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Sample records for assisted reproduction technologies

  1. Assisted Reproductive Technology (ART)

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print Assisted Reproductive Technology (ART) ART refers to treatments and procedures that ... American Society for Reproductive Medicine. (2015). Assisted reproductive technologies: A guide for patients . Retrieved May 31, 2016, ...

  2. Assisted Reproductive Technologies

    Science.gov (United States)

    ... and Research Fertility and Sterility Journal of Assisted Reproduction and Genetics Ethics Committee Opinions and Webinars Practice ... Donate copyright 1996 - 2018 ASRM, American Society for Reproductive Medicine. All Rights Reserved. ASRM Non Discrimination Policy ...

  3. Optimizing equine assisted reproductive technologies

    NARCIS (Netherlands)

    Onstein, W.K.|info:eu-repo/dai/nl/304833525

    2018-01-01

    Application of assisted reproductive technologies (ARTs) is more common in the horse breeding industries, but there is still room for improvement. Embryo recovery rate after embryo flushing, embryo production rate after ovum pick-up (OPU) and intracytoplasmic sperm injection (ICSI), cryopreservation

  4. [Evolution of assisted reproductive technologies].

    Science.gov (United States)

    Jouannet, Pierre

    2009-03-01

    When natural conception is impossible and the underlying problem cannot be treated, medical intervention can reproduce the steps necessary for fertilization and early embryo development. The first known medical action in the field of human reproduction took place at the end of the 18th century, in the form of artificial insemination with the husband's semen, thus dissociating sexual intercourse from procreation. A further upheaval occurred at the end of the 19th century, with the use of donor sperm, separating the notions of genetic descent and parenthood. In the second half of the 20th century, medically assisted procreation saw two major technological advances, namely gamete freezing and in vitro fertilization (IVF). The first child conceived with frozen-thawed sperm was born in 1953, and the first IVF baby in 1978. Fertilization by intracytoplasmic sperm injection (ICSI), first developed in 1992, can overcome many causes of male infertility. The convergence of reproductive biology and genetics has now opened up the possibility of screening for chromosome and gene defects in the embryo, prior to implantation. Thus, assisted reproductive technologies (ART) not only serve as a substitute for natural conception but can also avoid the birth of a disabled child While new technologies continue to extend the available options for infertile couples, they also have the potential to help single women and homosexual couples to have children. These practices are currently only accepted in certain countries. Overall, these new medical technologies have contributed to changing our conception of human reproduction, opening up new paradigms of parenthood and raising new challenges for society.

  5. Assisted Reproductive Technologies : Implications for Women's ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Assisted Reproductive Technologies : Implications for Women's Reproductive Rights and Social Citizenship. There is a general perception that assisted reproductive technologies (ARTs) affect only a small number of affluent women in India. However, the ART industry - tied as it is to the vigorously pushed medical tourism ...

  6. Imprinting disorders after assisted reproductive technologies

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Pinborg, Anja; Andersen, Anders Nyboe

    2006-01-01

    To assess the evidence of an increased risk of imprinting diseases in children born after use of assisted reproductive technologies.......To assess the evidence of an increased risk of imprinting diseases in children born after use of assisted reproductive technologies....

  7. Assisted reproductive technology in Europe, 2007

    DEFF Research Database (Denmark)

    de Mouzon, J; Goossens, V; Bhattacharya, S

    2012-01-01

    This 11th European IVF-monitoring report presents the results of assisted reproductive technology (ART) treatments initiated in Europe during 2007.......This 11th European IVF-monitoring report presents the results of assisted reproductive technology (ART) treatments initiated in Europe during 2007....

  8. Assisted reproductive technology in Europe, 2008

    DEFF Research Database (Denmark)

    Ferraretti, A P; Goossens, V; de Mouzon, J

    2012-01-01

    This 12th European IVF-monitoring (EIM) report presents the results of treatments involving assisted reproductive technology (ART) initiated in Europe during 2008.......This 12th European IVF-monitoring (EIM) report presents the results of treatments involving assisted reproductive technology (ART) initiated in Europe during 2008....

  9. Assisted reproductive technology in Europe, 2009

    DEFF Research Database (Denmark)

    Ferraretti, A P; Goossens, V; Kupka, M

    2013-01-01

    The 13th European in vitro fertilization (IVF)-monitoring (EIM) report presents the results of treatments involving assisted reproductive technology (ART) initiated in Europe during 2009: are there any changes in the trends compared with previous years?......The 13th European in vitro fertilization (IVF)-monitoring (EIM) report presents the results of treatments involving assisted reproductive technology (ART) initiated in Europe during 2009: are there any changes in the trends compared with previous years?...

  10. Towards making assisted reproductive technology affordable and ...

    African Journals Online (AJOL)

    Objective. To report the importance of public-private interaction (PPI) as a strategy to make assisted reproductive technology (ART) affordable. Methods. Design: Commentary. Setting: Reproductive Medicine Unit, Tygerberg Academic Hospital. Discussion. PPI together with simplified methods of IVF such as scaling down on ...

  11. Reducing multiple births in assisted reproduction technology.

    Science.gov (United States)

    Bhattacharya, Siladitya; Kamath, Mohan S

    2014-02-01

    Multiple pregnancy, a complication of assisted reproduction technology, is associated with poorer maternal and perinatal outcomes. The primary reason behind this is the strategy of replacing more than one embryo during an assisted reproduction technology cycle to maximise pregnancy rates. The solution to this problem is to reduce the number of embryos transferred during in-vitro fertilisation. The transition from triple- to double-embryo transfer, which decreased the risk of triplets without compromising pregnancy rates, was easily implemented. The adoption of a single embryo transfer policy has been slow because of concerns about impaired pregnancy rates in a fresh assisted reproduction technology cycle. Widespread availability of effective cryopreservation programmes means that elective single embryo transfer, along with subsequent frozen embryo transfers, could provide a way forward. Any such strategy will need to consider couples' preferences and existing funding policies, both of which have a profound influence on decision making around embryo transfer. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Preparing for Assisted Reproductive Technology

    Science.gov (United States)

    ... as rubella, tetanus, influenza, and whooping cough. Take advantage of wellness programs at work or in the ... Division of Reproductive Health Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding ...

  13. Assisted Reproductive Technologies : Implications for Women's ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    There is a general perception that assisted reproductive technologies (ARTs) affect only a small number of affluent women in India. However, the ART industry - tied as it is to the vigorously pushed medical tourism industry - has expanded to the extent that its consequences are no longer limited to a small number of affluent ...

  14. Epigenetics and assisted reproductive technologies

    DEFF Research Database (Denmark)

    Pinborg, Anja; Loft, Anne; Romundstad, Liv Bente

    2016-01-01

    associated with ART techniques, but disentangling the influence of the ART procedures per se from the effect of the reproductive disease of the parents is a challenge. Epidemiological human studies have shown altered birth weight profiles in ART compared with spontaneously conceived singletons. Conception...... adolescents conceived by ART have altered lipid and glucose profiles and thereby a higher long-term risk of cardiovascular disease and diabetes. This commentary describes the basic concepts of epigenetics and gives a short overview of the existing literature on the association between imprinting disorders...

  15. Cancer in women after assisted reproductive technology.

    Science.gov (United States)

    Luke, Barbara; Brown, Morton B; Spector, Logan G; Missmer, Stacey A; Leach, Richard E; Williams, Melanie; Koch, Lori; Smith, Yolanda; Stern, Judy E; Ball, G David; Schymura, Maria J

    2015-11-01

    To evaluate the risk of cancer after assisted reproductive technology (ART) therapy. Longitudinal cohort study. Not applicable. New York, Texas, and Illinois residents between 2004 and 2009, treated with ART, comprising cycles of 113,226 women, including 53,859 women without prior ART treatment, who were linked to their respective state cancer registries and whose cycles were reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). None. Diagnosis of cancer, as reported to the state cancer registry; standardized incidence ratios (SIR) and their 95% confidence intervals, comparing the observed to expected cancer cases based on age-specific cancer rates in the general population of each state. Among the cohort of women without prior ART therapy, hazard ratios (HR) and 95% confidence intervals (CI) were calculated for treatment parameters and reproductive history factors. The mean follow-up period was 4.87 years; among women without prior ART, 450 women developed 460 cancers. Women treated with ART had a statistically significantly lower risk for all cancers (for all women: SIR 0.78; CI, 0.73-0.83; women without prior ART: SIR 0.75; CI, 0.68-0.82), breast cancer, and all female genital cancers; a non-statistically-significant lower risk for endocrine and uterine cancer; and a non-statistically-significant higher risk for melanoma and ovarian cancer. Among women without prior ART, we found no statistically significant increased HR by parity, number of cycles, cumulative follicle-stimulating hormone dosage, or cycle outcome. Women initiating ART treatment have no greater risk for developing cancer after nearly 5 years of follow-up compared with the general population and with other women treated with ART. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Assisted reproductive technologies and the right to reproduce under ...

    African Journals Online (AJOL)

    Reproductive rights in South Africa have traditionally focused on the rights of individuals to avoid reproduction. However, with an increase in the use of assisted reproductive technologies (ART), there has been a shift in the focus on reproductive rights from the rights of individuals to avoid reproduction to the rights of ...

  17. Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update.

    Science.gov (United States)

    Toner, James P; Coddington, Charles C; Doody, Kevin; Van Voorhis, Brad; Seifer, David B; Ball, G David; Luke, Barbara; Wantman, Ethan

    2016-09-01

    The Society for Assisted Reproductive Technology (SART) was established within a few years of assisted reproductive technology (ART) in the United States, and has not only reported on the evolution of infertility care, but also guided it toward improved success and safety. Moving beyond its initial role as a registry, SART has expanded its role to include quality assurance, data validation, practice and advertising guidelines, research, patient education and advocacy, and membership support. The success of ART in this country has greatly benefited from SART's role, as highlighted by a series of graphs. SART continues to set the standard and lead the way. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Assisted reproductive technology: Islamic Sunni perspective.

    Science.gov (United States)

    Chamsi-Pasha, Hassan; Albar, Mohammed Ali

    2015-06-01

    Islam acknowledges that infertility is a significant hardship. Attempts to cure infertility are not only permissible, but also encouraged in Islam. Over the last three decades, a multitude of advances in assisted reproductive technologies (ARTs) have appeared. This review was carried out to inform readers, who are not familiar with Islamic doctrine, about the Sunni perspective on this topic. Systematic review of the literature. A series of searches was conducted of Medline databases published in English between January 1978 and December 2013 with the following assisted reproduction, infertility, gender selection, ethics, bioethics, and Islam. In Islamic Sunni law, all ARTs are allowed, provided that the source of the sperm, ovum, and uterus comes from a legally married couple during the span of their marriage. All forms of surrogacy are forbidden. A third-party donor is not allowed, whether he or she is providing sperm, eggs, embryos, or a uterus. Frozen preimplantation may be transferred to the wife in a successive cycle provided the marital bondage is not absolved by death or divorce. Gender selection for medical reasons is permitted. It is allowed for limited social reasons by some jurists, provided it does not involve discrimination against either sex. ART is acceptable and commendable in Islamic Sunni law provided it is practiced within the husband and wife dyad during the span of their marital contract. No third party should intrude upon the marital function of procreation. Surrogacy is not accepted by Sunni Islamic authorities.

  19. Assisted Reproductive Technology: MedlinePlus Health Topic

    Science.gov (United States)

    ... can be prevented or minimized by limiting the number of embryos that are put into the woman's body. Learn More Assisted Reproductive Technologies (American Society for Reproductive Medicine) - PDF Also ...

  20. Congenital anomalies after assisted reproductive technology

    DEFF Research Database (Denmark)

    Pinborg, Anja; Henningsen, Anna-Karina Aaris; Malchau, Sara Sofie

    2013-01-01

    Worldwide, more than 5 million children have been born after assisted reproductive technology (ART), and in many developed countries ART infants represent more than 1% of the birth cohorts. It is well known that ART children are at increased risk of congenital malformations even after adjustment...... for known confounders such as maternal age. The proportion of ART children is not negligible, and knowledge about the causes of the higher risk of congenital malformations is crucial to develop prevention strategies to reduce the future risk in ART children. The aim of this review is to summarize...... the literature on the association between ART and congenital anomalies with respect to subfertility, fertility treatment other than ART, and different ART methods including intracytoplasmic sperm injection, blastocyst culture, and cryotechniques. Trends over time in ART and congenital anomalies will also...

  1. Gestational carrier in assisted reproductive technology.

    Science.gov (United States)

    Murugappan, Gayathree; Farland, Leslie V; Missmer, Stacey A; Correia, Katharine F; Anchan, Raymond M; Ginsburg, Elizabeth S

    2018-03-01

    To compare clinical outcomes of in vitro fertilization (IVF) cycles with the use of gestational carriers (GCs) with non-GC IVF cycles. Retrospective cohort study of assisted reproductive technology (ART) cycles performed with (24,269) and without (1,313,452) the use of a GC. ART centers. Infertile patients seeking IVF with or without use of a GC. Autologous and donor oocyte cycles, fresh and cryopreserved embryo transfer cycles. Live birth rate (LBR), twin and high-order multiple birth rates. Approximately 2% of embryo transfers used a GC. Per embryo transfer, GCs had greater pregnancy rate and LBR across all IVF types compared with non-GC cycles in crude models and models adjusted a priori for potential confounders. For women with uterine-factor infertility, embryo transfer with the use of a GC resulted in a higher odds of live birth for autologous fresh embryos and for cryopreserved embryos compared with patients with non-uterine-factor infertility diagnoses. GC benefits LBRs for some patients seeking ART. The highest LBRs occurred when the indication for GC was uterine-factor infertility. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Assisted reproductive technology and major birth defects in Western Australia.

    Science.gov (United States)

    Hansen, Michele; Kurinczuk, Jennifer J; de Klerk, Nicholas; Burton, Peter; Bower, Carol

    2012-10-01

    To estimate the prevalence of major birth defects diagnosed by 6 years of age in all births and terminations of pregnancy for fetal anomaly conceived by assisted reproductive technology (when this included intracytoplasmic sperm injection and in vitro fertilization [IVF]) and the remainder of nonassisted reproductive technology-conceived children born in Western Australia from 1994 to 2002. This retrospective cohort study used data linkage between three population-based registers (Reproductive Technology Register, Western Australian Register of Developmental Anomalies, and Midwives' Notification of Birth System) to identify all assisted reproductive technology (n=2,911) and nonassisted reproductive technology (n=210,997) births with and without birth defects diagnosed by age 6 and all terminations of pregnancy for fetal anomaly. A major birth defect was diagnosed in 8.7% of assisted reproductive technology and 5.4% of nonassisted reproductive technology singletons (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.30-1.79), as well as 7.1% of assisted reproductive technology twins and 5.9% of nonassisted reproductive technology twins of unlike sex (OR 1.08, 95% CI 0.77-1.51). The prevalence of birth defects in assisted reproductive technology singletons and twins decreased markedly over the study period. This change was evident across all three clinics contributing data over the whole study and was particularly marked for children conceived as a result of IVF. There has been a decrease in the prevalence of birth defects over time in children born as a result of assisted reproductive technology in Western Australia; however, the prevalence of major birth defects in assisted reproductive technology singletons remains increased compared with nonassisted reproductive technology singletons. II.

  3. Assisted reproductive technologies in rhesus macaques

    Directory of Open Access Journals (Sweden)

    Wolf Don P

    2004-06-01

    Full Text Available Abstract The assisted reproductive technologies (ARTs have been used in the production of rhesus monkey offspring at the Oregon National Primate Research Center (ONPRC and that experience is summarized here. Additionally these technologies serve as a source of oocytes/embryos for monozygotic twinning, embryonic stem (ES cell derivation and cloning. High fertilization efficiencies were realized with conventional insemination or following the use of intracytoplasmic sperm injection (ICSI and approximately 50% of the resulting embryos grew in vitro to blastocysts. Both fresh and frozen sperm were employed in fertilization by ICSI and the resulting embryos could be low temperature stored for subsequent thawing and transfer when a synchronized recipient female was available or after shipment to another facility. Following the transfer of up to 3 embryos, an overall pregnancy rate of 30% was achieved with increasing rates dependent upon the number of embryos transferred. Singleton pregnancy outcomes following the transfer of ART produced embryos were similar to those observed in a control group of animals in the timed mated breeding colony at ONPRC. ICSI produced embryos were used in efforts to create monozygotic twins by blastomere separation or blastocyst splitting. While pregnancies were achieved following the transfer of demi-embryos, only one was a twin and it was lost to spontaneous abortion. ICSI produced embryos have also served as the source of blastocysts for the derivation of embryonic stem cells. These pluripotent cells hold potential for cell based therapies and we consider the monkey an important translational model in which to evaluate safety, efficacy and feasibility of regenerative medicine approaches based on the transplantation of stem cell-derived progeny. Finally, efforts to produce genetically-identical monkeys by nuclear transfer have been briefly summarized.

  4. Thirty-five years of assisted reproductive technologies in Israel

    Directory of Open Access Journals (Sweden)

    Daphna Birenbaum-Carmeli

    2016-06-01

    Full Text Available Israel is known as a pronatalist country. Whether due to the Biblical commandment to ‘be fruitful and multiply’ or the traumas of the Holocaust and perennial wars, reproduction is a central life goal for most Israelis. Israeli women bear substantially more children than their counterparts in industrialized countries and view child-rearing as a key life accomplishment. These personal world-view and real-life individual quests take place in a context of equally pronatalist state policies and religious openness to assisted reproductive technologies. In this paper, I outline 35 years of assisted reproductive technologies in Israel by tracing a principal axis in the development of three major technologies of assisted reproduction: the proliferation of IVF-ICSI; the globalization of gamete donation; and the privatization of surrogacy. The paper is based on a policy analysis as well as various studies of assisted reproductive technologies, conducted in Israel over this period.

  5. International Committee for Monitoring Assisted Reproductive Technology: world report on assisted reproductive technology, 2005.

    Science.gov (United States)

    Zegers-Hochschild, Fernando; Mansour, Ragaa; Ishihara, Osamu; Adamson, G David; de Mouzon, Jacques; Nygren, Karl G; Sullivan, Elizabeth A

    2014-02-01

    To analyze information on assisted reproductive technology (ART) performed worldwide and trends in outcomes over successive years. Cross-sectional survey on access, effectiveness, and safety of ART procedures performed in 53 countries during 2005. A total of 2,973 clinics from national and regional ART registries. Infertile women and men undergoing ART globally. Collection and analysis of international ART data. Number of cycles performed by country and region, including pregnancies, single and multiple birth rates, and perinatal mortality. Overall, 1,052,363 ART procedures resulted in an estimated 237,315 babies born. The availability of ART varied by country from 15 to 3,982 cycles per million of population. Of all initiated fresh cycles, 62.9% were intracytoplasmic sperm injection. The overall delivery rate per fresh aspiration was 19.6% and for frozen embryo transfer 17.4%, with a cumulative delivery rate of 23.9%. With wide regional variations, single embryo transfer represented 17.5% of cycles, and the proportion of deliveries with twins and triplets from fresh transfers was 23.6% and 1.5%, respectively. Systematic collection and dissemination of international ART data allows patients, health professionals, and policy makers to examine and compare the impact of reproductive strategies or lack of them as markers of reproductive health. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. International Committee for Monitoring Assisted Reproductive Technologies world report: Assisted Reproductive Technology 2008, 2009 and 2010.

    Science.gov (United States)

    Dyer, S; Chambers, G M; de Mouzon, J; Nygren, K G; Zegers-Hochschild, F; Mansour, R; Ishihara, O; Banker, M; Adamson, G D

    2016-07-01

    What were utilization, outcomes and practices in assisted reproductive technology (ART) globally in 2008, 2009 and 2010? Global utilization and effectiveness remained relatively constant despite marked variations among countries, while the rate of single and frozen embryo transfers (FETs) increased with a concomitant slight reduction in multiple birth rates. ART is widely practised in all regions of the world. Monitoring utilization, an approximation of availability and access, as well as effectiveness and safety is an important component of universal access to reproductive health. This is a retrospective, cross-sectional survey on utilization, effectiveness and safety of ART procedures performed globally from 2008 to 2010. Between 58 and 61 countries submitted data from a total of nearly 2500 ART clinics each year. Aggregate country data were processed and analyzed based on forms and methods developed by the International Committee for Monitoring Assisted Reproductive Technologies (ICMART). Results are presented at country, regional and global level. For the years 2008, 2009 and 2010, >4 461 309 ART cycles were initiated, resulting in an estimated 1 144 858 babies born. The number of aspirations increased by 6.4% between 2008 and 2010, while FET cycles increased by 27.6%. Globally, ART utilization remained relatively constant at 436 cycles/million in 2008 and 474 cycles/million population in 2010, but with a wide country range of 8-4775 cycles/million population. ICSI remained constant at around 66% of non-donor aspiration cycles. The IVF/ICSI combined delivery rate (DR) per fresh aspiration was 19.8% in 2008; 19.7% in 2009 and 20.0% in 2010, with corresponding DRs for FET of 18.8, 19.7 and 20.7%. In fresh non-donor cycles, single embryo transfer increased from 25.7% in 2008 to 30.0% in 2010, while the average number of embryos transferred fell from 2.1 to 1.9, again with wide regional variation. The rates of twin deliveries following fresh non-donor transfers

  7. Use of Assisted Reproductive Technologies for Livestock Development

    Directory of Open Access Journals (Sweden)

    Vikrama Chakravarthi. P and N. Sri Balaji

    2010-10-01

    Full Text Available Genetic improvement of farm animals is a prime concern over the years for researchers. Several reproductive technologies have been employed to achieve this. Assisted reproductive technologies like Artificial insemination, Superovulation, In vitro Fertilization, Embryo Transfer have been introduced to overcome reproductive problems, to increase the offspring from selected female’s and to reduce the generation intervals in farm animals. The progress achieved during the last few years in the assisted reproductive technologies field has been phenomenal. Artificial Insemination (AI is the most effective method being used for the genetic improvement of animals. Reproductive capacity and efficiency has been improved tremendously since the introduction of artificial insemination. The development of cloning using various cells from the animal body has created opening of a fascinating scientific arena. These technologies have been propounded as saviors of indigenous livestock breeds. These alternative reproductive techniques are available not only for manipulation of reproductive processes but also proven to be powerful tools in curbing the spread of vertically transmitted diseases. The successful reproductive technologies such as AI and Embryo transfer need be applied on a large scale, emerging biotechnogies such as MOET, IVF and Cloning provides powerful tool for rapidly changing the animal populations, genetically. This advanced reproduction technologies will definitely play an important role in the future perspective and visions for efficient reproductive performance in livestock. [Vet. World 2010; 3(5.000: 238-240

  8. Assisted reproductive technology surveillance -- United States, 2010.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara; Anderson, John E; Folger, Suzanne G; Jamieson, Denise J; Barfield, Wanda D

    2013-12-06

    Since the first U.S. infant conceived with Assisted Reproductive Technology (ART) was born in 1981, both the use of advanced technologies to overcome infertility and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which both eggs and sperm are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely to deliver multiple-birth infants than those who conceive naturally because more than one embryo might be transferred during a procedure. Multiple births pose substantial risks to both mothers and infants, including pregnancy complications, preterm delivery, and low birthweight infants. This report provides state-specific information on U.S. ART procedures performed in 2010 and compares infant outcomes that occurred in 2010 (resulting from procedures performed in 2009 and 2010) with outcomes for all infants born in the United States in 2010. 2010. In 1996, CDC began collecting data on all ART procedures performed in fertility clinics in the United States and U.S. territories, as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System (NASS), a web-based data collecting system developed by CDC. In 2010, a total of 147,260 ART procedures performed in 443 U.S. fertility clinics were reported to CDC. These procedures resulted in 47,090 live-birth deliveries and 61,564 infants. The largest numbers of ART procedures were performed among residents of six states: California (18,524), New York (excluding New York City) (14,212), Illinois (10,110), Massachusetts (9,854), New Jersey (8,783), and Texas (8,754). These six states also had the highest number of live-birth deliveries as a result of ART procedures and together accounted for 48.0% of all ART procedures performed, 45.0% of all infants born

  9. Assisted Reproductive Technology Surveillance - United States, 2014.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Jamieson, Denise J; Warner, Lee; Barfield, Wanda D

    2017-02-10

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks to both mothers and infants, including obstetric complications, preterm delivery, and low birthweight infants. This report provides state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2014 and compares birth outcomes that occurred in 2014 (resulting from ART procedures performed in 2013 and 2014) with outcomes for all infants born in the United States in 2014. 2014. In 1996, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). In 2014, a total of 169,568 ART procedures (range: 124 in Wyoming to 21,018 in California) with the intent to transfer at least one embryo were performed in 458 U.S. fertility clinics and reported to CDC. These procedures resulted in 56,028 live-birth deliveries (range: 52 in Wyoming to 7,230 in California) and 68,782 infants born (range: 64 in Wyoming to 8,793 in California). Nationally, the total number of ART procedures performed per million women of reproductive age (15-44 years), a proxy measure of the ART usage rate, was 2,647 (range: 364 in Puerto Rico

  10. Assisted Reproductive Technology Surveillance - United States, 2015.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Boulet, Sheree L; Warner, Lee; Barfield, Wanda D

    2018-02-16

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015. 2015. In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System, a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). In 2015, a total of 182,111 ART procedures (range: 135 in Alaska to 23,198 in California) with the intent to transfer at least one embryo were performed in 464 U.S. fertility clinics and reported to CDC. These procedures resulted in 59,334 live-birth deliveries (range: 55 in Wyoming to 7,802 in California) and 71,152 infants born (range: 68 in Wyoming to 9,176 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years), a proxy measure of the ART utilization rate, was

  11. Accuracy of self-reported survey data on assisted reproductive technology treatment parameters and reproductive history.

    Science.gov (United States)

    Stern, Judy E; McLain, Alexander C; Buck Louis, Germaine M; Luke, Barbara; Yeung, Edwina H

    2016-08-01

    It is unknown whether data obtained from maternal self-report for assisted reproductive technology treatment parameters and reproductive history are accurate for use in research studies. We evaluated the accuracy of self-reported in assisted reproductive technology treatment and reproductive history from the Upstate KIDS study in comparison with clinical data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Upstate KIDS maternal questionnaire data from deliveries between 2008 and 2010 were linked to data reported to Society for Assisted Reproductive Technology Clinic Outcome Reporting System. The 617 index deliveries were compared as to treatment type (frozen embryo transfer and donor egg or sperm) and use of intracytoplasmic sperm injection and assisted hatching. Use of injectable medications, self-report for assisted reproductive technology, or frozen embryo transfer prior to the index deliveries were also compared. We report agreement in which both sources had yes or both no and sensitivity of maternal report using Society for Assisted Reproductive Technology Clinic Outcome Reporting System as the gold standard. Significance was determined using χ(2) at P self-reported use (P reported than was use of injectable medication (agreement, 76%) (P report in vitro fertilization treatment but are less accurate about procedures handled in the laboratory (intracytoplasmic sperm injection or assisted hatching). Clinics might better communicate with patients on the use of these procedures, and researchers should use caution when using self-reported treatment data. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Collision of Media Positions on Assisted Reproductive Technologies

    Science.gov (United States)

    Emelyanova, T. P.; Vopilova, I. E.

    2016-01-01

    An analysis of the discourse on assisted reproductive technologies (ART) indicates the predominance of conservative representations of the family. The appearance of new technologies does not change the image of a "normal" family, because concepts connected with surrogate mothers and egg donors are minimally present in the discourse. In…

  13. International committee for monitoring assisted reproductive technologies: world report on assisted reproductive technologies, 2007.

    Science.gov (United States)

    Ishihara, Osamu; Adamson, G David; Dyer, Silke; de Mouzon, Jacques; Nygren, Karl G; Sullivan, Elizabeth A; Zegers-Hochschild, Fernando; Mansour, Ragaa

    2015-02-01

    To analyze information on assisted reproductive technology (ART) performed worldwide, and trends in outcomes over successive years. Cross-sectional survey on access, efficiency, and safety of ART procedures performed in 55 countries during 2007. Not applicable. Infertile women and men undergoing ART globally. Collection and analysis of international ART data. Number of cycles performed, by country and region, including pregnancies, single and multiple birth rates, and perinatal mortality. Overall, >1,251,881 procedures with ART were reported, and resulted in 229,442 reported babies born. The availability of ART varied by country, from 12 to 4,140 treatments per million population. Of all aspiration cycles, 65.2% (400,617 of 614,540) were intracytoplasmic sperm injection. The overall delivery rate per fresh aspiration was 20.3%, and for frozen-embryo transfer (FET), 18.4%, with a cumulative delivery rate of 25.8%. With wide regional variations, single-embryo transfer represented 23.4% of fresh transfers, and the proportion of deliveries with twins and triplets from fresh transfers was 22.3% and 1.2%, respectively. The perinatal mortality rate was 19.9 per 1,000 births for fresh in vitro fertilization using intracytoplasmic sperm injection, and 9.6 per 1,000 for FET. The proportion of women aged ≥40 years increased to 19.8% from 15.5% in 2006. The international trend toward women aged >40 years was a major component of ART services in some regions and countries. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Referral for assisted reproductive technology: Indications and ...

    African Journals Online (AJOL)

    Ramakantb

    Angelman syndrome, which have increasingly been associated with assisted conception.[11] Overall, there is insufficient evidence to conclude that genetic risk and congenital malformation are increased in assisted conception. Preference for a child of one particular gender is a source of concern in most African societies.

  15. Assisted Reproductive Technologies : Implications for Women's ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    But, because ART is not part of the public healthcare system it has yet to become a large concern for the health and reproductive rights movement in the way hazardous contraceptives and sex-selection have. This study will investigate the various dimensions of ART as it affects the lives of ordinary women. Researchers will ...

  16. Outcomes Of Assisted Reproductive Technologies At The Nairobi In ...

    African Journals Online (AJOL)

    Background: Infertility is a common problem affecting up to ten per cent of married couples. A systematic evaluation of aetiologic factors forms the basis for choice of treatment and future fertility. On the global perspective, Assisted Reproductive Technologies (ART) has become internationally recognised treatment option for ...

  17. Assisted Reproductive Technology and Risk for Autism Spectrum Disorder

    Science.gov (United States)

    Zachor, Ditza A.; Itzchak, E. Ben

    2011-01-01

    Epidemiologic studies on maternal and pregnancy risk factors for autism spectrum disorder (ASD), including use of assisted reproductive technology (ART), found conflicting results. This study included the following aims: to assess frequencies of ART in a large ASD group; to examine confounding birth and familial risk factors in the ASD with ART…

  18. Assisted reproductive technology in South Africa: First results ...

    African Journals Online (AJOL)

    Methods. All assisted reproductive technology (ART) centres in South Africa were invited to join the register. Participant centres voluntarily submitted information from 2009 on the number of ART cycles, embryo transfers, clinical pregnancies, age of female partners or egg donors, and use of fertilisation techniques.

  19. [Assisted reproductive technologies and the embryo status].

    Science.gov (United States)

    Englert, Y

    The status of the human embryo has always be a subject of philosophical and theological thoughts with major social consequences, but, until the 19th century, it has been mainly an abstraction. The arrival of the human embryo in vitro, materialized by Louise Brown's birth in 1978 and above all by the supernumerary embryos produced by the Australian team of Trounson and Wood following the introduction of ovarian stimulation, will turn theoretical thoughts into a reality. Nobody may ignore the hidden intentions behind the debate, as to recognise a status to a few days old embryo will immediately have a major impact on the status of a few weeks old foetus and therefore on the abortion rights. We will see that the embryo status, essentially based as well on a vision on the good and evil as on social order, cannot be based on a scientific analysis of the reproduction process but comes from a society's choice, by essence " arbitrary " and always disputable. This does not preclude the collectivity right and legitimacy to give a precise status and it is remarkable to observe the law is careful not to specify which status to give to the human embryo. It is more thru handling procedures and functioning rules that the law designed the embryo position, neither with a status of a person, nor of a thing. It nevertheless remains true that there is a constant risk that the legislation gives the embryo a status that would call into question it's unique characteristic of early reproductive stage, jeopardizing at once the hard-won reproductive freedom (reproductive choice) as well as freedom of research on embryonic stem cells, one of the most promising field of medical research.

  20. Assisted reproductive technologies in South Dakota: the first ten years.

    Science.gov (United States)

    Brannian, John; Hansen, Keith

    2006-07-01

    One in six couples experience infertility. New assisted reproductive technologies such as in vitro fertilization (IVF) have helped thousands of couples worldwide to have a family. IVF has been available in South Dakota for the past ten years. Improvements in the clinic and laboratory have led to better live birth rates and lower incidences of multiple pregnancies. Advances in technology will help even more people overcome fertility problems in the near future.

  1. Assisted reproductive technology in Europe, 2013

    DEFF Research Database (Denmark)

    Calhaz-Jorge, C.; De Geyter, C.; Kupka, M. S.

    2017-01-01

    STUDY QUESTION: Are there any changes in the treatments involving ART and IUI initiated in Europe during 2013 compared with previous years? SUMMARY ANSWER: An increase in the overall number of ART cycles resulting from a higher number of countries reporting data was evident, the pregnancy rates...... (PRs) in 2013 remained stable compared with those reported in 2012, the number of transfers with multiple embryos (3+) was lower than ever before yet the multiple delivery rates (DRs) remained unchanged, and IUI activity and success rates were similar to those of last years. WHAT IS KNOWN ALREADY......: Since 1997, ART data in Europe have been collected and reported in 16 manuscripts, published in Human Reproduction. STUDY DESIGN, SIZE, DURATION: Retrospective data collection of European ART data by the European IVF-monitoring Consortium for ESHRE. Data for cycles between 1 January and 31 December 2013...

  2. Perinatal Outcomes after Assisted Reproductive Technology

    Directory of Open Access Journals (Sweden)

    Setenay Arzu Yilmaz

    2014-08-01

    The aim of this review is to summarize perinatal outcomes and the congenital anomaly risk of IVF pregnancies and also examine the risks of different technologies including ICSI, blastocyst culture, and cryopreservation on this topic. [Archives Medical Review Journal 2014; 23(4.000: 575-586

  3. Referral for assisted reproductive technology: Indications and ...

    African Journals Online (AJOL)

    Ramakantb

    8. Faber K. IVF in the US: Multiple gestations, economic competition, and the necessity of excess. Hum Reprod. 1997;12:1614-6. 9. Tanbo T, Bakketeig LS, Jacobsen G, Orstavik KH, Lie RT,. Lyngstadaas A. Children born from intracytoplasmic sperm injection. Oslo: The Norwegian centre for health technology assessment.

  4. Application of microfluidic technologies to human assisted reproduction.

    Science.gov (United States)

    Smith, Gary D; Takayama, Shuichi

    2017-04-01

    Microfluidics can be considered both a science and a technology. It is defined as the study of fluid behavior at a sub-microliter level and the investigation into its application to cell biology, chemistry, genetics, molecular biology and medicine. There are at least two characteristics of microfluidics, mechanical and biochemical, which can be influential in the field of mammalian gamete and preimplantation embryo biology. These microfluidic characteristics can assist in basic biological studies on sperm, oocyte and preimplantation embryo structure, function and environment. The mechanical and biochemical characteristics of microfluidics may also have practical and/or technical application(s) to assisted reproductive technologies (ART) in rodents, domestic species, endangered species and humans. This review will consider data in mammals, and when available humans, addressing the potential application(s) of microfluidics to assisted reproduction. There are numerous sequential steps in the clinical assisted reproductive laboratory process that work, yet could be improved. Cause and effect relations of procedural inefficiencies can be difficult to identify and/or remedy. Data will be presented that consider microfluidic applications to sperm isolation, oocyte cumulus complex isolation, oocyte denuding, oocyte mechanical manipulation, conventional insemination, intracytoplasmic sperm injection, embryo culture, embryo analysis and oocyte and embryo cryopreservation. While these studies have progressed in animal models, data with human gametes and embryos are significantly lacking. These data from clinical trials are requisite for making future evidence-based decisions regarding the application of microfluidics in human ART. © The Author 2017. 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.

