach. However, the variability of immune response and time lag to attain titer among vaccinated individuals after active immunization has highlighted the potential relevance of preformed antibodies in this league. This review is an attempt to analyze the current status and progress of immunocontraceptive approaches with respect to their establishment as a future fertility control agent.

Environmental and health impacts of successive mineral fertilization in Egypt

Energy Technology Data Exchange (ETDEWEB)

Abdelhafez, Ahmed A. [Soils, Water and Environment Research Institute (SWERI), Agricultural Research Center (ARC), Giza (Egypt); Key Laboratory of Yangtze River Water Environment, Ministry of Education, Tongji University, Shanghai (China); Abbas, Hassan H.; Abd-El-Aal, Rafat S. [Faculty of Agriculture, Benha University (Egypt); Kandil, Nabil F. [Soils, Water and Environment Research Institute (SWERI), Agricultural Research Center (ARC), Giza (Egypt); Li, Jianhua [Key Laboratory of Yangtze River Water Environment, Ministry of Education, Tongji University, Shanghai (China); Mahmoud, Wahballah [Center of Excellence of Biotechnology Research, King Saud University, Riyadh (Saudi Arabia)

2012-04-15

Excessive amounts of mineral fertilizers are unnecessarily applied to agricultural soils in Egypt to increase crop yield. The current study aims at assessing the impacts of fertilization with different mineral fertilizers for different cultivation periods on the accumulation of heavy metals in soils and plants grown thereon. In addition, human risks resulted due to the exposure to these metal ions through ingestion, and dermal routes were evaluated. Soil and plant samples were collected from several locations in El-Behira Governorate, Egypt and their heavy metal contents were measured. The result indicated that there is a continuous accumulation of heavy metals in the soils and the plants grown thereon. Calculation of the hazard index (HI) revealed that humans, especially children, have a potential health risk for both Pb and Cd, which have levels greater than the safe level (1). Finally, the obtained results showed that the continuous application of mineral fertilizers containing high levels of heavy metals pose a potential health threat. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

How does variance in fertility change over the demographic transition?

Science.gov (United States)

Hruschka, Daniel J; Burger, Oskar

2016-04-19

Most work on the human fertility transition has focused on declines in mean fertility. However, understanding changes in the variance of reproductive outcomes can be equally important for evolutionary questions about the heritability of fertility, individual determinants of fertility and changing patterns of reproductive skew. Here, we document how variance in completed fertility among women (45-49 years) differs across 200 surveys in 72 low- to middle-income countries where fertility transitions are currently in progress at various stages. Nearly all (91%) of samples exhibit variance consistent with a Poisson process of fertility, which places systematic, and often severe, theoretical upper bounds on the proportion of variance that can be attributed to individual differences. In contrast to the pattern of total variance, these upper bounds increase from high- to mid-fertility samples, then decline again as samples move from mid to low fertility. Notably, the lowest fertility samples often deviate from a Poisson process. This suggests that as populations move to low fertility their reproduction shifts from a rate-based process to a focus on an ideal number of children. We discuss the implications of these findings for predicting completed fertility from individual-level variables. © 2016 The Author(s).

Local Safety Toolkit: Enabling safe communities of opportunity

CSIR Research Space (South Africa)

Holtmann, B

2010-08-31

Full Text Available remain inadequate to achieve safety. The Local Safety Toolkit supports a strategy for a Safe South Africa through the implementation of a model for a Safe Community of Opportunity. The model is the outcome of work undertaken over the course of the past...

Differentials of fertility in North and South Gondar zones, northwest Ethiopia: A comparative cross-sectional study

Directory of Open Access Journals (Sweden)

Worku Alemayehu

2008-12-01

Full Text Available Abstract Background Ethiopia is one of the most densely populated countries in Africa with an estimated population of 77.1 million in mid-2007. Uncontrolled fertility has adversely influenced the socio-economic, demographic and environmental situations of the country. It is one of the largest and poorest countries that, even in the midst of crisis, has maintained high levels of fertility. This study was aimed at investigating the most important factors influencing fertility behavior in Northwest Ethiopia. Methods A comparative cross-sectional study which included 2424 women aged 25 years and above was undertaken in the Amhara region of Northwest Ethiopia. The study subjects were grouped into high fertile and low fertile categories. There were 1011 and 1413 women in the high and low fertile groups, respectively. A multi-stage cluster sampling stratified by place of residence was employed to select the required study subjects. Both bivariate and multivariate logistic regression techniques were used to analyze the data. Results Among the 25 variables considered in this study, only 9 of them were found significantly and independently associated with the level of fertility. Women with at least secondary education were at a lower risk of high fertility with OR = 0.37 (95% CI: 0.21 to 0.64 compared to those with no formal education. However, women with primary education did not show any significant difference when compared with the same baseline group. Age at first marriage was inversely associated with the number of children ever born alive. Place of residence, household expenditure, number of children who have died, attitude towards using contraceptives, women's knowledge on the safe period, and current marital status were the other variables that showed significant associations with the level of fertility. Conclusion Female education beyond the primary level, reduced infant and child mortality, delayed marriage and correct knowledge on the safe

Cohort Fertility Patterns in the Nordic Countries

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Gunnar Andersson

2009-04-01

Full Text Available Previous analyses of period fertility suggest that the trends of the Nordic countries are sufficiently similar to speak of a common "Nordic fertility regime". We investigate whether this assumption can be corroborated by comparing cohort fertility patterns in the Nordic countries. We study cumulated and completed fertility of Nordic birth cohorts based on the childbearing histories of women born in 1935 and later derived from the population registers of Denmark, Finland, Norway, and Sweden. We further explore childbearing behaviour by women's educational attainment. The results show remarkable similarities in postponement and recuperation between the countries and very small differences in completed fertility across educational groups. Median childbearing age is about 2-3 years higher in the 1960-64 cohort than in the 1950-54 cohort, but the younger cohort recuperates the fertility level of the older cohort at ages 30 and above. A similar pattern of recuperation can be observed for highly educated women as compared to women with less education. An interesting finding is that of a positive relationship between educational level and the final number of children when women who become mothers at similar ages are compared. Country differences in fertility outcome are generally rather low. Childlessness is highest in Finland and lowest in Norway, and the educational differentials are largest in Norway. Despite such differences, the cohort analyses in many ways support the notion of a common Nordic fertility regime.

Embryological outcomes in cycles with human oocytes containing large tubular smooth endoplasmic reticulum clusters after conventional in vitro fertilization.

Science.gov (United States)

Itoi, Fumiaki; Asano, Yukiko; Shimizu, Masashi; Honnma, Hiroyuki; Murata, Yasutaka

2016-01-01

There have been no studies analyzing the effect of large aggregates of tubular smooth endoplasmic reticulum (aSERT) after conventional in vitro fertilization (cIVF). The aim of this study was to investigate whether aSERT can be identified after cIVF and the association between the embryological outcomes of oocytes in cycles with aSERT. This is a retrospective study examining embryological data from cIVF cycles showing the presence of aSERT in oocytes 5-6 h after cIVF. To evaluate embryo quality, cIVF cycles with at least one aSERT-metaphase II (MII) oocyte observed (cycles with aSERT) were compared to cycles with normal-MII oocytes (control cycles). Among the 4098 MII oocytes observed in 579 cycles, aSERT was detected in 100 MII oocytes in 51 cycles (8.8%). The fertilization rate, the rate of embryo development on day 3 and day 5-6 did not significantly differ between cycles with aSERT and control group. However, aSERT-MII oocytes had lower rates for both blastocysts and good quality blastocysts (p cycles with aSERT.

Future fertility for individuals with differences of sex development: Parent attitudes and perspectives about decision-making.

Science.gov (United States)

Johnson, Emilie K; Rosoklija, Ilina; Shurba, Angela; D'Oro, Anthony; Gordon, Elisa J; Chen, Diane; Finlayson, Courtney; Holl, Jane L

2017-08-01

Children, adolescents, and young adults (children/youth) with differences/disorders of sex development (DSD) face challenges related to future fertility; this may be due to variations in gonadal development, and, for some, gonadectomy performed to reduce the risk of malignancy. Childhood may be the only time for preservation of biological fertility potential for children/youth who undergo gonadectomy or have early gonadal failure. Fertility-related decision-making for these patients is particularly complicated, due to the need for parental proxy decision-making, potential discordance between gender identity and gonadal type, and uncertain future assisted reproductive technologies. This study aimed to assess: (1) attitudes regarding future fertility, and (2) healthcare needs for fertility-related decision-making among parents of children/youth with DSD. Semi-structured qualitative interviews about future fertility were conducted with parents of children/youth with DSD. Parents who had never discussed fertility with a healthcare provider were excluded. Grounded theory methodology was used to identify emergent themes and patterns. Demographics and clinical characteristics were assessed via survey and medical chart review. Nineteen parents were interviewed (participation rate: 60%, 14 mothers/5 fathers, median patient age at diagnosis 6 months (range 0-192), eight DSD diagnoses). The most common emergent themes are summarized in the Summary Table. Most parents identified fertility as a key concern, both at time of diagnosis and throughout development. Parents expressed difficulty with timing of disclosure about potential infertility to their children. Multiple preferences related to medical decision-making about future fertility and fertility preservation were expressed, including: a desire for step-by-step decision-making, and use of medically vetted information and research to guide decisions. This qualitative study provided new information about the perspectives of

Achieving pregnancy safely for HIV-serodiscordant couples: a social ecological approach.

Science.gov (United States)

Saleem, Haneefa T; Narasimhan, Manjulaa; Denison, Julie A; Kennedy, Caitlin E

2017-03-08

The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies) and skills (e.g. adhering to antiretroviral therapy or pre-exposure prophylaxis) are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV-serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV-serodiscordant couples.

Clinical Outcomes With Dose-Escalated Adaptive Radiation Therapy for Urinary Bladder Cancer: A Prospective Study

Energy Technology Data Exchange (ETDEWEB)

Murthy, Vedang, E-mail: vmurthy@actrec.gov.in [Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai (India); Masodkar, Renuka; Kalyani, Nikhil; Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai (India); Bakshi, Ganesh; Prakash, Gagan [Department of Surgical Oncology, Tata Memorial Centre, Parel, Mumbai (India); Joshi, Amit; Prabhash, Kumar [Department of Medical Oncology, Tata Memorial Centre, Parel, Mumbai (India); Ghonge, Sujata; Shrivastava, Shyamkishore [Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai (India)

2016-01-01

Purpose: The purpose of this study was to assess feasibility, clinical outcomes, and toxicity in patients with bladder cancer treated with adaptive, image guided radiation therapy (IGRT) for bladder preservation as a part of trimodality treatment. The role of dose escalation was also studied. Methods and Materials: Forty-four patients with localized bladder cancer were enrolled in a prospective study. They underwent maximal safe resection of bladder tumor and concurrent platinum-based chemotherapy. Patients with large tumors were offered induction chemotherapy. Radiation therapy planning was done using either 3 (n=34) or 6 (n=10) concentrically grown planning target volumes (PTV). Patients received 64 Gy in 32 fractions to the whole bladder and 55 Gy to the pelvic nodes and, if appropriate, a simultaneous integrated boost to the tumor bed to 68 Gy (equivalent dose for 2-Gy fractions assuming α/β of 10 [EQD2]{sub 10} = 68.7 Gy). Daily megavoltage (MV) imaging helped to choose the most appropriate PTV encompassing bladder for the particular day (using plan-of-the-day approach). Results: Most patients (88%) had T2 disease. Sixteen patients (36%) received neoadjuvant chemotherapy. A majority of the patients (73%) received prophylactic nodal irradiation, whereas 55% of the patients received escalated dose to the tumor bed. With a median follow-up of 30 months, the 3-year locoregional control (LRC), disease-free survival, and overall survival (OS) were 78%, 66%, and 67%, respectively. The bladder preservation rate was 83%. LRC (87% vs 68%, respectively, P=.748) and OS (74% vs 60%, respectively, P=.36) rates were better in patients receiving dose escalation. Instances of acute and late Radiation Therapy Oncology Group (RTOG) grade 3 genitourinary toxicity was seen in 5 (11%) and 2 (4%) patients, respectively. There was no acute or late RTOG grade 3 or higher gastrointestinal toxicity. Conclusions: Adaptive IGRT using plan-of-the-day approach for bladder