  5. Current and future assisted reproductive technologies for mammalian farm animals.

    Science.gov (United States)

    Hansen, Peter J

    2014-01-01

    technologies that have the potential to improve efficiency of livestock production. The focus will be on technologies that manipulate male and female gametes as well as the stem cells from which they are derived and the preimplantation embryo. While technology is crucial to other interventions in the reproductive process like control of seasonal breeding, hormonal regulation of ovulation, estrous cyclicity and pregnancy establishment, feeding to optimize reproduction, minimizing environmental stress, and selection of genes controlling reproduction, these will not be considered here. Rather the reader is directed to other chapters in this volume as well as some reviews on other aspects of artificial manipulation of reproduction (Reprod Fertil Dev 24:258-266, 2011; Reprod Domest Anim 43:40-47, 2008; Reprod Domest Anim 43:122-128, 2008; Soc Reprod Fertil Suppl 66:87-102, 2009; Comprehensive biotechnology, Amsterdam, pp 477-485; Dairy production medicine, Chichester, pp 153-163; Theriogenology 76:1619-1631, 2011; Theriogenology 76:1568-1582, 2011; Theriogenology 77:1-11, 2012). Given the large number of mammalian species used for production of products useful for man and the diversity in their biology and management, the review will not be comprehensive but instead will use results from species that are most illustrative of the opportunities generated by assisted reproductive technologies.

  6. Incubator management in an assisted reproductive technology laboratory.

    Science.gov (United States)

    Higdon, H Lee; Blackhurst, Dawn W; Boone, William R

    2008-03-01

    To study the effect of incubator management on assisted reproductive technology (ART) outcomes. Series of retrospective and controlled, randomized studies. Tertiary care infertility practice. Mammalian gametes/embryos. Evaluation of human and bovine oocytes/embryos cultured in various environmental conditions. Fertilization and embryo development rate as well as clinical pregnancy rate (PR). Here we review the general topic of incubator management as it pertains to ART. Discussed within the context of this article will be our experiences as they relate to incubator management. Details as they apply to incubator environment also will include gamete/embryo positions within incubator, air quality, and quality control.

  7. The thin endometrium in assisted reproductive technology: An ongoing challenge

    Directory of Open Access Journals (Sweden)

    Maryam Eftekhar

    2018-03-01

    Full Text Available Thin endometrium is identified to adversely affect reproductive success rates after assisted reproductive technology (ART. Several treatment modalities have been presented to patients with thin endometrium, to improve endometrial thickness and the subsequent endometrial receptivity. These approaches comprising hormonal management by estradiol, tamoxifen, human chorionic gonadotropin (hCG and gonadotropin-releasing hormone (GnRH agonist, vasoactive agents such as aspirin, vitamin E, pentoxifylline, nitroglycerin and sildenafil, intra-uterine infusion of growth factor such as Granulocyte Colony Stimulating Factor (G-CSF and the latest application of platelet-rich plasma, electrical stimulation, regenerative medicine and presentation of endometrial receptivity array. In spite of the large variety of treatment, most of the choices achieve only minor modification in the endometrium thickness and have not been validated so far. Treatment of thin endometrium remains a challenge and future enormous investigations are required to further clarification and ideal management of patients with thin endometrium.

  8. Experience with ISO quality control in assisted reproductive technology.

    Science.gov (United States)

    Alper, Michael M

    2013-12-01

    Assisted reproductive technology (ART) programs are complex organizations requiring the integration of multiple disciplines. ISO 9001:2008 is a quality management system that is readily adaptable to an ART program. The value that ISO brings to the entire organization includes control of documents, clear delineation of responsibilities of staff members, documentation of the numerous processes and procedures, improvement in tracking and reducing errors, and overall better control of systems. A quality ART program sets quality objectives and monitors their progress. ISO provides a sense of transparency within the organization and clearer understanding of how service is provided to patients. Most importantly, ISO provides the framework to allow for continual improvement. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Risk of hypertensive disorders in pregnancies following assisted reproductive technology

    DEFF Research Database (Denmark)

    Opdahl, S; Henningsen, A A; Tiitinen, A

    2015-01-01

    STUDY QUESTION: Is the risk of hypertensive disorders in pregnancies conceived following specific assisted reproductive technology (ART) procedures different from the risk in spontaneously conceived (SC) pregnancies? SUMMARY ANSWER: ART pregnancies had a higher risk of hypertensive disorders...... confounding cannot be excluded. In addition, we did not have information on all SC pregnancies in each woman's history, and could therefore not compare risk in ART versus SC pregnancies in the same mother. WIDER IMPLICATIONS OF THE FINDINGS: Pregnancies following frozen-thawed cycles have a higher risk......, the Danish Agency for Science, Technology and Innovation, the Nordic Federation of Societies of Obstetrics and Gynecology and the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology. None of the authors has any competing interests...

  10. Assisted reproductive technologies: professional and legal restrictions in Australian clinics.

    Science.gov (United States)

    Petersen, Kerry; Baker, H W G; Pitts, Marian; Thorpe, Rachel

    2005-02-01

    The professional and legal regulation of assisted reproductive technologies (ART) in Australia is a vast maze of intersecting laws and guidelines which place restrictions on the provision of services such as infertility treatment, surrogacy, sex selection for social reasons, donor insemination, pre-implantation diagnosis and human embryo research. This study investigated the application of these restrictions on clinical practice in New South Wales, a relatively unregulated State, and Victoria, a relatively highly regulated State. The results of the survey indicate that the range of ART services in Victorian clinics was far more limited than in New South Wales clinics. The Victorian clinics uniformly restricted access of single and lesbian women and did not offer social sex selection procedures. The New South Wales clinics adopted different polices regarding these services. It was found that restrictive laws governing "social" issues have a significant impact on the availability of ART services and some respondents seemed unclear about the nature of restrictions and laws relevant to their work. It was also found that "reproductive tourism" is prevalent and restrictions were circumnavigated by patients with assistance from clinics. It was concluded that more evidence is required to evaluate regulation in this field of medicine.

  11. Assisted reproductive technology treatment in women with severe eating disorders

    DEFF Research Database (Denmark)

    Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja

    2015-01-01

    INTRODUCTION: This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the first...... and last eating disorder diagnosis before, during, and after ART treatment, and evaluates differences in obstetric outcomes between women with and without a severe eating disorder. MATERIAL AND METHODS: Hospital-diagnosed eating disorders among 42 915 women in the Danish National ART cohort (DANAC......), registered during 1994-2009 in the mandatory Psychiatric Central Research Register, were compared with a non-eating disorder ART cohort of 42 644 women and an age-matched background population of 215 290 women without a history of ART treatment for the main outcome measures prevalence of eating disorders...

  12. Gender, infertility, motherhood, and assisted reproductive technology (ART) in Turkey.

    Science.gov (United States)

    Sahinoglu, Serap; Buken, Nuket Ornek

    2010-01-01

    In Turkey, as in many other countries, infertility is generally regarded as a negative phenomenon in a woman's life and is associated with a lot of stigma by society. In other words, female infertility and having a baby using Assisted Reproductive Technologies (ART) have to be taken into consideration with respect to gender motherhood, social factors, religion and law. Yet if a woman chooses to use ART she has to deal with the consequences of her decision, such as being ostracized by society. Other types of procedures in this area, such as sperm and ova donation or surrogate motherhood, are not permitted in law. However; both before and after the development of this techonology, society has been finding its own solutions which are rarely questioned and are still performed This article will discuss what these practices are and try to reach some pragmatic conclusions concerning female infertility, the concept of motherhood and some traditional practices in Turkey.

  13. Association between assisted reproductive technology and advanced retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    RV Paul Chan

    2010-11-01

    Full Text Available RV Paul Chan1, Yoshihiro Yonekawa1, Margaux A Morrison2,3, Grace Sun1, Ryan K Wong1, Jeffrey M Perlman4, Michael F Chiang5,6, Thomas C Lee7, M Elizabeth Hartnett3, Margaret M DeAngelis2,31Department of Ophthalmology, Weill Cornell Medical College, New York; 2Ocular Molecular Genetics Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; 3University of Utah School of Medicine, Moran Eye Center, Salt Lake City, Utah; 4Department of Pediatrics, Weill Cornell Medical College, New York; Departments of 5Ophthalmology and 6Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York; 7The Vision Center, Children’s Hospital Los Angeles, California, USAPurpose: To investigate the associations between assisted reproductive technology (ART and severe retinopathy of prematurity (ROP requiring treatment. Methods: Retrospective analyses of inborn preterm infants screened for severe ROP at the Weill Cornell Medical Center Neonatal Intensive Care Unit at the New York-Presbyterian Hospital by single factor logistic regression and multifactor models.Results: Of 399 ethnically diverse infants, 253 were conceived naturally and 146 by ART. Eight (3.16% patients conceived naturally, and 11 (7.53% with ART required laser treatment. In multifactor analyses, significant risks for severe ROP requiring treatment included both gestational age (odds ratio [OR] 0.34; 95% confidence interval [CI] 0.23–0.52; P< 0.001 and ART ([OR] 4.70; [CI], 1.52–4.57; P = 0.007.Conclusions: ART is associated with severe ROP requiring treatment in this cohort. This is the first report that demonstrates a statistically significant association between ART and severe ROP requiring treatment in infants in the US.Keywords: retinopathy of prematurity, low birth rate, blindness, assisted reproductive technology

  14. Risk of peripartum hysterectomy in births after assisted reproductive technology.

    Science.gov (United States)

    Cromi, Antonella; Candeloro, Ilario; Marconi, Nicola; Casarin, Jvan; Serati, Maurizio; Agosti, Massimo; Ghezzi, Fabio

    2016-09-01

    To investigate whether women who conceive after assisted reproductive technology (ART) are at higher risk for emergency peripartum hysterectomy. A case-control study using a prospectively maintained institutional database. A tertiary referral university teaching maternity hospital. Thirty-one women who underwent peripartum hysterectomy for management of hemorrhage, and 19,902 control women. None. Association between potential predictors and peripartum hysterectomy. The incidence of peripartum hysterectomy was 1.7 cases per 1,000 births (95% confidence interval [CI] 1.2-2.4). After adjustment for maternal age and twin pregnancy, placenta previa (odds ratio [OR] 50.78, 95% CI 23.30-110.68), prior cesarean delivery (OR 6.72, 95% CI 2.99-15.09 for one cesarean; OR 6.80, 95% CI 1.45-31.90 for two or more cesareans), previous myomectomy (OR 24.59, 95% CI 6.70-90.19), and ART conception (OR 5.98, 95% CI 2.18-16.40) were all antenatal predictors for peripartum hysterectomy. In women having a peripartum hysterectomy, 13.4% of the risk is attributable to mode of conception. A history of ART increases the likelihood of needing a peripartum hysterectomy to control hemorrhage. Further investigation is needed to determine whether ART conception should be included in algorithms of risk stratification for emergency cesarean hysterectomy and plan of care be modified accordingly. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Current status of assisted reproductive technology in Korea, 2009.

    Science.gov (United States)

    Choi, Young Min; Chun, Sang Sik; Han, Hyuck Dong; Hwang, Jung Hye; Hwang, Kyung Joo; Kang, In Soo; Kim, Dong Won; Kim, Ki Chul; Kim, Tak; Kwon, Hyuck Chan; Lee, Won Don; Lee, Jung Ho; Lee, Kyu Sup; Lee, Gyoung Hoon; Lee, Sang-Hoon; Lee, Yu Il; Min, Eung Gi; Moon, Hwa Sook; Moon, Shin Yong; Roh, Sung Il; Yoon, Tae Ki

    2013-11-01

    Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea in the year of 1985. However, it deserve to say that the invaluable data from fertility centers may serve as a useful source to find out which factors affect successful IVF outcome and to offer applicable information to infertile patients and fertility clinics. This article intended to report the status of ART in 2009 Korean Society of Obstetrics and Gynecology surveyed. The current survey was performed to assess the status and success rate of ART performed in Korea, between January 1 and December 31, 2009. Reporting forms had been sent out to IVF centers via e-mail, and collected by e-mail as well in 2012. With International Committee Monitoring Assisted Reproductive Technologies recommendation, intracytoplasmic sperm injection (ICSI) and non-ICSI cases have been categorized and also IVF-ET cases involving frozen embryo replacement have been surveyed separately. Seventy-four centers have reported the treatment cycles initiated in the year of 2009, and had performed a total of 27,947 cycles of ART treatments. Among a total of 27,947 treatment cycles, IVF and ICSI cases added up to 22,049 (78.9%), with 45.3% IVF without ICSI and 54.7% IVF with ICSI, respectively. Among the IVF and ICSI patients, patients confirmed to have achieved clinical pregnancy was 28.8% per cycle with oocyte retrieval, and 30.9% per cycle with embryo transfer. The most common number of embryos transferred in 2009 is three embryos (40.4%), followed by 2 embryos (28.4%) and a single embryo transferred (13.6%). Among IVF and ICSI cycles that resulted in multiple live births, twin pregnancy rate was 45.3% and triple pregnancy rate was 1.1%. A total of 191 cases of oocyte donation had been performed to result in 25.0% of live birth rate. Meanwhile, a total of 5,619 cases of frozen embryo replacement had been performed with 33.7% of clinical

  16. The process of justifying assisted reproductive technologies in Iran.

    Science.gov (United States)

    Gooshki, Ehsan Shamsi; Allahbedashti, Neda

    2015-01-01

    Infertility is medically defined as one year of unprotected intercourse that does not result in pregnancy. Infertility is a noticeable medical problem in Iran, and about a quarter of Iranian couples experience primary infertility at some point in their lives. Since having children is a basic social value in Iran, infertility has an adverse effect on the health of the couple and affects their well-being. The various methods of assisting infertile couples raise several ethical questions and touch upon certain sensitive points. Although the present Iranian legislative system, which is based on the Shi'a school of Islam, has legalised some aspects of assisted reproductive technologies (ARTs), given the absence of a general officially ratified act (official pathway), such medical interventions are usually justified through a fatwa system (non-official pathway). Officially registered married couples can access almost all ART methods, including third-party gamete donation, if they use such pathways. The process of justifying ART interventions generally began when in vitro fertilisation was given the nod and later, Ayatollah Khamenei (the political-religious leader of the country) issued a fatwa which permitted gamete donation by third parties. This open juristic approach paved the way for the ratification of the Embryo Donation to Infertile Spouses Act in 2003.

  17. Influence of Exogenous Factors on Genomic Imprinting 3. The Impact of Assisted Reproductive Technologies

    Directory of Open Access Journals (Sweden)

    A.E. Abaturov

    2016-10-01

    Full Text Available The analytical review demonstrated the impact of assisted reproductive technologies on genomic imprinting of a child. It is shown that assisted reproductive technologies have a risk of intrauterine growth retardation and imprinting-associated Beckwith-Wiedemann, Angelman, Silver-Russell syndromes.

  18. Balancing animal welfare and assisted reproduction: ethics of preclinical animal research for testing new reproductive technologies.

    Science.gov (United States)

    Jans, Verna; Dondorp, Wybo; Goossens, Ellen; Mertes, Heidi; Pennings, Guido; de Wert, Guido

    2018-02-07

    In the field of medically assisted reproduction (MAR), there is a growing emphasis on the importance of introducing new assisted reproductive technologies (ARTs) only after thorough preclinical safety research, including the use of animal models. At the same time, there is international support for the three R's (replace, reduce, refine), and the European Union even aims at the full replacement of animals for research. The apparent tension between these two trends underlines the urgency of an explicit justification of the use of animals for the development and preclinical testing of new ARTs. Considering that the use of animals remains necessary for specific forms of ART research and taking account of different views on the moral importance of helping people to have a genetically related child, we argue that, in principle, the importance of safety research as part of responsible innovation outweighs the limited infringement of animal wellbeing involved in ART research.

  19. Perinatal outcomes of pregnancies conceived by assisted reproductive technologies

    Directory of Open Access Journals (Sweden)

    Šljivančanin Tamara

    2015-01-01

    Full Text Available Introduction. Recent epidemiological studies showed significantly higher incidence of perinatal complications in newborns and women after the use of assisted reproductive technologies (ART. Multiple pregnancies are more frequent after the use of ART. Singleton pregnancies following ART are more prone to preterm birth, low and very low birth weight (LBW and VLBW, small for gestational age (SGA and perinatal mortality. Objective. The aim of this study was to summarize the results of relevant articles and to evaluate whether the mode of conception is the determining factor for different pregnancy outcomes after assisted and natural conceptions. Methods. Eleven studies were included in this review. The following outcomes were observed: preterm and very preterm birth, SGA, LBW, VLBW, perinatal mortality, admission to neonatal intensive care unit (NICU, and Apgar score (As ≤7 at fifth minute. Qualitative analysis and quantitative assessment were performed. Results. For singletons, odds ratios were 1.794 (95% confidence interval 1.660-1.939 for preterm birth, 1.649 (1.301-2.089 for LBW, 1.265 (1.048-1.527 for SGA. Admission to NICU, As≤7 at fifth minute and perinatal mortality showed significantly different frequency after assisted conception. Summary of results for twin gestations showed no significant difference between ART and spontaneous conception for preterm birth (32-36 weeks, very preterm birth (<32 weeks, LBW and VLBW. Conclusion. Analyzed studies showed that infants from ART have significantly worse perinatal outcome compared with natural conception. More observational studies should be conducted in order to establish the exact mechanism leading to more frequent perinatal morbidity and mortality after the use of ART.

  20. Patient monitoring in Polish assisted reproductive technology centres

    Directory of Open Access Journals (Sweden)

    Anna Krawczak

    2016-12-01

    Full Text Available In 2014, the Polish non-governmental patient association ‘Our Stork’ (Nasz Bocian introduced the ‘Patient monitoring in ART centres’ research project to gather previously unrecorded information on the situation of infertile people and the provision of assisted reproductive treatment in Poland. When the research project began, assisted reproductive treatment centres were unregulated by the state, a situation that had existed for more than 28 years following the birth of the first Polish test-tube baby in 1987. Patients signed civil contracts, remaining unprotected in terms of safety of treatment and recognition of their rights, and their presumed social position was described by doctors as ‘disciplined patients’ – a reflection of what Michele Foucault described as biopolitics. The research project comprised patient questionnaires (responses from 722 patients provided the basis for the document ‘Patient Recommendations in Infertility Treatment’, analysis of civil contracts and their accuracy in the context of patients’ legal rights in Poland, and in-depth interviews with assisted reproductive treatment centres’ owners, doctors, midwives, and patients to explore patient care. The data reveal that there is a lack of patient-centred care among doctors and medical staff in Poland and that following the passing into law of the 2015 Infertility Act, which introduced state regulation of assisted reproductive treatment centres, the situation for patients worsened.

  1. Regulatory framework in assisted reproductive technologies, relevance and main issues.

    Science.gov (United States)

    Merlet, Françoise

    2009-01-01

    Assisted reproductive technologies (ART) have changed life for the past 25 years and many ethical and social issues have emerged following this new method of conception. In order to protect individuals against scientific and ethical abuses without inhibiting scientific progress, a specific legal framework is necessary. The first French law on Bioethics was voted after an extensive debate in 1994 then reviewed in 2004. This review previously scheduled every five years is currently being discussed. Legal provisions applying to ART are part of a large framework including the protection of the patients' rights and biomedical research. The key principles consist of respect for human life and ban on commercial practices of human body parts, eugenic practices and any kind of cloning. These key principles apply to ART. Donation is anonymous and free. Created in 2004, the Agence de la biomédecine is a government agency and one of the main tools of the French regulations. The missions focus on improving the quality and the safety of the management of ART. Evaluation of activities is available to all from the annual report. The agency represents the French competent authority for medical and scientific aspects of ART. Substantial differences in European legislations exist from the open-up "laissez faire" to the most restrictive one. As a consequence a large reproductive tourism has developed particularly for egg donation or surrogacy. The medical and ethical conditions of management of patients and donors represent the main critical points. In order to avoid ethical abuses, homogenization regarding the key principles is necessary in Europe. It is an opportunity to reassert that human body parts should not be a source of financial gain.

  2. Associations between male reproductive characteristics and the outcome of assisted reproductive technology (ART).

    Science.gov (United States)

    Liu, Zhangshun; Shi, Xiaohong; Wang, Lihong; Yang, Yan; Fu, Qiang; Tao, Minfang

    2017-06-30

    The present study was designed to investigate the relationships between indicators of male body mass index (BMI), age, reproductive hormone levels, semen parameters, and the outcomes of assisted reproductive technology (ART). The clinical data were collected from 636 couples who underwent ART between January, 2013 and December, 2015 at the reproductive center involved in our study. Pearson's correlation or Spearman rank correlation was applied to establish the relevant correlation coefficients. The correlation between influence factors' and pregnancy outcomes was analyzed using the Logistic regression model. Analyses were conducted using SPSS software. Male BMI was found to be negatively correlated with testosterone (T) ( P ART outcome. A higher male age was also negatively connected with the outcome of clinical pregnancy. Reproductive hormones were not associated with ART outcome. Sperm concentration and female age were important factors influencing ART clinical pregnancy, while the only significant factor influencing live birth was female age. Levels of obesity-related inflammatory indicators (i.e. free fatty acid (FFA), glutathione peroxidase (GSH-Px), human inhibin-B (IHNB), interleukin-1 (IL-1), insulin-like growth factor-1 (IGF-1), and reactive oxygen species (ROS)) also varied with degrees of BMI. The present study provides information on the associations between male reproductive characteristics and the outcome of ART, which may contribute to improved strategies to help couples achieve better pregnancy outcomes. © 2017 The Author(s).

  3. Assisted reproductive technologies: medical safety issues in the older woman.

    Science.gov (United States)

    Segev, Yakir; Riskin-Mashiah, Shlomit; Lavie, Ofer; Auslender, Ron

    2011-06-01

    Abstract Previous study has shown that in the United States, most maternal deaths and severe obstetric complications due to chronic disease are potentially preventable through improved medical care before conception. Many women who need assisted reproductive technology (ART) because of infertility are older than the average pregnant woman. Risks for such chronic diseases as obesity, diabetes mellitus, chronic hypertension, cardiovascular disease (CVD), and malignancy greatly increase with maternal age. Chronic illness increases the risk of the in vitro fertilization (IVF) procedure and is also associated with increased obstetric risk and even death. The objective of this review is to outline the potential risks for older women who undergo ART procedures and pregnancy and to characterize guidelines for evaluation before enrollment in ART programs. A PubMed search revealed that very few studies have related to pre-ART medical evaluation. Therefore, we suggest a pre-ART medical assessment, comparable to the recommendations of the American Heart Association before noncompetitive physical activity and the American Society of Anesthesiologists before elective surgery. This assessment should include a thorough medical questionnaire and medical examination. Further evaluation and treatment should follow to ensure the safety of ART procedures and of ensuing pregnancies.

  4. [COMPLICATIONS OF PREGNANCY, RESULTING FROM ASSISTED REPRODUCTIVE TECHNOLOGY].

    Science.gov (United States)

    Aleksanyan, A

    2017-01-01

    When pregnancy occurs as a result of assisted reproductive technologies (ART), there are more chances of developing complications and adverse outcomes for the mother and fetus compared to spontaneous pregnancies. Taking into account the noted features, the purpose of our study was to determine the nature of the complications of induced pregnancy and their frequency, depending on the causes of infertility. Under our supervision were 86 women with induced single-pregnancy. Two clinical groups were formed depending on the causes of infertility: group I was represented by 53 observations, in which infertility of endocrine genesis took place; Group II included 33 women with tubal peritoneal infertility. Pregnancy, resulting from ART, should be attributed to the group at high risk of complications of pregnancy. Among the causes of female infertility, the tubal peritoneal factor is the least dangerous in terms of the complicated course of the gestational process, and the endocrine factors that can cause a two-fold increase in the frequency of the threat of abortion and pre-eclampsia are more dangerous. In turn, the cause of endocrine infertility are various factors that need to be determined when predicting the course of induced pregnancy. A special feature of maintaining this category of pregnant women is the constant observation and correction of dyshormonal disorders, which not only cause anovulation, but can also negatively affect the course of pregnancy.

  5. Assisted reproductive technologies and equity of access issues.

    Science.gov (United States)

    Peterson, M M

    2005-05-01

    In Australia and other countries, certain groups of women have traditionally been denied access to assisted reproductive technologies (ARTs). These typically are single heterosexual women, lesbians, poor women, and those whose ability to rear children is questioned, particularly women with certain disabilities or who are older. The arguments used to justify selection of women for ARTs are most often based on issues such as scarcity of resources, and absence of infertility (in lesbians and single women), or on social concerns: that it "goes against nature"; particular women might not make good mothers; unconventional families are not socially acceptable; or that children of older mothers might be orphaned at an early age. The social, medical, legal, and ethical reasoning that has traditionally promoted this lack of equity in access to ARTs, and whether the criteria used for client deselection are ethically appropriate in any particular case, are explored by this review. In addition, the issues of distribution and just "gatekeeping" practices associated with these sensitive medical services are examined.

  6. Effects of Assisted Reproduction Technology on Placental Imprinted Gene Expression

    Science.gov (United States)

    Katagiri, Yukiko; Aoki, Chizu; Tamaki-Ishihara, Yuko; Fukuda, Yusuke; Kitamura, Mamoru; Matsue, Yoichi; So, Akiko; Morita, Mineto

    2010-01-01

    We used placental tissue to compare the imprinted gene expression of IGF2, H19, KCNQ1OT1, and CDKN1C of singletons conceived via assisted reproduction technology (ART) with that of spontaneously conceived (SC) singletons. Of 989 singletons examined (ART n = 65; SC n = 924), neonatal weight was significantly lower (P < .001) in the ART group than in the SC group, but placental weight showed no significant difference. Gene expression analyzed by real-time PCR was similar for both groups with appropriate-for-date (AFD) birth weight. H19 expression was suppressed in fetal growth retardation (FGR) cases in the ART and SC groups compared with AFD cases (P < .02 and P < .05, resp.). In contrast, CDKN1C expression was suppressed in FGR cases in the ART group (P < .01), while KCNQ1OT1 expression was hyperexpressed in FGR cases in the SC group (P < .05). As imprinted gene expression patterns differed between the ART and SC groups, we speculate that ART modifies epigenetic status even though the possibilities always exist. PMID:20706653

  7. Outcome of assisted reproductive technology in overweight and obese women

    Science.gov (United States)

    MacKenna, Antonio; Schwarze, Juan Enrique; Crosby, Javier A; Zegers-Hochschild, Fernando

    2017-01-01

    Objective The main objective of this study was to assess the prevalence of overweight and obesity among patients undergoing assisted reproductive technology (ART) in Latin America and its consequences on treatment outcomes. Methods We used the Latin American Registry of ART to obtain women's age and body mass index (BMI), cancellation rate, number of oocytes retrieved and embryos transferred, clinical pregnancy, live birth and miscarriage rates from 107.313 patients undergoing autologous IVF and ICSI during four years; a multivariable analysis was performed to determine the effect of BMI on cancellation, oocytes retrieved, pregnancy, live birth and miscarriage, adjusting for age, number of embryos transferred and embryo developmental stage upon embryo transfer, when appropriate. Results The prevalence of overweight and obesity was 16.1% and 42.4%, respectively; correcting for age of female partner, overweight and obesity were associated to an increase in the odds of cancellation and to a lower mean number of oocytes retrieved; after adjusting for age, number of embryos transferred and stage of embryo development at transfer, we found that the BMI category was not associated to a change in the likelihoods of pregnancy, live birth and miscarriage. Conclusions The prevalence of obesity among women seeking ART in Latin America is surprisingly high; however, BMI does not influence the outcome of ART performed in these women. PMID:28609272

  8. Association between Thrombophilia and Repeated Assisted Reproductive Technology Failures

    Directory of Open Access Journals (Sweden)

    Kobra Hamdi

    2012-08-01

    Full Text Available Purpose: This study was performed to investigate the incidence of thrombophilic gene mutations in repeated assisted reproductive technology (ART failures. Methods: The prevalence of mutated genes in the patients with a history of three or more previous ART failures was compared with the patients with a history of successful pregnancy following ARTs. The study group included 70 patients, 34 with three or more previously failed ARTs (A and control group consisted of 36 patients with successful pregnancy following ARTs (B. All patients were tested for the presence of mutated thrombophilic genes including factor V Leiden (FVL, Methylenetetrahydrofolate reductase (MTHFR and Prothrombin (G20210A using real-time polymerase chain reaction (RT- PCR. Results: Mutation of FVL gene was detected in 5.9% women of group A (2 of 34 compared with 2.8% women (1 of 36 of control group (P = 0.6. Mutation of MTHFR gene was found in 35.3% (12 cases as compared with 50% (18 cases of control (35.3% versus 50%; P = 0.23. Regarding Prothrombin, only control group had 5.6% mutation (P = 0.49. No significant differences were detected in the incidences of FVL, Prothrombin and MTHFR in the study group A compared with the control group B. Conclusion: The obtained results suggest that thrombophilia does not have a significant effect in ART failures.

  9. Ocular Manifestations in Infants Resulted from Assisted Reproductive Technology (ART).

    Science.gov (United States)

    Jafarzadehpur, Ebrahim; Kermani, Ramin Mozafari; Mohhamadi, Ali Reza; Nateghi, Mohammad Reza; Fazeli, Abolhasan Shahzade; Kashi, Khashayar Mehdizadeh

    2013-12-01

    Nowadays, many infertile couples can have child by assistant reproductive technology (ART). Always the undesirable effects of these methods on newborn are considered and are evaluated. The aim of this study is to describe the impact of ART on ocular and visual performances of infants born by these methods. In a cross-sectional descriptive study, 479 infants aged three-nine months presented to an optometry clinic of Child Health and Development Research Department (CHDRD), Tehran, Iran. Static retinoscopy, qualitative fixation evaluation, Hirschberg test, red reflex assessment and external eye examination were carried out. Other information such as birth weight and maturity of the infants was recorded. It was possible to assess only 320 out of 479 infants due to general condition of some participants. Comparison of mean refractive error in infants' right and left eyes did not show any significant difference. Our findings confirmed that 20.3% had poor fixation, while 2.9% revealed manifest strabismus. The results also revealed the prevalences of myopia, hyperopia and emmetropia are 2.9%, 87%, and 10.1%, respectively. Red reflex abnormalities were significantly found in boys and in preterm infants (p ART, especially for premature male ART infants. These results also suggest the probability of fixation condition and visual deficiencies in these infants. It is recommended to pay close attention to this preliminary report about the refractive and fixation condition of the infants born after ART.

  10. Impact of endometrial cavity fluid on assisted reproductive technology outcomes.

    Science.gov (United States)

    Liu, Shan; Shi, Lin; Shi, Juanzi

    2016-03-01

    The impact of endometrial cavity fluid (ECF) on assisted reproductive technology (ART) outcomes has not been evaluated in a meta-analysis. To evaluate the impact of ECF on the outcome of ART cycles. PubMed, China Academic Journals Full-text Database, and China Doctoral/Masters Dissertations Full-text Databases were searched for reports published in any language before January 1, 2015, using relevant keywords. Studies were included if they compared the outcome of ART in women with and without ECF. Background information, participants' characteristics, and study outcomes were recorded. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel method. Six studies evaluating 5928 ART cycles were included. The pregnancy rate was significantly lower in the group with ECF than in the group without ECF (OR 0.74, 95% CI 0.55-0.98; P=0.03). The same association was observed if the analysis included only patients with hydrosalpinx (OR 0.36, 95% CI 0.15-0.86; P=0.02). The clinical pregnancy rate after ART is significantly lower among patients with ECF than among those without ECF. In addition, if ECF is found in patients with hydrosalpinx, ART cycles should be cancelled after oocyte retrieval. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Assisted reproductive technology in China: compliance and non-compliance.

    Science.gov (United States)

    Qiao, Jie; Feng, Huai L

    2014-04-01

    According to the WHO, infertility and sterility will be the third-most serious disease worldwide in the 21st century, after cancer and cardiovascular diseases. In contrast to developed countries, assisted reproductive technology (ART) were not offered in China until the mid-1980s with the first in vitro fertilization (IVF) infant born in Taiwan in 1985, then Hong Kong in 1986, and mainland China in 1988, respectively. Since those inceptions, the practice of ART in China has evoked a variety of social, cultural, political and one-child policy responses that have resulted in restrictions on the number of IVF cycles performed annually. According to recent survey, an estimate 40-50 million women and 45 million men suffered from infertility, which is estimated that more than ten million Chinese infertile couples require ART treatment. However, it has limited access to ART facilities, many of them may not have a child are whirling to all types of fertility therapies. Exposure to radiation, pesticides and other environmental pollutants, work-related stress and unhealthy lifestyles are believed to contribute to the increasing incidence of infertility in China. The aim of this first report is to provide China nationwide ART data and government policy in compliance and 
non-compliance, particularly related to family plan policy in China.

  12. The Role of Acupuncture in Assisted Reproductive Technology

    Directory of Open Access Journals (Sweden)

    Cui Hong Zheng

    2012-01-01

    Full Text Available The aim of this paper was to provide reliable evidence by performing a systematic review and meta-analysis for evaluating the role of acupuncture in assisted reproductive technology. All randomized controlled trials that evaluated the effects of acupuncture, including manual, electrical, and laser acupuncture (LA techniques, on the clinical pregnancy rate (CPR and live birth rate (LBR of in vitro fertilization (IVF or artificial insemination were included. The controlled groups consisted of no acupuncture and sham acupuncture groups. The sham acupuncture included sham acupuncture at acupoints, sham acupuncture at non- or inappropriate points, sham LA, and adhesive tapes. Twenty-three trials (a total of 5598 participants were included in this paper. The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups, whereas the LBR was not significantly different between the two groups. However, the results were quite distinct when the type of control and/or different acupuncture times were examined in a sensitivity analysis. The results mainly indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF. More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used.

  13. [Health and development of children conceived through assisted reproductive technologies].

    Science.gov (United States)

    Epelboin, Sylvie; Patrat, Catherine; Luton, Dominique

    2014-01-01

    Around 3% of children are conceived by assisted reproductive technology (ART) in France. Several questions concerning the early or late follow-up of these children are raised, as there are differences in the population in charge and because of clinical or biological procedures used. Nevertheless, one has to be cautious in interpreting the data as it is difficult to study one factor at a time, and as many other events can bias the results. However, ART is associated with a higher risk, even moderate, of prematurity, foetal hypotrophy, and neo natal complications, as compared to natural conceived children. There is also increasing evidence that ART-conceived children present more epigenetic diseases and congenital mainly concerning cardio-vascular, uro-genital and musculo-skeletal systems, as natural conceived children. Absolute risks remain anyway moderate and reassuring. Long term follow up is encouraging, with correct growth or psychomotor development of these children, and no significant excess of risk for cancer, but it is necessary to carry on this follow up in order to have data on their development to adulthood and on their fertility.

  14. Aneuploidy rates in failed pregnancies following assisted reproductive technology.

    Science.gov (United States)

    Nayak, Shweta; Pavone, Mary Ellen; Milad, Magdy; Kazer, Ralph

    2011-08-01

    Approximately 10%-15% of clinically recognized pregnancies end with a first trimester loss. Cytogenetic analysis of products of conception (POC) has revealed that a large proportion of these spontaneous miscarriages are a result of chromosomal abnormalities. However, relatively few studies have evaluated chromosomal abnormalities in pregnancies achieved using assisted reproductive technologies (ART). Here, we review the incidence and type of chromosomal abnormalities that occurred in our infertility patient population undergoing ART and provide a review of the literature pertaining to this subject. A retrospective chart review of all patients from our medical center who conceived using ART between January 2000 and January 2008, who experienced a subsequent early pregnancy loss, and whose POCs were successfully karyotyped were included. We also conducted a literature review in PubMed, searching for other articles on this subject. Two hundred fourteen patients conceived with ART, experienced an early loss, and subsequently underwent a dilation and curettage (D&C) between 2000 and 2008. A total of 59 (27%) patients chose to have cytogenetic testing, and their POCs were successfully karyotyped. The overall rate of aneuploidy in this group was 83%. Our PubMed search revealed a total of 12 studies that were identified and evaluated and deemed appropriate for review. Consistent with most of the literature, we found a high rate of aneuploidy present in infertile patients conceiving using ART. Because an abnormal karyotype provides an explanation for an early loss, this and other studies seem to suggest that routinely carrying out this assessment in such patients may be of value.

  15. Ocular Manifestations in Infants Resulted from Assisted Reproductive Technology (ART.

    Directory of Open Access Journals (Sweden)

    Ebrahim Jafarzadehpur

    2013-12-01

    Full Text Available Nowadays, many infertile couples can have child by assistant reproductive technology (ART. Always the undesirable effects of these methods on newborn are considered and are evaluated. The aim of this study is to describe the impact of ART on ocular and visual performances of infants born by these methods.In a cross-sectional descriptive study, 479 infants aged three-nine months presented to an optometry clinic of Child Health and Development Research Department (CHDRD, Tehran, Iran. Static retinoscopy, qualitative fixation evaluation, Hirschberg test, red reflex assessment and external eye examination were carried out. Other information such as birth weight and maturity of the infants was recorded.It was possible to assess only 320 out of 479 infants due to general condition of some participants. Comparison of mean refractive error in infants' right and left eyes did not show any significant difference. Our findings confirmed that 20.3% had poor fixation, while 2.9% revealed manifest strabismus. The results also revealed the prevalences of myopia, hyperopia and emmetropia are 2.9%, 87%, and 10.1%, respectively. Red reflex abnormalities were significantly found in boys and in preterm infants (p < 0.05. Failure of fixation control was seen more frequently with increasing refractive error, which significantly developed in preterm infants (p < 0.001.These results reflect the necessity of more comprehensive assessments and further follow-up of infants born by ART, especially for premature male ART infants. These results also suggest the probability of fixation condition and visual deficiencies in these infants. It is recommended to pay close attention to this preliminary report about the refractive and fixation condition of the infants born after ART.

  16. Tubal factor infertility and perinatal risk after assisted reproductive technology.

    Science.gov (United States)

    Kawwass, Jennifer F; Crawford, Sara; Kissin, Dmitry M; Session, Donna R; Boulet, Sheree; Jamieson, Denise J

    2013-06-01

    To assess trends of tubal factor infertility and to evaluate risk of miscarriage and delivery of preterm or low birth weight (LBW) neonates among women with tubal factor infertility using assisted reproductive technology (ART). We assessed trends of tubal factor infertility among all fresh and frozen, donor, and nondonor ART cycles performed annually in the United States between 2000 and 2010 (N=1,418,774) using the National ART Surveillance System. The data set was then limited to fresh, nondonor in vitro fertilization cycles resulting in pregnancy to compare perinatal outcomes for cycles associated with tubal compared with male factor infertility. We performed bivariate and multivariable analyses controlling for maternal characteristics and calculated adjusted risk ratios (RRs) and 95% confidence intervals (CI). The percentage of ART cycles associated with tubal factor infertility diagnoses decreased from 2000 to 2010 (26.02-14.81%). Compared with male factor infertility, tubal factor portended an increased risk of miscarriage (14.0% compared with 12.7%, adjusted RR 1.08, 95% CI 1.04-1.12); risk was increased for both early and late miscarriage. Singleton neonates born to women with tubal factor infertility had an increased risk of preterm birth (15.8% compared with 11.6%, adjusted RR 1.27, 95% CI 1.20-1.34) and LBW (10.9% compared with 8.5%, adjusted RR 1.28, 95% CI 1.20-1.36). Significant increases in risk persisted for early and late preterm delivery and very low and moderately LBW delivery. A significantly elevated risk was also detected for twin, but not triplet, pregnancies. Tubal factor infertility, which is decreasing in prevalence in the United States, is associated with an increased risk of miscarriage, preterm birth, and LBW delivery as compared with couples with male factor infertility using ART.

  17. Risk of Cancer in Children Conceived by Assisted Reproductive Technology.

    Science.gov (United States)

    Reigstad, Marte Myhre; Larsen, Inger Kristin; Myklebust, Tor Åge; Robsahm, Trude Eid; Oldereid, Nan Birgitte; Brinton, Louise A; Storeng, Ritsa

    2016-03-01

    An increasing number of children are born after assisted reproductive technology (ART), and monitoring their long-term health effects is of interest. This study compares cancer risk in children conceived by ART to that in children conceived without. The Medical Birth Registry of Norway contains individual information on all children born in Norway (including information of ART conceptions). All children born between 1984 and 2011 constituted the study cohort, and cancer data were obtained from the Cancer Registry of Norway. Follow-up started at date of birth and ended on the date of the first cancer diagnosis, death, emigration, or December 31, 2011. A Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) of overall cancer risk between children conceived by ART and those not. Cancer risk was also assessed separately for all childhood cancer types. The study cohort comprised 1 628 658 children, of which 25 782 were conceived by ART. Of the total 4554 cancers, 51 occurred in ART-conceived children. Risk of overall cancer was not significantly elevated (HR 1.21; 95% CI 0.90-1.63). However, increased risk of leukemia was observed for children conceived by ART compared with those who were not (HR 1.67; 95% CI 1.02-2.73). Elevated risk of Hodgkin's lymphoma was also found for ART-conceived children (HR 3.63; 95% CI 1.12-11.72), although this was based on small numbers. This population-based cohort study found elevated risks of leukemia and Hodgkin's lymphoma in children conceived by ART. Copyright © 2016 by the American Academy of Pediatrics.

  18. Current and future assisted reproductive technologies for fish species.

    Science.gov (United States)

    Weber, Gregory M; Lee, Cheng-Sheng

    2014-01-01

    The Food and Agriculture Organization of the United Nations (FAO) estimates that in 2012 aquaculture production of fish will meet or exceed that of the capture fisheries for the first time. Thus, we have just turned the corner from a predominantly hunting gathering approach to meeting our nutritional needs from fish, to a farming approach. In 2012, 327 finfish species and five hybrids were covered by FAO aquaculture statistics, although farming of carps, tilapias, salmonids, and catfishes account for most of food-fish production from aquaculture. Although for most major species at least part of production is based on what might be considered domesticated animals, only limited production in most species is based on farming of improved lines of fish or is fully independent of wild seedstock. Consistent with the infancy of most aquaculture industries, much of the development and implementation of reproductive technologies over the past 100 years has been directed at completion of the life cycle in captivity in order to increase seed production and begin the process of domestication. The selection of species to farm and the emphasis of selective breeding must also take into account other ways to modify performance of an animal. Reproductive technologies have also been developed and implemented to affect many performance traits among fishes. Examples include technologies to control gender, alter time of sexual maturation, and induce sterilization. These technologies help take advantage of sexually dimorphic growth, overcome problems with growth performance and flesh quality associated with sexual maturation, and genetic containment. Reproductive technologies developed to advance aquaculture and how these technologies have been implemented to advance various sectors of the aquaculture industry are discussed. Finally, we will present some thoughts regarding future directions for reproductive technologies and their applications in finfish aquaculture.

  19. Assisted reproductive technology surveillance--United States, 2009.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Flowers, Lisa; Anderson, John E; Folger, Suzanne G; Jamieson, Denise J; Barfield, Wanda D

    2012-11-02

    Since the birth of the first U.S. infant conceived with Assisted Reproductive Technology (ART) in 1981, use of advanced technologies to overcome the problem of infertility has increased steadily, as has the number of fertility clinics providing ART services in the United States. ART includes fertility treatments in which both eggs and sperm are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely to deliver multiple-birth infants than those who conceive naturally. Multiple births pose substantial risks to both mothers and infants, including pregnancy complications, preterm delivery, and low birthweight infants. This report presents the most recent data on ART use and birth outcomes for U.S. states and territories. 2009. In 1996, CDC began collecting data on all ART procedures performed in the United States, as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). ART data for 1995-2003 were obtained from the Society of Assisted Reproductive Technology (SART) through its proprietary Clinical Outcomes Reporting System data base (SART CORS). Since 2004, CDC has contracted with Westat, Inc., a statistical survey research organization, to obtain data from fertility clinics in the United States through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. In 2009, a total of 146,244 ART procedures were reported to CDC. These procedures resulted in 45,870 live-birth deliveries and 60,190 infants. The largest numbers of ART procedures were performed among residents of California (18,405), New York (14,539), Illinois (10,192), Massachusetts (9,845), New Jersey (9,146), and Texas (8,244). Together, these six states reported the highest number of live-birth deliveries as a result of ART and accounted for 48% of all ART procedures initiated, 46% of all infants born from ART, and 45

  20. Early embryonic development, assisted reproductive technologies, and pluripotent stem cell biology in domestic mammals

    DEFF Research Database (Denmark)

    Hall, Vanessa Jane; Hinrichs, K.; Lazzari, G.

    2013-01-01

    Over many decades assisted reproductive technologies, including artificial insemination, embryo transfer, in vitro production (IVP) of embryos, cloning by somatic cell nuclear transfer (SCNT), and stem cell culture, have been developed with the aim of refining breeding strategies for improved...... of pre-implantation development in cattle, pigs, horses, and dogs. Biological aspects and impact of assisted reproductive technologies including IVP, SCNT, and culture of pluripotent stem cells are also addressed....

  1. Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder

    DEFF Research Database (Denmark)

    Ebdrup, Ninna H; Assens, Maria; Hougaard, Charlotte O

    2014-01-01

    To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders.......To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders....

  2. Development of a security system for assisted reproductive technology (ART).

    Science.gov (United States)

    Hur, Yong Soo; Ryu, Eun Kyung; Park, Sung Jin; Yoon, Jeong; Yoon, San Hyun; Yang, Gi Deok; Hur, Chang Young; Lee, Won Don; Lim, Jin Ho

    2015-01-01

    In the field of assisted reproductive technology (ART), medical accidents can result in serious legal and social consequences. This study was conducted to develop a security system (called IVF-guardian; IG) that could prevent mismatching or mix-ups in ART. A software program was developed in collaboration with outside computer programmers. A quick response (QR) code was used to identify the patients, gametes and embryos in a format that was printed on a label. There was a possibility that embryo development could be affected by volatile organic components (VOC) in the printing material and adhesive material in the label paper. Further, LED light was used as the light source to recognize the QR code. Using mouse embryos, the effects of the label paper and LED light were examined. The stability of IG was assessed when applied in clinical practice after developing the system. A total of 104 cycles formed the study group, and 82 cycles (from patients who did not want to use IG because of safety concerns and lack of confidence in the security system) to which IG was not applied comprised the control group. Many of the label paper samples were toxic to mouse embryo development. We selected a particular label paper (P touch label) that did not affect mouse embryo development. The LED lights were non-toxic to the development of the mouse embryos under any experimental conditions. There were no differences in the clinical pregnancy rates between the IG-applied group and the control group (40/104 = 38.5 % and 30/82 = 36.6 %, respectively). The application of IG in clinical practice did not affect human embryo development or clinical outcomes. The use of IG reduces the misspelling of patient names. Using IG, there was a disadvantage in that each treatment step became more complicated, but the medical staff improved and became sufficiently confident in ART to offset this disadvantage. Patients who received treatment using the IG system also went through a somewhat

  3. Cancer risk among parous women following assisted reproductive technology.

    Science.gov (United States)

    Reigstad, M M; Larsen, I K; Myklebust, T Å; Robsahm, T E; Oldereid, N B; Omland, A K; Vangen, S; Brinton, L A; Storeng, R

    2015-08-01

    Do women who give birth after assisted reproductive technology (ART) have an increased risk of cancer compared with women who give birth without ART? Without correction, the results indicate an increase in overall cancer risk, as well as a 50% increase in risk of CNS cancer for women giving birth after ART, however the results were not significant after correcting for multiple analyses. Studies regarding the effects of hormonal treatments involved with ART on subsequent cancer risk have provided inconsistent results, and it has also been suggested that infertility itself could be a contributory factor. A population-based cohort consisting of all women registered in the Medical Birth Registry of Norway as having given birth between 1 January 1984 and 31 December 2010 was assembled (n = 812 986). Cancers were identified by linkage to the Cancer Registry of Norway. Study subjects were followed from start of first pregnancy during the observational period until the first cancer, death, emigration, or 31 December 2010. Of the total study population (n = 806 248), 16 525 gave birth to a child following ART. Cox regression analysis computed hazard ratios (HR) and 95% confidence intervals (CI) comparing cancer risk between ART women and non-ART women; for overall cancer, and for cervical, ovarian, uterine, central nervous system (CNS), colorectal and thyroid cancers, and for malignant melanoma. A total of 22 282 cohort members were diagnosed with cancer, of which 338 were ART women and 21 944 non-ART women. The results showed an elevated risk in one out of seven sites for ART women. The HR for cancer of the CNS was 1.50 (95% CI 1.03- 2.18), and among those specifically subjected to IVF (without ICSI) the HR was 1.83 (95% CI 1.22-2.73). Analysis of risk of overall cancer gave an HR of 1.16 (95% CI 1.04-1.29). Among those who had delivered only one child by the end of follow-up, the HR for ovarian cancer was 2.00 (95% CI 1.08-3.65), and for those nulliparous at entry the HR

  4. Assisted reproductive technology in the United States: 2001 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology registry.

    Science.gov (United States)

    2007-06-01

    To summarize the procedures and outcomes of assisted reproductive technologies (ART) that were initiated in the United States in 2001. Data were collected electronically using the Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System software and submitted to the American Society for Reproductive Medicine/SART Registry. Three hundred eighty-five clinics submitted data on procedures performed in 2001. Data were collated after November 2002 [corrected] so that the outcomes of all pregnancies would be known. Incidence of clinical pregnancy, ectopic pregnancy, abortion, stillbirth, and delivery. Programs reported initiating 108,130 cycles of ART treatment. Of these, 79,042 cycles involved IVF (with and without micromanipulation), with a delivery rate per retrieval of 31.6%; 340 were cycles of gamete intrafallopian transfer, with a delivery rate per retrieval of 21.9%; 661 were cycles of zygote intrafallopian transfer, with a delivery rate per retrieval of 31.0%. The following additional ART procedures were also initiated: 8,147 fresh donor oocyte cycles, with a delivery rate per transfer of 47.3%; 14,509 frozen ET procedures, with a delivery rate per transfer of 23.5%; 3,187 frozen ETs employing donated oocytes or embryos, with a delivery rate per transfer of 27.4%; and 1,366 cycles using a host uterus, with a delivery rate per transfer of 38.7%. In addition, 112 cycles were reported as combinations of more than one treatment type, 8 cycles as research, and 85 as embryo banking. As a result of all procedures, 29,585 deliveries were reported, resulting in 41,168 neonates. In 2001, there were more programs reporting ART treatment and a significant increase in reported cycles compared with 2000.

  5. Serum and follicular fluid organochlorine concentrations among women undergoing assisted reproduction technologies

    OpenAIRE

    Meeker, John D; Missmer, Stacey A; Altshul, Larisa; Vitonis, Allison F; Ryan, Louise; Cramer, Daniel W; Hauser, Russ

    2009-01-01

    Abstract Background Exposure to persistent organic pollutants, including polychlorinated biphenyls (PCBs) and organochlorine pesticides, is widespread among the general population. There is evidence of adverse effects on reproduction and early pregnancy in relation to organochlorine exposure but human studies remain limited. The increased use of assisted reproductive technologies (ART) presents unique opportunities for the assessment of environmental influences on early pregnancy outcomes not...

  6. Enduring politics: the culture of obstacles in legislating for assisted reproduction technologies in Ireland

    Directory of Open Access Journals (Sweden)

    Jill Allison

    2016-12-01

    Full Text Available Assisted reproductive technology has become a normalized part of reproductive medicine in many countries around the world. Access, however, is uneven and inconsistent, facilitated and restricted by such factors as affordability, social and moral acceptance or refusal and local cultures of medical practice. In Ireland, assisted reproductive technology has been available since 1987 but remains unregulated by legislation. This creates an uncertain and untenable legal circumstance given the contested issues related to constitutional protection of the right to life of the unborn and the indeterminate legal status of embryos in vitro. This paper examines the impact of an enduring political impasse. It explores how clinical assisted reproductive technology services in Ireland operate both inside and outside dominant institutional frameworks, meeting a pronatalist and pro-family social and political agenda, while sometimes contradicting the pro-life politics that has continued to shape women’s reproductive lives. The medical approaches to infertility thus intersect with the ongoing debates around abortion, the failure of the government to regulate, and notions of embodied motherhood and responsibility within changing meanings of family and kinship. At the same time women and their partners seek assisted reproductive technology treatment in other countries throughout the European Union where laws differ and availability of services varies. A decade has passed since the Commission on Assisted Human Reproduction in Ireland released its recommendations; the enduring legislative vacuum leaves women, families and practitioners in potential legal limbo.

  7. Assisted reproductive technology surveillance--United States, 2011.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Jamieson, Denise J; Barfield, Wanda D

    2014-11-21

    Since the first U.S. infant conceived with Assisted Reproductive Technology (ART) was born in 1981, both the use of advanced technologies to overcome infertility and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which both eggs and embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely to deliver multiple-birth infants than those who conceive naturally because more than one embryo might be transferred during a procedure. Multiple births pose substantial risks to both mothers and infants, including pregnancy complications, preterm delivery, and low birthweight infants. This report provides state-specific information on U.S. ART procedures performed in 2011 and compares infant outcomes that occurred in 2011 (resulting from procedures performed in 2010 and 2011) with outcomes for all infants born in the United States in 2011. 2011. In 1996, CDC began collecting data on all ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System (NASS), a web-based data collecting system developed by CDC. In 2011, a total of 151,923 ART procedures performed in 451 U.S. fertility clinics were reported to CDC. These procedures resulted in 47,818 live-birth deliveries and 61,610 infants. The largest numbers of ART procedures were performed among residents of six states: California (18,808), New York (excluding New York City) (14,576), Massachusetts (10,106), Illinois (9,886), Texas (9,576), and New Jersey (8,698). These six states also had the highest number of live-birth deliveries as a result of ART procedures and together accounted for 47.2% of all ART procedures performed, 45.3% of all infants born from ART, and 45.1% of

  8. Assisted Reproductive Technology Surveillance — United States, 2012.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Jamieson, Denise J; Warner, Lee; Barfield, Wanda D

    2015-08-14

    Since the first U.S. infant conceived with Assisted Reproductive Technology (ART) was born in 1981, both the use of advanced technologies to overcome infertility and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Because more than one embryo might be transferred during a procedure, women who undergo ART procedures, compared with those who conceive naturally, are more likely to deliver multiple birth infants. Multiple births pose substantial risks to both mothers and infants, including obstetric complications, preterm delivery, and low birthweight infants. This report provides state-specific information for the United States (including Puerto Rico) on ART procedures performed in 2012 and compares infant outcomes that occurred in 2012 (resulting from ART procedures performed in 2011 and 2012) with outcomes for all infants born in the United States in 2012. 2012. In 1996, CDC began collecting data on ART procedures performed in fertility clinics in the United States, as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System, a web-based data collecting system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia [DC], and Puerto Rico). In 2012, a total of 157,635 ART procedures performed in 456 U.S. fertility clinics were reported to CDC. These procedures resulted in 51,261 live-birth deliveries and 65,151 infants. The largest numbers of ART procedures were performed among residents of six states: California (20,241), New York (19,618), Illinois (10,449), Texas (10,281), Massachusetts (9,754), and New Jersey (8,590). These six states also had the highest number of live-birth deliveries as a result of

  9. Assisted reproductive technology in South Africa: first results generated from the South African Register of Assisted Reproductive Techniques.

    Science.gov (United States)

    Dyer, Silke Juliane; Kruger, Thinus Frans

    2012-02-23

    We present the first report from the South African Register of Assisted Reproductive Techniques. All assisted reproductive technology (ART) centres in South Africa were invited to join the register. Participant centres voluntarily submitted information from 2009 on the number of ART cycles, embryo transfers, clinical pregnancies, age of female partners or egg donors, and use of fertilisation techniques. Data were anonymised, pooled and analysed. The 12 participating units conducted a total of 4 512 oocyte aspirations and 3 872 embryo transfers in 2009, resulting in 1 303 clinical pregnancies. The clinical pregnancy rate (CPR) per aspiration and per embryo transfer was 28.9% and 33.6%, respectively. Fertilisation was achieved by intracytoplasmic sperm injection in two-thirds of cycles. In most cycles, 1 - 2 embryos or blastocysts were transferred. Female age was inversely related to pregnancy rate. The register achieved a high rate of participation. The reported number of ART cycles covers approximately 6% of the estimated ART demand in South Africa. The achieved CPRs compare favourably with those reported for other countries.

  10. High incidence of monozygotic twinning after assisted reproduction is related to genetic information, but not to assisted reproduction technology itself

    Czech Academy of Sciences Publication Activity Database

    Sobek Jr., A.; Zbořilová, B.; Procházka, M.; Šilhánová, E.; Koutná, O.; Klásková, E.; Tkadlec, Emil; Sobek, A.

    2015-01-01

    Roč. 103, č. 3 (2015), s. 756-760 ISSN 0015-0282 Institutional support: RVO:68081766 Keywords : monozygotic twins * genetics * assisted reproduction techniques * infertility Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.426, year: 2015

  11. Assisted Reproductive Technology Surveillance - 
United States, 2013.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Jamieson, Denise J; Warner, Lee; Barfield, Wanda D

    2015-12-04

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks to both mothers and infants, including obstetric complications, preterm delivery, and low birthweight infants. This report provides state-specific information for the United States (including Puerto Rico) on ART procedures performed in 2013 and compares infant outcomes that occurred in 2013 (resulting from ART procedures performed in 2012 and 2013) with outcomes for all infants born in the United States in 2013. 2013. In 1996, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia [DC], and Puerto Rico). In 2013, a total of 160,521 ART procedures (range: 109 in Wyoming to 20,299 in California) with the intent to transfer at least one embryo were performed in 467 U.S. fertility clinics and were reported to CDC. These procedures resulted in 53,252 live-birth deliveries (range: 47 in Alaska to 6,979 in California) and 66,691 infants (range: 61 in Alaska to 8,649 in California). Nationally, the total number of ART procedures performed per million women of reproductive age (15-44 years), a proxy measure of the ART usage rate, was 2,521 (range: 352 in Puerto Rico to 7,688 in DC). ART use

  12. Multiple gestation as a marker of reproductive efficacy: learning from assisted reproductive technologies.

    Science.gov (United States)

    Zegers-Hochschild, F; Bravo, M; Fernández, E; Fabres, C; Balmaceda, J P; Mackenna, A

    2004-01-01

    This study postulates that apart from the number of embryos transferred, women with multiple gestation represent a subgroup of highly fertile individuals, whose embryos implant with higher efficiency than women with single gestation. Furthermore, each embryo generated from these women has a higher chance of reaching full term. The objective of this study was to compare implantation rate with the outcome of pregnancy (up to week 20) in multiple gestations following assisted reproductive techniques. The study group comprised 162 women with multiple gestation after assisted reproduction, followed prospectively with at least three ultrasound examinations performed between weeks 5 and 20 after the last menstrual period. Control group A comprised 344 fertile women with spontaneous single pregnancy followed with transvaginal ultrasound. Control group B consisted of 317 infertile women conceiving with single gestation after assisted reproduction and followed prospectively as in the study group. Embryo implantation rate and spontaneous embryo/fetal reduction, either partial or total (abortion), were registered in each case. Overall implantation in women with multiple gestation was higher (54.6%) than in the corresponding controls (25.6%). Furthermore, spontaneous embryo/fetus reduction was similar in the study cases and in fertile women (12.6 and 10.8% respectively) and significantly smaller than in the control group B (20.8%). Women with high reproductive efficacy exposed to assisted reproductive techniques generate cohorts of good quality embryos, with a high chance of implantation and of reaching birth.

  13. Changing direction: the struggle of regulating assisted reproductive technology in Austria

    Directory of Open Access Journals (Sweden)

    Erich Griessler

    2016-12-01

    Full Text Available From 1992 until 2015, Austria had a very restrictive Reproductive Medicine Law (FMedG, 1992 that prohibited a number of treatments such as egg donation, preimplantation genetic diagnosis (PGD, heterologous sperm donation for IVF/intracytoplasmic sperm injection (ICSI as well as general access to assisted reproductive technology for same-sex couples. As one consequence of this rather prohibitive law, Austrian physicians active in the area of assisted reproductive technology co-operated with, or had daughter institutes in, countries with less restrictive legislation such as the Czech Republic and Slovakia, which are only a few hours’ drive away. For a long time, liberalisation of the Reproductive Medicine Law was blocked by the fierce and seemingly unresolvable struggle between the restrictive conservative party (ÖVP and the permissive social democrats’ party (SPÖ. In 2014 the impasse, which had lasted for decades, was finally resolved in favour of a more liberal Reproductive Medicine Law that permits egg donation, PGD in some cases and heterologous sperm donation for IVF/ICSI and lesbian couples. Assisted reproductive technology treatments for single women and surrogate motherhood remain prohibited. The new Reproductive Medicine Law was heavily opposed by the Catholic Church, by some conservatives and by disability associations. By applying the concept of political culture, this paper explains why a liberalisation of the Reproductive Medicine Law was blocked for decades, and how the sudden policy change came about.

  14. Assisted reproductive technologies are an integrated part of national strategies addressing demographic and reproductive challenges

    DEFF Research Database (Denmark)

    Ziebe, Søren; Devroey, Paul; Jensen, Tina Kold

    2012-01-01

    The decline in the total fertility rate in the latter half of the 20th century in many European countries is becoming increasingly important in determining the demographic composition of Europe and its individual member states. This review focuses on discussion surrounding how assisted reproductive...

  15. Perinatal outcomes among singletons after assisted reproductive technology with single-embryo or double-embryo transfer versus no assisted reproductive technology.

    Science.gov (United States)

    Martin, Angela S; Chang, Jeani; Zhang, Yujia; Kawwass, Jennifer F; Boulet, Sheree L; McKane, Patricia; Bernson, Dana; Kissin, Dmitry M; Jamieson, Denise J

    2017-04-01

    To examine outcomes of singleton pregnancies conceived without assisted reproductive technology (non-ART) compared with singletons conceived with ART by elective single-embryo transfer (eSET), nonelective single-embryo transfer (non-eSET), and double-embryo transfer with the establishment of 1 (DET -1) or ≥2 (DET ≥2) early fetal heartbeats. Retrospective cohort using linked ART surveillance data and vital records from Florida, Massachusetts, Michigan, and Connecticut. Not applicable. Singleton live-born infants. None. Preterm birth (PTB Reproductive Medicine. All rights reserved.

  16. A demographic projection of the contribution of assisted reproductive technologies to world population growth.

    Science.gov (United States)

    Faddy, Malcolm J; Gosden, Matthew D; Gosden, Roger G

    2018-04-01

    Enormous unmet needs for infertility treatment exist because access to assisted reproductive technologies is demographically skewed. Since the first IVF baby in 1978, the number of people conceived by reproductive technology has grown much faster than expected, reaching several million today and rapidly approaching 0.1% of the total world population. As more patients build families, and their children in turn become parents, the number owing their existence to assisted reproductive technologies, either directly or indirectly, will expand tremendously in future decades, but no attempts have been made hitherto to project the magnitude. We have projected growth to the year 2100, along with the fractional contribution to world population. The chief variable driving growth is access to fertility services. If it stagnates at current levels of about 400,000 babies per year, an estimated 157 million people alive at the end of the century will owe their lives to assisted reproductive technologies (1.4% of global population), but at an arbitrary upper limit of 30,000 extra births annually there will be 394 million additional people alive (3.5%). As the conquest of infertility continues, individuals who owe their lives to assisted reproductive technologies will quietly make a significant contribution to demographic growth as well as social progress. Copyright © 2018. Published by Elsevier Ltd.

  17. The clinical benefit and safety of current and future assisted reproductive technology.

    Science.gov (United States)

    Brown, Rachel; Harper, Joyce

    2012-08-01

    Since the first birth by IVF was achieved in 1978, the techniques involved in assisted reproductive technology have grown at an enormous rate. However, new technology has rarely been robustly validated before clinical use and developing scientific understanding of the available techniques has done little to alter their use. Furthermore, there are inconsistencies in the available clinical studies and endpoints. The benefits of some technologies already established for routine use are currently dubious and there are clear ethical concerns with providing them to patients when their scientific basis is not clear. As the uptake of assisted reproductive technology increases and newer technologies continue to push the boundaries of science, it is important to consider the clinical benefits and safety of all assisted reproductive technologies. This review will discuss aspects of some of the more recent techniques, including sperm DNA-damage tests, intracytoplasmic morphologically selected sperm injection, amino acid and metabolomics profiling, preimplantation genetic screening and time-lapse imaging, and those that may have substantial impacts on the field of reproductive medicine in the future including artificial gametes, ovarian transplantation and gene therapy. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  18. CDC-reported assisted reproductive technology live-birth rates may mislead the public.

    Science.gov (United States)

    Kushnir, Vitaly A; Choi, Jennifer; Darmon, Sarah K; Albertini, David F; Barad, David H; Gleicher, Norbert

    2017-08-01

    The Centre for Disease Control and Prevention (CDC) publicly reports assisted reproductive technology live-birth rates (LBR) for each US fertility clinic under legal mandate. The 2014 CDC report excluded 35,406 of 184,527 (19.2%) autologous assisted reproductive technology cycles that involved embryo or oocyte banking from LBR calculations. This study calculated 2014 total clinic LBR for all patients utilizing autologous oocytes two ways: including all initiated assisted reproductive technology cycles or excluding banking cycles, as done by the CDC. The main limitation of this analysis is the CDC report did not differentiate between cycles involving long-term banking of embryos or oocytes for fertility preservation from cycles involving short-term embryo banking. Twenty-seven of 458 (6%) clinics reported over 40% of autologous cycles involved banking, collectively performing 12% of all US assisted reproductive technology cycles. LBR in these outlier clinics calculated by the CDC method, was higher than the other 94% of clinics (33.1% versus 31.1%). However, recalculated LBR including banking cycles in the outlier clinics was lower than the other 94% of clinics (15.5% versus 26.6%). LBR calculated by the two methods increasingly diverged based on proportion of banking cycles performed by each clinic reaching 4.5-fold, thereby, potentially misleading the public. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Assisted reproductive technology with donor sperm: national trends and perinatal outcomes.

    Science.gov (United States)

    Gerkowicz, Sabrina A; Crawford, Sara B; Hipp, Heather S; Boulet, Sheree L; Kissin, Dmitry M; Kawwass, Jennifer F

    2018-04-01

    Information regarding the use of donor sperm in assisted reproductive technology, as well as subsequent treatment and perinatal outcomes, remains limited. Outcome data would aid patient counseling and clinical decision making. The objectives of the study were to report national trends in donor sperm utilization and live birth rates of donor sperm-assisted reproductive technology cycles in the United States and to compare assisted reproductive technology treatment and perinatal outcomes between cycles using donor and nondonor sperm. We hypothesize these outcomes to be comparable between donor and nondonor sperm cycles. This was a retrospective cohort study using data from all US fertility centers reporting to the Centers for Disease Control and Prevention's National Assisted Reproductive Technology Surveillance System, accounting for ∼98% of assisted reproductive technology cycles (definition excludes intrauterine insemination). The number and percentage of assisted reproductive technology cycles using donor sperm and rates of pregnancy, live birth, preterm birth (technology cycles using donor and autologous oocytes performed between 1996 and 2014 (n = 1,710,034). The outcomes analysis was restricted to include only fresh autologous cycles performed between 2010 and 2014 (n = 437,569) to focus on cycles with a potential outcome and cycles reflective of current practice, thereby improving the clinical relevance. Cycles canceled prior to retrieval were excluded. Statistical analysis included linear regression to explore polynomial trends and log-binomial regression to estimate relative risk for outcomes among cycles using donor and nondonor sperm. Of all banking and fresh donor and autologous oocyte assisted reproductive technology cycles performed between 1996 and 2014, 74,892 (4.4%) used donor sperm. In 2014, 7351 assisted reproductive technology cycles using donor sperm were performed, as compared with 1763 in 1996 (6.2% vs 3.8% of all cycles). Among all

  20. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology.

    Science.gov (United States)

    Al-Inany, Hesham G; Youssef, Mohamed A; Ayeleke, Reuben Olugbenga; Brown, Julie; Lam, Wai Sun; Broekmans, Frank J

    2016-04-29

    Gonadotrophin-releasing hormone (GnRH) antagonists can be used to prevent a luteinizing hormone (LH) surge during controlled ovarian hyperstimulation (COH) without the hypo-oestrogenic side-effects, flare-up, or long down-regulation period associated with agonists. The antagonists directly and rapidly inhibit gonadotrophin release within several hours through competitive binding to pituitary GnRH receptors. This property allows their use at any time during the follicular phase. Several different regimens have been described including multiple-dose fixed (0.25 mg daily from day six to seven of stimulation), multiple-dose flexible (0.25 mg daily when leading follicle is 14 to 15 mm), and single-dose (single administration of 3 mg on day 7 to 8 of stimulation) protocols, with or without the addition of an oral contraceptive pill. Further, women receiving antagonists have been shown to have a lower incidence of ovarian hyperstimulation syndrome (OHSS). Assuming comparable clinical outcomes for the antagonist and agonist protocols, these benefits would justify a change from the standard long agonist protocol to antagonist regimens. This is an update of a Cochrane review first published in 2001, and previously updated in 2006 and 2011. To evaluate the effectiveness and safety of gonadotrophin-releasing hormone (GnRH) antagonists compared with the standard long protocol of GnRH agonists for controlled ovarian hyperstimulation in assisted conception cycles. We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (searched from inception to May 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, inception to 28 April 2015), Ovid MEDLINE (1966 to 28 April 2015), EMBASE (1980 to 28 April 2015), PsycINFO (1806 to 28 April 2015), CINAHL (to 28 April 2015) and trial registers to 28 April 2015, and handsearched bibliographies of relevant publications and reviews, and abstracts of major scientific meetings, for

  1. Risk disparities in the globalisation of assisted reproductive technology: the case of Asia.

    Science.gov (United States)

    Ha, Jung-Ok

    2013-01-01

    This paper analyses the disparities in risks associated with biomedical technology focusing on the results of assisted reproductive technology (ART). ART among biomedical technologies transferred to Asia is a representative case that reveals in its clinical use and related scientific research the global politics of technology. This study notes the global politics at work in the recognition of and reaction to such risks. While many Asian countries aggressively pursue technological development, weak legislative and administrative regulations have created various problems and controversial cases. This study asserts that risks associated with technology are characterised as social facts not natural ones or mere 'side effects', since technological development and risk are closely intertwined.