Clinical Outcomes With Dose-Escalated Adaptive Radiation Therapy for Urinary Bladder Cancer: A Prospective Study

International Nuclear Information System (INIS)

Murthy, Vedang; Masodkar, Renuka; Kalyani, Nikhil; Mahantshetty, Umesh; Bakshi, Ganesh; Prakash, Gagan; Joshi, Amit; Prabhash, Kumar; Ghonge, Sujata; Shrivastava, Shyamkishore

2016-01-01

Purpose: The purpose of this study was to assess feasibility, clinical outcomes, and toxicity in patients with bladder cancer treated with adaptive, image guided radiation therapy (IGRT) for bladder preservation as a part of trimodality treatment. The role of dose escalation was also studied. Methods and Materials: Forty-four patients with localized bladder cancer were enrolled in a prospective study. They underwent maximal safe resection of bladder tumor and concurrent platinum-based chemotherapy. Patients with large tumors were offered induction chemotherapy. Radiation therapy planning was done using either 3 (n=34) or 6 (n=10) concentrically grown planning target volumes (PTV). Patients received 64 Gy in 32 fractions to the whole bladder and 55 Gy to the pelvic nodes and, if appropriate, a simultaneous integrated boost to the tumor bed to 68 Gy (equivalent dose for 2-Gy fractions assuming α/β of 10 [EQD2] 10  = 68.7 Gy). Daily megavoltage (MV) imaging helped to choose the most appropriate PTV encompassing bladder for the particular day (using plan-of-the-day approach). Results: Most patients (88%) had T2 disease. Sixteen patients (36%) received neoadjuvant chemotherapy. A majority of the patients (73%) received prophylactic nodal irradiation, whereas 55% of the patients received escalated dose to the tumor bed. With a median follow-up of 30 months, the 3-year locoregional control (LRC), disease-free survival, and overall survival (OS) were 78%, 66%, and 67%, respectively. The bladder preservation rate was 83%. LRC (87% vs 68%, respectively, P=.748) and OS (74% vs 60%, respectively, P=.36) rates were better in patients receiving dose escalation. Instances of acute and late Radiation Therapy Oncology Group (RTOG) grade 3 genitourinary toxicity was seen in 5 (11%) and 2 (4%) patients, respectively. There was no acute or late RTOG grade 3 or higher gastrointestinal toxicity. Conclusions: Adaptive IGRT using plan-of-the-day approach for bladder preservation

Fertilizers mobilization in alluvial aquifer: laboratory experiments

Science.gov (United States)

Mastrocicco, M.; Colombani, N.; Palpacelli, S.

2009-02-01

In alluvial plains, intensive farming with conspicuous use of agrochemicals, can cause land pollution and groundwater contamination. In central Po River plain, paleo-channels are important links between arable lands and the underlaying aquifer, since the latter is often confined by clay sediments that act as a barrier against contaminants migration. Therefore, paleo-channels are recharge zones of particular interest that have to be protected from pollution as they are commonly used for water supply. This paper focuses on fertilizer mobilization next to a sand pit excavated in a paleo-channel near Ferrara (Italy). The problem is approached via batch test leaking and columns elution of alluvial sediments. Results from batch experiments showed fast increase in all major cations and anions, suggesting equilibrium control of dissolution reactions, limited availability of solid phases and geochemical homogeneity of samples. In column experiments, early elution and tailing of all ions breakthrough was recorded due to preferential flow paths. For sediments investigated in this study, dispersion, dilution and chemical reactions can reduce fertilizers at concentration below drinking standards in a reasonable time frame, provided fertilizer loading is halted or, at least, reduced. Thus, the definition of a corridor along paleo-channels is recommended to preserve groundwater quality.

Laparoscopic pancreatectomy: Indications and outcomes

Science.gov (United States)

Liang, Shuyin; Hameed, Usmaan; Jayaraman, Shiva

2014-01-01

The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and short-term oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons’ experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. PMID:25339811

Vacuum sealing and cooling as methods to preserve surgical specimens

DEFF Research Database (Denmark)

Kielsgaard Kristensen, Thomas; Engvad, Birte; Nielsen, Ole

2011-01-01

Recently, vacuum-based preservation of surgical specimens has been proposed as a safe alternative to formalin fixation at the surgical theater. The method seems feasible from a practical point of view, but no systematic study has examined the effect of vacuum sealing alone with respect to tissue...

Fertilization and Embryo Development of Fresh and Cryopreserved Sibling Oocytes

Directory of Open Access Journals (Sweden)

Robert F. Casper

2010-01-01

Full Text Available Background: Oocyte cryopreservation is potentially the best way to preserve female fertility forunmarried women or young girls at risk of losing ovarian function. The aim of this study was tocompare fertilization and embryo development in frozen-thawed oocytes to their fresh siblings inwomen undergoing in vitro fertilization (IVF and embryo transfer (ET.Materials and Methods: Eleven infertile women undergoing infertility treatment, between theages of 24 to 37 years (mean ± SD = 31.6 ± 3.5, were included in this study. Mature oocytesfrom each patient were randomized into cryopreserved and fresh groups prior to intracytoplasmicsperm injection (ICSI. One hundred and thirty nine oocytes were retrieved, of which 105 were atmetaphase II (MII. Forty- five fresh MII oocytes were kept in culture whereas their sibling 60 MIIoocytes were cryopreserved using a slow cooling protocol. The frozen oocytes remained in LN2for 2 hours before thawing. ICSI was performed 1-2 hours after thawing for frozen oocytes and 4-5hours after retrieval for fresh oocytes. Fertilization and embryo development were compared.Results: Following thawing, 31 oocytes (51.6 % survived and 22 fertilized (79% while 32 freshoocytes fertilized upon ICSI (71%. The mean ± SE scores for embryos developing from frozenthawedoocytes were significantly lower at 48 and 72 hours post-ICSI than for embryos resultingfrom fresh oocytes (p<0.05.Conclusion: Our data demonstrated that oocyte freezing resulted in acceptable survival ratesfollowing cryopreservation, and similar fertilization rates following ICSI as compared to the freshsibling oocytes. However the number of blastomeres and the embryo quality on day three wassuperior in embryos from fresh oocytes when compared to the frozen oocytes.

Preservation of Domesticated Honey Bee (Hymenoptera: Apidae) Drone Semen.

Science.gov (United States)

Paillard, M; Rousseau, A; Giovenazzo, P; Bailey, J L

2017-08-01

Preservation of honey bee (Apis mellifera L., Hymenoptera: Apidae) sperm, coupled with instrumental insemination, is an effective strategy to protect the species and their genetic diversity. Our overall objective is to develop a method of drone semen preservation; therefore, two experiments were conducted. Hypothesis 1 was that cryopreservation (-196 °C) of drone semen is more effective for long-term storage than at 16 °C. Our results show that after 1 yr of storage, frozen sperm viability was higher than at 16 °C, showing that cryopreservation is necessary to conserve semen. However, the cryoprotectant used for drone sperm freezing, dimethyl sulfoxide (DMSO), can harm the queen and reduce fertility after instrumental insemination. Hypothesis 2 was that centrifugation of cryopreserved semen to reduce DMSO prior to insemination optimize sperm quality. Our results indicate that centrifuging cryopreserved sperm to remove cryoprotectant does not affect queen survival, spermathecal sperm count, or sperm viability. Although these data do not indicate that centrifugation of frozen-thawed sperm improves queen health and fertility after instrumental insemination, we demonstrate that cryopreservation is achievable, and it is better for long-term sperm storage than above-freezing temperatures for duration of close to a year. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Correlations in fertility across generations: can low fertility persist?

Science.gov (United States)

Kolk, Martin; Cownden, Daniel; Enquist, Magnus

2014-01-01

Correlations in family size across generations could have a major influence on human population size in the future. Empirical studies have shown that the associations between the fertility of parents and the fertility of children are substantial and growing over time. Despite their potential long-term consequences, intergenerational fertility correlations have largely been ignored by researchers. We present a model of the fertility transition as a cultural process acting on new lifestyles associated with fertility. Differences in parental and social influences on the acquisition of these lifestyles result in intergenerational correlations in fertility. We show different scenarios for future population size based on models that disregard intergenerational correlations in fertility, models with fertility correlations and a single lifestyle, and models with fertility correlations and multiple lifestyles. We show that intergenerational fertility correlations will result in an increase in fertility over time. However, present low-fertility levels may persist if the rapid introduction of new cultural lifestyles continues into the future. PMID:24478294

Hepatitis B virus infection on male partner has negative impact on in-vitro fertilization

Science.gov (United States)

Lubis, H. P.; Halim, B.; Adenin, I.; Rusda, M.; Prasetiawan, E.

2018-03-01

It is common to see HBV-infected couple seeking for fertility treatment in reproductive medical centers. The effect of hepatitis B virus (HBV) infection on pregnancy outcome after In Vitro Fertilization (IVF) treatment has been a controversy. The study aims this was to evaluate the outcome of in vitro fertilization in couples with the male partner being HBsAg-seropositive. A retrospective analytic study was in HBV-infected and non-HBV infected male partner groups who have been treated with in vitro fertilization (IVF) from October 2016 until May 2017 in HFC IVF Center. From 101 couples, 17 (16.83%) male partners were HBV seropositive. They had similar semen parameters compared to thenon-HBV infected group. Couples with the male partner being HBsAg-seropositive had significantly lower fertilized oocytes and cleaved embryos compared to thenon-HBV infected group. We also found lower clinical pregnancy rate in infected male partner group compared to control group (23.52% vs 51% respectively). Statistically, there was a significant difference in clinical pregnancy rate between HBV-infected group and control group (p<0.05). An hbv-infected male partner may lower the clinical pregnancy rate in couple undergoing IVF treatment. Therefore, the mechanism of impact of HBV infection on IVF outcome needs further exploration.

Family Law Effects on Divorce, Fertility and Child Investment

OpenAIRE

Joseph Mullins; Christopher Flinn; Meta Brown

2015-01-01

In order to assess the child welfare impact of policies governing divorced parenting, such as child support orders, child custody and placement regulations, and marital dissolution standards, one must consider their influence not only on the divorce rate but also on spouses' fertility choices and child investments. We develop a model of marriage, fertility and parenting, with the main goal being the investigation of how policies toward divorce influence outcomes for husbands, wives and childr...

Obstetric outcomes in women with polycystic ovary syndrome and isolated polycystic ovaries undergoing in vitro fertilization: a retrospective cohort analysis.

Science.gov (United States)

Wan, Hei Lok Tiffany; Hui, Pui Wah; Li, Hang Wun Raymond; Ng, Ernest Hung Yu

2015-03-01

This retrospective cohort study evaluated the obstetric outcomes in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in vitro fertilization (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. Obstetric outcomes and complications including gestational diabetes (GDM), gestational hypertension (GHT), gestational proteinuric hypertension (PET), intrauterine growth restriction (IUGR), gestation at delivery, baby's Apgar scores and admission to the neonatal intensive care unit (NICU) were reviewed. Among the 864 patients undergoing IVF treatment, there were 253 live births in total (25 live births in the PCOS group, 54 in the PCO group and 174 in the control group). The prevalence of obstetric complications (GDM, GHT, PET and IUGR) and the obstetric outcomes (gestation at delivery, birth weight, Apgar scores and NICU admissions) were comparable among the three groups. Adjustments for age and multiple pregnancies were made using multiple logistic regression and we found no statistically significant difference among the three groups. Patients with PCO ± PCOS do not have more adverse obstetric outcomes when compared with non-PCO patients undergoing IVF treatment.

Smoke, alcohol and drug addiction and male fertility.