  2. Prognostic factors for assisted reproductive technology in women with endometriosis-related infertility.

    Science.gov (United States)

    Maignien, Chloé; Santulli, Pietro; Gayet, Vanessa; Lafay-Pillet, Marie-Christine; Korb, Diane; Bourdon, Mathilde; Marcellin, Louis; de Ziegler, Dominique; Chapron, Charles

    2017-03-01

    Assisted reproductive technology is one of the therapeutic options offered for managing endometriosis-associated infertility. Yet, published data on assisted reproductive technology outcome in women affected by endometriosis are conflicting and the determinant factors for pregnancy chances unclear. We sought to evaluate assisted reproductive technology outcomes in a series of 359 endometriosis patients, to identify prognostic factors and determine if there is an impact of the endometriosis phenotype. This was a retrospective observational cohort study, including 359 consecutive endometriosis patients undergoing in vitro fertilization or intracytoplasmic sperm injection, from June 2005 through February 2013 at a university hospital. Endometriotic lesions were classified into 3 phenotypes-superficial peritoneal endometriosis, endometrioma, or deep infiltrating endometriosis-based on imaging criteria (transvaginal ultrasound, magnetic resonance imaging); histological proof confirmed the diagnosis in women with a history of surgery for endometriosis. Main outcome measures were clinical pregnancy rates and live birth rates per cycle and per embryo transfer. Prognostic factors of assisted reproductive technology outcome were identified by comparing women who became pregnant and those who did not, using univariate and adjusted multiple logistic regression models. In all, 359 endometriosis patients underwent 720 assisted reproductive technology cycles. In all, 158 (44%) patients became pregnant, and 114 (31.8%) had a live birth. The clinical pregnancy rate and the live birth rate per embryo transfer were 36.4% and 22.8%, respectively. The endometriosis phenotype (superficial endometriosis, endometrioma, or deep infiltrating endometriosis) had no impact on assisted reproductive technology outcomes. After multivariate analysis, history of surgery for endometriosis (odds ratio, 0.14; 95% confidence ratio, 0.06-0.38) or past surgery for endometrioma (odds ratio, 0.39; 95

  3. Impact of assisted reproductive technology on the incidence of multiple-gestation infants: a population perspective

    NARCIS (Netherlands)

    Scholten, Irma; Chambers, Georgina M.; van Loendersloot, Laura; van der Veen, Fulco; Repping, Sjoerd; Gianotten, Judith; Hompes, Peter G. A.; Ledger, William; Mol, Ben W. J.

    2015-01-01

    To study the value of a population view in assessing assisted reproductive technology (ART) multiple-gestation infants. Descriptive comparison of ART treatment and population statistics in seven developed countries (United States [U.S.], South Korea, United Kingdom, the Netherlands, Australia,

  4. Assisted reproductive technology and severe postpartum haemorrhage: a case-control study.

    Science.gov (United States)

    Nyfløt, L T; Sandven, I; Oldereid, N B; Stray-Pedersen, B; Vangen, S

    2017-07-01

    To investigate the association between assisted reproductive technology and severe postpartum haemorrhage. Case-control study. The study was conducted in Norway; Division of Gynaecology and Obstetrics at Oslo University Hospital and Department of Obstetrics and Gynaecology at Drammen Hospital. A source population including all women admitted for delivery at Oslo University Hospital and Drammen Hospital during the time period 1 January 2008 to 31 December 2011. The study population consisted of all cases of severe postpartum haemorrhage (n = 1064) and a random sample of controls (n = 2059). We used an explanatory strategy in the analysis, with multivariable logistic regression. Severe postpartum haemorrhage; defined as blood loss ≥1500 ml or need for blood transfusion. Assisted reproductive technology was associated with an increased risk of severe postpartum haemorrhage (crude OR = 2.92; 95% CI 2.18-3.92, P single gestation (adjusted OR = 1.58, 95% CI 1.12-2.24, P = 0.010). Our findings warrant an increased awareness of the risk of severe postpartum haemorrhage in women conceiving with assisted reproductive technology. Furthermore, the high risk of severe postpartum haemorrhage in the presence of a twin or triplet pregnancy is an additional argument for single embryo transfer. Assisted reproductive technology is associated with an increased risk of severe postpartum haemorrhage. © 2016 Royal College of Obstetricians and Gynaecologists.

  5. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome?

    DEFF Research Database (Denmark)

    Pinborg, A; Wennerholm, U B; Romundstad, L B

    2013-01-01

    Assisted reproduction technology (ART) is used worldwide, at increasing rates, and data show that some adverse outcomes occur more frequently than following spontaneous conception (SC). Possible explanatory factors for the well-known adverse perinatal outcome in ART singletons were evaluated....

  6. The costs and consequences of assisted reproductive technology : an economic perspective

    NARCIS (Netherlands)

    Connolly, Mark P.; Hoorens, Stijn; Chambers, Georgina M.

    2010-01-01

    Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding of the economics of ART to inform policy about effective, safe and equitable financing of ART treatment. A review was undertaken of key studies regarding the costs and consequences of

  7. The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: A qualitative Brazilian study.

    Science.gov (United States)

    Dornelles, L M N; MacCallum, F; Lopes, R C S; Piccinini, C A; Passos, E P

    2016-04-01

    Pregnancies achieved through medical treatments following a period of infertility may demand extra emotional and practical investment from women. This paper aims at understanding the experience of pregnancy after Assisted Reproductive Technology, and exploring whether this experience is affected by previous failed infertility treatments. This paper uses a qualitative approach. Participants were nineteen expectant first-time mothers from Brazil who conceived through Assisted Reproductive Technology treatment. During the third trimester of gestation, a semi-structured interview was administered to assess perceptions of and feelings about treatment and pregnancy. Interview transcripts were analysed using thematic analysis, and the sample was divided into two groups according to whether it was the participant's first treatment or not. Themes identified include: tolerance of the demands of treatment and pregnancy, consideration of the mechanics of treatment and pregnancy, and emotionally painful aspects of treatment and pregnancy. Pregnancy itself was regarded as a reward or compensation for the difficulties undergone. Perspectives differed according to whether pregnancy followed the first Assisted Reproductive Technology treatment; those who had undergone previously unsuccessful treatments focused less on the mechanical aspects of the process but were more concerned about possible physical problems. The similarities and differences found according to number of treatments attempted should be taken into consideration when providing psychological support for expectant Assisted Reproductive Technology mothers. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  8. Trends of racial disparities in assisted reproductive technology outcomes in black women compared with white women: Society for Assisted Reproductive Technology 1999 and 2000 vs. 2004-2006.

    Science.gov (United States)

    Seifer, David B; Zackula, Rosey; Grainger, David A

    2010-02-01

    To determine trends in assisted reproductive technology (ART) in black and white women by comparing Society for Assisted Reproductive Technology (SART) database outcomes for 2004-2006 with previously reported outcomes for 1999 and 2000. Retrospective, cohort study. The SART member clinics that performed at least 50 cycles of IVF and reported race in more than 95% of cycles. Women receiving 158,693 IVF cycles. In vitro fertilization using nondonor embryos. Live birth rate per cycle started. Reporting of race increased from 52% to 60%. The proportion of black, non-Hispanic (BNH) women increased from 4.6% to 6.5%. For BNH women using fresh embryos and no prior ART, significant increasing trends were observed for older age, male factor, uterine factor, diminished ovarian reserve, and ovulation disorders. The BNH women were 2.5 times more likely to have tubal factor for those cycles with no prior ART. The proportion of live births per cycle started increased across all groups over time, although greater increases occurred for white women. There seems to be widening disparities in IVF outcomes between BNH and white women, perhaps attributable to poor prognostic factors among black women. Race continues to be a marker for prognosis for ART outcomes and should be reported. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Validity for assisted hatching on pregnancy rate in assisted reproductive technology: analysis based on results of Japan Assisted Reproductive Technology Registry System 2010.

    Science.gov (United States)

    Nakasuji, Takashi; Saito, Hidekazu; Araki, Ryuichiro; Nakaza, Aritoshi; Kuwahara, Akira; Ishihara, Osamu; Irahara, Minoru; Kubota, Toshiro; Yoshimura, Yasunori; Sakumoto, Tetsuro

    2014-06-01

    The aim of this study was to assess the efficacy of assisted hatching (AH) in assisted reproductive technology (ART) treatment. In this retrospective observational study, the data of patients who were registered in the National ART Registry System of Japan between January and December 2010 were analyzed. The descriptive statistics and validity of AH in fresh embryo transfer (ET) and frozen-thawed ET were assessed by using multiple logistic regression analyses. From a total of 105,450 single ET, 46,029 (43.7%) cycles underwent AH. A total of 9737 (21.3%) and 36,292 (60.9%) cycles underwent AH from 45,818 fresh single ET and 59,632 frozen-thawed single ET, respectively. In the fresh ET patients that underwent AH, the clinical pregnancy and live birth rate were significantly decreased in patients of all ages compared with that of the non-AH group. In the frozen-thawed ET patients, there was no significant difference in pregnancy and live birth rate between the AH group and the non-AH group. AH treatment was more frequently performed in frozen-thawed ET patients than in fresh ET patients, and in the blastocyst stage than in the early cleavage stage. A significantly decreased pregnancy and live birth rate was observed in the fresh ET patients who underwent AH. In the frozen-thawed ET patients who underwent AH, improvement in the clinical pregnancy and live birth rate was not observed. Further studies on the indication and application of AH in ART treatment are required. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  10. Trends and correlates of good perinatal outcomes in assisted reproductive technology.

    Science.gov (United States)

    Joshi, Nikhil; Kissin, Dmitry; Anderson, John E; Session, Donna; Macaluso, Maurizio; Jamieson, Denise J

    2012-10-01

    To estimate trends in good perinatal outcomes (singleton live births at term with birthweight more than 2,500 g) among live births after assisted reproductive technology in the United States from 2000 to 2008, and associated factors among singletons in 2008. Using retrospective cohort data from the National Assisted Reproductive Technology Surveillance System from 2000 to 2008, we calculated relative change and χ tests for trend in the proportion of good perinatal outcomes among assisted reproductive technology live births (n=444,909) and liveborn singletons (n=222,500). We conducted univariable analyses followed by multiple logistic regression to estimate the effects of various characteristics on the outcome among singletons born in 2008 after fresh, nondonor assisted reproductive technology cycles (n=20,780). The proportion of good perinatal outcomes among all liveborn neonates increased from 38.6% in 2000 to 42.5% in 2008, whereas it declined marginally among singletons from 83.6% to 83.4%. One previous birth, transfer of fewer than three embryos, and the presence of fewer than three fetal hearts on 6-week ultrasound examination were associated with good perinatal outcome among singletons. Non-Hispanic black race, tubal factor infertility, uterine factor infertility, ovulatory disorder, and 5-day embryo culture were associated with reduced odds for a good outcome. The strongest association was the presence of one fetal heart compared with more than two (adjusted odds ratio 2.43, 95% confidence interval 1.73-3.42). From 2000 to 2008, good perinatal outcomes increased among assisted reproductive technology live births. Among singleton live births, odds for good outcome were greatest with the presence of a single fetal heart and lowest in women of non-Hispanic black race. II.

  11. Prerequsite result of routine human immunodeficiency virus serology among infertile women before assisted reproduction technology.

    Science.gov (United States)

    Osemwenkha, Abieyuwa Patricia; Ibadin, Kennedy Osegua; Akotha, Egodi Eugenia; Ibeh, Isaiah Ndubuisi

    2011-04-01

    Sexually transmitted diseases such as Human Immunodeficiency Virus (HIV) which causes or induces incurable fatal infections have been transmitted through Assisted Reproduction Technology and from infected mothers to the fetus or new born. The aim of this study is to determine the prevalence of this chronic viral agent among infertile women recruited for Assisted Reproduction Technique programme in Benin City, Nigeria. Sera (serum) from Five hundred and Ninety infertile women attending Human Reproduction Research Programme/In-vitro fertilization Center at University of Benin Teaching Hospital were screened for the presence of Human Immunodeficiency Virus antibody using three algorithm or techniques of Determine, Unigold and Stat Pack kits. The age range of the infertile women was 20-49 years. 28 (4.7%) out of Five Hundred and fifty infertile women recruited for Assisted Reproduction Technique and screened for Human Immunodeficiency Virus antibody were seropositive with increase in prevalence of 10. 0%, 8.5% and 7.5% among infertile women in age groups of (20 - 24), (25 - 29)yrs and (30 - 34)yrs. Chi-square statistical analysis of data shows insignificance in seroprevalence rate in relation to the number of infertile women screened (P > 0.0001) but the screening of these infertile women for the presence Human Immunodeficiency Virus should continue due to the attendant effects. Infertile women who are Human Immunodeficiency Virus carriers give a new dimension to assisted reproductive techniques. This will no doubt help to prevent further spread and adverse pregnancy outcome.

  12. Cervical Ectopic Pregnancy following Assisted Reproductive Technology: A Case Report

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2012-01-01

    Full Text Available Cervical ectopic pregnancy (EP is an infrequent, life-threatening form of ectopic gestationpregnancy that implants within the endocervical canal. With the increase in use of assistedreproductive technology (ART worldwide and more liberal use of transvaginal sonography (TVSduring early pregnancy, more cases of cervical ectopic pregnancy are being diagnosed. Earlydiagnosis of this condition by using ultrasound imaging allows for prevention of maternal morbiditydue to hemorrhage and leads to conservative management of this condition.We present the case ofa 38-year old woman (gravida 1, para 0 who was found to have acervical ectopic pregnancy at sixweeks of gestation.

  13. Polar bodies in assisted reproductive technology: current progress and future perspectives.

    Science.gov (United States)

    Wei, Yanchang; Zhang, Teng; Wang, Ya-Peng; Schatten, Heide; Sun, Qing-Yuan

    2015-01-01

    During meiotic cell-cycle progression, unequal divisions take place, resulting in a large oocyte and two diminutive polar bodies. The first polar body contains a subset of bivalent chromosomes, whereas the second polar body contains a haploid set of chromatids. One unique feature of the female gamete is that the polar bodies can provide beneficial information about the genetic background of the oocyte without potentially destroying it. Therefore, polar body biopsies have been applied in preimplantation genetic diagnosis to detect chromosomal or genetic abnormalities that might be inherited by the offspring. Besides the traditional use in preimplantation diagnosis, recent findings suggest additional important roles for polar bodies in assisted reproductive technology. In this paper, we review the new roles of polar bodies in assisted reproductive technology, mainly focusing on single-cell sequencing of the polar body genome to deduce the genomic information of its sibling oocyte and on polar body transfer to prevent the transmission of mtDNA-associated diseases. We also discuss additional potential roles for polar bodies and related key questions in human reproductive health. We believe that further exploration of new roles for polar bodies will contribute to a better understanding of reproductive health and that polar body manipulation and diagnosis will allow production of a greater number of healthy babies. © 2015 by the Society for the Study of Reproduction, Inc.

  14. A review of luteinising hormone and human chorionic gonadotropin when used in assisted reproductive technology

    DEFF Research Database (Denmark)

    Ezcurra, Diego; Humaidan, Peter

    2014-01-01

    Gonadotropins extracted from the urine of post-menopausal women have traditionally been used to stimulate folliculogenesis in the treatment of infertility and in assisted reproductive technology (ART). Products, such as human menopausal gonadotropin (hMG), consist not only of a mixture...... gonadotropins (r-hFSH and r-hLH) have become available for ART therapies. Recombinant LH contains only LH molecules. In the field of reproduction there has been controversy in recent years over whether r-hLH or hCG should be used for ART. This review examines the existing evidence for molecular and functional...

  15. Cancer in children and young adults born after assisted reproductive technology

    DEFF Research Database (Denmark)

    Sundh, Karin Jerhamre; Henningsen, Anna-Karina A; Källen, Karin

    2014-01-01

    STUDY QUESTION: Do children and young adults born after assisted reproductive technology (ART) have an increased risk of cancer? SUMMARY ANSWER: Children born after ART showed no overall increase in the rate of cancer when compared with children born as a result of spontaneous conception. WHAT...... with ART. STUDY FUNDING/COMPETING INTERESTS: No conflict of interest was reported. The study was supported by grants from The European Society for Human Reproduction and Embryology (ESHRE), Sahlgrenska University Hospital, Gothenburg, Sweden, the University of Copenhagen, Denmark, the Danish Agency...

  16. Global cultural and socioeconomic factors that influence access to assisted reproductive technologies.

    Science.gov (United States)

    Adamson, G David

    2009-07-01

    Assisted reproductive technology (ART) is the most successful treatment for the 9% of people at reproductive age who suffer with infertility, but only a small percentage of those needing ART actually access it. Access varies greatly internationally owing to religious, cultural and political factors, probably the most important factor being each society's perspective on the moral status of the embryo. Economic factors, the nature of the healthcare system and public funding affect access both among and within countries. Regulations and guidelines are highly variable, but critical, in determining access and types of services. Cross-border travel for reproductive care is not uncommon. In the future, better public funding of ART, technological improvements, lower cost and slow international harmonization with fewer differences in ART services will probably increase access significantly.

  17. “Living each week as unique” : maternal fears in Assisted Reproductive Technology pregnancies

    OpenAIRE

    Dornelles, Lia Mara; MacCallum, Fiona; Lopes, Rita; Piccinini, Cesar Augusto; Passos, Eduardo

    2014-01-01

    Objective:\\ud to explore women's fears during pregnancy following conception via assisted reproductive technology (ART).\\ud \\ud Methods:\\ud 19 expectant first-time mothers were interviewed during the third trimester of pregnancy using a semi-structured schedule. Perceptions of and feelings about pregnancy were assessed. Content analysis was used to identify themes and subthemes.\\ud \\ud Findings:\\ud four overarching themes emerged: the baby's survival, the health of the baby, the efficacy of t...

  18. Infertility and assisted reproductive technology: the role of the perinatal social worker.

    Science.gov (United States)

    Greenfeld, D A

    1997-01-01

    The inability to conceive a pregnancy can cause disruption and anguish to individuals and couples sharing that experience. The treatments for infertility, especially those involving assisted reproductive technology such as in vitro fertilization, can be physically, financially and emotionally stressful for participants. The impact of infertility and its treatment has introduced a new venue for perinatal social worker services to counsel, educate and support these patients.

  19. The Role of Varicocele Repair in the New Era of Assisted Reproductive Technology

    OpenAIRE

    Cocuzza, Marcello; Cocuzza, Mariana Amora; Bragais, Frances Monette Papa; Agarwal, Ashok

    2008-01-01

    Infertility affects 10-15% of couples who are trying to conceive, and half of the cases are due to male infertility. Intracytoplasmic sperm injection is increasingly being used to overcome multiple sperm deficiencies. Due to its effectiveness, some have proposed ICSI as a solution for all cases of male infertility, regardless of the cause. Hence, even men with potentially treatable causes of infertility have sought the aid of assisted reproductive technology, rather than undergo specific ther...

  20. Assisted reproductive techniques.

    Science.gov (United States)

    Huang, Jack Yu Jen; Rosenwaks, Zev

    2014-01-01

    Assisted reproductive technologies (ART) encompass fertility treatments, which involve manipulations of both oocyte and sperm in vitro. This chapter provides a brief overview of ART, including indications for treatment, ovarian reserve testing, selection of controlled ovarian hyperstimulation (COH) protocols, laboratory techniques of ART including in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), embryo transfer techniques, and luteal phase support. This chapter also discusses potential complications of ART, namely ovarian hyperstimulation syndrome (OHSS) and multiple gestations, and the perinatal outcomes of ART.

  1. Protection for Children Born Through Assisted Reproductive Technologies Act, B.E. 2558: The Changing Profile of Surrogacy in Thailand.

    Science.gov (United States)

    Stasi, Alessandro

    2017-01-01

    The National Legislative Assembly of Thailand has enacted on February 19, 2015 the Protection for Children Born through Assisted Reproductive Technologies Act (ART Act). Its primary objective aims at protecting children born through assisted reproductive technologies and providing the legal procedures that the intended parents must follow. The focus of this article is to discuss the ongoing issues involving assisted reproduction in Thailand. After reviewing the past legal framework surrounding surrogate motherhood and the downsides of the assisted reproductive technology market in Thailand, the article will discuss the new ART Act and its regulatory framework. It will conclude that although the new law contains some flaws and limitations, it has so far been successful in tackling surrogacy trafficking and preventing reproductive scandals from occurring again.

  2. Protection for Children Born Through Assisted Reproductive Technologies Act, B.E. 2558: The Changing Profile of Surrogacy in Thailand

    Directory of Open Access Journals (Sweden)

    Alessandro Stasi

    2017-12-01

    Full Text Available The National Legislative Assembly of Thailand has enacted on February 19, 2015 the Protection for Children Born through Assisted Reproductive Technologies Act (ART Act. Its primary objective aims at protecting children born through assisted reproductive technologies and providing the legal procedures that the intended parents must follow. The focus of this article is to discuss the ongoing issues involving assisted reproduction in Thailand. After reviewing the past legal framework surrounding surrogate motherhood and the downsides of the assisted reproductive technology market in Thailand, the article will discuss the new ART Act and its regulatory framework. It will conclude that although the new law contains some flaws and limitations, it has so far been successful in tackling surrogacy trafficking and preventing reproductive scandals from occurring again.

  3. Assisted reproductive technology in Europe, 2012: results generated from European registers by ESHREaEuro

    DEFF Research Database (Denmark)

    Calhaz-Jorge, C.; De Geyter, C.; Kupka, M. S.

    2016-01-01

    1997, ART data in Europe have been collected and re-ported in 15 manuscripts, published in Human Reproduction. Retrospective data collection of European ART data by the EIM Consortium for the European Society of Human Reproduction and Embryology (ESHRE). Data for cycles between 1 January and 31......The 16th European IVF-monitoring (EIM) report presents the data of the treatments involving assisted reproductive technology (ART) and intrauterine insemination (IUI) initiated in Europe during 2012: are there any changes compared with previous years? Despite some fluctuations in the number...... of countries reporting data, the overall number of ART cycles has continued to increase year by year, the pregnancy rates (PRs) in 2012 remained stable compared with those reported in 2011, and the number of transfers with multiple embryos (3+) and the multiple delivery rates were lower than ever before. Since...

  4. New frontiers of assisted reproductive technology (Chien Tien Hsu Memorial Lecture 2007).

    Science.gov (United States)

    Ho, P C

    2009-02-01

    Many significant advances have been made in assisted reproductive technology since the birth of the first baby conceived with in vitro fertilization and embryo transfer. The development of recombinant gonadotropins and gonadotropin releasing hormone antagonists helps to simplify the ovarian stimulation. Excessive ovarian stimulation should be avoided because of the risks of ovarian hyperstimulation syndrome and reduction in endometrial receptivity. Maturation of oocytes in vitro has been developed in some centers. It is still uncertain whether techniques such as assisted hatching, blastocyst transfer and pre-implantation aneuploidy screening can improve the live birth rates in assisted reproduction. The introduction of pre-implantation genetic diagnosis for selection of human lymphocyte antigens (HLA) compatible embryos for treatment of siblings has raised ethical concerns. There is a higher risk of obstetric complications and congenital abnormalities even in singleton pregnancies achieved with assisted reproduction. Because of the risks of multiple pregnancies, elective single embryo transfer is increasingly used in good-prognosis patients. With a good freezing program, the cumulative pregnancy rate (including the pregnancies from subsequent replacement of frozen-thawed embryos) is not adversely affected. Improvement in cryopreservation techniques has made it possible to cryopreserve slices of ovarian tissue or oocytes, thus helping women who have to receive sterilizing forms of anti-cancer treatment to preserve their fertility. It is important that the development of the new techniques should be based on good scientific evidence. Ethical, legal and social implications should also be considered before the introduction of new techniques.

  5. A comparative analysis of assisted reproductive technology cycles in Australia and New Zealand 2004-2007.

    Science.gov (United States)

    Farquhar, C M; Wang, Y A; Sullivan, E A

    2010-09-01

    There are different funding arrangements for fertility treatments between New Zealand (NZ) and Australia. In NZ, there are two options for patients accessing treatment: either meeting specified criteria for age, no smoking and BMI for publicly funding or funding their own treatment. This differs from Australia, which has no explicit eligibility criteria restricting access to fertility treatment. An analysis of assisted reproductive technology (ART) in Australia and NZ was undertaken to consider the impact of these different funding approaches. Data were extracted from the Australian and New Zealand Assisted Reproduction Database between 2004 and 2007. A total of 116 111 autologous fresh cycles were included. In Australia, more cycles were in women aged 40 years or older compared with those in NZ (23.5 versus 16.0%, P Single embryo transfer was more common in NZ than that in Australia, in women women women undergoing treatment and may explain the improved pregnancy outcomes seen in NZ couples who undergo fertility treatments.

  6. Comparison of three infertility-specific measures in men and women going through assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Pedro, Juliana; Frederiksen, Yoon; Schmidt, Lone

    2017-01-01

    We compared the psychometric properties of COMPI Fertility Problem Stress Scales, Fertility Problem Inventory, and Fertility Quality of Life Tool in 293 patients enrolled for assisted reproductive technology. COMPI Fertility Problem Stress Scales and Fertility Problem Inventory subscales presented...

  7. Assisted Reproductive Technologies (ART) with Baboons Generate Live Offspring: A Nonhuman Primate Model for ART and Reproductive Sciences

    Science.gov (United States)

    Simerly, Calvin R.; Castro, Carlos A.; Jacoby, Ethan; Grund, Kevin; Turpin, Janet; McFarland, Dave; Champagne, Jamie; Jimenez, Joe B.; Frost, Pat; Bauer, Cassandra; Hewitson, Laura; Schatten, Gerald

    2012-01-01

    Human reproduction has benefited significantly by investigating non-human primate (NHP) models, especially rhesus macaques. To expand the Old World monkey species available for human reproductive studies, we present protocols in baboons, our closest Old World primate relatives, for Assisted Reproductive Technologies (ART) leading to live-born offspring. Baboons complement rhesus by confirming or modifying observations generated in humans often obtained by the study of clinically-discarded specimens donated by anonymous infertility patient-couples. Here, baboon ART protocols, including oocyte collection, in vitro fertilization, intracytoplasmic sperm injection (ICSI), preimplantation development to blastocyst stage and embryo transfer techniques are described. With baboon ART methodologies in place, motility during baboon fertilization was investigated by time-lapse video microscopy. The first ART baboons produced by ICSI, a pair of male twins, were delivered naturally at 165 days post-gestation. Genetic testing of these twins confirmed their ART parental origins and demonstrated that they are unrelated fraternal twins, not identicals. These results have implications for ART outcomes, embryonic stem cell derivation, and reproductive sciences. PMID:20631291

  8. "It just alienated us": a case study to explore the impact of assisted reproductive technology on family relationships.

    Science.gov (United States)

    Peters, Kathleen; Jackson, Debra; Rudge, Trudy

    2007-01-01

    New reproductive technologies have the capacity to impact on both personal and healthcare relationships. This article utilizes a case study approach to unpack experiences of one couple who encountered immense and unforeseen difficulties as a result of treatment with assisted reproductive technology. Findings of this case reveal both difficulties and breaches in obtaining informed consent and the consequences these breaches have on relationships. Comprehensive information contributes to positive relationships between patients and healthcare providers. Maintaining supportive relationships between all parties concerned with assisted reproductive technology services is essential, as rifts in these relationships can be devastating and long-lasting.

  9. High incidence of monozygotic twinning after assisted reproduction is related to genetic information, but not to assisted reproduction technology itself.

    Science.gov (United States)

    Sobek, Aleš; Zbořilová, Blažena; Procházka, Martin; Šilhánová, Eva; Koutná, Olga; Klásková, Eva; Tkadlec, Emil; Sobek, Aleš

    2015-03-01

    To study the incidence of monozygotic twinning (MZT) in patients using in vitro fertilization, relative to their age, genetic background, ovarian function, and assisted reproductive techniques used. Analysis of a collected database. Infertility treatment center. A total of 1,876 patients receiving infertility treatment between 2000 and 2012. Pregnancies with monozygotic twins (A: 23) were compared with deliveries of dizygotic twins (B: 423), singleton pregnancies (C: 880), and aborted pregnancies (D: 389). None. A genetic survey on multiple pregnancies in the extended family. Measures were micromanipulation technique, the length of embryo cultivation, type of cultivation media, basal follicle-stimulating hormone level, estradiol level on the day of human chorionic gonadotropin administration, number of oocytes, total consumption of gonadotropins, and consumption of gonadotropins needed for recovery of 1 oocyte. No differences were found between the incidence of MZT in cycles that did vs. did not use micromanipulation techniques. In addition, the length of embryo cultivation or type of cultivation media used did not affect the results. Estradiol levels and implantation rates were significantly higher in group A. The incidence of MZT in families in group A was significantly higher than that in groups B and C. We propose that the high incidence of MZT in infertility-clinic patients is conditioned by hereditary factors, and good ovarian function only facilitates the expression. The resulting recommendation is that young women with a positive family history and good ovarian function undergo elective single-embryo transfer, and proper counseling is advisable. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Assisted reproductive technologies in Latin America: the Latin American Registry, 2012.

    Science.gov (United States)

    Zegers-Hochschild, Fernando; Schwarze, Juan Enrique; Crosby, Javier A; Musri, Carolina; do Carmo Borges de Souza, Maria

    2015-01-01

    Multinational data on assisted reproduction technologies were collected from 155 institutions in 14 Latin American countries during 2012. Case-by-case data included 47,326 assisted reproduction technology cycles covering over 80% of cycles carried out in Latin America. Treatments included IVF, intracytoplasmic sperm injection (ICSI), frozen embryo transfers, oocyte donations and fertility preservation. Embryo transfer and IVF-ICSI was carried out in 39% of women aged 35-39 years and 31% of women aged 40 years or over. Delivery rate per oocyte retrieval was 20.9% for ICSI and 26.5% for IVF. Multiple births comprised 20.6% twins and 1.2% triplets and over. In oocyte donations, twins reached 27.8% and triplets and over 2.4%. Pre-term births in singletons were 14%. The relative risk of prematurity increased by 4.30 (95% CI 4.1 to 4.6) in twins and 43.8 (95% CI 28.5 to 67.4) in triplets and higher. Perinatal mortality increased from 25.2 per thousand in singletons to 44.4 in twins and 80.7 in triplets and over. Elective single embryo transfer was carried out in only 1.4%, of cycles, with a delivery rate of 30% in women 34 years or younger, and should be considered the way forward provided access is facilitated with public funding. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Application of failure mode and effect analysis in an assisted reproduction technology laboratory.

    Science.gov (United States)

    Intra, Giulia; Alteri, Alessandra; Corti, Laura; Rabellotti, Elisa; Papaleo, Enrico; Restelli, Liliana; Biondo, Stefania; Garancini, Maria Paola; Candiani, Massimo; Viganò, Paola

    2016-08-01

    Assisted reproduction technology laboratories have a very high degree of complexity. Mismatches of gametes or embryos can occur, with catastrophic consequences for patients. To minimize the risk of error, a multi-institutional working group applied failure mode and effects analysis (FMEA) to each critical activity/step as a method of risk assessment. This analysis led to the identification of the potential failure modes, together with their causes and effects, using the risk priority number (RPN) scoring system. In total, 11 individual steps and 68 different potential failure modes were identified. The highest ranked failure modes, with an RPN score of 25, encompassed 17 failures and pertained to "patient mismatch" and "biological sample mismatch". The maximum reduction in risk, with RPN reduced from 25 to 5, was mostly related to the introduction of witnessing. The critical failure modes in sample processing were improved by 50% in the RPN by focusing on staff training. Three indicators of FMEA success, based on technical skill, competence and traceability, have been evaluated after FMEA implementation. Witnessing by a second human operator should be introduced in the laboratory to avoid sample mix-ups. These findings confirm that FMEA can effectively reduce errors in assisted reproduction technology laboratories. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Survey assessing obesity policies for assisted reproductive technology in the United States.

    Science.gov (United States)

    Kaye, Leah; Sueldo, Carolina; Engmann, Lawrence; Nulsen, John; Benadiva, Claudio

    2016-03-01

    To determine what assisted reproductive technologies (ART) policies, if any, have been instituted in response to an increasingly overweight and obese patient population. Cross-sectional survey. University-affiliated IVF clinic. Women in the overweight and obese body mass index (BMI) categories seeking ART treatments. Anonymous survey sent to medical directors at 395 IVF centers listed in Society for Assisted Reproductive Technology database. Assessment of recommendations, policies, and restrictions for patients who are overweight/obese and who desire treatment for infertility, including in IVF, IUI, and donor egg cycles. Seventy-seven anonymous responses were received (19.5% response rate): 64.9% of centers have a formal policy for obesity, and 84% of those have a maximum BMI at which they will perform IVF, while 38% of those have a maximum BMI for performing IUI; 64.6% of respondents reported anesthesia requirements/concerns as the primary criteria for patient exclusion. Other primary considerations included safety during ongoing pregnancy and ART outcomes. Centers that have policies regarding obesity and access to ART consider efficacy, procedural safety, safety in pregnancy, and overall health status. Policies vary widely. The patient's autonomy must be balanced with nonmaleficence and the avoidance of interventions that may be unsafe both immediately and long term. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Globalisation of birth markets: a case study of assisted reproductive technologies in India

    Directory of Open Access Journals (Sweden)

    Sarojini Nadimpally

    2011-08-01

    Full Text Available Abstract The escalation of Assisted Reproductive Technologies (ARTs in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality. This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies

  14. Globalisation of birth markets: a case study of assisted reproductive technologies in India.

    Science.gov (United States)

    Sarojini, Nadimpally; Marwah, Vrinda; Shenoi, Anjali

    2011-08-12

    The escalation of Assisted Reproductive Technologies (ARTs) in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality.This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies, particularly policy

  15. Globalisation of birth markets: a case study of assisted reproductive technologies in India

    Science.gov (United States)

    2011-01-01

    The escalation of Assisted Reproductive Technologies (ARTs) in India into a veritable fertility industry is the result of a multitude of reasons. This paper places the bio-genetic industry within the larger political economy framework of globalisation and privatisation, thus employing a framework that is often omitted from discussions on ARTs, but has direct and significant bearings on the ART industry in India. As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality. This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, actors and collaborations in the field, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting unethical medical practices and making a case for the regulation of the ART industry. As such, it forms a significant part of Sama's ongoing work on women and technologies, particularly policy

  16. Trends over time in congenital malformations in live-born children conceived after assisted reproductive technology

    DEFF Research Database (Denmark)

    Henningsen, Anna-Karina Aaris; Bergh, Christina; Skjaerven, Rolv

    2018-01-01

    INTRODUCTION: Children born after assisted reproductive technology (ART), particularly singletons, have been shown to have an increased risk of congenital malformations compared with children born after spontaneous conception. We wished to study if there has been a change in the risk of major...... spontaneous conception during the study period. The relative risk of being born with a major congenital malformation between all ART children and spontaneous conception children remained similar through all four time periods, p=0.39. However, we found that over time the number of children diagnosed...

  17. Low birth weight: Is it related to assisted reproductive technology or underlying infertility?

    Science.gov (United States)

    Kondapalli, Laxmi A.; Perales-Puchalt, Alfredo

    2013-01-01

    Since 1978, we have witnessed a successful evolution of assisted reproductive technology (ART), with improvement of the pregnancy rates and a growing demand. However, in recent years, there has been increasing concern regarding its safety due to the potential health impact on its infants. The raise of the developmental origins of adult disease has positioned low birth weight (LBW) as a significant health issue. Despite multiple studies have associated ART with LBW, the etiology of this association remains largely unknown. This paper reviews the potential association between different components of ART and infertility with LBW, while acknowledging the limitations to interpretation of the existing literature. PMID:23375144

  18. The role of steroid hormone supplementation in non-assisted reproductive technology treatments for unexplained infertility.

    Science.gov (United States)

    Quaas, Alexander M; Hansen, Karl R

    2016-12-01

    Fertility treatment strategies are evolving, with a more rapid transition to assisted reproductive technology (ART) treatments after unsuccessful non-ART treatments. This trend increases the potential importance of adjuvant treatments in non-ART cycles, such as steroid hormone supplementation. It has been established that success rates of ART treatments are increased with the use of luteal support with progesterone. In the setting of non-ART cycles, however, the evidence is less clear, and clinical practices vary widely between providers and clinics. In this review, we aimed to provide an overview of the current evidence for the use of steroid hormone supplementation, including progesterone for luteal support, estrogens, androgens, and mineralocorticoids, in the setting of non-ART treatments for ovulatory women. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Intrauterine demise due to congenital mesoblastic nephroma in a fetus conceived by assisted reproductive technology.

    Science.gov (United States)

    De Paepe, Monique E; Shapiro, Svetlana; Young, Lawrence; Carr, Stephen R; Gundogan, Fusun

    2011-03-01

    To report a case of antenatally diagnosed congenital mesoblastic nephroma in an assisted reproductive technology (ART) conception. Case report. Tertiary care university-affiliated hospital. Fetus of 26-weeks' gestation with antenatally diagnosed large abdominal tumor. ART with transfer of cryopreserved embryo. Postmortem examination. Examination revealed a congenital mesoblastic nephroma, mixed classic and cellular type, with marked intratumoral hemorrhage and associated hydrops. The marked fetal erythroblastosis was suggestive of fetal response to pronounced anemia. Intrauterine demise is attributed to fetal intratumoral hemorrhage and early nonimmune hydrops secondary to a large congenital mesoblastic nephroma. This is the third reported case of congenital mesoblastic nephroma in an ART conception. Whether the association between mesoblastic nephroma and ART is coincidental or causative remains to be determined. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Assisted reproductive technology and the risk of preterm birth among primiparas.

    Science.gov (United States)

    Dunietz, Galit Levi; Holzman, Claudia; McKane, Patricia; Li, Chenxi; Boulet, Sheree L; Todem, David; Kissin, Dmitry M; Copeland, Glenn; Bernson, Dana; Sappenfield, William M; Diamond, Michael P

    2015-04-01

    To investigate the risk of preterm birth among liveborn singletons to primiparas who conceived with assisted reproductive technology (ART) using four mutually exclusive categories of infertility (female infertility only, male infertility only, female and male infertility, and unexplained infertility) and to examine preterm birth risk along the gestational age continuum. Retrospective cohort study. Not applicable. Singletons born to primiparas who conceived with or without ART. None. Preterm (risk for preterm birth, even when only the male partner had been diagnosed with infertility. The risk of preterm birth for ART-conceived infants whose mothers were diagnosed with infertility included the earliest deliveries. Copyright © 2015 American Society for ReproductiveMedicine. All rights reserved.

  1. Provision of assisted reproductive technology for single women in China: a new challenge.

    Science.gov (United States)

    Zhou, Ling Jing

    2004-01-01

    Following the enactment of the Jilin Regulation, single women, for the first time, are allowed to access assisted reproductive services in China. This paper is intended to analyze the arguments over whether single women are entitled to access assisted reproductive services, in relation to Chinese legal, ethical and social characteristics.

  2. Should older and postmenopausal women have access to assisted reproductive technology?

    Science.gov (United States)

    Goold, Imogen

    2005-01-01

    In vitro fertilisation and other assisted reproductive technologies (ART) now enable many women to have children, who would otherwise have remained childless. The most obvious application for these technologies is to help physically infertile, but otherwise healthy young women to have children. However, increasingly, other groups are seeking access to ART to conceive, raising ethical questions about who should be allowed to use these technologies to bear children. In particular, the question of access to ART by lesbian couples and single groups has roused considerable ethical, legal and public debate. This paper examines the perhaps less often considered issue of older and postmenopausal women, who are infertile due to age, using ART to conceive. A range of objections have been made to allowing these women access to ART, including concerns about their ability to care for the child, the risk of birth defects and the 'unnaturalness' of extending childbearing capacity beyond the menopause. This paper examines these objects and provides some responses.

  3. Advanced maternal age: ethical and medical considerations for assisted reproductive technology.

    Science.gov (United States)

    Harrison, Brittany J; Hilton, Tara N; Rivière, Raphaël N; Ferraro, Zachary M; Deonandan, Raywat; Walker, Mark C

    2017-01-01

    This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs) make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved. A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical) were included in the review. There are significant ethical considerations and medical (maternal and fetal) complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old). This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a pregnancy with a similar risk profile to that of her younger counterparts when using donated oocytes.

  4. A retrospective study of the effect of increasing age on success rates of assisted reproductive technology.

    Science.gov (United States)

    O'Brien, Yvonne M; Ryan, Michael; Martyn, Fiona; Wingfield, Mary B

    2017-07-01

    To demonstrate the effect of increasing age on the outcome of assisted reproductive technology, particularly among women aged 40 years or older. A retrospective analysis was conducted using prospectively collected data for all in vitro fertilization and intracytoplasmic sperm injection cycles among women aged 30-35 years or 40-44 years conducted at Merrion Fertility Clinic, Dublin, Ireland, between January 1, 2010, and December 31, 2014. The relationship between age and treatment outcome was assessed. Among women aged 30-35 years, 726 cycles led to 281 (38.7%) clinical pregnancies and 242 (33.3%) live births. By contrast, among women aged 40-44 years, 433 cycles led to 102 (23.6%) clinical pregnancies and 64 (14.8%) live births (both Ptechnology are decreased among women aged older than 40 years. Fertility clinics have a responsibility to fully inform this group about the limitations of assisted reproductive technology. © 2017 International Federation of Gynecology and Obstetrics.

  5. Assisted reproductive technology in India: A 3 year retrospective data analysis

    Directory of Open Access Journals (Sweden)

    Narendra Malhotra

    2013-01-01

    Full Text Available Assisted reproductive technology (ART has grown by leaps and bounds in the last few years. India has one of the highest growths in the ART centers and the number of ART cycles performed every year. Very soon India will be the leader in the world of ART in terms of a number of cycles. With the advances of technology and availability of techniques even in tier II and tier III cities our country, the results still vary dramatically. There is no standardization of protocols and reporting is very inadequate. Furthermore, there are only ART guidelines and no law still exists. Our first and the biggest challenge is to document the tremendous work being done in India and on the basis of analysis of this work, a proper registry can be made and guidance given to all on standardization and improvement. This is the 8 th edition of National ART Registry of India being presented and analyzed.

  6. Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

    Science.gov (United States)

    Toth, Thomas L; Lee, Malinda S; Bendikson, Kristin A; Reindollar, Richard H

    2017-04-01

    To better understand practice patterns and opportunities for standardization of ET. Cross-sectional survey. Not applicable. Not applicable. An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled. The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET. There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed technique. Multiple steps in the ET process were identified as "highly conserved;" others demonstrated discordance. ET technique is divided among [1] trial transfer followed immediately with ET (40%); [2] afterload transfer (30%); and [3] direct transfer without prior trial or afterload (27%). Embryos are discharged in the upper (66%) and middle thirds (29%) of the endometrial cavity and not closer than 1-1.5 cm from fundus (87%). Details of each step were reported and allowed the development of a "common" practice ET procedure. ET training and practices vary widely. Improved training and standardization based on outcomes data and best practices are warranted. A common practice procedure is suggested for validation by a systematic literature review. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment.

    Science.gov (United States)

    Stern, Judy E; Luke, Barbara; Tobias, Michael; Gopal, Daksha; Hornstein, Mark D; Diop, Hafsatou

    2015-06-01

    To compare the risks for adverse pregnancy and birth outcomes by diagnoses with and without assisted reproductive technology (ART) treatment to non-ART pregnancies in fertile women. Historical cohort of Massachusetts vital records linked to ART clinic data from Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Not applicable. Diagnoses included male factor (ART only), endometriosis, ovulation disorders, tubal (ART only), and reproductive inflammatory disorders (non-ART only). Pregnancies resulting in singleton and twin live births from 2004 to 2008 were linked to hospital discharges in women who had ART treatment (n = 3,689), women with no ART treatment in the current pregnancy (n = 4,098), and non-ART pregnancies in fertile women (n = 297,987). None. Risks of gestational diabetes, prenatal hospitalizations, prematurity, low birth weight, and small for gestational age were modeled using multivariate logistic regression with fertile deliveries as the reference group adjusted for maternal age, race/ethnicity, education, chronic hypertension, diabetes mellitus, and plurality (adjusted odds ratios [AORs] and 95% confidence intervals [CIs]). Risk of prenatal hospital admissions was increased for endometriosis (ART: 1.97, 1.38-2.80; non-ART: 3.34, 2.59-4.31), ovulation disorders (ART: 2.31, 1.81-2.96; non-ART: 2.56, 2.05-3.21), tubal factor (ART: 1.51, 1.14-2.01), and reproductive inflammation (non-ART: 2.79, 2.47-3.15). Gestational diabetes was increased for women with ovulation disorders (ART: 2.17, 1.72-2.73; non-ART: 1.94, 1.52-2.48). Preterm delivery (AORs, 1.24-1.93) and low birth weight (AORs, 1.27-1.60) were increased in all groups except in endometriosis with ART. The findings indicate substantial excess perinatal morbidities associated with underlying infertility-related diagnoses in both ART-treated and non-ART-treated women. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Association between ovarian stimulators with or without intrauterine insemination, and assisted reproductive technologies on multiple births.

    Science.gov (United States)

    Chaabane, Sonia; Sheehy, Odile; Monnier, Patricia; Bissonnette, François; Trasler, Jacquetta M; Fraser, William; Bérard, Anick

    2015-10-01

    We sought to quantify the risk of multiple births associated with the use of different modalities of medically assisted reproduction. We conducted a case-control study using a birth cohort from 2006 through 2009. This cohort was built with the linkage of data obtained by a self-administered questionnaire and medical, hospital, pharmaceutical, birth, and death databases in Quebec. Cases were pregnancies resulting in multiple live births (International Classification of Diseases, Ninth Revision/International Statistical Classification of Diseases, 10th Revision codes). Each case was matched, on maternal age and year of delivery, with 3 singleton pregnancies (controls) randomly selected among all Quebec singleton pregnancies. Data on the use of different fertility treatments were collected by a self-administered questionnaire. Multiple logistic regression models, adjusted for body mass index, number of previous live births, ethnicity, family income, place of residence, marital status, subfertility, reduction of embryos, diabetes, metformin treatment, folic acid supplementation, and lifestyle factors, were used to calculate the odds ratios (ORs) and confidence intervals (CIs). We evaluated the associations between each type of fertility treatment (ovarian stimulators used alone, intrauterine insemination [IUI] used with ovarian stimulation, and assisted reproductive technologies [ART]) and the risk of multiple births. A total of 1407 cases of multiple births and 3580 controls were analyzed. More than half of multiple births following medically assisted reproduction (53.6%) occurred among women having used ovarian stimulation with or without IUI. The use of ovarian stimulators alone and IUI with ovarian stimulation increase the risk of multiple births (adjusted OR, 4.5; 95% CI, 3.2-6.4; and adjusted OR, 9.32; 95% CI, 5.60-15.50, respectively) compared to spontaneous conception. The use of invasive ART was associated with a greatly increased risk of multiple births

  9. Cost-effectiveness of varicocele surgery in the era of assisted reproductive technology

    Directory of Open Access Journals (Sweden)

    Kelly A Chiles

    2016-01-01

    Full Text Available The advent of innovative techniques for addressing infertility has made for exciting times in the arena of andrology. The success of microTESE for retrieving sperm has enabled azoospermic men to have the opportunity to father biological children when it was previously impossible. The ability to offer a variety of assisted reproductive techniques that includes intracytoplasmic sperm injection has opened the door for couples with male factor infertility who were otherwise untreatable. With the multitude of options available to infertile couples, however, comes an unsurprising degree of controversy regarding what treatments should be offered and when. Complicating the picture is the question of if and when varicocele repair should be undertaken, and the financial implications of the treatment decisions that are made. The infertile couple with varicocele warrants careful consideration. The overall efficacy of varicocele repair as well as cost-effectiveness of repair compared to immediate microTESE in azoospermic men and assisted reproductive technology in men with suboptimal semen parameters will be reviewed.

  10. [Opinion survey on the use of assisted reproductive technologies applied to inhabitants of Santiago, Chile].

    Science.gov (United States)

    Herrera, Florencia; Teitelbom, Berta; Russo, Moisés; Salas, Sofía P; Zegers Hochschild, Fernando

    2013-07-01

    Advances in reproductive medicine and the use of assisted reproductive technologies (ART) have a great impact in the lives of people and the conformation of their families. To report the results of an opinion survey applied to inhabitants of Santiago, Chile about the use of ART to conceive. A survey was designed and applied to a random representative sample of 1.500 people between the ages of 18 and 65 in the 34 municipalities of Santiago. Eighty eight percent of respondents support the use of medical assistance to conceive children. Wide approval exists for the use of in vitro fertilization (IVF) by heterosexual couples, even when not married (85.9%) and by single women (70.4%), by both mole and female participants of every socioeconomic level, age group and religious affiliation. Support decreases significantly when the use of IVF is considered for post-menopausal women (35.1 %) and by same-sex couples (26.6%). Results of this survey indicate that the majority of inhabitants in Santiago favor the use of ART, including IVF. This support decreases significantly for elderly women and homosexual couples.

  11. Neonatal outcome following new assisted reproductive technology regulations in Turkey - a nationwide multicenter point prevalence study.

    Science.gov (United States)

    Kultursay, Nilgun; Yalaz, Mehmet; Koroglu, Ozge Altun

    2015-01-01

    In March 2010, a new legislation about assisted reproductive technology (ART) activities, favoring single embryo transfer, was introduced in Turkey. Consequences of new regulations on neonatal outcome have not been evaluated in multicenter studies yet. In this study, our aim was to evaluate neonatal outcome of infants from medically assisted reproduction (MAR) pregnancies in the post-legislation era. A point prevalence study was conducted at 51 centers in Turkey on 1 April 2013. Data about fertility treatments and neonatal characteristics were evaluated for "live births" (Group 1) and "patients being cared in the NICU" (Group 2). Seventeen (4%) of 420 infants in group 1, and 89 (8.1%) of 1094 infants in group 2 were born after MAR pregnancies. The ratio of multiple births in MAR pregnancies was still very high as 47.1% for group 1, 69.1% for group 2 infants. MAR babies constituted 9.9% of infants in Level 3 NICUs and 7.6% infants in Level 2 NICUs. MAR was associated with increased risk of multiple births and prematurity. After the new legislation, multiple birth rates are still high in MAR pregnancies, resulting in unfavorable neonatal outcomes. Efforts to decrease multiple birth rates should be encouraged.

  12. Yoga Can Improve Assisted Reproduction Technology Outcomes in Couples With Infertility.

    Science.gov (United States)

    Darbandi, Sara; Darbandi, Mahsa; Khorram Khorshid, Hamid Reza; Sadeghi, Mohammad Reza

    2017-11-07

    Context • Depending on the cause of the infertility, nonsurgical or surgical treatments may be used to treat men and women with infertility. Despite improved outcomes due to medical advances, assisted reproductive technology (ART) for couples with infertility is sometimes unsuccessful. Success may be affected by the patient's social, psychological, and physical status. Objective • The study examined the effects of yoga-including asanas (yoga poses), pranayama (proper breathing), shavasana, and meditation-on male and female fertility and ART outcomes. Design • The research team performed a literature review, electronically searching for articles published between January 1978 and January 2016 in the PubMed, Scopus, ScienceDirect, and Google Scholar databases. Setting • The study took place at the Reproductive Biotechnology Research Center at the Avicenna Research Institute at the Academic Center for Education, Culture, and Research (Tehran, Iran). Participants • Participants were couples with infertility taking part in 87 reviewed studies. Intervention • Yoga was the intervention. Outcome Measures • The outcome measures comprised fertility factors in males and females, fertility rate, and ART success rate. Results • The reviewed studies showed that yoga can provide stress management for patients with infertility, with beneficial effects on fertility, helping couples give birth. They found that yoga also could reduce pain; decrease depression, anxiety, and stress; reduce the rate of assisted vaginal delivery; and improve fetal outcomes. Conclusions • Yoga can help couples overcome infertility and increase the ART success rate by improving the physiological and psychological states of both men and women.

  13. Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE

    DEFF Research Database (Denmark)

    de Mouzon, J; Goossens, V; Bhattacharya, S

    2010-01-01

    In this 10th European IVF-monitoring (EIM) report, the results of assisted reproductive techniques from treatments initiated in Europe during 2006 are presented. Data were mainly collected from existing national registers.......In this 10th European IVF-monitoring (EIM) report, the results of assisted reproductive techniques from treatments initiated in Europe during 2006 are presented. Data were mainly collected from existing national registers....

  14. Responding to Requests for Assisted Reproductive Technology Intervention Involving Women Who Cannot Give Consent.

    Science.gov (United States)

    Bard, Jennider S; Penrose, Lindsay

    2015-01-01

    One of the plots of the Canadian science fiction thriller Orphan Black involves a scheme to create dozens of siblings by harvesting the eggs of one woman, fertilizing them with the sperm of a single man, and implanting them for gestation in dozens of apparently willing surrogates.¹ The casualness of the procedure speaks to how comfortable we have all become with reproduction by technology. Yet there are still aspects of this process that remain outside the normative boundaries of most of our worldviews. This article considers recent advances in assisted reproductive technology (ART) that can result in a viable, fertilized embryo even when the mother is herself either permanently unconscious from a severe injury or has actually lost all brain function and therefore meets the legal criteria for brain death. It reviews these advances and applies them to four scenarios, or vignettes, that represent different concerns about the prospective mother’s intent to reproduce before losing her ability to give consent.

  15. SIAMS survey on sexological screening during the assisted reproductive technologies in Italy.

    Science.gov (United States)

    Ciocca, G; Limoncin, E; Mollaioli, D; Gravina, G L; Carosa, E; Di Sante, S; Gianfrilli, D; Lombardo, F; Lenzi, A; Jannini, E A

    2015-09-01

    The assessment of sexual function is fundamental to the Assisted Reproductive Technology (ART). Nevertheless, it is still not a common clinical routine among infertility centres. The aim of this survey is to describe the main aspects of sexological screening that are considered in Italian centres of ART. After the consensus of the Italian Society of Andrology and Sexual Medicine (SIAMS), a mailing list of reproductive medicine centres was created. Then, we sent a questionnaire concerning the essential characteristics of sexological screening. The respondents to compilers of the questionnaire sent back the information from their centres, and an analysis of absolute frequencies and percentages was performed. First, 16 centres completed and returned the questionnaire, while 5 ignored the invitation. The main findings concerned the wide use consideration of vardenafil 10 mg (68.7%; 11/16) for the treatment of erectile dysfunction in comorbidity with reproductive problems, the diffuse administration of International Index of Erectile Function (68.2%; 11/16) and Structured Interview for the Erectile Dysfunction (50%; 8/16) as psychometric tools and lesser use of Female Sexual Function Index (31.2%; 5/16) for the evaluation of female sexuality in the infertile couple. To conclude, we noticed a major focus on male sexuality and the eventual treatment or evaluation of sexual dysfunction compared to female sexuality. This aspect highlights an important issue for clinical practice to strongly consider and eventually reinforce. In this regard, improvement of the assessment and treatment of possible female sexual problems in reproductive medicine seems necessary.

  16. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  17. [Research progress on the safety of offsprings conceived by assisted reproductive technology].

    Science.gov (United States)

    Wang, Liya; Qian, Yeqing; Jin, Fan

    2017-05-25

    Assisted reproductive technology (ART) employs superovulation, in vitro culture and other micromanipulation to complete oocyte maturation, fertilization and early embryo development. Although these techniques have been successfully applied to solve infertility problems, the process may interfere in cell proliferation, differentiation and growth. The clinical and laboratory studies on the safety issue of ART are reviewed in this article. Studies found that the incidence of birth defects increased in ART offspring. Superovulation, in vitro culture and intracytoplasmic sperm injection may induce epigenetic aberrations during embryo development, which would influence the development of ART conceived children. The epigenetic susceptibility related to ART might be transmitted to subsequent generations, and the potential impact on ART offspring still need further investigation. In addition, ART treatments may also increase the risk of genetic diseases.

  18. The influence of thyroid autoimmunity on embryo quality in women undergoing assisted reproductive technology.

    Science.gov (United States)

    Andrisani, A; Sabbadin, C; Marin, L; Ragazzi, E; Dessole, F; Armanini, D; Donà, G; Bordin, L; Ambrosini, G

    2018-02-20

    The influence of thyroid autoimmunity in assisted reproductive technology (ART) outcome in euthyroid women is still controversial. In this study, we retrospectively evaluated embryo quality in 123 euthyroid women undergoing ART with or without thyroid autoantibodies (TAA). Embryo quality was assessed in 119 embryos of 29 infertile patients with TAA and in 394 embryos of 94 infertile patients without TAA. Our results showed not statistically significant differences in age, body mass index, anti-Müllerian hormone, follicle stimulating hormone, free triiodothyronine, and free thyroxine levels between cases and controls. Thyroid stimulating hormone was within the normal range, but significantly higher in TAA patients compared with the controls (2.4 ± 0.8 vs. 2 ± 0.9 mIU/L, respectively, p women with at least one autoantibody (p women undergoing ART even when thyroid function is normal.

  19. Significance of positive semen culture in relation to male infertility and the assisted reproductive technology process.

    Science.gov (United States)

    Jue, Joshua S; Ramasamy, Ranjith

    2017-10-01

    There are currently no WHO guidelines on the indications for semen culture; however, semen cultures are performed in the evaluation of male infertility and the assisted reproductive technology (ART) process. The relevance and significance of positive semen cultures is widely debated in the literature, with no current consensus on the usefulness of this test in relation to male infertility. We review the pathogenic mechanisms of potentially pathogenic bacteria, general bacteria, urethral flora, and skin flora on sperm parameters. We also present, possible routes of semen contamination, measures to reduce contamination, and the clinical significance of culture contamination. First, it is critical to distinguish round cells in semen as leukocytes from immature germ cells. Second, it is critical to distinguish leukocytospermia from infected semen in order to guide management.

  20. The paternal genome and the health of the assisted reproductive technology child

    Directory of Open Access Journals (Sweden)

    Sheena EM Lewis

    2015-01-01

    Full Text Available As a number of children born by assisted reproductive technology (ART are increasing each year across the developed world, the health of such offspring is a matter of public concern. Does the integrity of the paternal genome impact on offspring health? In societal terms, as birth rates fall, and the Western population become unsustainable, do the benefits outweigh the costs of creating and providing for this ART conceived subpopulation? There are little data to date to answer these questions. The long-term health of such children has largely been ignored, and success measured only by early (prebirth outcomes such as embryo quality or pregnancy. However, there are powerful paradigms such as ageing and smoking that give vital clues as to the potential impact of unhealthy spermatozoa on disease risk, mental and physical health, fertility and mortality of these offspring.

  1. Psychological Disorders among Iranian Infertile Couples Undergoing Assisted Reproductive Technology (ART).

    Science.gov (United States)

    Karimzadeh, Mansoureh; Salsabili, Nasser; Akbari Asbagh, Firouzeh; Teymouri, Robab; Pourmand, Golamreza; Soleimanieh Naeini, Tahereh

    2017-03-01

    Worldwide, infertility affects 10%-15% of couples and most of them seek medical help including Assisted Reproductive Technology (ART) treatments. Undergoing ART treatments create many physical and emotional burdens. This study examined the psychological consequences of infertility in Iranian infertile males and females as well as their spouses, unlike previous studies that examined mainly females with infertility. Subjects in this descriptive analytical design were recruited from the IVF Department of Mirza Koochak Khan Hospital and the Rouyesh Infertility Treatment Center of Tehran, Iran between Aug 2014 and Sep 2015. Overall, 256 couples (64% response rate), consisting of 78 infertile male and their spouses and 50 infertile female and their spouses, were included in this research. The psychological disorders were measured by the Persian version of Symptoms Checklist-90-Revised and Cattle Inventory. Psychological disorders of infertile couples are significantly associated with increasing age, higher education, longer duration of infertility and unemployment ( P ART treatments.

  2. The understanding and acceptability of assisted reproductive technology (ART) among infertile women in urban Lagos, Nigeria.

    Science.gov (United States)

    Fabamwo, A O; Akinola, O I

    2013-01-01

    This descriptive study was carried out to assess the awareness and acceptability of Assisted Reproductive Technology (ART) among infertile women in Lagos, Nigeria. Self-administered questionnaires on the knowledge of ART in the women were used. After a brief exposé on ART, questions relating to their attitude were answered. A total of 166 women were studied. Only 51.8% had any knowledge of ART and most of these had poor knowledge. A total of 137 women would embrace ART if offered but 29 would not, for reasons such as religion, fear of side-effects, failure and unaffordable costs. There is a paucity of good knowledge of ART. A significant number of the women would consider ART if offered. There is thus a need to create more awareness about the possibilities offered by ART, as well as instituting low cost ART strategies in developing world countries.

  3. Kant's 'formula of humanity' and assisted reproductive technology: a case for duties to future children.

    Science.gov (United States)

    Patrone, Tatiana

    2017-11-01

    The paper asks the question whether Kant's ethical theory can be applied to issues in assisted reproductive technology (ART). It argues against three objections to applying Kant's ethics to ART: (i) the non-identity objection, (ii) the gen-ethics objection, and (iii) the care-ethics objection. After showing that neither of the three objections is sufficiently persuasive the paper proposes a reading of Kant's 'formula of humanity,' and especially its negative clause (i.e., the 'merely as means' clause), that can be of some guidance in ART. The paper conclude that although Kant's 'formula of humanity' cannot be used as a simple litmus test for determining whether an ART practice is morally permissible or not, it nonetheless can supply us with some guidance in our moral deliberation.

  4. Comparison of semen quality between university-based and private assisted reproductive technology laboratories

    DEFF Research Database (Denmark)

    Jensen, Christian Fuglesang S; Khan, Omar; Sønksen, Jens

    2018-01-01

    .9%). No significant differences were found in volume, concentration and total motile sperm count although the Bland-Altman plot bias for concentration was clinically significant (15.9 × 106/ml). CONCLUSIONS: In this small series, motility was significantly higher at private laboratories compared to a university......OBJECTIVE: Obtaining a semen analysis (SA) is an essential step in evaluating infertile men. Despite using standardized procedures for analysis semen quality in the same individual often varies on repeated tests. The objective of this study was to investigate inter-laboratory variation in semen...... quality between private- and university-based assisted reproductive technology (ART) laboratories. MATERIALS AND METHODS: IRB approval was obtained to retrospectively evaluate men with a SA at both the private- and university-based ART laboratories. When more than one SA was available from either...

  5. Effect of assisted reproductive technology on fetal brain development assessed by prenatal ultrasonography.

    Science.gov (United States)

    Yin, Linliang; Xu, Yongle; Li, Hong; Ling, Chen; Choy, Kwong Wai; Xia, Fei; Deng, Xuedong

    2015-01-01

    The aim was to evaluate whether assisted reproductive technology (ART) affects the development of the fetal central nervous system (CNS). This study was carried out on women with singleton pregnancies, including 427 women who became pregnant by ART and 32,859 women with natural conceptions (NCs). The cavum septum pellucidum (CSP) width, transverse cerebellar diameter (TCD), cisterna magna (CM) depth, and lateral ventricle width were measured by ultrasound for 72 normal ART fetuses and 201 normal NC fetuses. The malformation rate of CNS was determined for both groups. In both groups, significant positive correlations with gestational age were found for CSP width (ART: r=0.7841, NC: r=0.7864; P0.05). The development and malformation rate of the fetal CNS is not significantly different between ART and NC fetuses, thus, ART does not affect the development of the fetal brain.

  6. Advanced maternal age: ethical and medical considerations for assisted reproductive technology

    Directory of Open Access Journals (Sweden)

    Harrison BJ

    2017-08-01

    Full Text Available Brittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada; 3Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada; 4University of Ottawa Interdisciplinary School of Health Sciences, Ottawa, ON, Canada; 5Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, CanadaObjectives: This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved.Methods: A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical were included in the review.Conclusion: There are significant ethical considerations and medical (maternal and fetal complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old. This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a

  7. The impact of endometriosis on the outcome of Assisted Reproductive Technology.

    Science.gov (United States)

    González-Comadran, Mireia; Schwarze, Juan Enrique; Zegers-Hochschild, Fernando; Souza, Maria do Carmo B; Carreras, Ramon; Checa, Miguel Ángel

    2017-01-24

    Endometriosis has been described to impair fertility through various mechanisms. However, studies evaluating the reproductive outcomes of women undergoing assisted reproductive technologies show controversial results. The aim of this study is to assess whether the reproductive outcome is impaired among women with endometriosis-associated infertility undergoing IVF. A retrospective cohort study was performed, including women undergoing IVF reported by the Red Latinoamericana de Reproduccion Asistida (Redlara) registry, between January 2010 and December 2012. The study group included women with endometriosis-associated infertility, and the control group women with tubal factor, endocrine disorders or unexplained infertility. Women above 40 years, severe male factor and premature ovarian failure were excluded. The reproductive outcomes of between both groups were compared. The primary outcome was live birth. Secondary outcomes included clinical pregnancy, miscarriage, number of oocytes retrieved and number of fertilized oocytes. Outcomes were assessed after the first fresh IVF cycle, and were adjusted for age and number of embryos transferred. A total of 22.416 women were included (3.583 with endometriosis and 18.833 in the control group). Mean age of patients in the endometriosis group and control group was 34.86 (3.47) and 34.61 (3.91) respectively, p = 0.000. The mean number of oocytes retrieved were 8.89 (6.23) and 9.86 (7.02) respectively, p = 0.000. No significant differences were observed between groups in terms of live birth (odds ratio (OR) 1.032, p = 0.556), clinical pregnancy (OR 1.044, p = 0.428) and miscarriage rates (OR 1.049, p = 0.623). Women with endometriosis had significantly lower number of oocytes retrieved (incidence risk ratio (IRR) 0.917, 95% CI 0.895-0.940), however, the number of fertilized oocytes did not differ among the two groups when adjusting for the number of oocytes retrieved (IRR 1.003, p = 0.794). An age

  8. Inpatient hospitalizations in women with and without assisted reproductive technology live birth.

    Science.gov (United States)

    Stern, Judy E; Gopal, Daksha; Diop, Hafsatou; Missmer, Stacey A; Coddington, Charles C; Luke, Barbara

    2017-08-01

    The aim of this study is to evaluate frequency of hospitalization before, during, and after assisted reproductive technology (ART) treatment by cycle outcome. Six thousand and one hundred thirty women residing in Massachusetts undergoing 17,135 cycles of ART reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SARTCORS) from 2004 to 2011 were linked to hospital discharges and vital records. Women were grouped according to ART treatment cycle outcome as: no pregnancy (n = 1840), one or more pregnancies but no live birth (n = 968), or one or more singleton live births (n = 3322). Hospital delivery discharges during 1998-2011 were categorized as occurring before, during, or after the ART treatment. The most prevalent ICD-9 codes for non-delivery hospital discharges were compared. Groups were compared using chi square test using SAS 9.3 software. The proportion of any hospitalization was 57.0, 58.3, and 91.3% for women with no pregnancy, no live birth, and ART singleton live birth, respectively; the proportion of non-delivery hospitalizations was 30.4, 31.0, and 28.3%, respectively. The non-ART delivery proportion after ART treatment did not differ by group (33.4, 36.2, and 36.9%, respectively, p = 0.17). Most frequent non-delivery diagnoses (including fibroids, obesity, ectopic pregnancy, depression, and endometriosis) also did not differ by group. A secondary analysis limited to only women with no delivery discharges before the first ART cycle showed similar results. All groups had live birth deliveries during the study period, suggesting an important contribution of non-ART treatment or treatment-independent conception to overall delivery and live births. Hospitalizations not associated with delivery suggested similarity in morbidity for all ART patients regardless of success with ART treatment.

  9. Does Bariatric Surgery Improve Assisted Reproductive Technology Outcomes in Obese Infertile Women?

    Science.gov (United States)

    Milone, Marco; Sosa Fernandez, Loredana M; Sosa Fernandez, Laura V; Manigrasso, Michele; Elmore, Ugo; De Palma, Giovanni D; Musella, Mario; Milone, Francesco

    2017-08-01

    Little is known about the impact of bariatric surgery on obese infertile women seeking an assisted reproductive technology. All obese women with a history of assisted reproductive technology (ART) failure that underwent ART treatment cycles both prior to and following bariatric surgery were included. ART outcomes were compared evaluating the duration and dose of gonadotrophins used; the measurement of day 3 FSH; the anti-mullerian hormone dosage; the number of follicles >15 mm; the number of retrieved and fertilized oocytes; the number of metaphase II, metaphase I and germinal vesicle oocytes; the number of embryos obtained; the number of top-quality oocytes and embryos; the number of transferred embryo; the pregnancy rate and the live birth rate. Forty women were included. The total number of gonadotropin units required and in the length of stimulation following bariatric surgery decreased (p = .001), with an increase of the number of follicles ≥15 mm (p = .005), of retrieved oocytes (p = .004), of top-quality oocytes (p = .001) and metaphase II oocytes (p = .008). More oocytes were fertilized (4.2 ± 1.7 vs 5.3 ± 2.4; p = .02). After surgery, we have registered also a better number of top-quality embryos (0.5 ± 0.6 vs 1.1 ± 0.9; p = .003). Pregnancy rate following the bariatric surgery increased to 15/40 (37.5%) (p women seeking an ART treatment.

  10. Risk of ectopic pregnancy associated with assisted reproductive technology in the United States, 2001-2011.

    Science.gov (United States)

    Perkins, Kiran M; Boulet, Sheree L; Kissin, Dmitry M; Jamieson, Denise J

    2015-01-01

    To assess national trends in ectopic pregnancy incidence among assisted reproductive technology users and identify risk factors associated with ectopic pregnancy. We identified 553,577 pregnancies reported to the National ART Surveillance System between 2001 and 2011. Of those, 9,480 were ectopic, of which 485 were heterotopic. As a result of small numbers, ectopic and heterotopic pregnancies were combined for analysis. We assessed temporal trends in annual ectopic pregnancy rates using Poisson regression. We used log-binomial regression models with generalized estimating equations for correlated outcomes within clinics to calculate unadjusted and adjusted risk ratios for the association between ectopic pregnancy and selected patient characteristics and treatment factors. The rate of ectopic pregnancy declined from 2.0% (n=735, 95% confidence interval [CI] 1.9-2.2) in 2001 to 1.6% (n=968, 95% CI 1.5-1.7) in 2011 (P for trend ectopic pregnancy rate ranged from 2.0% (n=7,469, 95% CI 1.9-2.0) for fresh, nondonor cycles to 1.0% (n=641, 95% CI 0.9-1.1) for fresh, donor cycles. Among fresh, nondonor cycles, the rate of ectopic pregnancy was 1.6% (95% CI 1.4-1.7) when one embryo was transferred compared with 1.7% (95% CI 1.7-1.8), 2.2% (95% CI 2.1-2.3), and 2.5% (95% CI 2.4-2.6) when two, three, or four or more embryos were transferred, respectively (adjusted risk ratios 1.11, 95% CI 0.94-0.30; 1.33, 95% CI 1.12-1.56; and 1.49, 95% CI 1.25-1.78). Ectopic pregnancy incidence after assisted reproductive technology has decreased over time, but factors such as multiple embryo transfer increase the risk of ectopic pregnancy. II.

  11. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates.

    Science.gov (United States)

    Kushnir, Vitaly A; Barad, David H; Albertini, David F; Darmon, Sarah K; Gleicher, Norbert

    2016-01-01

    Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) exclude embryo banking cycles from outcome calculations. We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles), as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles). During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women 44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P banking cycles led to inflation of live birth rates in fresh ART cycles, increasing in size in parallel to advancing female age and utilization of embryo banking, reaching 56.3% in women age >44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater. Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women. Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women.