Science.gov (United States)

Sansone, Andrea; Di Dato, Carla; de Angelis, Cristina; Menafra, Davide; Pozza, Carlotta; Pivonello, Rosario; Isidori, Andrea; Gianfrilli, Daniele

2018-01-15

In recent decades, the decline in human fertility has become increasingly more worrying: while therapeutic interventions might help, they are vexing for the couple and often burdened with high failure rates and costs. Prevention is the most successful approach to fertility disorders in males and females alike. We performed a literature review on three of the most common unhealthy habits - tobacco, alcohol and drug addiction - and their reported effects on male fertility. Tobacco smoking is remarkably common in most first-world countries; despite a progressive decline in the US, recent reports suggest a prevalence of more than 30% in subjects of reproductive age - a disturbing perspective, given the well-known ill-effects on reproductive and sexual function as well as general health. Alcohol consumption is often considered socially acceptable, but its negative effects on gonadal function have been consistently reported in the last 30 years. Several studies have reported a variety of negative effects on male fertility following drug abuse - a worrying phenomenon, as illicit drug consumption is on the rise, most notably in younger subjects. While evidence in these regards is still far from solid, mostly as a result of several confounding factors, it is safe to assume that cessation of tobacco smoking, alcohol consumption and recreational drug addiction might represent the best course of action for any couple trying to achieve pregnancy.

Is Buddhism the low fertility religion of Asia?

Directory of Open Access Journals (Sweden)

Vegard Skirbekk

2015-01-01

Full Text Available Background: The influence of religion on demographic behaviors has been extensively studied mainly for Abrahamic religions. Although Buddhism is the world's fourth largest religion and is dominant in several Asian nations experiencing very low fertility, the impact of Buddhism on childbearing has received comparatively little research attention. Objective: This paper draws upon a variety of data sources in different countries in Asia in order to test our hypothesis that Buddhism is related to low fertility. Methods: Religious differentials in terms of period fertility in three nations (India, Cambodia and Nepal and cohort fertility in three case studies (Mongolia, Thailand and Japan are analyzed. The analyses are divided into two parts: descriptive and multivariate analyses. Results: Our results suggest that Buddhist affiliation tends to be negatively or not associated with childbearing outcomes, controlling for education, region of residence, age and marital status. Although the results vary between the highly diverse contextual and institutional settings investigated, we find evidence that Buddhist affiliation or devotion is not related to elevated fertility across these very different cultural settings. Conclusions: Across the highly diverse cultural and developmental contexts under which the different strains of Buddhism dominate, the effect of Buddhism is consistently negatively or insignificantly related to fertility. These findings stand in contrast to studies of Abrahamic religions that tend to identify a positive link between religiosity and fertility.

Preserving the memory of waste disposal centres for the future generations

International Nuclear Information System (INIS)

2006-01-01

Radioactive waste disposal and storage facilities are designed to be intrinsically safe (lowest possible impact) for a duration depending on the lifetime of wastes. The French national agency of waste management (ANDRA) wishes to preserve as long as possible the memory of its waste facilities taking into account a possible loss of this memory beyond the legal monitoring period. For this reason, the ANDRA has analyzed the means that have permitted the preservation of the historical heritage through the centuries. The conclusions show that it is possible to preserve with a good confidence a patrimony during long time scales providing some organizing and structuring of this memory (archiving on numerical media and on permanent paper). (J.S.)

Investigation of technologies for producing organic-mineral fertilizers and biogas from waste products

Directory of Open Access Journals (Sweden)

Anna V. Ivanchenko

2015-12-01

Full Text Available Modern agriculture requires special attention to a preservation of soil fertility; development of cultures fertilization; producing of new forms of organic-mineral fertilizers which nutrient absorption coefficient would be maximum. Application of artificial fertilizers has negative influence on soils. Aim: The aim of the study is to identify the scientific regularities of organic-mineral fertilizers and biogas technologies from waste products and cattle manure with the addition of fermentation additive. Materials and Methods: The affordable organic raw material for production of organic-mineral fertilizers is the cattle manure. Environmental technology of the decontamination and utilization of manure is its anaerobic bioconversion to fermented fertilizer and biogas. The waste decontamination and the degradation of complex polymers into simple renewable and plant-available compounds takes place during the conversion of manner to biogas. Experimental research carried out for the three types of loads to the model reactor of anaerobic fermentation with 1 dm3 volume for dry matter. The mesophilic fermentation mode used in the experiments (at 33 °C. Results: It has been shown that the addition of whey to the input raw materials in a ratio of 1:30 accelerates the process of anaerobic digestion and biogas generation in 1,3...2,1 times. An analysis of organic-mineral fertilizers from cattle manure were conducted. Technological schemes of organic-mineral fertilizers and biogas technologies from waste products were developed. Conclusions: Implementation of research results to farms and urban waste treatment facilities lead to increased energy potential of our country and expansion of high-quality organic-mineral fertilizers variety, which are well absorbed by plants.

Zambia Communications Support for Health Safe Love Campaign Outcome Evaluation

Data.gov (United States)

US Agency for International Development — The Safe Love campaign was a three-year comprehensive HIV prevention behavior change and communication (BCC) initiative implemented between June 2011 and June 2014....

Analysis of international practice patterns regarding postvasectomy fertility options.

Science.gov (United States)

Blach, Ola; Shridharani, Anand N; Sandlow, Jay I

2014-05-01

To review the management of postvasectomy fertility options by urologists with vs without andrology fellowship and compare the features of practice in the USA vs UK. We conducted an audit of all American Urological Association-affiliated urologists regarding their practice in managing men requesting vasectomy reversal (VR). Standards of practice were assessed against 10 index parameters deemed, by 1 UK study, to reflect best practice. Fisher exact test was used to test the hypothesis that management of postvasectomy fertility options and practice of VR are no different when undertaken by urologists with vs without andrology training and no different in the USA vs UK. Three hundred twenty-five of 645 US respondents (50.4%) practiced VR vs 178 of 213 (83.6%) in the UK; only 11.9% in the US and 10% in the UK performed >25 and >15 (P <.0001) VR/year, respectively. Compared with the UK urologists the US urologists offered more detailed information on all fertility options and/or outcomes, used microsurgical techniques more often, but less frequently counseled couples together, and referred patients to specialist centers for in vitro fertilization with intracytoplasmic sperm injection (P <.0001-.05). Only 74 of the US and 61 of the UK urologists were fellowship-trained in andrology. Most non-fellowship-trained urologists, in both the countries, performed <5 VR/year and were, statistically, significantly less likely to counsel couples about all fertility options, be conversant in in vitro fertilization with intracytoplasmic sperm injection, provide individualized outcomes data, and use microsurgical techniques (P <.0001-.05). Significant differences exist in the standards of practice between both the US and UK urologists performing VR. Concordance with the indices of "best practice" improves with andrology training and increasing number of procedures performed. Copyright © 2014 Elsevier Inc. All rights reserved.

Prognostic significance of diagnostic laparoscopy for spontaneous fertility

NARCIS (Netherlands)

Mol, B. W.; Swart, P.; Bossuyt, P. M.; van der Veen, F.

1999-01-01

OBJECTIVE: To determine the prognostic significance of laparoscopy results for fertility outcome. STUDY DESIGN: Consecutive patients undergoing hysterosalpingography and laparoscopy for subfertility in our department between May 1985 and November 1987 were identified from medical records. The impact

Does fertility treatment increase the risk of uterine cancer? A meta-analysis.

Science.gov (United States)

Saso, Srdjan; Louis, Louay S; Doctor, Farah; Hamed, Ali Hassan; Chatterjee, Jayanta; Yazbek, Joseph; Bora, Shabana; Abdalla, Hossam; Ghaem-Maghami, Sadaf; Thum, Meen-Yau

2015-12-01

An ongoing debate over the last two decades has focused on whether fertility treatment in women may lead to an increased risk of developing uterine cancer over a period of time. Uterine cancer (including mainly endometrial carcinoma and the less common uterine sarcoma) is the commonest reproductive tract cancer and the fourth commonest cancer in women in the UK. Our objective was to assess the association between fertility drugs used in the treatment of female infertility (both as an independent therapy and during in vitro fertilization cycles) and the development of uterine cancer. A literature search was performed using Medline, Embase, Cochrane Library and Google Scholar databases for comparative studies until December 2014 to investigate a clinical significance of fertility treatment on the incidence of developing uterine cancer. General and MESH search headings, as well as the 'related articles' function were applied. All comparative studies of 'fertility treatment' versus 'non-fertility treatment' reporting the incidence of uterine cancer as an outcome were included. Uterine cancer incorporated the following terms: uterine cancer, uterine body tumours, uterine sarcomas and endometrial cancers. The primary outcome of interest was the uterine cancer incidence in all 'fertility treatment' versus 'non-fertility treatment' patient groups. Secondary outcomes of interest were: (a) uterine cancer incidence in 'IVF' versus 'non-IVF' patient groups; and (b) uterine cancer incidence according to type of fertility drug used. Odds ratio was the summary statistic. Random-effects modelling, graphical exploration and sensitivity analysis were used to evaluate the consistency of the calculated treatment effect. We included six studies in our final analysis, which comprised 776,224 patients in total. Of these, 103,758 had undergone fertility treatment and 672,466 had not. There was 100% agreement between the two reviewers regarding the data extraction. All the studies

Robotic spleen-preserving distal pancreatectomy. A case report.

Science.gov (United States)

Vasilescu, C; Sgarbura, O; Tudor, S; Herlea, V; Popescu, I

2009-01-01

Distal pancreatectomy (DP) is the removal of the pancreatic tissue at the left side of the superior mesenteric vein and it is traditionally approached by an open or laparoscopic exposure. Preservation of the spleen is optional but appears to have a better immunological outcome. We present the case of a 53-year old patient with a 2.4/2.2 tumor located in the tail of the pancreas, with high tumour marker values for whom we decided to perform a robotic spleen-preserving distal pancreatectomy (RSPDP). The postoperative outcome was satisfactory. In conclusion, we recommend this type of approach for small pancreatic tail lesions.

Fertility patterns according to occupational grouping in Norway, 1989.

Science.gov (United States)

Strand, K; Wergeland, E; Bjerkedal, T

1996-03-01

In the early 1990s, most pregnant women in Norway were in gainful employment. This led to increased interest in the possible consequences for reproductive health, and a growing concern for the need to accommodate the pregnancy. We have therefore investigated how accurately general fertility rates predict the number of pregnancies in the workforce. Fertility rates (FR) among employed women and standardized fertility ratios (SFR) in occupational groups were estimated on the basis of information from the Labour Market Statistics and the national survey "Pregnancy and Work", Norway, 1989. The fertility rate among employed women was 17% higher than the general fertility rate. Two occupational groups had significantly different SFRs: technical/professional workers (SFR 118) and transport/communication workers (SFR 82). In addition, differences were found for parity-specific SFRs in administrative/executive work (SFR nullipara 80, SFR para 125) and service work (SFR nullipara 114, SFR para 80). We suggest that work status and occupation should be included among the variables registered in the Medical Birth Registry of Norway, in order to facilitate routine presentations of fertility rates and pregnancy outcomes for women in paid work. The results further indicate that work-specific conditions influence first-birth fertility. This should be explored in demographic studies of the relation between women's fertility and participation in paid work.

Fertility and the changing female educational attainment in Croatia

Directory of Open Access Journals (Sweden)

Čipin Ivan

2016-01-01

Full Text Available This paper investigates the aggregate relationship between cohort fertility and female educational attainment in Croatia. Numerous demographic studies have examined the link between fertility and the level of education. However, newer research indicates that the field of education might also play a role when trying to explain fertility behavior. We contribute to existing literature on macro-level factors related to reproductive outcomes by considering both the level and field of education as possible sources of cohort fertility differentials. The main goal of the present study is to assess the effect of structural changes in educational attainment on cohort fertility decline by means of demographic decomposition techniques. Our analysis is based on detailed 2011 Census data, which provide information on the number of livebirths by mother’s year of birth, birth order, marital status and educational attainment (i.e. the level and field of education. The results of our decomposition analyses reveal the dominance of the structural effect in explaining the overall completed fertility decline in Croatia. We assumed that the changing distribution of women by field of education at least partially accounts for the observed patterns in completed fertility but found no strong evidence in support of the outlined hypothesis.

Knowledge Preservation and Consolidation through an Innovative Multimedia Tool

International Nuclear Information System (INIS)

Corniani, E.

2013-01-01

The JRC (Joint Research Centre) is the European Commission’s in-house science service. It provides the science for policy decisions, with a view to ensuring that the EU achieves its Europe 2020 goals for a productive economy as well as a safe, secure and sustainable future. The JRC plays a key role in the European Research Area and reinforces its multi-disciplinarity by networking extensively with leading scientific organisations in the Member States, Associated Countries and worldwide. The presentation is about • JRC methodology in Knowledge Preservation; • A Multimedia tool developed for preserving knowledge on WWER reactors; • EC involvement on Fast Reactors

Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

Science.gov (United States)

Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

2016-09-01

Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

Endometrial immune markers are potential predictors of normal fertility and pregnancy after in vitro fertilization.

Science.gov (United States)

Kofod, Louise; Lindhard, Anette; Bzorek, Michael; Eriksen, Jens Ole; Larsen, Lise Grupe; Hviid, Thomas Vauvert F

2017-09-01

Elucidating immune mechanisms in the endometrium, which lead to the success of implantation and pregnancy, is important in reproductive medicine. Studies of immune cell abundance have shown conflicting results, and the expression and importance of HLA class Ib proteins in pre-implantation endometrium have not yet been investigated. The study population consisted of four subgroups: a hydrosalpinx, a salpingectomy, an unexplained infertility, and a fertile control group. Endometrial samples were collected during the implantation window. Immune markers (CD56 + and CD16 + cells, FoxP3 + Tregs, HLA-G, HLA-F) were quantified in the samples. The outcome of the subsequent IVF treatment was recorded. Increased CD56 + uNK cells and high HLA-G expression served as predictor for successful pregnancy outcome. HLA-F expression was positively correlated with uNK cells, being indirectly predictive for achieving pregnancy. Endometrial uNK cell abundance in the pre-implantation endometrium seems to be important for normal fertility and pregnancy success, and they may be used as clinical markers to predict implantation success in IVF. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of Body Mass Index on Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Among Polycystic Ovarian Syndrome Patients

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Na Cui

2016-10-01

Full Text Available Background: The aim of this study is to assess the effect of body mass index (BMI on outcomes of in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI among polycystic ovarian syndrome (PCOS and non-PCOS patients. Methods: This was a retrospective cohort study that was performed in the Second Hospital of Hebei Medical University. Patients who were under 35 years old were included in the study and were divided into four groups based on their BMI. The number of retrieved oocytes, implantation rate, clinical pregnancy rate, miscarriage rate and live births among PCOS and non-PCOS patients were compared between different BMIs. Results: IVF/ICSI pregnancies in obese PCOS women had a considerably higher risk of miscarriage and low rate of clinical pregnancy than in non-obese PCOS pregnancies. However, in non-PCOS patient, obesity significantly elevated miscarriage rate but did not affect clinical pregnancy rate. Conclusion: Obesity in PCOS patients led to poor outcomes of IVF/ICSI.

Perinatal outcomes in 375 children born after oocyte donation

DEFF Research Database (Denmark)

Malchau, Sara S; Loft, Anne; Larsen, Elisabeth C

2013-01-01

To describe perinatal outcomes in children born after oocyte donation (OD) compared with in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and spontaneous conception (SC).......To describe perinatal outcomes in children born after oocyte donation (OD) compared with in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and spontaneous conception (SC)....

Pancreas preserving total duodenectomy for complex duodenal injury.

Science.gov (United States)

Wig, Jai Dev; Kudari, Ashwinikumar; Yadav, Thakur Deen; Doley, Rudra Prasad; Bharathy, Kishore Gurumoorthy Subramanya; Kalra, Naveen

2009-07-06

To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma. Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years) presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum). There were no complications attributable to the procedure. Both patients are well on follow up. A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.

Fertility and age

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Korula George

2010-01-01

Full Text Available The changing social scenario together with economic growth and an increase in job opportunities has to a great extent reduced gender inequality and has resulted in more and more older women seeking help from infertility clinics. Fertility and aging have always been closely linked and the age of the female partner remains the single most important factor in predicting success with treatment. Although tests for the ovarian reserve are an important informative tool and are helpful in selecting treatment options, they are poor predictors of the outcome.

Nuclear techniques used in soil fertility and plant nutrition

International Nuclear Information System (INIS)

Halitligil, M.B.; Kislal, H.; Sirin, H.; Sirin, C.; Kilicaslan, A.

2004-01-01

Full text: Nuclear techniques, which include the usage of radioactive and stable isotopes, had been used in soil fertility, plant nutrition, plant breeding, plant protection and food preservation research works after 1950s. Ultimately these nuclear techniques contributed greatly in increased plant production. In general, it is possible to separate the nuclear techniques used in soil fertility and plant nutrition into two groups. The first group is the use of radioactive and stable isotopes as a tracer in order to find out the optimum fertilization rate of plants precisely. The second group is the use of neutron probe in determining the soil moisture at different periods of the growing season and at various soil depths precisely without any difficulty. In research works where conventional techniques are used, it is not possible to identify how much of the nutrient taken up by the plant came from applied fertilizer or soil. However, when tracer techniques are used in research works it is possible to identify precisely which amount of the nutrient taken from fertilizer or from soil. Therefore, the nuclear techniques are very important in finding out which variety of fertilizer and how much of it must be used. The determination of the soil moisture is very important in finding the water needs of the plants for a good growth. Soil moisture contents changes often during the growth period, so it must be determined very frequently in order to determine the amount of irrigation that has to be done. Conventional soil moisture determination (gravimetric method) is very laborious especially when it has to be done frequently. However, by using neutron probe soil moisture determinations can be done very easily any time during the plant growth period

Nuclear techniques used in soil fertility and plant nutrition

International Nuclear Information System (INIS)

Halitligil, M.B.

2004-01-01

Nuclear techniques, which include the usage of radioactive and stable isotopes, had been used in soil fertility, plant nutrition, plant breeding, plant protection and food preservation research works after 1950s. Ultimately these nuclear techniques contributed greatly in increased plant production. In general, it is possible to separate the nuclear techniques used in soil fertility and plant nutrition into two groups. The first group is the use of radioactive and stable isotopes as a tracer in order to find out the optimum fertilization rate of plants precisely. The second group is the use of neutron probe in determining the soil moisture at different periods of the growing season and at various soil depths precisely without any difficulty. In research works where conventional techniques are used, it is not possible to identify how much of the nutrient taken up by the plant came from applied fertilizer or soil. However, when tracer techniques are used in research works it is possible to identify precisely which amount of the nutrient taken from fertilizer or from soil. Therefore, the nuclear techniques are very important in finding out which variety of fertilizer and how much of it must be used. The determination of the soil moisture is very important in finding the water needs of the plants for a good growth. Soil moisture contents changes often during the growth period, so it must be determined very frequently in order to determine the amount of irrigation that has to be done. Conventional soil moisture determination (gravimetric method) is very laborious especially when it has to be done frequently. However, by using neutron probe soil moisture determinations can be done very easily any time during the plant growth period. (author)

Reproductive Endocrinology: Pregnancy and fertility after bariatric surgery.

Science.gov (United States)

Ginsburg, Elizabeth S

2009-05-01

Increases in rates of bariatric surgery are staggering, and many obese individuals who undergo such procedures are women of reproductive age. So, how does the surgery affect women's fertility and pregnancy outcomes thereafter? A new systemic review aimed to find out.

Clonal structure and variable fertilization success in Florida Keys broadcast-spawning corals

Science.gov (United States)

Miller, M. W.; Baums, I. B.; Pausch, R. E.; Bright, A. J.; Cameron, C. M.; Williams, D. E.; Moffitt, Z. J.; Woodley, C. M.

2018-03-01

Keystone reef-building corals in the Caribbean are predominantly self-incompatible broadcast spawners and a majority are threatened due to both acute adult mortality and poor recruitment. As population densities decline, concerns about fertilization limitation and effective population size in these species increase and would be further exacerbated by either high clonality or gametic incompatibility of parental genotypes. This study begins to address these concerns for two Caribbean broadcasting species by characterizing clonal structure and quantifying experimental pairwise fertilization success. Orbicella faveolata showed surprisingly high and contrasting levels of clonality between two sampled sites; Acropora palmata was previously known to be highly clonal. Individual pairwise crosses of synchronously spawning genotypes of each species were conducted by combining aliquots of gamete bundles immediately after spawning, and showed high and significant variability in fertilization success. Over half of the individual crosses of O. faveolata and about one-third of A. palmata crosses yielded ≤ 40% fertilization. Total sperm concentration was quantified in only a subset of O. faveolata crosses (range of 1-6 × 107 mL-1), but showed no correlation with fertilization success. We interpret that both parental incompatibility and individual genotypes with low-quality gametes are likely to have contributed to the variable fertilization observed with important implications for conservation. Differential fertilization success implies effective population size may be considerably smaller than hoped and population enhancement efforts need to incorporate many more parental genotypes at the patch scale to ensure successful larval production than indicated by estimates based simply on preserving levels of standing genetic diversity.

Web-based survey of fertility issues in young women with breast cancer.

Science.gov (United States)

Partridge, Ann H; Gelber, Shari; Peppercorn, Jeffrey; Sampson, Ebonie; Knudsen, Katherine; Laufer, Marc; Rosenberg, Randi; Przypyszny, Michele; Rein, Alison; Winer, Eric P

2004-10-15

Young women with breast cancer often seek advice about whether treatment will affect their fertility. We sought to gain a better understanding of women's attitudes about fertility and how these concerns affect decision making. We developed a survey about fertility issues for young women with a history of early-stage breast cancer. The survey was e-mailed to all registered Young Survival Coalition survivor members (N = 1,702). E-mail reminders were used. Six hundred fifty-seven eligible respondents completed the survey. Mean age at breast cancer diagnosis was 32.9 years; mean current age was 35.8 years. Ninety percent of women were white; 62% were married; 76% were college graduates. Stages at diagnosis were as follows: 0, 10%; I, 27%; II, 47%; III, 13%. Sixty-two percent of women were within 2 years of diagnosis. Fifty-seven percent recalled substantial concern at diagnosis about becoming infertile with treatment. In multivariate logistic regression, greater concern about infertility was associated with wish for children/more children (odds ratio [OR], 120; P women reported that infertility concerns influenced treatment decisions. Seventy-two percent of women reported discussing fertility concerns with their doctors; 51% felt their concerns were addressed adequately. Women seemed to overestimate their risk of becoming postmenopausal with treatment. Fertility after treatment is a major concern for young women with breast cancer. There is a need to communicate with and educate young patients regarding fertility issues at diagnosis and a need for future research directed at preserving fertility for young breast cancer survivors.

Fertility treatment and childhood type 1 diabetes mellitus

DEFF Research Database (Denmark)

Kettner, Laura Ozer; Matthiesen, Niels Bjerregaard; Ramlau-Hansen, Cecilia Høst

2016-01-01

OBJECTIVE: To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus. DESIGN: Nationwide birth cohort study. SETTING: Not applicable. PATIENT(S): All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003....... INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013. RESULT(S): The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination......, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus...

Prevalence of Child Marriage and its Impact on the Fertility and Fertility Control Behaviors of Young Women in India

Science.gov (United States)

Raj, Anita; Saggurti, Niranjan; Balaiah, Donta; Silverman, Jay G.