  12. Effect of Etanercept on the Success of Assisted Reproductive Technology in Patients with Endometrioma.

    Science.gov (United States)

    Önalan, Göğşen; Tohma, Yusuf Aytaç; Zeyneloğlu, Hulusi Bülent

    2017-11-24

    To determine the effects of a tumor necrosis factor inhibitor (etanercept) on pregnancy outcomes in patients with endometrioma who were treated with assisted reproductive technology. Sixty-eight infertile patients who had endometrioma were included in our retrospective case-control study. We administered etanercept (Enbrel, 50 mg in 1 mL intramuscularly) to 19 patients on the second day of their previous menstrual cycle. All patients were treated with assisted reproductive technology. Pregnancy and live birth rates (LBR) were documented. When all other parameters (age, body mass index, infertility) are supposed to be constant, the clinical pregnancy rate was significantly higher in patients who used etanercept in an antagonist protocol than in patients who did not use etanercept (χ2 = 5.547; p = 0.019) but LBR did not reach a statistical significance (χ2 = 3.179; p = 0.075). The use of etanercept had an OR of 4.17 (95% CI 1.23-14.14) compared with not using etanercept for clinical pregnancy rate. The use of etanercept increased the rate of pregnancy (χ2 = 6.55; p = 0.01). The pregnancy rate with the use of etanercept had an OR of 4.23 (95% CI 1.35-13.25) compared with patients who did not use etanercept. In the same way, the use of etanercept increased LBR twofold, but it is not significant in the border line (χ2 = 3.771; p = 0.052). Etanercept may be a new non-hormonal therapy that may be an adjunct to treatment of infertile women with endometrioma. However, the safety of etanercept on embryos and fetuses has not been fully clarified. © 2017 S. Karger AG, Basel.

  13. Female Obesity and Clinical Outcomes of Assisted Reproductive Technologies (ART): an Updated Systematic Review and Meta-analysis

    OpenAIRE

    Heidar Heidari Khoei

    2016-01-01

    Assisted Reproductive Technology (ART) has been developed to be used for reproductive-age women with primary and secondary infertilities. Obesity is a worldwide epidemic for both women and men and a major global health concern. The direct effect of Body Mass Index (BMI) increase on the outcomes of ART is still unclear. This study aimed to carry out a systematic review of the available scientific evidence to assess the effects of obesity on the clinical outcome of ART treatment. Numerous studi...

  14. Women with one ovary in assisted reproduction technologies: a review of the literature.

    Science.gov (United States)

    Bouchlariotou, Sofia; Sofia, Bouchlariotou; Tsikouras, Panagiotis; Panagiotis, Tsikouras; Rösing, Beniamin; Beniamin, Rösing; Neulen, Josef; Josef, Neulen

    2012-10-01

    A number of patients who have undergone assisted reproductive technology (ART) have only one ovary. This article reviews the clinical implications of the absence of an ovary on the reproductive potential and the outcome in ART cycle. MEDLINE, Pubmed, the Cochrane Controlled Trials Register, and Cochrane Database of Systematic Reviews from the 1980s through April 2010. Randomized, controlled trials; systematic reviews of trials; and observational studies; all restricted to English-language articles. This review includes 58 articles. Women with a single ovary did not, in general, respond as well to ovulation induction treatment than women with two ovaries in ART cycles. It appears however, that once women with a single ovary achieve the stage of embryo transfer, they can be reassured that their chances of having a child are the same as women with two ovaries. Whether the right or left ovary responds better to superovulation is a question which remains unanswered in the literature. The authors could not address all management questions, and excluded non-English-language literature.

  15. GnRH antagonist, cetrorelix, for pituitary suppression in modern, patient-friendly assisted reproductive technology.

    Science.gov (United States)

    Tur-Kaspa, Ilan; Ezcurra, Diego

    2009-10-01

    Gonadotropin-releasing hormone (GnRH) analogues are used routinely to prevent a premature luteinizing hormone (LH) surge in women undergoing assisted reproductive technology (ART) treatments. In contrast to GnRH agonists, antagonists produce rapid and reversible suppression of LH with no initial flare effect. To review the role of cetrorelix, the first GnRH antagonist approved for the prevention of premature LH surges during controlled ovarian stimulation in modern ART. A review of published literature on cetrorelix. Both multiple- and single-dose cetrorelix protocols were shown to be at least as effective as long GnRH agonist regimens for pituitary suppression in Phase II/III clinical trials. Furthermore, cetrorelix co-treatment resulted in similar live birth rates but a shorter duration of gonadotropin stimulation, a lower total gonadotropin dose requirement and lower incidence of ovarian hyperstimulation syndrome compared with long agonist regimens. A single-dose cetrorelix protocol further decreased the number of injections required. Preliminary studies have also produced promising data on the use of cetrorelix in modified ART protocols, such as frozen embryo transfer and donor oocyte recipient cycles. Cetrorelix offers a potential therapeutic alternative to GnRH agonists during controlled ovarian stimulation and has become an integral part of modern, patient-friendly reproductive medicine.

  16. Dual ovarian stimulation and random start in assisted reproductive technologies: from ovarian biology to clinical application.

    Science.gov (United States)

    Vaiarelli, Alberto; Venturella, Roberta; Vizziello, Damiano; Bulletti, Francesco; Ubaldi, Filippo M

    2017-06-01

    The opportunity to use gonadotropins to stimulate the growth of antral follicles coming from different follicular waves available in different moment of the menstrual cycle allowed the implementation of innovative protocols in assisted reproductive technologies. The purpose of this review is to explore the possible advantages related to these new controlled ovarian stimulation (COS) strategies. Women exhibit major and minor wave patterns of ovarian follicular development during the menstrual cycle, as it is in animal species. These observations led to the introduction of two new strategies for COS: the random start and the double ovarian stimulation within a single menstrual cycle. The use of gonadotropin-releasing hormone antagonist COS protocols, started randomly at any day of the menstrual cycle, is today a standard procedure in those cases where obtaining oocytes is an urgent task, such as in case of fertility preservation for malignant diseases or other medical indications.On the other hand, in poor prognosis patients, double ovarian stimulation has been suggested with the aim of maximizing the number of oocytes retrieved within a single menstrual cycle and, in turn increasing the chance to obtain a reproductively competent embryo. Randomized control trials are necessary to confirm these preliminary findings.

  17. Soy food intake and treatment outcomes of women undergoing assisted reproductive technology.

    Science.gov (United States)

    Vanegas, Jose C; Afeiche, Myriam C; Gaskins, Audrey J; Mínguez-Alarcón, Lidia; Williams, Paige L; Wright, Diane L; Toth, Thomas L; Hauser, Russ; Chavarro, Jorge E

    2015-03-01

    To study the relation of dietary phytoestrogens intake and clinical outcomes of women undergoing infertility treatment with the use of assisted reproductive technology (ART). Prospective cohort study. Fertility center. A total of 315 women who collectively underwent 520 ART cycles from 2007 to 2013. None. Implantation, clinical pregnancy, and live birth rates per initiated cycle. Soy isoflavones intake was positively related to live birth rates in ART. Compared with women who did not consume soy isoflavones, the multivariable-adjusted odds ratios of live birth (95% confidence interval) for women in increasing categories of soy isoflavones intake were 1.32 (0.76-2.27) for women consuming 0.54-2.63 mg/d, 1.87 (1.12-3.14) for women consuming 2.64-7.55 mg/d, and 1.77 (1.03-3.03) for women consuming 7.56-27.89 mg/d. Dietary soy intake was positively related to the probability of having a live birth during infertility treatment with ART. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Investigation of Personality Traits between Infertile Women Submitted to Assisted Reproductive Technology or Surrogacy.

    Science.gov (United States)

    Asgari, Najmeh; Yazdkhasti, Fariba; Nasr Esfahani, Mohammad Hossein

    2016-01-01

    Personality traits affect human relationships, social interactions, treatment procedures, and essentially all human activities. The purpose of this study is to investigate the personality traitsincluding sensation seeking, flexibility, and happiness among a variety of infertile women who were apt to choose assisted reproductive technology (ART) or surrogacy. This is a cross-sectional study that was performed on 251 infertile women who visited Isfahan and Tehran Reproductive Medicine Center. These fertility clinics are located in Isfahan and Tehran, Iran. In this study, 201 infertile women who underwent treatment using ART and 50 infertile women who tended to have surrogacy were chosen by convenience sampling. Zuckerman's Sensation Seeking Scale Form V (SSS-V), Psychological Flexibility Questionnaire (adapted from NEO Personality Inventory-Revised) and Oxford Happiness Questionnaire (OHQ) were used as research instruments. All participants had to complete the research instruments in order to be included in this study. Data were analyzed by descriptive-analytical statistics and statistical tests including multivariate analysis of variance (MANOVA) and Z Fisher. Statistically significant effects were accepted for Pwomen underwent ART (Pwomen sought surrogacy (Pwomen who sought surrogacy (Pwomen who sought either ART or surrogacy (Pwomen who underwent treatment using ART compared women who tended to have surrogacy. This study shows that demographic variables are effective in happiness of infertile women. Also, there is a significant relation among sensation seeking, flexibility and happiness in infertile women.

  19. A review of luteinising hormone and human chorionic gonadotropin when used in assisted reproductive technology.

    Science.gov (United States)

    Ezcurra, Diego; Humaidan, Peter

    2014-10-03

    Gonadotropins extracted from the urine of post-menopausal women have traditionally been used to stimulate folliculogenesis in the treatment of infertility and in assisted reproductive technology (ART). Products, such as human menopausal gonadotropin (hMG), consist not only of a mixture of the hormones, follicle-stimulating hormone (FSH), luteinising hormone (LH) and human chorionic gonadotropin (hCG), but also other biologically active contaminants, such as growth factors, binding proteins and prion proteins. The actual amount of molecular LH in hMG preparations varies considerably due to the purification process, thus hCG, mimicking LH action, is added to standardise the product. However, unlike LH, hCG plays a different role during the natural human menstrual cycle. It is secreted by the embryo and placenta, and its main role is to support implantation and pregnancy. More recently, recombinant gonadotropins (r-hFSH and r-hLH) have become available for ART therapies. Recombinant LH contains only LH molecules. In the field of reproduction there has been controversy in recent years over whether r-hLH or hCG should be used for ART. This review examines the existing evidence for molecular and functional differences between LH and hCG and assesses the clinical implications of hCG-supplemented urinary therapy compared with recombinant therapies used for ART.

  20. The appeal to nature implicit in certain restrictions on public funding for assisted reproductive technology.

    Science.gov (United States)

    Carter, Drew; Braunack-Mayer, Annette

    2011-10-01

    Certain restrictions on public funding for assisted reproductive technology (ART) are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein (sometimes) a source of moral guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. © 2011 Blackwell Publishing Ltd.

  1. Association between serum folate and vitamin B-12 and outcomes of assisted reproductive technologies.

    Science.gov (United States)

    Gaskins, Audrey J; Chiu, Yu-Han; Williams, Paige L; Ford, Jennifer B; Toth, Thomas L; Hauser, Russ; Chavarro, Jorge E

    2015-10-01

    Preconceptional folate and vitamin B-12 have been linked to beneficial reproductive outcomes in both natural pregnancies and those after assisted reproductive technology (ART) treatment. The objective of the study was to evaluate the associations of serum folate and vitamin B-12 with ART outcomes. This analysis included a random sample of 100 women (154 ART cycles) participating in a prospective cohort study [Environment and Reproductive Health (EARTH)] at the Massachusetts General Hospital Fertility Center (2007-2013). Serum folate and vitamin B-12 were measured in blood samples collected between days 3 and 9 of treatment. Generalized estimating equations with adjustment for age, BMI, and race were used to evaluate the association of serum folate and vitamin B-12 with ART outcomes. Women in the highest quartile of serum folate (>26.3 ng/mL) had 1.62 (95% CI: 0.99, 2.65) times the probability of live birth compared with women in the lowest quartile (Women in the highest quartile of serum vitamin B-12 (>701 pg/mL) had 2.04 (95% CI: 1.14, 3.62) times the probability of live birth compared with women in the lowest quartile (women with serum folate and vitamin B-12 concentrations greater than the median had 1.92 (95% CI: 1.12, 3.29) times the probability of live birth compared with women with folate and vitamin B-12 concentrations less than or equal to the median. This translated into an adjusted difference in live birth rates of 26% (95% CI: 10%, 48%; P = 0.02). Higher serum concentrations of folate and vitamin B-12 before ART treatment were associated with higher live birth rates among a population exposed to folic acid fortification. This trial was registered at clinicaltrials.gov as NCT00011713. © 2015 American Society for Nutrition.

  2. Assisted reproductive technology use and outcomes among women with a history of cancer.

    Science.gov (United States)

    Luke, Barbara; Brown, Morton B; Missmer, Stacey A; Spector, Logan G; Leach, Richard E; Williams, Melanie; Koch, Lori; Smith, Yolanda R; Stern, Judy E; Ball, G David; Schymura, Maria J

    2016-01-01

    How do the assisted reproductive technology (ART) outcomes of women presenting for ART after cancer diagnosis compare to women without cancer? The likelihood of a live birth after ART among women with prior cancer using autologous oocytes is reduced and varies by cancer diagnosis but is similar to women without cancer when donor oocytes are used. Premenopausal patients faced with a cancer diagnosis frequently present for fertility preservation. Population-based cohort study of women treated with ART in NY, TX and IL, USA. Women with their first ART treatment between 2004 and 2009 were identified from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database and linked to their respective State Cancer Registries based on name, date of birth and social security number. Years were rounded, i.e. year 1 = 6-18 months before treatment. This study used reports of cancer from 5 years, 6 months prior to treatment until 6 months after first ART treatment. Women who only presented for embryo banking were omitted from the analysis. The likelihood of pregnancy and of live birth with ART using autologous oocytes was modeled using logistic regression, with women without prior cancer as the reference group, adjusted for woman's age, parity, cumulative FSH dosage, infertility diagnosis, number of diagnoses, number of ART cycles, State of residency and year of ART treatment. Results of the modeling are reported as adjusted odds ratios (AORs) and (95% confidence intervals). The study population included 53 426 women; 441 women were diagnosed with cancer within 5 years prior to ART cycle start. Mean (±SD) age at cancer diagnosis was 33.4 ± 5.7 years; age at start of ART treatment was 34.9 ± 5.8 for women with cancer compared with 35.3 ± 5.3 years for women without cancer (P = 0.03). Live birth rates among women using autologous oocytes differed substantially by cancer status (47.7% without cancer versus 24.7% with cancer, P information on

  3. [Extension of assisted reproductive technologies with donor sperm (ARTD) to non-medical indications].

    Science.gov (United States)

    Jouannet, Pierre

    2014-01-01

    In France as in other countries, more and more single women and lesbian couples wish to become mothers. To carry through their parenting project they may consult a physician in France and often go abroad in order to get Assisted Reproductive Technologies with donor sperm (ARTD). Should ARTD be available to those women in France? The physician has not to take the decision. In such situations ARTD has no medical indication or contraindication. This assisted procreation raises many questions on children development and well-being. The results of studies made in other countries are often reassuring but their methodologies do not allow any conclusion to be drawn and grey areas persist. Therefore it should be necessary to develop a research effort in the field as it recently started in France. Would ARTD access to women without a male partner be legalized, the law should respect the ethical principles of non-payment and anonymity associated with donation of all body components. In any case, it should also allow an efficient medical care to be performed to ensure under the best conditions the well-being of the children and their mothers.

  4. Selective Reproductive Technologies

    DEFF Research Database (Denmark)

    Gammeltoft, Tine; Wahlberg, Ayo

    2014-01-01

    selective reproduction has been placed under the aegis of science and expertise in novel ways. New laboratory and clinical techniques allow for the selective fertilization of gametes, implantation of embryos, or abortion of fetuses. Although they will often overlap with assisted reproductive technologies......From a historical perspective, selective reproduction is nothing new. Infanticide, abandonment, and selective neglect of children have a long history, and the widespread deployment of sterilization and forced abortion in the twentieth century has been well documented. Yet in recent decades...... (ARTs), what we term selective reproductive technologies (SRTs) are of a more specific nature: Rather than aiming to overcome infertility, they are used to prevent or allow the birth of certain kinds of children. This review highlights anthropological research into SRTs in different parts of the world...

  5. Male and female alcohol consumption and live birth after assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Vittrup, Ida; Petersen, Gitte Lindved; Kamper-Jørgensen, Mads

    2017-01-01

    The objective was to assess the potential association between female and male alcohol consumption and probability of achieving a live birth after assisted reproductive treatment. From a nationwide Danish register-based cohort information on alcohol consumption at assisted reproductive treatment......, 22.6% and 20.2% of cycles resulted in a live birth for abstainers and heavy consumers (>14 drinks/week), respectively. No statistically significant associations between alcohol consumption and live birth were observed. Adjusted odds ratios from trend analyses were 1.00 (95% confidence interval (CI) 0.......99-1.01) and 0.99 (95% CI 0.97-1.01) for every one-unit increase in female and male weekly alcohol consumption at assisted reproductive treatment initiation, respectively. In conclusion, this study did not show significant associations between male or female alcohol consumption and odds of live birth after...

  6. AB28. Management of male factor infertility: present on the assisted reproductive technology

    Science.gov (United States)

    Lee, Sang-Chan

    2014-01-01

    Infertility is a common yet complex problem affecting approximately 10-15% of couples attempting to conceive a baby. Especially, 40-50% of these factors are known as male-related disorders. Unlike female infertility, the cause of which is often easily identified, diagnosing male factors can be difficult. Male infertility is due to low sperm production, abnormal sperm function or blockages of sperm transport. Classical semen analysis in laboratory, which include sperm concentration, motility and morphology gives an approximate evaluation of the functional competence of spermatozoa, but does not always reflect the quality of sperm DNA. The fertilizing potential of sperm depends not only on the functional competence of spermatozoa but also on sperm DNA integrity. The most commonly used techniques to assess sperm DNA integrity are the TUNEL assay, Comet assay, SCSA assay and hallo sperm assay. Recent studies have highlighted the significance of sperm DNA integrity as an important factor which affects functional competence of the sperm. Sperm DNA damage has been closely associated with numerous indicators of reproductive health including fertilization, embryo quality, implantation, spontaneous abortion, congenital malformations. To overcome male infertility, there are variety of surgical and non-surgical urological procedures and medical-pharmacological interventions, and advanced assisted reproductive technologies (ART). Among the surgically retrieved methods, there are TESE, TFNA, PESA and MESA that is used with ICSI. The ART, augmented with ICSI in moderate to serve cases, efficiently treat a variety of male infertility disorders by constituting validated and successfully treatment methods. Also, this technique is employed because the limited numbers and functional capacity of motile sperm that can be obtained. Especially, there are technologies such as IMSI and PICSI that are used to select healthy sperms.

  7. Politics, doctors, assisted reproductive technologies & religion: Transgenerational understandings and experiences of single motherhood in Spain.

    Science.gov (United States)

    Bravo-Moreno, Ana

    2017-10-01

    The aim is to achieve a transgenerational view of single motherhood in Spain, to look at which contexts it arises in, how it changes with the introduction of assisted reproduction, and how the role of religion in Spanish society permeates medical practice and affects the lives of women patients. I examine single motherhood and investigate two interconnected themes: (a) being a mother and being mothered are both permeated with sociocultural, political, religious, economic and psychological significance; (b) Spain led Europe in multiple births due to assisted reproduction, thus ethical conflicts and patient rights are analyzed.

  8. Incidence of abnormal offspring from cloning and other assisted reproductive technologies.

    Science.gov (United States)

    Hill, Jonathan R

    2014-02-01

    In animals produced by assisted reproductive technologies, two abnormal phenotypes have been characterized. Large offspring syndrome (LOS) occurs in offspring derived from in vitro cultured embryos, and the abnormal clone phenotype includes placental and fetal changes. LOS is readily apparent in ruminants, where a large calf or lamb derived from in vitro embryo production or cloning may weigh up to twice the expected body weight. The incidence of LOS varies widely between species. When similar embryo culture conditions are applied to nonruminant species, LOS either is not as dramatic or may even be unapparent. Coculture with serum and somatic cells was identified in the 1990s as a risk factor for abnormal development of ruminant pregnancies. Animals cloned from somatic cells may display a combination of fetal and placental abnormalities that are manifested at different stages of pregnancy and postnatally. In highly interventional technologies, such as nuclear transfer (cloning), the incidence of abnormal offspring continues to be a limiting factor to broader application of the technique. This review details the breadth of phenotypes found in nonviable pregnancies, together with the phenotypes of animals that survive the transition to extrauterine life. The focus is on animals produced using in vitro embryo culture and nuclear transfer in comparison to naturally occurring phenotypes.

  9. Combined jugular and subclavian vein thrombosis following assisted reproductive technology--new observation.

    Science.gov (United States)

    Salomon, Ophira; Schiby, Ginette; Heiman, Zehava; Avivi, Kamila; Sigal, Carol; Levran, David; Dor, Jeushua; Itzchak, Yacov

    2009-08-01

    To study the predilection of jugular and subclavian vein thrombosis in patients going through assisted reproductive technology (ART). This technology puts women at high risk of developing the ovarian hyperstimulation syndrome (OHSS) and thrombotic events. Study cases. Large Academic Medical Center. Five women who developed jugular and subclavian vein thrombosis following ART were included in the study. The deep vein thrombosis was demonstrated by ultrasound Doppler or computerized tomography angiography. All women were interviewed and data obtained from outpatient and hospital medical charts. Magnetic resonance imaging and complete thrombophilic profile workup was performed in each woman. Open biopsy from the lesions was taken from one of the women. Correlation between mechanical branchial cysts filled with fluid during OHSS and jugular and subclavian vein thrombosis. Five women developed jugular and subclavian vein thrombosis following ART. They were found to harbor clusters of rudimentary branchial cysts filled with fluid at the time of OHSS, which compressed the jugular and subclavian veins at their junction at the base of the neck. Four patients (80%) were found to be carriers of factor V Leiden. Predilection of jugular and subclavian vein thrombosis early in pregnancy is the result of mechanical compression mediated by rudimentary branchial cysts filled with fluid during OHSS, particularly in subjects who are carriers of factor V Leiden.

  10. Risk of Ectopic Pregnancy Associated With Assisted Reproductive Technology in the United States, 2001–2011

    Science.gov (United States)

    Perkins, Kiran M.; Boulet, Sheree L.; Kissin, Dmitry M.; Jamieson, Denise J.

    2015-01-01

    OBJECTIVE To assess national trends in ectopic pregnancy incidence among assisted reproductive technology users and identify risk factors associated with ectopic pregnancy. METHODS We identified 553,577 pregnancies reported to the National ART Surveillance System between 2001 and 2011. Of those, 9,480 were ectopic, of which 485 were heterotopic. As a result of small numbers, ectopic and heterotopic pregnancies were combined for analysis. We assessed temporal trends in annual ectopic pregnancy rates using Poisson regression. We used log-binomial regression models with generalized estimating equations for correlated outcomes within clinics to calculate unadjusted and adjusted risk ratios for the association between ectopic pregnancy and selected patient characteristics and treatment factors. RESULTS The rate of ectopic pregnancy declined from 2.0% (n5735, 95% confidence interval [CI] 1.9–2.2) in 2001 to 1.6% (n=968, 95% CI 1.5–1.7) in 2011 (P for trend ,.001). The ectopic pregnancy rate ranged from 2.0% (n=7,469, 95% CI 1.9–2.0) for fresh, nondonor cycles to 1.0% (n=641, 95% CI 0.9–1.1) for fresh, donor cycles. Among fresh, nondonor cycles, the rate of ectopic pregnancy was 1.6% (95% CI 1.4–1.7) when one embryo was transferred compared with 1.7% (95% CI 1.7–1.8), 2.2% (95% CI 2.1–2.3), and 2.5% (95% CI 2.4–2.6) when two, three, or four or more embryos were transferred, respectively (adjusted risk ratios 1.11, 95% CI 0.94–0.30; 1.33, 95% CI 1.12–1.56; and 1.49, 95% CI 1.25–1.78). CONCLUSION Ectopic pregnancy incidence after assisted reproductive technology has decreased over time, but factors such as multiple embryo transfer increase the risk of ectopic pregnancy. PMID:25560107

  11. Urinary phthalate metabolite concentrations in relation to history of infertility and use of assisted reproductive technology.

    Science.gov (United States)

    Alur, Snigdha; Wang, Hongyue; Hoeger, Kathy; Swan, Shanna H; Sathyanarayana, Sheela; Redmon, Bruce J; Nguyen, Ruby; Barrett, Emily S

    2015-11-01

    To examine urinary phthalate metabolite concentrations in pregnant women with planned pregnancies in relation to history of infertility and use of assisted reproductive technology (ART). Phthalate metabolite concentrations were measured in first-trimester urine samples collected from women participating in a prospective pregnancy cohort study. Prenatal clinics. A total of 750 women, of whom 86 had a history of infertility. Forty-one women used ART to conceive. None. Primary outcomes were concentrations of four metabolites of diethylhexyl phthalate (DEHP) and their molar sum (∑DEHP). Multivariable analyses compared phthalate metabolite levels in [1] women reporting a history of infertility vs. those who did not (comparison group); and [2] those who used ART to conceive the index pregnancy vs. women with a history of infertility who did not use ART. Among women with a history of infertility, ∑DEHP was significantly lower in women who conceived after ART compared with those who did not (geometric mean ratio: 0.83; 95% confidence interval 0.71-0.98). Similar significant associations were observed for all of the individual DEHP metabolites. There were no differences in DEHP metabolite concentrations between women with a history of infertility and the comparison group. Women who used ART to conceive had lower first-trimester phthalate metabolite concentrations than women with a history of infertility who did not use ART. Further research is needed to explore whether those pursuing fertility treatments take precautions to avoid exposure to environmental toxins, to improve treatment outcomes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Serum and follicular fluid organochlorine concentrations among women undergoing assisted reproduction technologies.

    Science.gov (United States)

    Meeker, John D; Missmer, Stacey A; Altshul, Larisa; Vitonis, Allison F; Ryan, Louise; Cramer, Daniel W; Hauser, Russ

    2009-07-14

    Exposure to persistent organic pollutants, including polychlorinated biphenyls (PCBs) and organochlorine pesticides, is widespread among the general population. There is evidence of adverse effects on reproduction and early pregnancy in relation to organochlorine exposure but human studies remain limited. The increased use of assisted reproductive technologies (ART) presents unique opportunities for the assessment of environmental influences on early pregnancy outcomes not otherwise observable in humans, but studies need to be designed to maximize the efficiency of the exposure data collected while minimizing exposure measurement error. The present study was conducted to assess the correlation between concentrations of organochlorines in serum and follicular fluid samples collected from a subset of women undergoing ART in a large study that took place between 1994 and 2003, as well as the temporal reliability of serum organochlorine concentrations among women undergoing multiple ART cycles in the study. PCB congeners (118, 138, 153, and 180), 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (p,p'-DDT), the DDT metabolite p,p'-DDE, hexachlorobenzene (HCB), oxychlordane, trans-nonachlor and mirex were measured in 72 follicular fluid samples and 265 serum samples collected from 110 women. Organochlorine concentrations in paired serum and follicular fluid samples were correlated, with Pearson and Spearman coefficients ranging from 0.60 to 0.92. Serum organochlorine concentrations were two- to three-fold greater than in follicular fluid, and a significant inverse trend was observed in the distribution of follicular fluid:serum ratios with increasing molecular weight of the compound (p-value for trend single serum sample to adequately represent a more biologically relevant dose (concentrations in follicular fluid), as well as exposure levels over time, in epidemiological studies of ART outcomes in relation to organochlorine exposure.

  13. Serum and follicular fluid organochlorine concentrations among women undergoing assisted reproduction technologies

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    Ryan Louise

    2009-07-01

    Full Text Available Abstract Background Exposure to persistent organic pollutants, including polychlorinated biphenyls (PCBs and organochlorine pesticides, is widespread among the general population. There is evidence of adverse effects on reproduction and early pregnancy in relation to organochlorine exposure but human studies remain limited. The increased use of assisted reproductive technologies (ART presents unique opportunities for the assessment of environmental influences on early pregnancy outcomes not otherwise observable in humans, but studies need to be designed to maximize the efficiency of the exposure data collected while minimizing exposure measurement error. Methods The present study was conducted to assess the correlation between concentrations of organochlorines in serum and follicular fluid samples collected from a subset of women undergoing ART in a large study that took place between 1994 and 2003, as well as the temporal reliability of serum organochlorine concentrations among women undergoing multiple ART cycles in the study. PCB congeners (118, 138, 153, and 180, 1,1,1-trichloro-2,2-bis(p-chlorophenylethane (p,p'-DDT, the DDT metabolite p,p'-DDE, hexachlorobenzene (HCB, oxychlordane, trans-nonachlor and mirex were measured in 72 follicular fluid samples and 265 serum samples collected from 110 women. Results Organochlorine concentrations in paired serum and follicular fluid samples were correlated, with Pearson and Spearman coefficients ranging from 0.60 to 0.92. Serum organochlorine concentrations were two- to three-fold greater than in follicular fluid, and a significant inverse trend was observed in the distribution of follicular fluid:serum ratios with increasing molecular weight of the compound (p-value for trend Conclusion Our results support the use of a single serum sample to adequately represent a more biologically relevant dose (concentrations in follicular fluid, as well as exposure levels over time, in epidemiological studies of

  14. Increased incidence of gestational hypertension and preeclampsia after assisted reproductive technology treatment.

    Science.gov (United States)

    Wang, Yueping A; Chughtai, Abrar A; Farquhar, Cynthia M; Pollock, Wendy; Lui, Kei; Sullivan, Elizabeth A

    2016-04-01

    To determine the association between assisted reproductive technology (ART) treatment and the rate of combined gestational hypertension (GH), preeclampsia (PE). Retrospective population study. Not applicable. A total of 596,520 mothers (3.6% ART mothers) who gave birth between 2007 and 2011. Not applicable. Comparison of the rate of GH/PE for ART and non-ART mothers, with odds ratio (OR), adjusted odds ratio (AOR), and 95% confidence interval (CI) used to assess the association between ART and GH/PE. The overall rate of GH/PE was 4.3%, with 6.4% for ART mothers and 4.3% for non-ART mothers. The rate of GH/PE was higher for mothers of twins than singletons (12.4% vs. 5.7% for ART mothers; 8.6% vs. 4.2% for non-ART mothers). The ART mothers had a 17% increased odds of GH/PE compared with the non-ART mothers (AOR 1.17; 95% CI, 1.10-1.24). After stratification by plurality, the difference in GH/PE rates between ART and non-ART mothers was not statistically significant, with AOR 1.05 (95% CI, 0.98-1.12) for mothers of singletons and AOR 1.10 (95% CI, 0.94-1.30) for mothers of twins. The changes in AOR after stratification indicated that multiple pregnancies after ART are the single most likely explanation for the increased rate of GH/PE among ART mothers. The lower rate of GH/PE among mothers of singletons compared with mothers of twins suggests that a policy to minimize multiple pregnancies after ART may reduce the excess risk of GH/PE due to ART treatment. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Maternal Smoking Among Women With and Without Use of Assisted Reproductive Technologies

    Science.gov (United States)

    Tong, Van T.; Kissin, Dmitry M.; Bernson, Dana; Copeland, Glenn; Boulet, Sheree L.; Zhang, Yujia; Jamieson, Denise J.; England, Lucinda J.

    2016-01-01

    Objective To estimate smoking prevalence during the year before pregnancy and during pregnancy and adverse outcomes among women who delivered infants with and without assisted reproductive technology (ART) using linked birth certificates (BC) and National ART Surveillance System (NASS) data. Methods Data were analyzed for 384,390 women and 392,248 infants born in Massachusetts and Michigan during 2008–2009. Maternal smoking prevalence was estimated using smoking indicated from BC by ART status. For ART users, to evaluate underreporting, prepregnancy smoking was estimated from BC, NASS, or both sources. Effect of prenatal smoking on preterm and mean birthweight (term only) for singleton infants were examined by ART status. Results Maternal smoking prevalence estimates were significantly lower for ART users than nonusers (pre-pregnancy = 3.2% vs. 16.7%; prenatal = 1.0% vs. 11.1%, p smoking information from BC and NASS, prepregnancy smoking prevalence estimates for ART users could be as high as 4.4% to 6.1%. Adverse effects of smoking on infant outcomes in ART pregnancies were consistent with the effects seen in non-ART pregnancies, specifically decline in infant birthweight and increase in preterm delivery, although association between smoking and preterm was not significant. Conclusion A low, but substantial proportion of ART users smoked before and during pregnancy. As ART users are highly motivated to get pregnant, it should be clearly communicated that smoking can decrease fertility and adversely affect pregnancy outcomes. Continued efforts are needed to encourage smoking cessation and maintain tobacco abstinence among all women of reproductive age. PMID:27243366

  16. Homocysteine in embryo culture media as a predictor of pregnancy outcome in assisted reproductive technology.

    Science.gov (United States)

    Boyama, Burcu Aydin; Cepni, Ismail; Imamoglu, Metehan; Oncul, Mahmut; Tuten, Abdullah; Yuksel, Mehmet Aytac; Kervancioglu, Mehmet Ertan; Kaleli, Semih; Ocal, Pelin

    2016-01-01

    The aim of this study was to determine whether homocysteine (hcy) concentrations in embryo culture media correlate with pregnancy outcome in assisted reproductive technology (ART) cycles. Forty patients who underwent single embryo transfer at the infertility clinic of a tertiary care center were recruited for this case-control study. Spent embryo culture media from all patients were collected after single embryo transfer on day 3 (n = 40). Hcy concentrations in embryo culture media were analyzed by enzyme cycling method. Patients were grouped according to the diagnosis of a clinical pregnancy. Sixteen patients were pregnant while 24 patients failed to achieve conception. Mean Hcy levels in the culture media were significantly different between the groups (p < 0.003), as 4.58 ± 1.31 μmol/l in the non-pregnant group and 3.37 ± 0.92 μmol/l in the pregnant group. Receiver operator curve analysis for determining the diagnostic potential of Hcy for pregnancy revealed an area under the curve of 0.792 (confidence interval: 0.65-0.94; p < 0.05). A cut-off value of 3.53 μmol/l was determined with a sensitivity of 83.3%, and a specificity of 68.8%. Lower hcy levels were associated with a better chance of pregnancy and better embryo grades. Hcy may be introduced as an individual metabolomic profiling marker for embryos.

  17. Methotrexate treatment for ectopic pregnancy after assisted reproductive technology: A case-control study.

    Science.gov (United States)

    Ohannessian, A; Crochet, P; Courbiere, B; Gnisci, A; Agostini, A

    2016-06-01

    Ectopic pregnancy (EP) occurs in 2% to 5.6% of pregnancies achieved by assisted reproductive technology (ART). EP treatment options include medical treatment by uses of methotrexate (MTX) systemic injection. The objective of this study was to compare MTX treatment effectiveness for EP occurring spontaneously or following ART. A case-control study performed in the department of obstetrics and gynecology at a tertiary health care center in France. Twenty EP achieved by ART (ART group) and 60 spontaneous EP (SEP group) received MTX treatment between January 2002 and May 2012. The main outcome measures were MTX treatment failure rates, number of MTX injections administered and recovery time. MTX treatment failure rates observed in ART and SEP groups were similar (3/20 [15%] versus 10/60 [17%]: OR=0.88 [0.22-3.58]). Mean duration of recovery time in patients with successful MTX treatment did not differ between ART and SEP groups (33±14 days versus 28±13 days, P=0.39). A second MTX injection was required more frequently in ART group than in SEP group (10/20 [50%] versus 10/60 [17%]: OR=5 [1.65-15.15]). It is concluded that MTX treatment is equally effective for spontaneous EP and EP achieved by ART, two injections of MTX being more frequently required in case of ART. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Increased Length of Awareness of Assisted Reproductive Technologies Fosters Positive Attitudes and Acceptance among Women

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    Chelsea Fortin

    2016-12-01

    Full Text Available Background: The field of infertility medicine has witnessed a surge of scientific developments in recent years, but research on public attitudes towards infertility treatments has remained minimal. This study examined the social and demographic factors that affect women’s attitudes towards assisted reproductive technology (ART in general, as well as their opinions of specific issues related to ART. Materials and Methods: This cross-sectional study was conducted from March 2011 to April 2011 by means of an online survey administered to a sample of 287 women. Results: Women with a longer length of awareness of ART had significantly greater attitudinal favorability towards ART. Political affiliation was also significantly related to general attitudes, as well as several specific aspects of ART issues. Conclusion: The results of this study suggest that several factors influence attitudes that women hold in regards to ART. Identifying some of these factors serves as a crucial starting point for devising strategies to increase public acceptance of ART.

  19. States Monitoring Assisted Reproductive Technology (SMART) Collaborative: data collection, linkage, dissemination, and use.

    Science.gov (United States)

    Mneimneh, Allison S; Boulet, Sheree L; Sunderam, Saswati; Zhang, Yujia; Jamieson, Denise J; Crawford, Sara; McKane, Patricia; Copeland, Glenn; Mersol-Barg, Michael; Grigorescu, Violanda; Cohen, Bruce; Steele, JoAnn; Sappenfield, William; Diop, Hafsatou; Kirby, Russell S; Kissin, Dmitry M

    2013-07-01

    Assisted reproductive technology (ART) refers to fertility treatments in which both eggs and sperm are handled outside the body. The Centers for Disease Control and Prevention (CDC) oversees the National ART Surveillance System (NASS), which collects data on all ART procedures performed in the United States. The NASS, while a comprehensive source of data on ART patient demographics and clinical procedures, includes limited information on outcomes related to women's and children's health. To examine ART-related health outcomes, CDC and three states (Massachusetts, Florida, and Michigan) established the States Monitoring ART (SMART) Collaborative to evaluate maternal and perinatal outcomes of ART and improve state-based ART surveillance. To date, NASS data have been linked with states' vital records, disease registries, and hospital discharge data with a linkage rate of 90.2%. The probabilistic linkage methodology used in the SMART Collaborative has been validated and found to be both accurate and efficient. A wide breadth of applied research within the Collaborative is planned or ongoing, including examinations of the impact of insurance mandates on ART use as well as the relationships between ART and birth defects and cancer, among others. The SMART Collaborative is working to improve state-based ART surveillance by developing state surveillance plans, establishing partnerships, and conducting data analyses. The SMART Collaborative has been instrumental in creating linked datasets and strengthening epidemiologic and research capacity for improving maternal and infant health programs and evaluating the public health impact of ART.

  20. Thrombophilia and assisted reproduction technology-any detrimental impact or unnecessary overuse?

    Science.gov (United States)

    Ata, Baris; Urman, Bulent

    2016-10-01

    The aim of this study is to provide an overview of the studies investigating a possible association between thrombophilia and assisted reproductive technology (ART) outcome. This is a literature review. Congenital thrombophilias (CoT) are reported to be associated with pregnancy loss. However, the association between CoT and early pregnancy loss is weak and does not necessarily support causation. CoT are more likely to be associated with late fetal loss. Even though data pooled from case-control and cohort studies suggest an increased risk of ART failure in women with CoTs, there seems no association when the analysis is confined to better quality cohort studies. The evidence supporting anticoagulation to improve ART outcome in CoT carriers is weak. Likewise, studies on antiphospholipid antibodies (APAs) and ART outcome suffer from multiple methodological limitations and a detrimental impact of APA positivity is controversial. Empirical administration of heparin or low molecular weight heparin to women with recurrent ART failures is supported by weak evidence. Importantly, thrombophilias are likely to increase thrombotic complications after ovarian stimulation for ART. Current evidence does not support routinely testing for or treatment of thrombophilia in the setting of ART nor in couples with implantation failure. A careful personal and family history should be obtained and a risk assessment for thrombotic complications should be made in every woman undergoing ovarian stimulation. If positive, testing for thrombophilia is warranted.

  1. [Adverse pregnancy outcomes after Assisted Reproduction Technology in women with endometriosis].

    Science.gov (United States)

    Carassou-Maillan, A; Pouly, J-L; Mulliez, A; Dejou-Bouillet, L; Gremeau, A-S; Brugnon, F; Janny, L; Canis, M

    2014-04-01

    While association between endometriosis and infertility is well established, there are few studies about the impact of endometriosis on adverse pregnancy outcomes. The aim of this study was to determine the effect of endometriosis on obstetric outcomes and whether the severity of the disease had an influence on these. We performed a retrospective study to investigate the obstetric outcomes of a population of 1204 subfertile women, including 258 with endometriosis, who obtained, thanks to assisted reproduction technology, a singleton pregnancy evolving beyond embryonic stage. Two analyzes were performed. The first compared women with endometriosis to women with other causes of infertility. The second observed adverse pregnancy outcomes according to AFS-R stages of endometriosis. The overall rate of live birth children was 95.8%. In case of endometriosis, there was a significant increase of the incidence of preterm delivery, especially before 32 weeks amenorrhea (6.2% vs 3.1% in the group "without endometriosis", P = 0.03), antenatal bleeding (5.3% vs 2.2%, P = 0.01) and placenta previa (4.9% vs 0.9%, P women with endometriosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men.

    Science.gov (United States)

    Agostini, Francesca; Monti, Fiorella; Andrei, Federica; Paterlini, Marcella; Palomba, Stefano; La Sala, Giovanni Battista

    2017-10-01

    Quality of life (QoL) may represent a comprehensive indicator for the assessment of the psychological impact of complex clinical conditions, such as infertility. Infertile women have a worse QoL compared to both infertile men and non-infertile controls. However, the initial phases of infertility treatments have been frequently investigated using cross-sectional study designs. This prospective longitudinal study aimed at assessing the health-related QoL change across different phases of assisted reproductive technology (ART) treatments in subfertile women and men. Eighty-five subfertile women and men undergoing ART cycles were assessed at the beginning of the ovarian stimulation, during oocyte retrieval before discharging, and around 14 days after the embryo transfer. QoL was assessed through the Short Form 36. Irrespective of the cause of infertility, work status, and age, QoL levels decreased from the first to the third assessment, and women scored significantly lower than men to each QoL indicator. Additionally, a higher number of previous ART failures had a negative impact on QoL, irrespective of gender and the phase of treatment. ART outcome marginally affected women's QoL across time. Infertile women have a worse QoL throughout all phases of ARTs compared to men, and this difference increases in infertile patients with more than one previous ART failure.

  3. Assisted Reproductive Technology in Iran: The First National Report on Centers, 2011

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    Mehrandokht Abedini

    2016-09-01

    Full Text Available Background: Due to the worldwide increase in infertility, it is both necessary and important to have assisted reproductive technology (ART registries. In Iran, donation and surrogacy programs are approved by decrees from religious scholars. ART has been used since 1984 in Iran and the first Iranian infant conceived by gamete intra-fallopian transfer (GIFT was born in 1989. This report, however, is the first national report on Iranian ART centers. Materials and Methods: This cross-sectional study, conducted under the supervision of the Iranian Ministry of Health, presented a summary of the numbers and percentages of centers that provided infertility services in Iran, as well as the status of ART in Iran during 2011. Results: A total of 52 centers reported treatment cycles and performed approximately 29000 intrauterine insemination (IUI, in addition to 35000 in vitro fertilization (IVF and intra-cytoplasmic sperm injection (ICSI cycles. Conclusion: Iran has considerable potential to provide IVF services for both Iranians as well as other nationalities throughout the region. This proves the need for a national center that will implement a registry system.

  4. Should there be a female age limit on public funding for assisted reproductive technology?

    Science.gov (United States)

    Carter, Drew; Watt, Amber M; Braunack-Mayer, Annette; Elshaug, Adam G; Moss, John R; Hiller, Janet E

    2013-03-01

    Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice-the capacity to benefit, personal responsibility, and need-to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice.

  5. Comparison of the outcomes between reduced and nonreduced triplet pregnancies achieved by Assisted Reproductive Technology.

    Science.gov (United States)

    Shiva, Marzieh; Mohammadi Yeganeh, Ladan; Mirzaagha, Elaheh; Chehrazi, Mohammad; Bagheri Lankarani, Narges

    2014-10-01

    In recent years, the significant increase in multiple pregnancies as a result of assisted reproductive technology (ART) has introduced the concept of multifetal reduction techniques. However, it is still unclear whether there are significant advantages of using this technique. To compare the outcomes of triplet pregnancies achieved by ART managed expectantly with those receiving fetal reduction interventions. In this retrospective study of 115 triplet pregnancies, 57 pregnancies were reduced to twins while 58 were managed expectantly. The fetal loss rate before 24 weeks did not differ between reduced and nonreduced pregnancies (12.3% vs 12.1%). However, the results of those using fetal reduction techniques showed a lower incidence of preterm labour (26.3% vs 50%, P = 0.009), higher mean gestational age at delivery (35.1 ± 2.6 vs 32.4 ± 3.6 weeks, P = 0.002) and higher mean birthweights compared with the control group (2188 ± 547 vs 1674 ± 546 g, P fetal loss. Additionally, there was a lower perinatal mortality, higher live birth rate and lower NICU admission. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  6. Risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology: a meta-analysis.

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    Jun-Zhen Qin

    Full Text Available BACKGROUND: Studies on the risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology (ART are relatively controversial and insufficient. Thus, to obtain a more precise evaluation of the risk of embryonic chromosomal abnormalities in first-trimester miscarriage after ART, we performed a meta-analysis of all available case-control studies relating to the cytogenetic analysis of chromosomal abnormalities in first-trimester miscarriage after ART. METHODS: Literature search in the electronic databases MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL based on the established strategy. Meta-regression, subgroup analysis, and Galbraith plots were conducted to explore the sources of heterogeneity. RESULTS: A total of 15 studies with 1,896 cases and 1,186 controls relevant to the risk of chromosomal abnormalities in first- trimester miscarriage after ART, and 8 studies with 601 cases and 602 controls evaluating frequency of chromosome anomaly for maternal age≥35 versus <35 were eligible for the meta-analysis. No statistical difference was found in risk of chromosomally abnormal miscarriage compared to natural conception and the different types of ART utilized, whereas the risk of fetal aneuploidy significantly increased with maternal age≥35 (OR 2.88, 95% CI: 1.74-4.77. CONCLUSIONS: ART treatment does not present an increased risk for chromosomal abnormalities occurring in a first trimester miscarriage, but incidence of fetal aneuploidy could increase significantly with advancing maternal age.

  7. Anger in women treated with assisted reproductive technology (ART): effects on mother and newborn.

    Science.gov (United States)

    Muscatello, Maria Rosaria Anna; Lorusso, Simona; Bruno, Antonio; Reale, Rosa; Ciura, Giulia La; Laganà, Antonio Simone; Retto, Giovanni; Sturlese, Emanuele; Zoccali, Rocco Antonio

    2016-03-01

    To assess anger, as well as other negative emotions, in women who underwent assisted reproductive technology (ART) respect to women who conceived naturally, and explore the effect of anger on neonatal outcomes. We recorded personal and obstetric history of the patients, neonatal weight, Apgar score, obstetric and neonatal complications. We performed Structural Clinical Interview for DSM-SCID I and II in order to assess the DSM IV axis I and axis II, State-Trait Anger Expression Inventory 2 (STAXI-2), the Self-rating Depression Scale (SDS) and Self-rating Anxiety scale (SAS). On the STAXI-2 scale, the ART group scored higher than the natural conception group on measures of general tendency and personality disposition to get angry. Moreover, the ART group women showed quite low levels of tolerance to negative environmental feedback. Our results further suggest that trait anger provides the most meaningful contribution as predictor of weight at birth. No significant differences were found for anxiety and depression between the two groups. Our study highlights the important role of anger during pregnancy, and suggests the need for further studies on both biochemical and behavioural patterns in larger samples of women who became pregnant by ART.

  8. Developmental outcomes of Japanese children born through Assisted Reproductive Technology (ART) in toddlerhood.

    Science.gov (United States)

    Aoki, Sayaka; Hashimoto, Keiji; Ogawa, Kohei; Horikawa, Reiko; Sago, Haruhiko

    2018-02-27

    This study aimed to investigate developmental outcomes of Japanese babies born through Assisted Reproductive Technology (ART) at ages 2 and 3. The data were gathered from 1085 children in a hospital-based cohort study conducted in Japan. The children's level of development was assessed through a parent-rated questionnaire, the Kinder Infant Development Scale, which consists of nine developmental domains. We compared the development of children born through ART and those born naturally by conducting analyses of covariance. For the analyses, the effect of maternal age, family income, parental education and multiple birth were controlled for. At 24 months, no significant difference was found between children born through ART and those born naturally in development in any domain. At 36 months, a significant difference was found in development of Receptive language (F (1, 845) = 6.148, P = 0.013), Expressive language (F (1, 845) = 4.060, P = 0.044) and Language concept (F (1, 845) = 6.968, P = 0.008). For these domains, children born through ART had a significantly higher developmental age compared to children born naturally. At age 2, no significant difference was found between the children born through ART and those born naturally in nine developmental domains, although at age 3, the children born through ART showed significantly better language development than the children born naturally. © 2018 Japan Society of Obstetrics and Gynecology.

  9. Obesity and ultrasound-estimated visceral fat deposits in women undergoing Assisted Reproductive Technology (ART) procedures.

    Science.gov (United States)

    Ciavattini, Andrea; Montik, Nina; Clemente, Nicolò; Santoni, Fabrizia; Moriconi, Lorenzo; Serri, Matteo; Barbadoro, Pamela; Sabbatinelli, Jacopo; Vignini, Arianna

    2017-12-01

    The aim of this study was to evaluate the influence of body mass index (BMI) and ultrasound-estimated visceral adipose tissue deposits on oocyte quality and pregnancy rate in women undergoing Assisted Reproductive Technology (ART) procedures. The study included 58 women who underwent ART procedures. According to their BMI, the women were divided into normal weight and overweight/obese; an ultrasound evaluation of preperitoneal fat thickness (PFT) was also performed for each patient. The oocyte quality was then assessed, and samples of follicular fluid were collected from each woman, in order to evaluate the intrafollicular concentration of reactive oxygen species (ROS) as markers of oxidative stress and pro-inflammatory cytokines (IL-1β and IL-6) as markers of chronic inflammation. A negative correlation was found between BMI (as well as PFT) and the number of retrieved oocytes (r = -0.3; p ART procedures, BMI and PFT negatively influence the number of oocytes retrieved and their quality. However, on multivariable analysis, only age, PFT and number of retrieved oocytes affect the success rate of ART procedures.

  10. Risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology: a meta-analysis.

    Science.gov (United States)

    Qin, Jun-Zhen; Pang, Li-Hong; Li, Min-Qing; Xu, Jing; Zhou, Xing

    2013-01-01

    Studies on the risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology (ART) are relatively controversial and insufficient. Thus, to obtain a more precise evaluation of the risk of embryonic chromosomal abnormalities in first-trimester miscarriage after ART, we performed a meta-analysis of all available case-control studies relating to the cytogenetic analysis of chromosomal abnormalities in first-trimester miscarriage after ART. Literature search in the electronic databases MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) based on the established strategy. Meta-regression, subgroup analysis, and Galbraith plots were conducted to explore the sources of heterogeneity. A total of 15 studies with 1,896 cases and 1,186 controls relevant to the risk of chromosomal abnormalities in first- trimester miscarriage after ART, and 8 studies with 601 cases and 602 controls evaluating frequency of chromosome anomaly for maternal age≥35 versus risk of chromosomally abnormal miscarriage compared to natural conception and the different types of ART utilized, whereas the risk of fetal aneuploidy significantly increased with maternal age≥35 (OR 2.88, 95% CI: 1.74-4.77). ART treatment does not present an increased risk for chromosomal abnormalities occurring in a first trimester miscarriage, but incidence of fetal aneuploidy could increase significantly with advancing maternal age.

  11. Risk of Preeclampsia in Pregnancies After Assisted Reproductive Technology and Ovarian Stimulation.

    Science.gov (United States)

    Martin, Angela S; Monsour, Michael; Kawwass, Jennifer F; Boulet, Sheree L; Kissin, Dmitry M; Jamieson, Denise J

    2016-10-01

    Objective To compare the risk of preeclampsia among spontaneously conceived pregnancies to those after hyperestrogenic ovarian stimulation (hyperestrogenic OS) with and without assisted reproductive technology (ART), and stimulation with non-hyperestrogenic aromatase inhibitor stimulation (non-hyperestrogenic OS). Methods Live-born singleton deliveries among women 20-49 years were identified in the 2004-2012 Truven Health MarketScan Commercial Claims and Encounters Databases using ICD-9 and CPT codes. Maternal characteristics were compared using Chi squared and Fisher exact tests. We performed multilevel multivariable logistic regression, controlling for maternal age, parity, comorbid conditions, and region of delivery, and calculated adjusted odds ratios (aOR) and 95 % confidence intervals for mild and severe preeclampsia. Results 1,014,526 spontaneously conceived, 6881 hyperestrogenic OS with ART, 27,516 hyperestrogenic OS without ART, and 2117 non-hyperestrogenic OS pregnancies were identified. The adjusted odds of developing preeclampsia were increased for deliveries after hyperestrogenic OS with ART (mild preeclampsia aOR 1.42, 1.24-1.62; severe preeclampsia aOR 1.83, 1.59-2.11) and without ART (mild preeclampsia aOR 1.32, 1.24-1.42; severe preeclampsia aOR 1.53, 1.41-1.66). Adjusted odds of preeclampsia were similar between spontaneously conceived and non-hyperestrogenic OS pregnancies. Conclusions for Practice Risk of preeclampsia after ART may in part be related to supraphysiologic estrogen associated with hyperestrogenic OS.

  12. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: A retrospective study

    Directory of Open Access Journals (Sweden)

    Mariano Mascarenhas

    2014-01-01

    Full Text Available Objectives : The overwhelming numbers of twins following assisted reproductive technology (ART are dichorionic twins, but monochorionic twins account for around 0.9% of post ART pregnancies. The data for post ART-monochorionic pregnancy outcomes are scarce due to the rarity of this condition. Hence, we evaluated the obstetric outcomes of monochorionic and dichorionic pregnancies conceived on ART. Settings : University teaching hospital. Study Design : A case-control study of monochorionic diamniotic (MCDA and dichorionic diamniotic (DCDA pregnancies conceived following ART treatment. Charts of all women who conceived following ART from 2008 to 2013 were screened. Among them, the monochorionic twins diagnosed in the first trimester were included and their obstetric outcome was followed-up. For comparison, an equal number of dichorionic twin pregnancies from age and body mass index matched mothers was selected. Results : The baseline clinical characteristics were similar between the two groups. MCDA group had a higher miscarriage rate (50% than the DCDA group (10%, with three seconds trimester miscarriages in the MCDA group. The live birth rates were lower in the MCDA versus DCDA group (40% vs. 90%. Among triplet pregnancies with a monochorionic component, the live birth rate was only 25%. Conclusions : Monochorionic pregnancies following ART have poorer obstetric outcomes when compared to dichorionic pregnancies. For monochorionic pregnancies following ART, intensive antenatal surveillance at a tertiary level obstetric and neonatal center may help optimize the outcome.

  13. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: A retrospective study.

    Science.gov (United States)

    Mascarenhas, Mariano; Kamath, Mohan S; Muthukumar, K; Mangalaraj, Ann M; Chandy, Achamma; Aleyamma, Tk

    2014-04-01

    The overwhelming numbers of twins following assisted reproductive technology (ART) are dichorionic twins, but monochorionic twins account for around 0.9% of post ART pregnancies. The data for post ART-monochorionic pregnancy outcomes are scarce due to the rarity of this condition. Hence, we evaluated the obstetric outcomes of monochorionic and dichorionic pregnancies conceived on ART. University teaching hospital. A case-control study of monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) pregnancies conceived following ART treatment. Charts of all women who conceived following ART from 2008 to 2013 were screened. Among them, the monochorionic twins diagnosed in the first trimester were included and their obstetric outcome was followed-up. For comparison, an equal number of dichorionic twin pregnancies from age and body mass index matched mothers was selected. The baseline clinical characteristics were similar between the two groups. MCDA group had a higher miscarriage rate (50%) than the DCDA group (10%), with three seconds trimester miscarriages in the MCDA group. The live birth rates were lower in the MCDA versus DCDA group (40% vs. 90%). Among triplet pregnancies with a monochorionic component, the live birth rate was only 25%. Monochorionic pregnancies following ART have poorer obstetric outcomes when compared to dichorionic pregnancies. For monochorionic pregnancies following ART, intensive antenatal surveillance at a tertiary level obstetric and neonatal center may help optimize the outcome.

  14. Menopausal women requesting egg/embryo donation: examining health screening guidelines for assisted reproductive technology.

    Science.gov (United States)

    MacArthur, Taleen; Bachmann, Gloria; Ayers, Charletta

    2016-07-01

    As more postreproductive women opt to pursue pregnancy with advanced assisted reproductive technologies (ART), the menopausal practitioner will become more involved in counseling, screening, and referral of premenopausal, perimenopausal, and postmenopausal women for these services. This review was conducted with the aim of (1) evaluating ART screening practices as they pertain to postreproductive women, and (2) reviewing the outcomes of ART using oocyte donation in postreproductive women. A total of 950 unique records were found on PubMed, Clinical Key, and Google Scholar. Of these, 252 records were screened for relevance based on their titles and abstracts. With further review of these 252 records, 93 full-text articles were assessed for eligibility, and 63 were excluded based on relevance to our study. Finally, 30 studies were included in our qualitative synthesis. Despite the increasing use of ART in postreproductive women, there are limited guidelines for determining candidacy with regard to maternal health, the most comprehensive of which are the guidelines from the American Society for Reproductive Medicine (ASRM). Although the American Society for Reproductive Medicine guidelines state that healthy women over 50 who are prepared for parenthood are candidates for ART through oocyte donation, they note that older women should be counseled as to the increased obstetric risk associated with advanced maternal age. With aging, particularly for those women who are menopausal and postmenopausal, the woman and her fetus, however, are at risk of increased morbidity and mortality as compared with younger, healthy pregnant women. Because national trends suggest that women are delaying childbearing, the cohort of postreproductive women looking toward ART using donor oocytes as a fertility option will expand and menopausal practitioners will often participate in the ART counseling of these women. Because maternal and fetal morbidity and mortality increase in

  15. Assisted reproductive technology and pregnancy-related hypertensive complications: a systematic review.

    Science.gov (United States)

    Thomopoulos, C; Tsioufis, C; Michalopoulou, H; Makris, T; Papademetriou, V; Stefanadis, C

    2013-03-01

    Hypertensive complications in pregnancy are the leading cause of maternal morbidity, at least in the developed countries. In recent years, infertility issues are managed with ever growing therapeutic options namely assisted reproductive technologies (ART), which improve the ratio of successful induction of pregnancy. It is still debated whether various ART modalities are associated with adverse pregnancy outcomes, including hypertensive complications, particularly with higher incidence of preeclampsia. The main source of controversy stems from the diversity of effect modifiers modulating the association between ART-oriented pregnancy and hypertensive disorders. Indeed, women undergoing an ART procedure are affected by diverse causes of infertility, are frequently characterized by different genetic patterns with respect to their artificially conceived embryo and experienced multiple gestations. In order to investigate whether ART modalities are associated with increased incidence of hypertensive complications in pregnancy, we reviewed all published studies carried out before the end of 2010 and identified in the PubMed database. Among the 47 studies finally selected and by acknowledging the potential of shortcomings related to the different study design and populations, the overall evidence suggests that ART-oriented pregnancies-especially the in-vitro fertilization techniques-are accompanied by increased risk for gestational hypertension and preeclampsia as compared with non-ART pregnancies, even after adjustment for confounders. Multiple gestations, advanced age and underlying polycystic ovary syndrome resulted in constant confounders of the questioned association. Reducing multiple gestations by implementing single embryo techniques might be the therapeutic limiting step to lower the rate of hypertensive complications in assisted pregnancies.

  16. A Biochemical Approach to Detect Oxidative Stress in Infertile Women Undergoing Assisted Reproductive Technology Procedures

    Science.gov (United States)

    Becatti, Matteo; Fucci, Rossella; Mannucci, Amanda; Barygina, Victoria; Mugnaini, Marco; Criscuoli, Luciana; Giachini, Claudia; Bertocci, Francesco; Picone, Rita; Emmi, Giacomo; Evangelisti, Paolo; Rizzello, Francesca; Cozzi, Cinzia; Taddei, Niccolò; Coccia, Maria Elisabetta

    2018-01-01

    Oxidative stress plays a major role in critical biological processes in human reproduction. However, a reliable and biologically accurate indicator of this condition does not yet exist. On these bases, the aim of this study was to assess and compare the blood and follicular fluid (FF) redox status of 45 infertile subjects (and 45 age-matched controls) undergoing in vitro fertilization (IVF), and explore possible relationships between the assessed redox parameters and IVF outcomes. Reactive Oxygen Species (ROS) production, assessed by flow cytometry analysis in blood leukocytes and granulosa cells, significantly increased (p assisted reproductive techniques and infertility management is recommended. PMID:29462946

  17. Zika virus and assisted reproduction.

    Science.gov (United States)

    Cordeiro, Christina N; Bano, Rashda; Washington Cross, Chantel I; Segars, James H

    2017-06-01

    Due to the fact that the Zika virus can be sexually transmitted, there is a potential risk for disease transmission at several stages of assisted reproduction. Such a possibility poses a serious challenge to couples pursing fertility with reproductive technologies. Here, we discuss what is known regarding Zika virus infection with respect to sexual transmission and correlate this knowledge with recent recommendations in the realm of infertility treatment. Zika virus can be transmitted from infected men and women through vaginal, oral or anal intercourse. Zika virus RNA has been detected in blood, semen, cervical mucus and vaginal fluid. Currently, the Centers for Disease Control recommends that infected men wait 6 months, and infected women 8 weeks, prior to attempting pregnancy. Reproductive tissue donors should wait 6 months before giving a specimen. Further study of Zika virus transmission in different reproductive tissues and establishment of validated testing methods for viral disease transmissibility are urgently needed. Reproductive technologists need to establish screening, testing and laboratory protocols aimed to reduce the risk of Zika virus transmission during assisted reproduction.

  18. Assisted reproductive technology in Europe, 2004: results generated from European registers by ESHRE

    DEFF Research Database (Denmark)

    Goossens, V.; Ferraretti, A.P.; Bhattacharya, S.

    2008-01-01

    BACKGROUND: European results of assisted reproductive techniques from treatments initiated during 2004 are presented in this eighth report. METHODS: Data were mainly collected from existing national registers. From 29 countries, 785 clinics reported 367,066 treatment cycles including: IVF (114......: Compared with earlier years, the reported number of ART cycles in Europe increased and the pregnancy rates increased marginally, even though fewer embryos were transferred and the multiple delivery rates were reduced Udgivelsesdato: 2008/4...

  19. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies

    OpenAIRE

    Boivin, Jacky; Griffiths, E.; Venetis, C. A.

    2011-01-01

    Objective To examine whether pretreatment emotional distress in women is associated with achievement of pregnancy after a cycle of assisted reproductive technology. \\ud \\ud Design Meta-analysis of prospective psychosocial studies. \\ud \\ud Data sources PubMed, Medline, Embase, PsycINFO, PsychNET, ISI Web of Knowledge, and ISI Web of Science were searched for articles published from 1985 to March 2010 (inclusive). We also undertook a hand search of reference lists and contacted 29 authors. Elig...

  20. Investigation of Personality Traits between Infertile Women Submitted to Assisted Reproductive Technology or Surrogacy

    Directory of Open Access Journals (Sweden)

    Najmeh Asgarini

    2016-05-01

    Full Text Available Background: Personality traits affect human relationships, social interactions, treatment procedures, and essentially all human activities. The purpose of this study is to investigate the personality traits -including sensation seeking, flexibility, and happiness - among a variety of infertile women who were apt to choose assisted reproductive technology (ART or surrogacy. Materials and Methods: This is a cross-sectional study that was performed on 251 infertile women who visited Isfahan and Tehran Reproductive Medicine Center. These fertility clinics are located in Isfahan and Tehran, Iran. In this study, 201 infertile women who underwent treatment using ART and 50 infertile women who tended to have surrogacy were chosen by convenience sampling. Zuckerman’s Sensation Seeking Scale Form V (SSS-V, Psychological Flexibility Questionnaire (adapted from NEO Personality Inventory-Revised and Oxford Happiness Questionnaire (OHQ were used as research instruments. All participants had to complete the research instruments in order to be included in this study. Data were analyzed by descriptive-analytical statistics and statistical tests including multivariate analysis of variance (MANOVA and Z Fisher. Statistically significant effects were accepted for P<0.05. Results: In the sensation-seeking variable, there was a meaningful difference between under-study groups. However, the flexibility and happiness variables did not have a significant difference between under-study groups (P<0.001. Interaction between education, employment, and financial status was effective in happiness of infertile women underwent ART (P<0.05, while age, education and financial status were also effective in happiness of infertile women sought surrogacy (P<0.05. A positive meaningful relationship was seen between sensation seeking and flexibility variables in both groups (P<0.05. And a negative meaningful relationship was seen between sensation seeking and happiness in infertile

  1. Child interests in assisted reproductive technology: how is the welfare principle applied in practice?

    Science.gov (United States)

    de Lacey, Sheryl L; Peterson, Karen; McMillan, John

    2015-03-01

    How is the welfare principle interpreted and practised and what meaning does it hold for health professionals who must apply it in assisted reproductive technology (ART)? The welfare of a child is a meaningful concept to ART counsellors but it is also impractical when applied preconception. Policy which promotes the interests of a child to be born is inconsistent between and within countries, and has been widely criticized as meaningless, as an unfair imposition and for its lack of clarity and inconsistent translation to ART practice. We conducted a qualitative study of ART counsellors in Australia and New Zealand in 2012. This study took an inductive approach. Thirty-two counsellors (15 psychologists and 17 social workers) participated in 6 focus groups. Vignettes were used to focus and stimulate discussion of how the welfare of all participants but especially the interests of a non-existent child were interpreted and operationalized in practice. Qualitative descriptive content analysis was used to analyse the data into themes. Five themes emerged in the data: giving presence to the child that could be, balancing welfare interests, welfare concerns, balancing values and making a decision and screening and legal presumptions against treatment. Themes were validated according to qualitative research standards. The study showed that counsellors take the child welfare principle seriously but that the concept is indeed slippery and difficult to operationalize. Counsellors denied a role in screening patients for parenting fitness but were engaged in health care assessment of patients and these roles need further differentiation, clarity and research. Health care practitioners would benefit from a process that reviews decisions and clarifies professional values. Participants were drawn from only two of the six Australian states and two territories. The study provides insight and deeper understanding of how welfare principles play out in counselling practice, what gives

  2. Culture media influenced laboratory outcomes but not neonatal birth weight in assisted reproductive technology.

    Science.gov (United States)

    Yin, Tai-lang; Zhang, Yi; Li, Sai-jiao; Zhao, Meng; Ding, Jin-li; Xu, Wang-ming; Yang, Jing

    2015-12-01

    Whether the type of culture media utilized in assisted reproductive technology has impacts on laboratory outcomes and birth weight of newborns in in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was investigated. A total of 673 patients undergoing IVF/ICSI and giving birth to live singletons after fresh embryo transfer on day 3 from Jan. 1, 2010 to Dec. 31, 2012 were included. Three types of culture media were used during this period: Quinn's Advantage (QA), Single Step Medium (SSM), and Continuous Single Culture medium (CSC). Fertilization rate (FR), normal fertilization rate (NFR), cleavage rate (CR), normal cleavage rate (NCR), good-quality embryo rate (GQER) and neonatal birth weight were compared using one-way ANOVA and χ (2) tests. Multiple linear regression analysis was performed to determine the impact of culture media on laboratory outcomes and birth weight. In IVF cycles, GQER was significantly decreased in SSM medium group as compared with QA or CSC media groups (63.6% vs. 69.0% in QA; vs. 71.3% in CSC, P=0.011). In ICSI cycles, FR, NFR and CR were significantly lower in CSC medium group than in other two media groups. No significant difference was observed in neonatal birthweight among the three groups (P=0.759). Multiple linear regression analyses confirmed that the type of culture medium was correlated with FR, NFR, CR and GQER, but not with neonatal birth weight. The type of culture media had potential influences on laboratory outcomes but did not exhibit an impact on the birth weight of singletons in ART.

  3. Microbial colonization of follicular fluid: alterations in cytokine expression and adverse assisted reproduction technology outcomes.

    Science.gov (United States)

    Pelzer, Elise S; Allan, John A; Cunningham, Kelly; Mengersen, Kerrie; Allan, Janet M; Launchbury, Tara; Beagley, Kenneth; Knox, Christine L

    2011-07-01

    Previous studies have measured cytokines expressed within follicular fluid and compared the profiles with the aetiology of infertility and/or successful or unsuccessful assisted reproduction technology (ART) outcomes. In this study, 71 paired follicular fluid and vaginal secretions collected from ART patients were cultured to detect microorganisms and tested for the presence of cytokines. Patient specimens were selected for assay based on two criteria: whether the follicular fluid specimen was colonized (with microorganisms prior to oocyte retrieval) or contaminated by vaginal flora and; the aetiology of infertility. Patients included fertile women (with infertile male partners; n = 18), women with endometriosis (n = 16) or polycystic ovary syndrome (PCOS, n = 14), or couples with a history of genital tract infection (n = 9) or idiopathic infertility (n = 14). Microorganisms and cytokines were detected within all tested specimens. Colonizing microorganisms in follicular fluid were associated with: decreased fertilization rates for fertile women (P = 0.005), women with endometriosis (P = 0.0002) or PCOS (P = 0.002) compared with women whose follicular fluid was contaminated at the time of oocyte retrieval and with decreased pregnancy rates for couples with idiopathic infertility (P = 0.001). A single cytokine was discriminatory for women with an idiopathic aetiology of infertility (follicular fluid interleukin (IL)-18). Unique cytokine profiles were also associated with successful fertilization (IL-1α, IL-1β, IL-18 and vascular endothelial growth factor). Follicular fluid is not sterile. Microorganisms colonizing follicular fluid and the ensuing cytokine response could be a further as yet unrecognized cause and/or predictor of adverse ART outcomes and infertility.

  4. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART).

    Science.gov (United States)

    La Marca, A; Sighinolfi, G; Radi, D; Argento, C; Baraldi, E; Artenisio, A Carducci; Stabile, G; Volpe, A

    2010-01-01

    In women, anti-Müllerian hormone (AMH) levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies (ART). In men AMH is secreted in both the serum and seminal fluid. Its measurement may be useful in clinical evaluation of the infertile male. The PubMed database was systematically searched for studies published until the end of January 2009, search criteria relevant to AMH, ovarian reserve, ovarian response to gonadotrophin stimulation, spermatogenesis and azoospermia were used. AMH seems to be a better marker in predicting ovarian response to controlled ovarian stimulation than age of the patient, FSH, estradiol and inhibin B. A similar performance for AMH and antral follicular count has been reported. In clinical practice, AMH measurement may be useful in the prediction of poor response and cycle cancellation and also of hyper-response and ovarian hyperstimulation syndrome. In the male, the wide overlap of AMH values between controls and infertile men precludes this hormone from being a useful marker of spermatogenesis. As AMH may permit the identification of both the extremes of ovarian stimulation, a possible role for its measurement may be in the individualization of treatment strategies in order to reduce the clinical risk of ART along with optimized treatment burden. It is fundamental to clarify the cost/benefit of its use in ovarian reserve testing. Regarding the role of AMH in the evaluation of infertile men, AMH as single marker of spermatogenesis does not seem to reach a satisfactory clinical utility.