2009-01-01

Objectives Child marriage in India is considered a major barrier to the nation's social and economic development, as well as a major women's health concern. The current study assesses prevalence of child marriage (i.e., marriage prior to the national legal age of 18 years) among young adult women in India, and associations between child marriage and women's fertility and fertility control behaviors. Study Design Cross-sectional analyses of a nationally representative household sample of Indian women ages 16-49 years (N=124,385) collected in 2005-2006 via the National Family Health Survey-3. Participants Analyses were restricted to women age 20-24 years (n=22,807) and the subsample of ever married women aged 20-24 years (n=14,628). Data Analysis Prevalence estimates of child marriage were produced for all women 20-24 years. Using the ever married subsample, simple regression models, models adjusted for demographics, and models adjusted for demographics and duration of marriage were constructed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between child marriage and both fertility and fertility control outcomes. Fertility and Fertility Control Outcomes No contraception prior to childbirth, childbirth within first year of marriage, high fertility (3 or more births), history of recent rapid repeat childbirth, unwanted pregnancy, and female sterilization. Results Child marriage was reported by 44.5% of Indian women ages 20-24 years; 22.6% reported marriage prior to age 16 years, and 2.6% were married prior to age 13 years. Child marriage was significantly associated with women's increased risk for no contraceptive use prior to first childbirth (AOR=1.37, 95% CI=1.22, 1.54), high fertility (AOR=7.40, 95% CI=6.45, 8.50), history of rapid repeat childbirth (AOR=3.00, 95% CI=2.74, 3.29), multiple unwanted pregnancies (AOR=2.36, 95% CI=1.90, 2.94), pregnancy termination (AOR=1.22; 95% CI=1.06, 1.41) and female sterilization (AOR=5

Predictive value of early serum beta-human chorionic gonadotrophin for the successful outcome in women undergoing in vitro fertilization

Directory of Open Access Journals (Sweden)

Neeta Singh

2013-01-01

Full Text Available Aims: Pregnancies achieved by in vitro fertilization (IVF are at increased risk of adverse outcome. The main objective of this study was to evaluate the predictive value of β-human chorionic gonadotrophin (β-HCG and age of the patient for the successful outcome in IVF. Materials and Methods: A retrospective study was done in 139 pregnancies after IVF at single IVF center from June 2007 to July 2012. The age of the patient and initial serum values of β-HCG on day 14 of embryo transfer were correlated with ongoing pregnancy (>12 weeks gestation. Results: The β-HCG level on day 14 of more than 347 mIU/ml has a sensitivity of 72.2% and specificity of 73.6% in prediction of pregnancy beyond 12 weeks period of gestation. Positive likelihood ratio (LR is 2.74 and negative LR is 0.37, (receiver operating characteristic area = 0.79. Discussion: In IVF cycles, there is a lot of stress on the couples while the cycle is going on. There was a positive correlation between the higher values of early serum β-HCG levels and ongoing pregnancy. Hence, it can be used as an independent predictor of a successful outcome of IVF cycle. Conclusion: We concluded from our study that early serum β-HCG can be used as a predictor of a successful outcome in IVF.

Proteomic analysis of Aspergillus niger type strain (MUM 03.01) after accelerated freeze-drying preservation

OpenAIRE

Simões, Marta Filipa Jesus Freitas; Santos, Cledir; Rampitsch, Christof; Lima, Nelson

2013-01-01

Industrial processes based on biotechnology require a reliable source of microbial cultures, raising a need for the microbial safe long-term storage. The expanding biotechnological applications of Aspergillus niger requires effective long-term preservation that maintains their viability and also their physiological and genetic features [I]. From the best of our knowledge, proteomic analysis for monitoring the effect of preservation techniques on fungai intra- and extracellular ...

The fertility transition in Cuba and the Federal Republic of Korea: the impact of organised family planning.

Science.gov (United States)

Noble, J; Potts, M

1996-04-01

South Korea and Cuba are dissimilar in religion, economy, culture and attitudes toward premarital sexual relations. In 1960, Korea instituted a national family planning programme to combat rapid population growth. Cuba explicitly rejected Malthusian policies, but made family planning universally available in 1974 in response to health needs. Both countries have undergone rapid fertility declines and today have less than replacement level fertility. Both countries have also used a similar mixture of methods, including a high prevalence of female sterilisation. Abortion has played a major role in the fertility decline of both countries, rising in the first half of the fertility transition and then falling, although remaining a significant variable in the second half. It is concluded that access to contraception, voluntary sterilisation, and safe abortion has a direct impact on fertility and has been associated with a rapid fall in family size in two very different countries.

Semen preservation and artificial insemination in domesticated South American camelids.

Science.gov (United States)

Bravo, P Walter; Alarcon, V; Baca, L; Cuba, Y; Ordoñez, C; Salinas, J; Tito, F

2013-01-10

Semen preservation and artificial insemination in South American camelids are reviewed giving emphasis to work done in Peru and by the authors. Reports on semen evaluation and the preservation process indicate that semen of alpacas and llamas can be manipulated by making it liquid first. Collagenase appears to be the best enzyme to eliminate viscosity. Tris buffer solution maintains a higher motility than egg-yolk citrate, phosphate buffered saline (PBS), Triladyl, and Merck-I extenders. Cooling of semen took 1h after collected, and equilibrated with 7% glycerol presented a better motility and spermatozoa survival at 1, 7, 15 and 30days after being slowly frozen in 0.25mL plastic straws. Trials of artificial insemination with freshly diluted semen and frozen-thawed semen are encouraging and needs to be tested extensively under field conditions. Recently, fertility rates varied from 3 to 67%. Semen preservation and most important, artificial insemination appear to be a reality, and could be used to improve the genetic quality of alpacas and llamas. Copyright © 2012 Elsevier B.V. All rights reserved.

Preserved scleral patch graft for unexpected extreme scleral thinning found at the scleral buckling procedure: A case report

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Spela Stunf

2011-01-01

Full Text Available Pre-existing scleral pathology is an important risk factor for globe rupture during scleral buckling procedures. We report here, the surgical management of an unexpected scleral pathology found at the scleral buckling procedure in a retinal detachment patient. A 77-year-old white female with retinal detachment underwent a scleral buckling procedure. The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively. An alcohol-preserved donor sclera graft was used. The second surgery for definitive retinal alignment was performed two weeks later. The presented case of an unexpected scleral pathology in a retinal detachment patient was managed with a combination of scleral grafting and pars plana vitrectomy, without any major complications. The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory. A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

Clinical and Echocardiographic Characteristics and Cardiovascular Outcomes According to Diabetes Status in Patients With Heart Failure and Preserved Ejection Fraction

DEFF Research Database (Denmark)

Kristensen, Søren L; Mogensen, Ulrik M; Jhund, Pardeep S

2017-01-01

in Heart Failure With Preserved Ejection Fraction) according to history of diabetes mellitus. Cox regression models were used to estimate hazard ratios for cardiovascular outcomes adjusted for known predictors, including age, sex, natriuretic peptides, and comorbidity. Echocardiographic data were available...... versus 29 kg/m2), worse Minnesota Living With Heart Failure score (48 versus 40), higher median N-terminal pro-B-type natriuretic peptide concentration (403 versus 320 pg/mL; all Pdifference in left ventricular ejection fraction. Patients with diabetes...

Nano Fertilizers

Directory of Open Access Journals (Sweden)

Hatice DAĞHAN

2017-06-01

Full Text Available Agricultural land is decreasing day by day due to erosion, environmental pollution, unconscious irrigation and fertilization. On the other hand, it is necessary to increase agricultural production in order to meet the needs of the developing industry as well as the nutritional needs of the growing population. In the recent years, nano fertilizers have begun to be produced to obtain the highest amount and quality of production from the unit area. Previous research shows that nano fertilizers cause an increase in the use efficiency of plant nutrients, reduce soil toxicity, minimize the potential adverse effects of excessive chemical fertilizer use, and reduce fertilizer application frequency. Nano fertilizers are important in agriculture to increase crop yield and nutrient use efficiency, and to reduce excessive use ofchemical fertilizers. The most important properties of these fertilizers are that they contain one or more of macro and micronutrients, they can be applied frequently in small amounts and are environmentally friendly. However, when applied at high doses, they exhibit decreasing effects on plant growth and crop yields, similar to chemical fertilizers. In this review, the definition, importan ce, and classification of nano fertilizers, their application in plant production, advantages and disadvantages and the results obtained in this field were discussed.

Culture: an empirical investigation of beliefs, work, and fertility

OpenAIRE

Raquel Fernandez; Alessandra Fogli

2005-01-01

We study the effect of culture on important economic outcomes by using the 1970 Census to examine the work and fertility behaviour of women 30-40 years old, born in the US, but whose parents were born elsewhere. We use past female labour force participation and total fertility rates from the country of ancestry as our cultural proxies. These variables should capture, in addition to past economic and institutional conditions, the beliefs commonly held about the role of women in society, i.e. c...

Education as policy: the impact of education on marriage, contraception, and fertility in Colombia, Peru, and Bolivia.

Science.gov (United States)

Heaton, T B; Forste, R

1998-01-01

Using data from the World Fertility and Demographic and Health Surveys of Colombia, Peru, and Bolivia, we model the effects of education on three demographic outcomes: the timing of first sexual union, contraceptive use, and fertility. These effects are examined over time and across geographic areas using a multivariate framework. We find substantial improvements in female educational attainment over the last fifty years and a strong relationship between education and the demographic outcomes. Each successive increment in education is associated with declines in the marriage rate, increased contraceptive use, and lower fertility. Education accounts for some of the changes over time in the demographic outcomes, but the pattern varies by outcome, time period, and geographic area. In support of the social diffusion hypothesis, our results indicate that educational differences in reproductive behavior are reduced as the level of development increases and societies pass through their demographic transition.

Detailed process design based on genomics of survivors of food preservation processes

NARCIS (Netherlands)

Brul, S.; Klis, F.M.; Oomes, S.J.C.M.; Montijn, R.C.; Schuren, F.H.J.; Coote, P.; Hellingwerf, K.J.

2002-01-01

The food processing industry is faced with an ever-increasing demand for safe and minimally processed wholesome foods. In order to come to a knowledge-based rather than a mainly empirical combination of appropriate preservation hurdles, we will introduce the application of the recently booming

Surrogate in vitro fertilization outcome in typical and atypical forms of Mayer-Rokitansky-Kuster-Hauser syndrome.

Science.gov (United States)

Raziel, A; Friedler, S; Gidoni, Y; Ben Ami, I; Strassburger, D; Ron-El, R

2012-01-01

The genital malformations in Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) are frequently accompanied by associated malformations whose forms were recently classified as typical (isolated uterovaginal aplasia/hypoplasia) and atypical (the addition of malformations in the ovary or renal system). The aim of this study was to compare the surrogate IVF performance of women with typical and atypical forms including their chances of achieving pregnancy. The follow-up data on a total of 102 cycles of surrogate IVF in 27 MRKH patients treated in our department between 2000 and 2010 were analysed. Twenty patients with the typical form who underwent 72 IVF cycles were compared with seven patients with the atypical form who underwent 30 IVF cycles. The various examined parameters of these intended mothers were age, hormonal profile during controlled ovarian hyperstimulation and laboratory outcome. The mean number of gonadotrophin ampoules needed for stimulation and treatment duration was significantly higher in the atypical form (3600 ± 1297IU for 13 ± 2.3 days versus 2975 ± 967 IU for 11.6 ± 1.6 days, P≤ 0.01). Serum estradiol and progesterone levels measured on the hCG administration day were similar. A significantly higher mean number of follicles 12.6 ± 6 versus 8.9 ± 5.4, P≤ 0.03, metaphase II (MII) oocytes 8.7 ± 5.1 versus 6.7 ± 4.8, P≤ 0.05, fertilizations 6 ± 3.6 versus 4.4 ± 3.3, P≤ 0.03 and cleaving embryos 5.7 ± 3.8 versus 4.1 ± 3.3, P≤ 0.01 were available in patients with the typical form compared with those with the atypical form, respectively. There was no significant difference in fertilization rate, cleavage rate or the mean number of transferred embryos. Embryo quality of the transferred ones and pregnancy rate per cycle were also similar between the two groups. Women with the typical form of MRKH needed fewer gonadotrophins and for a shorter duration for ovarian hyperstimulation. The mean number of follicles, oocytes, MII oocytes

Outcomes of in vitro fertilization cycles among patients with polycystic ovary syndrome following ovarian puncture for in vitro maturation.

Science.gov (United States)

Lin, Jia; Wang, Peiyu; Zhao, Junzhao; Xiao, Shiquan; Yu, Rong; Jin, Congcong; Zhu, Ruru

2016-12-01

To investigate the effects of ovarian puncture for in vitro maturation (IVM) on subsequent in vitro fertilization (IVF) embryo transfer cycles in patients with polycystic ovary syndrome (PCOS). A retrospective study included data from patients admitted to the First Affiliated Hospital of Wenzhou Medical University, China, between January 1, 2008 and December 31, 2014. Patients with PCOS undergoing IVF cycles after having been treated with IVM unsuccessfully were included as the study group and an IVF-procedure data-matched control group of patients undergoing their first IVF cycles was included in a 1:4 ratio. Patients with reproductive anomalies were excluded. Endocrine-hormone levels and antral follicle counts were measured and fertilization-related outcomes were evaluated. There were 49 patients included in the study group and 196 included in the control group. Within the study group, basal luteal-hormone, testosterone, and antral follicle count levels were significantly lower following IVM treatment. The total gonadotropin dose was lower (Povarian hyper-stimulation syndrome (P=0.633). Previous IVM resulted in improved endocrine profiles and increased clinical-pregnancy rates among patients with PCOS undergoing IVF cycles. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Factors related to outcome in heart failure with a preserved (or normal) left ventricular ejection fraction.

Science.gov (United States)

Sanderson, John E

2016-07-01

Heart failure with a preserved ejection faction (HFpEF) is a growing and expensive cause of heart failure (HF) affecting particularly the elderly. It differs in substantial ways in addition to the normal left ventricular ejection fraction, from the more easily recognized form of heart failure with a reduced ejection fraction (HFrEF or 'systolic heart failure') and unlike HFrEF there have been little advances in treatment. In part, this relates to the complexity of the pathophysiology and identifying the correct targets. In HFpEF, there appears to be widespread stiffening of the vasculature and the myocardium affecting ventricular function (both systolic and diastolic), impeding ventricular suction, and thus early diastolic filling leading to breathlessness on exertion and later atrial failure and fibrillation. Left ventricular ejection fraction tends to gradually decline and some evolve into HFrEF. Most patients also have a mixture of several co-morbidities including hypertension, diabetes, obesity, poor renal function, lack of fitness, and often poor social conditions. Therefore, many factors may influence outcome in an individual patient. In this review, the epidemiology, possible causation, pathophysiology, the influence of co-morbidities and some of the many potential predictors of outcome will be considered.

Testicular Biopsy for Fertility Preservation in Prepubertal Boys with Cancer: Identifying Preferences for Procedure and Reactions to Disclosure Practices.

Science.gov (United States)

Gupta, Abha A; Donen, Rachel M; Sung, Lillian; Boydell, Katherine M; Lo, Kirk C; Stephens, Derek; Pritchard, Sheila; Portwine, Carol; Maloney, Anne Marie; Lorenzo, Armando J

2016-07-01

Fertility preservation options are limited in prepubertal boys with cancer. Worldwide there has been growing interest in testicular tissue cryopreservation as a promising experimental strategy to address future infertility. We measured and compared parent, male cancer survivor and provider willingness to accept the risk of testicular biopsy among prepubertal boys with cancer, and identified reactions to disclosure practices. We conducted a multicenter study that included 153 parents of prepubertal boys with cancer, 77 male survivors of childhood cancer and 30 oncology providers. The threshold technique was used to measure subject relative willingness to accept risk of testicular biopsy under 4 different aspects of care, ie chance of infertility, complications from biopsy, development of technology to use tissue and tissue storage cost. A total of 47 in-depth interviews were conducted to identify reactions to disclosure practices. A total of 52 survivors (67%), 22 providers (73%) and 110 parents (72%) selected to have testicular biopsy (vs no biopsy). Median minimum infertility risk to make biopsy worthwhile varied from 25% to 30% among the 3 respondent groups. Interviews revealed that some providers would not offer biopsy in cases of greater perceived risk than benefit, that parents preferred having information regardless of risk of infertility and that nondisclosure elicited adverse feelings from some parents. Parents, survivors and providers were willing to accept risk of prepubertal testicular biopsy. Parental/survivor desire for information and provider decision not to disclose suggest that barriers to information delivery need to be addressed. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Prediction of individual probabilities of livebirth and multiple birth events following in vitro fertilization (IVF): a new outcomes counselling tool for IVF providers and patients using HFEA metrics.

Science.gov (United States)

Jones, Christopher A; Christensen, Anna L; Salihu, Hamisu; Carpenter, William; Petrozzino, Jeffrey; Abrams, Elizabeth; Sills, Eric Scott; Keith, Louis G

2011-01-01

In vitro fertilization (IVF) has become a standard treatment for subfertility after it was demonstrated to be of value to humans in 1978. However, the introduction of IVF into mainstream clinical practice has been accompanied by concerns regarding the number of multiple gestations that it can produce, as multiple births present significant medical consequences to mothers and offspring. When considering IVF as a treatment modality, a balance must be set between the chance of having a live birth and the risk of having a multiple birth. As IVF is often a costly decision for patients-financially, medically, and emotionally-there is benefit from estimating a patient's specific chance that IVF could result in a birth as fertility treatment options are contemplated. Historically, a patient's "chance of success" with IVF has been approximated from institution-based statistics, rather than on the basis of any particular clinical parameter (except age). Furthermore, the likelihood of IVF resulting in a twin or triplet outcome must be acknowledged for each patient, given the known increased complications of multiple gestation and consequent increased risk of poor birth outcomes. In this research, we describe a multivariate risk assessment model that incorporates metrics adapted from a national 7.5-year sampling of the Human Fertilisation & Embryology Authority (HFEA) dataset (1991-1998) to predict reproductive outcome (including estimation of multiple birth) after IVF. To our knowledge, http://www.formyodds.com is the first Software-as-a-Service (SaaS) application to predict IVF outcome. The approach also includes a confirmation functionality, where clinicians can agree or disagree with the computer-generated outcome predictions. It is anticipated that the emergence of predictive tools will augment the reproductive endocrinology consultation, improve the medical informed consent process by tailoring the outcome assessment to each patient, and reduce the potential for adverse

Small amounts of tissue preserve pancreatic function: Long-term follow-up study of middle-segment preserving pancreatectomy.

Science.gov (United States)

Lu, Zipeng; Yin, Jie; Wei, Jishu; Dai, Cuncai; Wu, Junli; Gao, Wentao; Xu, Qing; Dai, Hao; Li, Qiang; Guo, Feng; Chen, Jianmin; Xi, Chunhua; Wu, Pengfei; Zhang, Kai; Jiang, Kuirong; Miao, Yi

2016-11-01

Middle-segment preserving pancreatectomy (MPP) is a novel procedure for treating multifocal lesions of the pancreas while preserving pancreatic function. However, long-term pancreatic function after this procedure remains unclear.The aims of this current study are to investigate short- and long-term outcomes, especially long-term pancreatic endocrine function, after MPP.From September 2011 to December 2015, 7 patients underwent MPP in our institution, and 5 cases with long-term outcomes were further analyzed in a retrospective manner. Percentage of tissue preservation was calculated using computed tomography volumetry. Serum insulin and C-peptide levels after oral glucose challenge were evaluated in 5 patients. Beta-cell secreting function including modified homeostasis model assessment of beta-cell function (HOMA2-beta), area under the curve (AUC) for C-peptide, and C-peptide index were evaluated and compared with those after pancreaticoduodenectomy (PD) and total pancreatectomy. Exocrine function was assessed based on questionnaires.Our case series included 3 women and 2 men, with median age of 50 (37-81) years. Four patients underwent pylorus-preserving PD together with distal pancreatectomy (DP), including 1 with spleen preserved. The remaining patient underwent Beger procedure and spleen-preserving DP. Median operation time and estimated intraoperative blood loss were 330 (250-615) min and 800 (400-5500) mL, respectively. Histological examination revealed 3 cases of metastatic lesion to the pancreas, 1 case of chronic pancreatitis, and 1 neuroendocrine tumor. Major postoperative complications included 3 cases of delayed gastric emptying and 2 cases of postoperative pancreatic fistula. Imaging studies showed that segments representing 18.2% to 39.5% of the pancreas with good blood supply had been preserved. With a median 35.0 months of follow-ups on pancreatic functions, only 1 patient developed new-onset diabetes mellitus of the 4 preoperatively euglycemic

Short-term preservation of porcine oocytes in ambient temperature: novel approaches.

Directory of Open Access Journals (Sweden)

Cai-Rong Yang

Full Text Available The objective of this study was to evaluate the feasibility of preserving porcine oocytes without freezing. To optimize preservation conditions, porcine cumulus-oocyte complexes (COCs were preserved in TCM-199, porcine follicular fluid (pFF and FCS at different temperatures (4°C, 20°C, 25°C, 27.5°C, 30°C and 38.5°C for 1 day, 2 days or 3 days. After preservation, oocyte morphology, germinal vesicle (GV rate, actin cytoskeleton organization, cortical granule distribution, mitochondrial translocation and intracellular glutathione level were evaluated. Oocyte maturation was indicated by first polar body emission and spindle morphology after in vitro culture. Strikingly, when COCs were stored at 27.5°C for 3 days in pFF or FCS, more than 60% oocytes were still arrested at the GV stage and more than 50% oocytes matured into MII stages after culture. Almost 80% oocytes showed normal actin organization and cortical granule relocation to the cortex, and approximately 50% oocytes showed diffused mitochondria distribution patterns and normal spindle configurations. While stored in TCM-199, all these criteria decreased significantly. Glutathione (GSH level in the pFF or FCS group was higher than in the TCM-199 group, but lower than in the non-preserved control group. The preserved oocytes could be fertilized and developed to blastocysts (about 10% with normal cell number, which is clear evidence for their retaining the developmental potentiality after 3d preservation. Thus, we have developed a simple method for preserving immature pig oocytes at an ambient temperature for several days without evident damage of cytoplasm and keeping oocyte developmental competence.

Short-term preservation of porcine oocytes in ambient temperature: novel approaches.

Science.gov (United States)

Yang, Cai-Rong; Miao, De-Qiang; Zhang, Qing-Hua; Guo, Lei; Tong, Jing-Shan; Wei, Yanchang; Huang, Xin; Hou, Yi; Schatten, Heide; Liu, ZhongHua; Sun, Qing-Yuan

2010-12-07

The objective of this study was to evaluate the feasibility of preserving porcine oocytes without freezing. To optimize preservation conditions, porcine cumulus-oocyte complexes (COCs) were preserved in TCM-199, porcine follicular fluid (pFF) and FCS at different temperatures (4°C, 20°C, 25°C, 27.5°C, 30°C and 38.5°C) for 1 day, 2 days or 3 days. After preservation, oocyte morphology, germinal vesicle (GV) rate, actin cytoskeleton organization, cortical granule distribution, mitochondrial translocation and intracellular glutathione level were evaluated. Oocyte maturation was indicated by first polar body emission and spindle morphology after in vitro culture. Strikingly, when COCs were stored at 27.5°C for 3 days in pFF or FCS, more than 60% oocytes were still arrested at the GV stage and more than 50% oocytes matured into MII stages after culture. Almost 80% oocytes showed normal actin organization and cortical granule relocation to the cortex, and approximately 50% oocytes showed diffused mitochondria distribution patterns and normal spindle configurations. While stored in TCM-199, all these criteria decreased significantly. Glutathione (GSH) level in the pFF or FCS group was higher than in the TCM-199 group, but lower than in the non-preserved control group. The preserved oocytes could be fertilized and developed to blastocysts (about 10%) with normal cell number, which is clear evidence for their retaining the developmental potentiality after 3d preservation. Thus, we have developed a simple method for preserving immature pig oocytes at an ambient temperature for several days without evident damage of cytoplasm and keeping oocyte developmental competence.

Knowledge, attitudes, and intentions toward fertility awareness and oocyte cryopreservation among obstetrics and gynecology resident physicians.

Science.gov (United States)

Yu, L; Peterson, B; Inhorn, M C; Boehm, J K; Patrizio, P

2016-02-01

What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients? Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines. Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients. A cross-sectional online survey was conducted during the fall of 2014 among residents in American Council for Graduate (ACOG) Medical Education-approved OB/GYN residency programs. Program directors were emailed via the ACOG Council on Resident Education in Obstetrics and Gynecology server listing and asked to solicit resident participation. Participants included 238 residents evenly distributed between post-graduate years 1-4 with varied post-residency plans; 90% of residents were women and 75% were 26-30 years old. The survey was divided into three sections: demographics, fertility awareness, and attitudes toward discussing fertility preservation options with patients. Descriptive and inferential statistics were conducted. A strong majority of residents (83%) believed an OB/GYN should initiate discussions about age-related fertility decline with patients (mean patient age 31.8), and 73% percent believed these discussions should be part of an annual exam. One third of residents overestimated the age at which there is a slight decline in female fertility, while nearly half of residents overestimated the age at which female fertility markedly declines. Over three-quarters of residents (78.4%) also overestimated the likelihood of success using assisted

Numerical Simulation of Non-Thermal Food Preservation

Science.gov (United States)

Rauh, C.; Krauss, J.; Ertunc, Ö.; Delgado, a.

2010-09-01

Food preservation is an important process step in food technology regarding product safety and product quality. Novel preservation techniques are currently developed, that aim at improved sensory and nutritional value but comparable safety than in conventional thermal preservation techniques. These novel non-thermal food preservation techniques are based for example on high pressures up to one GPa or pulsed electric fields. in literature studies the high potential of high pressures (HP) and of pulsed electric fields (PEF) is shown due to their high retention of valuable food components as vitamins and flavour and selective inactivation of spoiling enzymes and microorganisms. for the design of preservation processes based on the non-thermal techniques it is crucial to predict the effect of high pressure and pulsed electric fields on the food components and on the spoiling enzymes and microorganisms locally and time-dependent in the treated product. Homogenous process conditions (especially of temperature fields in HP and PEF processing and of electric fields in PEF) are aimed at to avoid the need of over-processing and the connected quality loss and to minimize safety risks due to under-processing. the present contribution presents numerical simulations of thermofluiddynamical phenomena inside of high pressure autoclaves and pulsed electric field treatment chambers. in PEF processing additionally the electric fields are considered. Implementing kinetics of occurring (bio-) chemical reactions in the numerical simulations of the temperature, flow and electric fields enables the evaluation of the process homogeneity and efficiency connected to different process parameters of the preservation techniques. Suggestions to achieve safe and high quality products are concluded out of the numerical results.

Combination of preservation factors applied to minimal processing of foods.

Science.gov (United States)

Tapia de Daza, M S; Alzamora, S M; Chanes, J W

1996-07-01

Innovative technologies for producing minimally processed (MP) foods that apply the concept of combination of preservation factors are addressed in this article with special emphasis on a new combined approach that has been successfully applied in several Latin American countries for MP high-moisture fruit products (HMFP). HMFP can be regarded as a different approach to the commercially available and widely accepted MP concept for fruits and vegetables (even if developed for the same purpose of obtaining freshlike high-quality products with an extended shelf life) that is better adapted to Latin American countries in terms of independence of the chill chain and the use of simple and energy-efficient technologies. The continuous refrigeration hurdle associated with MP refrigerated fruits is not included in the preservation system of HMFP because a different combination of hurdles must be overcome to enhance the shelf stability of nonrespiring vegetable tissues while preserving freshlike character. Guidelines to obtain safe and high-quality MP fruit products are proposed. Other products preserved by combined factors technology are also discussed, as well as some other classical and new preservation factors whose application could enhance the quality of HMFP.

Cryopreservation of turkey semen: effect of breeding line and freezing method on post-thaw sperm quality, fertilization, and hatching

Science.gov (United States)

Cryopreservation methods for poultry semen are not reliable for germplasm preservation, especially for turkeys, where fertility rates from frozen/thawed semen are particularly low. The objective was to evaluate cryopreservation methods for effectiveness in promoting cryosurvival and post-thaw funct...

Bariatric Surgery in Obese Women of Reproductive Age Improves Conditions That Underlie Fertility and Pregnancy Outcomes: Retrospective Cohort Study of UK National Bariatric Surgery Registry (NBSR).

Science.gov (United States)

Edison, Eric; Whyte, Martin; van Vlymen, Jeremy; Jones, Simon; Gatenby, Piers; de Lusignan, Simon; Shawe, Jill

2016-12-01

The aims of this study are the following: to describe the female population of reproductive age having bariatric surgery in the UK, to assess the age and ethnicity of women accessing surgery, and to assess the effect of bariatric surgery on factors that underlie fertility and pregnancy outcomes. Demographic details, comorbidities, and operative type of women aged 18-45 years were extracted from the National Bariatric Surgery Registry (NBSR). A comparison was made with non-operative cases (aged 18-45 and BMI ≥40 kg/m 2 ) from the Health Survey for England (HSE, 2007-2013). Analyses were performed using "R" software. Data were extracted on 15,222 women from NBSR and 1073 from HSE. Women aged 18-45 comprised 53 % of operations. Non-Caucasians were under-represented in NBSR compared to HSE (10 vs 16 % respectively, p years (Wilcoxon test p year postoperatively from 48.2 ± 8.3 to 37.4 ± 7.5 kg/m 2 (t test, p fertility and pregnancy outcomes. A prospective study is required to verify these effects.

[Risk and protection of fertility in male cancer patients].

Science.gov (United States)

Dong, Gan; Xiu, Zi-Chao; Wang, Pei-Tao; Wang, Xin-Sheng

2017-03-01

Gonad damage is one of the major complications of chemotherapy, radiotherapy or surgery in male cancer patients. For those who wish for childbearing after treatment, it is of great significance how to protect the reproductive function of the cancer patients. The main strategy for fertility protection is to optimize the treatment protocol, hormone therapy, antioxidant therapy, and the preservation of sperm and testicular tissue. This article presents an overview on the pathogenesis of gonadal damage induced by different treatments and protection of the reproductive function of the patient.

Desired Fertility and Number of Children Born Across Time and Space.

Science.gov (United States)

Günther, Isabel; Harttgen, Kenneth

2016-02-01

Economists have often argued that high fertility rates are mainly driven by women's demand for children (and not by family planning efforts) with low levels of unwanted fertility across countries (and hence with little room for family planning efforts to reduce population growth). We study the relationship between wanted fertility and number of children born in a panel of 200 country-years controlling for country fixed effects and global time trends. In general, we find a close relationship between wanted and actual fertility, with one desired child leading to one additional birth. However, our results also indicate that in the last 20 years, the level of unwanted births has stayed at 2 across African countries but has, on average, decreased from 1 to close to 0 in other developing countries. Hence, women in African countries are less able to translate child preferences into birth outcomes than women in other developing countries, and forces other than fertility demand have been important for previous fertility declines in many developing countries. Family planning efforts only partially explain the observed temporal and spatial differences in achieving desired fertility levels.

Fertility outcome in male and female patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

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Mahdi Kamoun

2014-06-01

Conclusion: Fertility in male and female patients with CAH is reduced. Early and adequate glucocorticoid therapy along with good compliance, careful monitoring of androgen levels and continuous psychological management could contribute to improved fertility rates in this population, even among those with the severe variant.

Using manure as fertilizer for maize could improve sustainability of milk production

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José D. Jiménez-Calderón

2018-04-01

Full Text Available This study evaluated the effect of organic or chemical fertilization of maize on cow performance, economic outcomes, and greenhouse gas emission. Each type of maize silage according its different fertilization was used in two rations offered to two different groups of nine Friesian-Holstein cows throughout 4 months. The production cost of the maize silage was 8.8% lower for organic than for chemical fertilization. Both silages had similar nutritive value, except a higher concentration of starch in maize with organic fertilization, which allowed a reduction in the proportion of concentrate in the ration, saving 25.3 eurocents per cow in the daily ration, generating a positive balance of 21.8 eurocents per cow and day. The milk yield and composition were unaffected depending on the type of fertilization, whereas the estimation of CH4 and N2O emissions with chemical fertilization was higher than emissions with organic fertilization. As a result, it is possible to increase the sustainability and profitability of dairy production with reuse and recycling of manure.

Using manure as fertilizer for maize could improve sustainability of milk production

International Nuclear Information System (INIS)

Jiménez-Calderón, J.M.; Martínez-Fernández, A.; Prospero-Bernal, F.; Velarde-Guillén, J.; Arriaga-Jordán, C.M.; Vicente, F.

2018-01-01

This study evaluated the effect of organic or chemical fertilization of maize on cow performance, economic outcomes, and greenhouse gas emission. Each type of maize silage according its different fertilization was used in two rations offered to two different groups of nine Friesian-Holstein cows throughout 4 months. The production cost of the maize silage was 8.8% lower for organic than for chemical fertilization. Both silages had similar nutritive value, except a higher concentration of starch in maize with organic fertilization, which allowed a reduction in the proportion of concentrate in the ration, saving 25.3 eurocents per cow in the daily ration, generating a positive balance of 21.8 eurocents per cow and day. The milk yield and composition were unaffected depending on the type of fertilization, whereas the estimation of CH4 and N2O emissions with chemical fertilization was higher than emissions with organic fertilization. As a result, it is possible to increase the sustainability and profitability of dairy production with reuse and recycling of manure.

The impact of bariatric surgery on obesity-related infertility and in vitro fertilization outcomes.

Science.gov (United States)

Tan, Orkun; Carr, Bruce R

2012-12-01

Obesity-related infertility is one of the most common problems of reproductive-age obese women who desire childbearing. The various types of bariatric surgeries have proved effective in controlling excessive weight gain, improving fertility, and preventing certain maternal and fetal complications in these women. This article summarizes the current evidence regarding the impact of bariatric surgery on obesity-related infertility and in vitro fertilization (IVF) outcomes. We have also attempted to draw conclusions about maternal and fetal risks and the benefits of bariatric surgery. Laparoscopic adjustable gastric banding and Roux-en-Y procedures are the two most commonly performed bariatric surgeries. Bariatric surgery was believed to improve menstrual irregularity and increase ovulation rate in anovulatory obese women, which lead to increased pregnancy rates. Although there are data in the literature suggesting the improvement of both the ovulatory function and the spontaneous pregnancy rates in obese women who lost weight after bariatric surgery, most of these are case-control studies with a small number of patients. The data are insufficient to determine an ideal time interval for pregnancy after bariatric surgery; however, the general consensus is that pregnancy should be delayed 12 to 18 months after bariatric surgery to avoid nutritional deficiencies. Few data exist regarding IVF success rates in women who have undergone bariatric surgery. One pairwise study discussed five patients who underwent bariatric surgery followed by IVF that resulted in three term pregnancies in three patients after the first IVF cycle. Many studies reported reductions in obesity-related pregnancy complications such as gestational diabetes and hypertensive disorders after bariatric surgery. Although data are inconsistent, some studies reported increased rate of preterm delivery and small for gestational age infants after bariatric surgery. Pregnancies after bariatric surgery may be

RESTORATION OF FERTILITY IN A MAN WITH AZOOSPERMIA DEVELOPED IN RESPONSE TO TREATMENT WITH TESTOSTERONE GEL (A CASE REPORT

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I. A. Korneev

2017-01-01

Full Text Available Testosterone replacement therapy (TRT allows to combat the symptoms of age-related androgen deficiency (AAD; however, it may have side effects, including the reduction in sperm count and even complete cessation of spermatogenesis and development of azoospermia. The fertility may not be restored even within 18 month after treatment completion. Russian researcher explored the impact of TRT with gel on the ejaculate parameters in men with hypogonadism and observed no negative effects on spermatogenesis within 3 months after treatment initiation. We describe a clinical case of reversible azoospermia induced by a relatively short course of TRT with gel. Fertilizing capacity of sperm was finally restored, which was confirmed by a clinical pregnancy obtained by in vitro fertilization. Physicians prescribing TRT should inform their patients that such treatment is contraindicated to those men who would like to preserve their fertility and explain that the restoration of fertility will take some time after treatment completion.

Successful pregnancy outcome after fertility-sparing surgery and chemotherapy for dysgerminoma.

Science.gov (United States)

Shamim, Muhammad

2010-09-01

Ovarian dysgerminoma is a rare malignancy of the ovary. This is a case report of a 30-year-old female, presenting with a huge ovarian mass along with multiple gallstones; she was treated by fertility-sparing excision of the mass and cholecystectomy, followed by chemotherapy. She later had an uneventful pregnancy and delivered a healthy baby.

Global Fertilizer and Manure, Version 1: Nitrogen Fertilizer Application

Data.gov (United States)

National Aeronautics and Space Administration — The Nitrogen Fertilizer Application dataset of the Global Fertilizer and Manure, Version 1 Data Collection represents the amount of nitrogen fertilizer nutrients...

Global Fertilizer and Manure, Version 1: Phosphorus Fertilizer Application

Data.gov (United States)

National Aeronautics and Space Administration — The Phosphorus Fertilizer Application dataset of the Global Fertilizer and Manure, Version 1 Data Collection represents the amount of phosphorus fertilizer nutrients...

Association between human leukocyte antigen-G genotype and success of in vitro fertilization and pregnancy outcome

DEFF Research Database (Denmark)

Hviid, T V F; Hylenius, S; Lindhard, A

2004-01-01

spontaneous abortions (RSA), 29 white women undergoing IVF treatments, 61 RSA women and 93 fertile controls were HLA-G genotype. The HLA-G genotype, homozygous for the presence of the 14 bp sequence in exon 8, was significantly associated with reduced fertility with respect to unsuccessful IVF treatments...

Development of a health promotion programme to improve awareness of factors that affect fertility, and evaluation of its reach in the first 5 years

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Karin Hammarberg

2017-06-01

Full Text Available Awareness among people of reproductive age about the factors that influence fertility and reproductive outcomes, including medically assisted reproduction outcomes, is generally low. To improve awareness about the potentially modifiable factors that affect fertility and reproductive outcomes, ‘Your Fertility’, a fertility health promotion programme funded by the Australian Government, was established in 2011. This paper describes the development and evaluation of the reach of the Your Fertility programme from its inception in 2011 to June 2016. Systematically recorded outcomes for the programme’s key focus areas and Google Analytics data were collated. Key achievements include developing and maintaining an internationally renowned website that experiences high growth and demand for fertility-related information; by 2016, over 5 million users had viewed more than 10 million webpages, and over 96,000 users had engaged in programme messages across social media. Programme messages have reached more than 4 million Australian social media users, and a potential audience of 150 million through media coverage across more than 320 media features. More than 4200 education and health professionals have completed online learning modules, and external partnerships have been established with 14 separate organizations. Data collected over 5 years indicate that the Your Fertility programme meets a need for targeted, evidence-based, accessible fertility-related information.

Responses to fertility treatment among patients with cancer: a retrospective cohort study.

Science.gov (United States)

Dolinko, A V; Farland, L V; Missmer, S A; Srouji, S S; Racowsky, C; Ginsburg, E S

2018-01-01

Cancer treatments have significant negative impacts on female fertility, but the impact of cancer itself on fertility remains to be clarified. While some studies have shown that compared with healthy women, those with cancer require higher doses of gonadotropins resulting in decreased oocyte yields, others have shown comparable oocyte yields between the two groups. The purpose of this study is to evaluate whether there is an association between any cancer and/or type of cancer, and response to ovarian stimulation for egg and embryo banking. In this retrospective cohort study, ovarian stimulation cycles performed from June 2007 through October 2014 at a single academic medical center were reviewed to identify those undertaken for women with cancer undergoing fertility preservation ( n  = 147) or women with no cancer undergoing their first cycle due to male factor infertility ( n  = 664). Of the 147 women undergoing fertility preservation, 105 had local cancer (Stage I-III solid malignancies) and 42 had systemic cancer (hematologic or Stage IV solid malignancies). Response to ovarian stimulation was compared among these two groups and women with no cancer. Adjusting for age and BMI, women with systemic cancer had lower baseline antral follicle counts (AFC) than women with no cancer or local cancer. Women with systemic cancer required higher doses of FSH than women with no cancer or local cancer, and they had higher oocyte to AFC ratios than women with no cancer or local cancer, but greater odds of cycle cancellation as compared to women with no cancer or local cancer. No significant differences were observed among the three groups for duration of stimulation, number of oocytes and mature oocytes retrieved, or number of embryos created. Women with cancer achieve similar oocyte and embryo yields as women with no cancer, although those with systemic cancer require higher FSH doses and are at greater risk of cycle cancellation.

Preservation of live cultures of basidiomycetes - recent methods.

Science.gov (United States)

Homolka, Ladislav

2014-02-01

Basidiomycetes are used in industrial processes, in basic or applied research, teaching, systematic and biodiversity studies. Efficient work with basidiomycete cultures requires their reliable source, which is ensured by their safe long-term storage. Repeated subculturing, frequently used for the preservation, is time-consuming, prone to contamination, and does not prevent genetic and physiological changes during long-term maintenance. Various storage methods have been developed in order to eliminate these disadvantages. Besides lyophilization (unsuitable for the majority of basidiomycetes), cryopreservation at low temperatures seems to be a very efficient way to attain this goal. Besides survival, another requirement for successful maintenance of fungal strains is the ability to preserve their features unchanged. An ideal method has not been created so far. Therefore it is highly desirable to develop new or improve the current preservation methods, combining advantages and eliminate disadvantages of individual techniques. Many reviews on preservation of microorganisms including basidiomycetes have been published, but the progress in the field requires an update. Although herbaria specimens of fungi (and of basidiomycetes in particular) are very important for taxonomic and especially typological studies, this review is limited to live fungal cultures. Copyright © 2013 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.

ICE911 Research: Floating Safe Inert Materials to Preserve Ice and Conserve Water in Order to Mitigate Climate Change Impacts

Science.gov (United States)

Field, L. A.; Manzara, A.; Chetty, S.; Venkatesh, S.; Scholtz, A.

2015-12-01

Ice911 Research has conducted years of field testing to develop and test localized reversible engineering techniques to mitigate the negative impacts of polar ice melt. The technology uses environmentally safe materials to reflect energy in carefully selected, limited areas from summertime polar sun. The technology is now being adapted to help with California's drought. We have tested the albedo modification technique on a small scale over seven Winter/Spring seasons at sites including California's Sierra Nevada Mountains, a Canadian lake, and a small artificial pond in Minnesota about 100 ft in diameter and 6 ft deep at the center, using various materials and an evolving array of instrumentation. On the pond in Minnesota, this year's test results for ice preservation, using hollow glass spheres deployed over our largest test areas yet, showed that glass bubbles can provide an effective material for increasing albedo, significantly reducing the melting rate of ice. This year Ice911 also undertook its first small Arctic field test in Barrow, Alaska on a lake in Barrow's BEO area, and results are still coming in. The technology that Ice911 has been developing for ice preservation has also been shown to keep small test areas of water cooler, in various small-scale tests spanning years. We believe that with some adaptations of the technology, the materials can be applied to reservoirs and lakes to help stretch these precious resources further in California's ongoing drought. There are several distinct advantages for this method over alternatives such as large reverse osmosis projects or building new reservoirs, which could possibly allow a drought-stricken state to build fewer of these more-costly alternatives. First, applying an ecologically benign surface treatment of Ice911's materials can be accomplished within a season, at a lower cost, with far less secondary environmental impact, than such capital-and-time-intensive infrastructure projects. Second, keeping

Preservation of the External Jugular Vein in Bilateral Radical Neck Dissections: Technique in Two Cases and Review of the Literature

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Rodrigo Lima Bastos da Rocha

2015-01-01

Full Text Available Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients’ outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

Why the concern about irradiation as a food preservation technique?

International Nuclear Information System (INIS)

Anon

2001-01-01

Full text: Irradiation is a food preservation process that like the more traditional and alternative methods is intended to keep food safe to eat by delaying the natural decomposition processes that result from bacterial action. Preservation of foods by irradiation, although still not available in Australia, is readily accepted in some 44 countries, including France. This project is set up to examine if a sample of fresh fruits and vegetables, when irradiated to the recommended 'preservation' dose level, becomes 'radioactive'. By placing the 'irradiated' sample, together with an identical 'control' sample of the same fresh fruit and vegetables, in an x-radiography cassette in a shielded 'cave', differences in film 'blackening' over the exposure period would indicate relative radioactivity from within the respective samples. Also, using simultaneous daily photographs of both the 'irradiated' and non-irradiated 'control' samples, the delay of onset of visible decay of both can be determined

The ESEP study: Salpingostomy versus salpingectomy for tubal ectopic pregnancy; The impact on future fertility: A randomised controlled trial

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van Mello Norah M

2008-06-01

Full Text Available Abstract Background For most tubal ectopic pregnancies (EP surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy or radically (salpingectomy in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP. Methods/Design International multi centre randomised controlled trial comparing salpingostomy versus salpingectomy in women with a tubal EP without contra lateral tubal pathology. Hemodynamically stable women with a presumptive diagnosis of tubal EP, scheduled for surgery, are eligible for inclusion. Patients pregnant after in vitro fertilisation (IVF and/or known documented tubal pathology are excluded. At surgery, a tubal EP must be confirmed. Only women with a tubal EP amenable to both interventions and a healthy contra lateral tube are included. Salpingostomy and salpingectomy are performed according to standard procedures of participating hospitals. Up to 36 months after surgery, women will be contacted to assess their fertility status at six months intervals starting form the day of the operation. The primary outcome measure is the occurrence of spontaneous viable intra uterine pregnancy. Secondary outcome measures are persistent trophoblast, repeat EP, all pregnancies including those resulting from IVF and financial costs. The analysis will be performed according to the intention to treat principle. A cost-effectiveness analysis will be performed within a decision

Privacy preserving interactive record linkage (PPIRL).

Science.gov (United States)

Kum, Hye-Chung; Krishnamurthy, Ashok; Machanavajjhala, Ashwin; Reiter, Michael K; Ahalt, Stanley

2014-01-01

Record linkage to integrate uncoordinated databases is critical in biomedical research using Big Data. Balancing privacy protection against the need for high quality record linkage requires a human-machine hybrid system to safely manage uncertainty in the ever changing streams of chaotic Big Data. In the computer science literature, private record linkage is the most published area. It investigates how to apply a known linkage function safely when linking two tables. However, in practice, the linkage function is rarely known. Thus, there are many data linkage centers whose main role is to be the trusted third party to determine the linkage function manually and link data for research via a master population list for a designated region. Recently, a more flexible computerized third-party linkage platform, Secure Decoupled Linkage (SDLink), has been proposed based on: (1) decoupling data via encryption, (2) obfuscation via chaffing (adding fake data) and universe manipulation; and (3) minimum information disclosure via recoding. We synthesize this literature to formalize a new framework for privacy preserving interactive record linkage (PPIRL) with tractable privacy and utility properties and then analyze the literature using this framework. Human-based third-party linkage centers for privacy preserving record linkage are the accepted norm internationally. We find that a computer-based third-party platform that can precisely control the information disclosed at the micro level and allow frequent human interaction during the linkage process, is an effective human-machine hybrid system that significantly improves on the linkage center model both in terms of privacy and utility.

Effects of supplementation of fertilizers on human selenium status in Finland.

Science.gov (United States)

Aro, A; Alfthan, G; Varo, P

1995-03-01

The Se concentration of foods can be increased by supplementing fertilizers with soluble Se compounds. In Finland the availability of soil Se for plants is poor owing to the relatively low Se concentration, low pH and high iron content of the soil. Since 1984 multimineral fertilizers have been supplemented with Se (16 mg kg-1 to fertilizers for grain production and 6 mg kg-1 to those for fodder production) in the form of sodium selenate. Within two years a three-fold increase of mean Se intake was observed. The supplementation affected the Se content of all major food groups with the exception of fish. The concomitant human serum Se concentration increased by 70%. In 1990 the amount of Se that was supplemented was reduced to 6 mg kg-1 for all fertilizers. This reduced the mean Se intake by 30% and the serum Se concentration decreased by 25% from the highest levels observed in 1989. Plants take up part of the supplemented selenate and transform it into organic Se compounds, mainly selenomethionine. This affects human nutrition by increasing the Se content of foods of both animal and vegetable origin. According to data obtained in Finland, supplementation of fertilizers with Se is a safe and effective means of increasing the Se intake of both animals and humans that is feasible in countries with relatively uniform geochemical conditions. This kind of intervention requires careful monitoring of the effects on both animal and human nutrition and the environment.