  5. Organochlorine pesticides in follicular fluid of women undergoing assisted reproductive technologies from central China

    International Nuclear Information System (INIS)

    Zhu, Yindi; Huang, Bo; Li, Qing X.; Wang, Jun

    2015-01-01

    Female infertility rates have increased by approximately 4% since the 1980s. There is evidence of adverse effects on female fertility in relation to exposure of chemical pollution in recent years. Follicular fluid samples were collected from 127 woman patients (aged 20–35) who underwent assisted reproductive technologies (ART) and had no records indicating occupational exposure to OCPs. Seventeen OCPs were analyzed in this study. The results showed that methoxychlor was dominant, accounted for 13.4% of total OCPs with a mean concentration of 167.9 ± 33.9 ng/g lipid weight (lw), followed by heptachlor-epoxide, hexachlorocyclohexanes, endrin and DDT. The concentrations of OCPs in the follicular fluid samples in the present study were moderate in comparison with those reported from developed or industrialized countries. All these pollutants can accumulate in different tissues of human body through diet, drinking water and respiration. No correlation between patient age and OCP concentrations was observed in this study. - Highlights: • 17 OCPs in follicular fluid samples from 127 woman patients were analyzed. • Methoxychlor was the most dominant, constituting 13.4% of total OCPs with a mean concentration of 168 ng/g lw. • The concentrations of DDT and HCHs were lower than those in human breast milk from Russia and Iran and blood from India. • DDTs and HCHs in the samples would be mainly from historical usage. • The correlation between patient ages and concentrations of OCPs was weak. - OCPs at median concentrations of 460.0–2927.2 ng/g lipid weight in follicular fluids of central China have physiological effects.

  6. Assisted reproductive technology treatment in women with severe eating disorders: a national cohort study.

    Science.gov (United States)

    Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja; Schmidt, Lone; Hougaard, Charlotte O; Hageman, Ida

    2015-11-01

    This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the first and last eating disorder diagnosis before, during, and after ART treatment, and evaluates differences in obstetric outcomes between women with and without a severe eating disorder. Hospital-diagnosed eating disorders among 42,915 women in the Danish National ART cohort (DANAC), registered during 1994-2009 in the mandatory Psychiatric Central Research Register, were compared with a non-eating disorder ART cohort of 42,644 women and an age-matched background population of 215,290 women without a history of ART treatment for the main outcome measures prevalence of eating disorders, frequency distribution of diagnoses before/during/after ART treatment, as well as ART treatment and obstetric outcomes. In the ART cohort, 271 women (0.63%) had an eating disorder diagnosis compared with 0.73% in the background population (p = 0.025). The prevalence of ovulatory disorder was significantly higher in women with a severe eating disorder compared with the ART cohort without eating disorders. Obstetric outcomes were similar in ART-treated women with and without an eating disorder. Women with severe eating disorders were identified in the ART cohort, although significantly less often than in the age-matched background population. Women with severe eating disorders suffered more often from anovulatory infertility than the ART comparison cohort without this disease. Obstetric outcomes appeared reassuring in the ART cohort with eating disorders. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes.

    Science.gov (United States)

    Boots, Christina E; Hill, Micah J; Feinberg, Eve C; Lathi, Ruth B; Fowler, Susan A; Jungheim, Emily S

    2016-05-01

    The purpose of this research was to study whether methotrexate (MTX) as treatment for ectopic pregnancy (EP) impacts the future fertility of women undergoing assisted reproductive technology (ART) METHODS: In a systematic review and multi-center retrospective cohort from four academic and private fertility centers, 214 women underwent an ART cycle before and after receiving MTX as treatment for an EP. Measures of ovarian reserve and responsiveness and rates of clinical pregnancy (CP) and live birth (LB) were compared in the ART cycles prior and subsequent to MTX. Seven studies were identified in the systematic review, and primary data from four institutions was included in the final analysis. Women were significantly older in post-MTX cycles (35.3 vs 34.7 years). There were no differences in follicle stimulating hormone, antral follicle count, duration of stimulation, oocytes retrieved, or fertilization rate between pre- and post-MTX cycles. However, post-MTX cycles received a significantly higher total dose of gonadotropins (4206 vs 3961 IU). Overall, 42 % of women achieved a CP and 35 % achieved a LB in the post-MTX ART cycle, which is similar to national statistics. Although no factors were identified that were predictive of LB in young women, the number of oocytes retrieved in the previous ART cycle and current AFC were predictive of LB (AUC 0.76, 0.75) for the older women. MTX does not influence ovarian reserve, response to gonadotropin stimulation, and CP or LB rate after ART. MTX remains a safe and effective treatment option for women with asymptomatic EPs.

  8. Disparities in Assisted Reproductive Technology Utilization by Race and Ethnicity, United States, 2014: A Commentary.

    Science.gov (United States)

    Dieke, Ada C; Zhang, Yujia; Kissin, Dmitry M; Barfield, Wanda D; Boulet, Sheree L

    2017-06-01

    Disparities in infertility and access to infertility treatments, such as assisted reproductive technology (ART), by race/ethnicity, have been reported. However, identifying disparities in ART usage may have been hampered by missing race/ethnicity information in ART surveillance. We review infertility prevalence and treatment disparities, use recent data to examine ART use in the United States by race/ethnicity and residency in states with mandated insurance coverage for in vitro fertilization (IVF), and discuss approaches for reducing disparities. We used 2014 National ART Surveillance System (NASS) data to calculate rates of ART procedures per million women 15-44 years of age, a proxy measure of ART utilization, for Census-defined racial/ethnic groups in the United States; rates were further stratified by the presence of insurance mandates for IVF treatment. Missing race/ethnicity data (35.6% of cycles) were imputed. Asian/Pacific Islander (A/PI) women had the highest rates of ART utilization at 5883 ART procedures per million women 15-44 years of age in 2014, whereas American Indian/Alaska Native non-Hispanic women had the lowest rates at 807 per million, compared with other racial/ethnic groups. In each racial/ethnic category, ART utilization rates were higher for women in states with an insurance mandate for IVF treatment versus those without. In 2014, A/PI women had the highest rates of ART utilization. ART utilization for all racial/ethnic groups was higher in states with insurance mandates for IVF than those without, although disparities were still evident. Although mandates may increase access to infertility treatments, they are not sufficient to eliminate these disparities.

  9. Pregnancy outcome of assisted reproductive technology cycle in patients with hypogonadotropic hypogonadism.

    Science.gov (United States)

    Pandurangi, Monna; Tamizharasi, M; Reddy, N Sanjeeva

    2015-01-01

    Ovulation induction in patients with hypogonadotropic hypogonadism (HH) is a challenge to the treating physician. The threshold for ovarian response in HH may differ substantially from that of normal patients. To reach that threshold levels of follicle stimulating hormone, in a step-up protocol longer duration of stimulation is required in some cases so as to prevent multiple pregnancy and to eliminate the risk of ovarian hyperstimulation syndrome. To evaluate the duration of stimulation, quality of oocytes, and embryo, and the pregnancy outcome in the assisted reproductive technology (ART) cycles in patients with HH. Over the period of 4 years, we had 14 patients with HH in whom 21 cycles of ovulation induction were done. Of these 7 patients underwent oocyte retrieval and intracytoplasmic sperm injection (ICSI). We present a retrospective study of these 7 patients who underwent ART to evaluate the duration of stimulation, quality of oocytes and embryo, and the pregnancy outcome. In the study group on ovulation induction with gonadotropins, only one patient had the duration of stimulation of the standard 12 days, the remaining 6 patients took ≥12 days to respond to stimulation (maxium being 54 days). Mean ET in these patients was 8.9 mm. Six patients had >70% good quality MII oocytes. One patient responded poorly and had only 2 good quality MII oocytes (50%). After ICSI procedure, resultant embryos were of grade 1 and 2 in all the patients irrespective of the duration of stimulation. Fertilization rate in these patients was 85% (except in one 50% fertilization rate), and the cumulative pregnancy rate was 68.6%. In the patients with HH the quality of oocytes and embryos, and the pregnancy rate is not affected even if the duration of stimulation is prolonged.

  10. Fetal cardiac remodeling in twin pregnancy conceived by assisted reproductive technology.

    Science.gov (United States)

    Valenzuela-Alcaraz, B; Cruz-Lemini, M; Rodríguez-López, M; Goncé, A; García-Otero, L; Ayuso, H; Sitges, M; Bijnens, B; Balasch, J; Gratacós, E; Crispi, F

    2018-01-01

    Recent data suggest that singleton fetuses conceived by assisted reproductive technology (ART) present cardiovascular remodeling that may persist postnatally. Twin pregnancies are more frequent in the ART population and are associated with increased adverse perinatal outcomes, such as hypertensive disorders, gestational diabetes and preterm birth. However, it is unknown whether cardiac remodeling is also present in twin pregnancies conceived by ART. Our aim was to assess the presence of fetal cardiac remodeling and dysfunction in twin pregnancies conceived by ART as compared with those conceived spontaneously (SC). This was a prospective cohort study including 50 dichorionic twin fetuses conceived by ART and 50 SC twin fetuses. The study protocol included collection of baseline/perinatal data and a fetal ultrasound examination at 28-30 weeks' gestation, including assessment of estimated fetal weight, fetoplacental Doppler and fetal echocardiography. Measurements of atrial area, atrial/heart ratio, ventricular sphericity index, free wall thickness, mitral and tricuspid annular plane systolic excursions, and systolic and early diastolic peak velocities were assessed. Multilevel analyses were used to compare perinatal and ultrasonographic parameters. Comparisons of echocardiographic variables were adjusted for parental age, paternal body mass index and incidence of pre-eclampsia. Compared with SC twins, ART twin fetuses showed significant cardiac changes, predominantly affecting the right heart, such as dilated atria (right atrial/heart area: 15.7 ± 3.1 vs 18.4 ± 3.2, P fetal cardiac programing in ART. These results open opportunities for early detection and intervention in infants conceived by ART. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

  11. Assisted Reproduction Technologies Alter Steroid Delivery to the Mouse Fetus During Pregnancy

    Science.gov (United States)

    Raunig, Jefferey M.; Yamauchi, Yasuhiro; Ward, Monika A.; Collier, Abby C.

    2011-01-01

    Assisted reproduction technologies (ART) include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), and are common treatments for infertility. Although generally successful, ART warrant further investigations due to emerging perinatal issues, especially low birth weight. Herein we extend our previous work demonstrating higher steroid clearance in murine ART placentas by examining steroid biosynthesis and the directional flow of steroids in the maternal-placental-fetal units. The activities of the major steroidogenic enzymes 3β-Hydroxysteroid Dehydrogenase (3β-HSD) and Cytochrome P450 17-αhydroxylase (CYP17) were assessed in maternal liver and ovaries and fetal livers as were levels of cholesterol, progesterone, estrone (E1), and estradiol (E2) in the maternal, placental and fetal units. No structural abnormalities were found in placentas from ART. Although ART increased 3β-HSD activity in maternal livers, there were no other changes in 3β-HSD- or CYP17-mediated steroidogenesis. Cholesterol levels were significantly lower in maternal livers of ICSI pregnancies and in placentas from both IVF and ICSI pregnancies but not altered in the fetal livers. Progesterone levels were higher in maternal and fetal livers in IVF and ICSI, respectively, but were significantly lowered in ICSI placentas, compared to normal fertilization. For estrogenic hormones, no differences in E1 or E2 levels were observed in maternal livers but ICSI significantly increased both E1 and E2 levels in placentas while both IVF and ICSI significantly lowered E1 but raised E2 levels in fetal livers. In summary, while steroid production was normal, steroid diffusion/flow from mother to fetus was altered in murine pregnancies conceived by ART. This appears to occur, at least in part; through placental mechanisms. Impaired cholesterol and steroid transfer may affect correct regulation of fetal growth and development. PMID:21193037

  12. Accuracy of assisted reproductive technology information on birth certificates: Florida and Massachusetts, 2004-06.

    Science.gov (United States)

    Cohen, Bruce; Bernson, Dana; Sappenfield, William; Kirby, Russell S; Kissin, Dmitry; Zhang, Yujia; Copeland, Glenn; Zhang, Zi; Macaluso, Maurizio

    2014-05-01

    Assisted Reproductive Technology (ART) includes fertility procedures where both egg and sperm are handled in the lab. ART use has increased considerably in recent years, accounting for 47,090 livebirths in the U.S. in 2010. ART increases the probability of multiple gestation births, which are at higher risks than singletons for adverse outcomes. Additionally, ART is associated with a greater risk of complications during pregnancy, labour, and delivery, and increased risk of adverse perinatal outcomes in singleton births. We merged Florida and Massachusetts birth records from 2004-06 with the National ART Surveillance System (NASS) and using NASS as the gold standard, calculated sensitivity, specificity, and positive predictive value (PPV) of ART reporting on the birth certificates by maternal, infant, and hospital characteristics. We fit random-effects logistic regression models to evaluate simultaneously the association of ART reporting with these predictors while accounting for correlation among births occurring in the same hospital. Sensitivity of ART reporting on the birth certificate was 28.9% in Florida and 41.4% in Massachusetts. Specificity was >99% in both states. PPV was 45.5% in Florida and 54.6% in Massachusetts. The odds of ART reporting varied by state and by several maternal and delivery characteristics including age, parity, history of fetal loss, plurality, race/Hispanic ethnicity, delivery payment source, pre-existing conditions, and complications during pregnancy or labour and delivery. There was significant under-reporting of ART procedures on the birth certificates. Using data on ART births identified only from birth certificates yields a biased sample of the population of ART births. © 2014 John Wiley & Sons Ltd.

  13. Births resulting from assisted reproductive technology: comparing birth certificate and National ART Surveillance System Data, 2011.

    Science.gov (United States)

    Thoma, Marie E; Boulet, Sheree; Martin, Joyce A; Kissin, Dmitry

    2014-12-10

    This report compares data on births resulting from assisted reproductive technology (ART) procedures from 2011 birth certificates with data from the 2011 National ART Surveillance System (NASS) among the subset of jurisdictions that adopted the 2003 revised birth certificate as of January 1, 2011, with information on ART. Birth certificate data are based on 100% of births registered in 27 states and the District of Columbia. NASS data included all ART cycles initiated in 2010 or 2011 for which a live birth in 2011 was reported. The same reporting area was used for both data sources and represents 67% of all births in the United States in 2011. A ratio was computed by dividing the percentage of births resulting from ART procedures for NASS data by the percentage for birth certificate data. A ratio of 1.0 represents equivalent levels of reporting. Because this reporting area is not a random sample of births, the results are not generalizable to the United States as a whole. Overall, the percentage of births resulting from ART procedures was 2.06 times higher for NASS data (1.44%) compared with birth certificate data (0.70%). The ratio for each jurisdiction varied from 1.04 for Utah and Wisconsin to 7.50 for Florida. Higher-risk groups had more consistent reporting. between data sources [e.g., triplet or higher-order multiples (1.36) compared with singletons (2.11)]. Births resulting from ART procedures appear to be underreported on the birth certificate; however, the magnitude of underreporting varied by jurisdiction and maternal-infant health characteristics.

  14. Public opinion regarding utilization of assisted reproductive technology (ART) in obese women.

    Science.gov (United States)

    Shah, Divya K; Ginsburg, Elizabeth S; Correia, Katharine F; Barton, Sara E; Missmer, Stacey A

    2013-11-01

    There have been calls to restrict access to fertility treatment in women above a certain body mass index (BMI). It is important to consider public expectations before formulating policy. The study objective was to assess public opinion regarding provision of assisted reproductive technology (ART) to obese (BMI>30 kg/m(2)) women in the United States. The study was conducted through an Internet-based survey of U.S. residents ages 18-75. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression to describe predictors of response based on demographic characteristics. Of the 1049 respondents, 60.7% support the use of ART in obese women. Adjusting for age and gender, the odds of support were over twice as high in participants with BMI>40 kg/m(2) as in normal-weight respondents (OR=2.87, 95% CI=1.28-6.44). Fifty-five percent of participants supported a BMI limit for access to ART. Both increasing education (p-value=0.02) and BMI (p-value=0.01) were inversely associated with support of a BMI limit. Individuals who had themselves used ART were also less likely (OR=0.27, 95% CI=0.07--0.99) to support a BMI limit. In an Internet-based survey, participants who are in favor of ART are likely to support its use among obese women. More than 50% of these respondents also support implementation of a BMI limit for access to these services.

  15. Assisted Reproductive Technology and Birth Defects: Effects of Subfertility and Multiple Births.

    Science.gov (United States)

    Liberman, Rebecca F; Getz, Kelly D; Heinke, Dominique; Luke, Barbara; Stern, Judy E; Declercq, Eugene R; Chen, Xiaoli; Lin, Angela E; Anderka, Marlene

    2017-08-15

    Assisted reproductive technology (ART) has been associated with birth defects, but the contributions of multiple births and underlying subfertility remain unclear. We evaluated the effects of subfertility and mediation by multiple births on associations between ART and nonchromosomal birth defects. We identified a retrospective cohort of Massachusetts live births and stillbirths from 2004 to 2010 among ART-exposed, ART-unexposed subfertile, and fertile mothers using linked information from fertility clinics, vital records, hospital discharges, and birth defects surveillance. Log-binomial regression was used to estimate prevalence ratios and 95% confidence intervals (CIs). Mediation analyses were performed to deconstruct the ART-birth defects association into the direct effect of ART, the indirect effect of multiple births, and the effect of ART-multiples interaction. Of 17,829 ART-exposed births, 355 had a birth defect, compared with 162 of 9431 births to subfertile mothers and 6183 of 445,080 births to fertile mothers. The adjusted prevalence ratio was 1.5 (95% CI, 1.3-1.6) for ART and 1.3 (95% CI, 1.1-1.5) in subfertile compared with fertile deliveries. We observed elevated rates of several birth defects with ART, including tetralogy of Fallot and hypospadias. Subfertility and multiple births affect these associations, with multiple births explaining 36% of the relative effect of ART on nonchromosomal birth defects. Although the risk of birth defects with ART is small, a substantial portion of the relative effect is mediated through multiple births, with subfertility contributing an important role. Future research is needed to determine the impact of newer techniques, such as single embryo transfer, on these risks. Birth Defects Research 109:1144-1153, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Assisted reproductive technologies are associated with cardiovascular remodeling in utero that persists postnatally.

    Science.gov (United States)

    Valenzuela-Alcaraz, Brenda; Crispi, Fàtima; Bijnens, Bart; Cruz-Lemini, Monica; Creus, Montserrat; Sitges, Marta; Bartrons, Joaquim; Civico, Salvadora; Balasch, Juan; Gratacós, Eduard

    2013-09-24

    Assisted reproductive technologies (ARTs) have been shown to be associated with general vascular dysfunction in late childhood. However, it is unknown whether cardiac remodeling is also present and if these changes already manifest in prenatal life. Our aim was to assess fetal and infant (6 months of age) cardiovascular function in ART pregnancies. This prospective cohort study included 100 fetuses conceived by ART and 100 control pregnancies. ART fetuses showed signs of cardiovascular remodeling, including a more globular heart with thicker myocardial walls, decreased longitudinal function (tricuspid ring displacement in controls: median, 6.5 mm [interquartile range, 6.1-7.1 mm]; tricuspid ring displacement in ART: 5.5 mm [interquartile range, 5.1-6.1]; Pinterquartile range, 1.2-1.5 cm(2)]; atrial area in ART, 1.6 cm(2) [interquartile range, 1.3-1.8 cm(2)]; Pinterquartile range, 67-83 mm Hg]; systolic blood pressure in ART, 83 mm Hg [interquartile range, 75-94 mm Hg]; Pinterquartile range, 0.45-0.56 mm]; aortic intima-media thickness in ART, 0.64 mm [interquartile range, 0.62-0.67]; P<0.001). We could not demonstrate that our findings were directly caused by ART because of their association with various confounding factors, including intrauterine growth restriction or factors related to the cause of infertility. Children conceived by ART manifest cardiac and vascular remodeling that is present in fetal life and persists in postnatal life, suggesting opportunities for early detection and potential intervention. The underlying mechanisms and the effect of potential confounders such as growth restriction or prematurity remain to be elucidated.

  17. Possible risk for cancer among children born following assisted reproductive technology in Israel.

    Science.gov (United States)

    Lerner-Geva, Liat; Boyko, Valentina; Ehrlich, Shelley; Mashiach, Shlomo; Hourvitz, Ariel; Haas, Jigal; Margalioth, Ehud; Levran, David; Calderon, Ilan; Orvieto, Raoul; Ellenbogen, Adrian; Meyerovitch, Joseph; Ron-El, Raphael; Farhi, Adel

    2017-04-01

    Among children conceived by assisted reproductive technology (ART), increased risk of adverse birth outcomes has been observed, including multiple births, preterm births, and congenital malformations. Regarding cancer among ART-conceived children, findings are discrepant. This is a historical cohort of 9,042 ART-conceived children and 211,763 spontaneously conceived (SC) children born from 1997 through 2004. The median duration of follow-up was 10.6 years (interquartile range 9.0-12.3) in the ART group and 9.3 years (interquartile range 8.0-10.6) in the SC group. The cohort database was linked with the Israel National Cancer Registry updated until December 31, 2011 using each child's personal identification number. Twenty-one cases of cancer were identified in the ART group (2.2 per 10,000 person-years), as compared to 361 cancer cases in the SC group (1.8 per 10,000 person-years). The relative risk (RR) for overall cancer in the ART group compared to the SC group adjusted for maternal characteristics was 1.18 (95% confidence interval [CI] 0.80-1.75). ART children had a significantly increased risk for specific cancers, although based on small number of cases, including two cases of retinoblastoma (RR 6.18, 95% CI 1.22-31.2), as well as four cases of renal tumors (RR 3.25, 95% CI 1.67-6.32). A statistically significant increased risk for two pediatric cancers was found. However, for overall types of cancer the risk estimate was elevated but not statistically significant. Further studies with larger sample size and longer follow-up time are warranted in order to either confirm or refute these findings. © 2016 Wiley Periodicals, Inc.

  18. The effect of assisted reproductive technology on the incidence of birth defects among livebirths.

    Science.gov (United States)

    Shechter-Maor, Gil; Czuzoj-Shulman, Nicholas; Spence, Andrea R; Abenhaim, Haim Arie

    2018-02-15

    Our study objective is to examine the association between births conceived with assisted reproductive technology (ART) and birth defects using a large database from the United States. Using the Centers for Disease Control and Prevention's Period-linked birth-infant death data files and fetal death database for 2011-2013, we conducted a retrospective cohort study comprised of live births that occurred in the USA during that time. Multivariate logistic regression was used to estimate the association between ART and birth defects, both overall and by specific defects. There were 11,862,780 live births between 2011 and 2013. Of these births, 11,791,730 were spontaneous pregnancies and 71,050 were conceived by ART, with an increasing trend in incidence of ART during the study period and an overall increasing trend of birth defects. Overall, infants conceived by ART had a greater risk of having birth defects than did infants conceived spontaneously (77/10,000 vs 25/10,000, respectively, OR 2.14, 95% CI 1.94-2.35). The malformations most commonly associated with ART were cyanotic heart defects (OR 2.74, 95% CI 2.42-3.09), cleft lip and/or palate (OR 1.47, 95% CI 1.14-1.89), and hypospadias (OR 1.77, 95% CI 1.42-2.19). There were no differences in risk of omphalocele or neural tube defects between the two groups. There is an overall and type-specific increased risk of birth defects in the ART population. Appropriate counseling and specialized ultrasound evaluations should be considered in pregnancies conceived by ART.

  19. Patient satisfaction concerning assisted reproductive technology treatments in moderate to severe endometriosis.

    Science.gov (United States)

    van der Houwen, Lisette E E; Schreurs, Anneke M F; Schats, Roel; Lambalk, Cornelis B; Hompes, Peter G A; Mijatovic, Velja

    2014-11-01

    A prospective observational cohort study was performed to examine patient satisfaction after one Assisted Reproductive Technology (ART) treatment cycle in moderate to severe endometriosis patients. From May 2012 till September 2013, 25 patients with surgically proven endometriosis stage III-IV were included per group and received intrauterine insemination (IUI), in vitro fertilization (IVF) or IVF preceded by long-term pituitary down-regulation (IVF-ultralong). The median patient satisfaction scores were 8.3, 7.9 and 8.0 in patients receiving IUI (n = 22), IVF (n = 24) and IVF-ultralong (n = 23), respectively (p = 0.89). Both deterioration in pain and quality-of-life could not be identified as determinants of decreased patient satisfaction scores. Satisfaction was higher in women receiving their first ART treatment attempt (p = 0.002), after treatment accomplishment (p = 0.04) and after a positive pregnancy test (p = 0.04). A median satisfaction score concerning preceding long term pituitary down-regulation of 6.1 (IVF-ultralong n = 25, IUI n = 8) was reported. Only three patients would refrain from this preceding therapy in a next treatment attempt. We concluded that patient satisfaction scores were comparable between the three different ART treatments. Since patient satisfaction was in particular dependent on treatment outcomes, it is recommended to compare those three ART treatments in a randomized controlled trial investigating the efficacy, safety and cost-effectiveness.

  20. Investigating Infertility-Related Stress and Adoption in Iranian Infertile Females with Assisted Reproductive Technology Failure

    Directory of Open Access Journals (Sweden)

    Tayebe Hajiyan

    2016-09-01

    Full Text Available Background Using Assisted Reproductive Technologies (ART is a stressful experience marked by lengthy and invasive medical procedures, high financial cost and relatively low success rate. Adoption is considered as one of the infertility treatment methods that can have great impact on healing emotional problems of infertile couples and can improve their relationship. Objectives The current study aimed to investigate infertility-related stress and adoption in Iranian Infertile females with a history of ART failure, during year 2015. Methods This was a cross sectional study in which 30 Iranian infertile females, 30 to 45 years old, with primary infertility of five years or more, and history of ART failure, were investigated. Data collection instruments included the questionnaire of infertility and demographic factors, fertility problem inventory (FPI and adoption questionnaire. The data were analyzed by SPSS V22, using descriptive statistics and Pearson test to assess possible correlations. Results The mean of the total score of infertility stress of the participants was 186.1 ± 29.46 (moderate to high. All participants showed some level of infertility stress. The mean score of adoption was 38.4 ± 3.73 (moderate acceptance, 53.33% of which showed moderate acceptance. There was no relationship between infertility stress and adoption (correlation = - 0.13, P = 0.48. Conclusions Infertile females with a history of unsuccessful ART had a high level of infertility stress and moderate acceptance of adoption. We must pay more attention to psychological aspects of infertility and failure of treatment. There is an obvious need to increase society awareness about adoption and promote “adoption” as a sensible choice to form a family.

  1. Heparin for assisted reproduction.

    Science.gov (United States)

    Akhtar, Muhammad A; Sur, Shyamaly; Raine-Fenning, Nick; Jayaprakasan, Kannamannadiar; Thornton, Jim G; Quenby, Siobhan

    2013-08-17

    Heparin as an adjunct in assisted reproduction (peri-implantation heparin) is given at or after egg collection or at embryo transfer during assisted reproduction. Heparin has been advocated to improve embryo implantation and clinical outcomes.  It has been proposed that heparin enhances the intra-uterine environment by improving decidualisation with an associated activation of growth factors and a cytokine expression profile in the endometrium that is favourable to pregnancy. To investigate whether the administration of heparin around the time of implantation (peri-implantation heparin) improves clinical outcomes in subfertile women undergoing assisted reproduction. A comprehensive and exhaustive search strategy was developed in consultation with the Trials Search Co-ordinator of the Cochrane Menstrual Disorders and Subfertility Group (MDSG). The strategy was used in an attempt to identify all relevant studies regardless of language or publication status (published, unpublished, in press, and in progress). Relevant trials were identified from both electronic databases and other resources (last search 6 May 2013). All randomised controlled trials (RCTs) were included where peri-implantation heparin was given during assisted reproduction. Peri-implantation low molecular weight heparin (LMWH) during IVF/ICSI was given at or after egg collection or at embryo transfer in the included studies. Live birth rate was the primary outcome. Two review authors independently assessed the eligibility and quality of trials and extracted relevant data. The quality of the evidence was evaluated using GRADE methods. Three RCTs (involving 386 women) were included in the review.Peri-implantation LMWH administration during assisted reproduction was associated with a significant improvement in live birth rate compared with placebo or no LMWH (odds ratio (OR) 1.77, 95% confidence interval (CI) 1.07 to 2.90, three studies, 386 women, I(2) = 51%, very low quality evidence with high

  2. Can the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) be used to accurately report clinic total reproductive potential (TRP)?

    Science.gov (United States)

    Stern, Judy E; Hickman, Timothy N; Kinzer, Donna; Penzias, Alan S; Ball, G David; Gibbons, William E

    2012-04-01

    To assess whether total reproductive potential (TRP), the chance of a live birth from each fresh cycle (fresh cycle plus frozen transfers), could be calculated from the national Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database and whether information not available in SART CORS resulted in significant changes to the TRP calculation. Retrospective study using SART CORS and clinic data. Three assisted reproductive technology clinics. Women undergoing ART. None. Two- and three-year TRPs for 2005 and 2006 were calculated according to patient age at cycle start by linking fresh to frozen cycles up to first live birth. Clinic records were used to adjust for (remove) frozen cycles that used more than one fresh cycle as a source of embryos and for any embryos donated to other patients or research or shipped to another facility before a live birth. TRP was higher than fresh per-cycle rates for most ages at all clinics, although accuracy was compromised when there were fewer than 20 cycles per category. Two- and 3-year TRPs differed in only 2 of 24 calculations. Adjusted TRPs differed less than three percentage points from unadjusted TRPs when volume was sufficient. Clinic TRP can be calculated from SART CORS. Data suggest that calculations of clinic TRP from the national dataset would be meaningful. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Low-technology assisted reproduction and the risk of preterm birth in a hospital-based cohort.

    Science.gov (United States)

    Messerlian, Carmen; Platt, Robert W; Tan, Seang-Lin; Gagnon, Robert; Basso, Olga

    2015-01-01

    To estimate the risk of preterm birth in singleton infants conceived through low-technology assisted reproduction (intrauterine insemination and/or ovulation induction/stimulation). Hospital-based cohort study. University-affiliated hospital. Singleton babies born between 2001 and 2007 to 16,712 couples with no reported infertility (reference category), 378 babies conceived with low-technology treatment; 437 conceived with high-technology treatment; and 620 conceived naturally after a period of infertility. None. Treatment data were obtained from couples undergoing standard infertility investigation and care. Preterm birth, defined at three clinical endpoints: assisted reproduction appeared to be a moderately strong predictor of preterm birth, with similar associations observed in the high-technology treatment group. After adjusting for confounders, as well as the shared characteristics of infertile couples, associations were attenuated but remained significant, suggesting that part of the risk is likely attributable to the treatment. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. From the Middle Ages to the 21st Century. Abortion, Assisted Reproduction Technologies and LGBT Rights in Argentina

    Directory of Open Access Journals (Sweden)

    Florencia Luna

    2018-02-01

    Full Text Available Despite "progressive" legislative changes concerning the LGBT collective and assisted reproductive technologies (ARTs in Argentina, women and their sexual and reproductive rights have been overlooked. This article presents a critical perspective of some of these legislative modifications in the country. It addresses why some legislators and society are prepared to challenge a conservative or traditional approach for certain groups while ignoring others. Several factors are at play. There is no all-inclusive explanation. I stress that a striking double standard prevails in Argentina with respect to women and their sexual and reproductive rights. I also contend that powerful discrimination exists, in particular against poor women, who continue to suffer and are "punished" by the criminalization of abortion.  

  5. [Effect of overweight on the outcome of assisted reproductive technology in infertile women].

    Science.gov (United States)

    Čedíková, M; Babuška, V; Lhotská, P; Lošan, P; Zech, N H; Králíčková, M; Novotný, Z

    2014-01-01

    Obesity and overweight negatively affect the ability of women to conceive naturally, contributes to the increased incidence of obstetric complications during pregnancy and affect the outcome of assisted reproduction techniques (ART). The aim of our study was to compare the results of treatment of infertilityin a group of infertile women undergoing ART, depending on the values of BMI and changes in levels of selected hormones and markers of oxidative stress in follicular fluid. Retrospective comparative study. Faculty of Medicine in Pilsen, Charles University in Prague; Institute of Reproductive Medicine and Endocrinology, IVF Centers - Prof. Zech, Plzeň. The studied group consisted of 44 women (mean age of 31.9 years, SD = 4.35) treated for infertility at the Institute of Reproductive Medicine and Endocrinology - IVF Centers Prof. Zech. Women were divided into 2 groups according to BMI (37 women had normal BMI, 7 women were overweight). Prolactin, free T3 and T4 hormone, homocysteine, malondialdehyde, glutathione peroxidase, total antioxidant capacity and total protein were analyzed in the follicular fluid both groups. Only blood free samples were studied after pooling of all FF samples of each patient. We observed significantly lower levels of glutathion peroxidase in the group of overweight women(p = 0.0044). The pregnancy success rate with women with normal BMI and overweight women did not differ significantly from each other (p = 0.4430). Our study did not confirm the negative effect of obesity on the results of treatment of infertility, specifical-ly pregnancy rate in a group of infertile women undergoing treatment with assisted reproduction techniques.

  6. Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?

    DEFF Research Database (Denmark)

    Sejbaek, Camilla S; Pinborg, Anja; Hageman, Ida

    2015-01-01

    INTRODUCTION: Previous studies have shown conflicting results whether unsuccessful medically assisted reproduction is a risk factor for depression among women. This study therefore investigated if women with no live birth after assisted reproductive technology (ART) treatment had a higher risk...... of unipolar depression compared with women with a live birth after ART treatment. MATERIAL AND METHODS: The Danish National ART-Couple (DANAC) Cohort is a national register-based cohort study that consists of women who received ART treatment from 1 January 1994 to 30 September 2009, in Denmark (n = 41 050......). Information on unipolar depression was obtained from the Danish Psychiatric Central Research Register. The analyses were conducted in Cox regression analysis. RESULTS: During the 308 494 person-years of follow up, 552 women were diagnosed with unipolar depression. A Cox proportional hazards model showed...

  7. [Impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy: a case-control study].

    Science.gov (United States)

    Kim, Ju Hee; Shin, Hye Sook; Park, Bo Kyung; Yang, Kwang Moon; Lee, Young Ho; Ryu, Hyun Mee

    2012-08-01

    To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy. A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital. There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ≥25 was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group. The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

  8. Evolving ethics in medically assisted reproduction.

    Science.gov (United States)

    Pennings, Guido; de Wert, Guido

    2003-01-01

    Ethical problems arising from the application of assisted reproductive technology are discussed for four specific areas, namely embryo research, multiple pregnancies, preimplantation genetic diagnosis (PGD) for social sexing, and finally PGD with HLA typing.

  9. Cycle 1 as predictor of assisted reproductive technology treatment outcome over multiple cycles: an analysis of linked cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System online database.

    Science.gov (United States)

    Stern, Judy E; Brown, Morton B; Luke, Barbara; Wantman, Ethan; Lederman, Avi; Hornstein, Mark D

    2011-02-01

    To determine whether the first cycle of assisted reproductive technology (ART) predicts treatment course and outcome. Retrospective study of linked cycles. Society for Assisted Reproductive Technology Clinic Outcome Reporting System database. A total of 6,352 ART patients residing or treated in Massachusetts with first treatment cycle in 2004-2005 using fresh, autologous oocytes and no prior ART. Women were categorized by first cycle as follows: Group I, no retrieval; Group II, retrieval, no transfer; Group III, transfer, no embryo cryopreservation; Group IV, transfer plus cryopreservation; and Group V, all embryos cryopreserved. None. Cumulative live-birth delivery per woman, use of donor eggs, intracytoplasmic sperm injection (ICSI), or frozen embryo transfers (FET). Groups differed in age, baseline FSH level, prior gravidity, diagnosis, and failure to return for Cycle 2. Live-birth delivery per woman for groups I through V for women with no delivery in Cycle I were 32.1%, 35.9%, 40.1%, 53.4%, and 51.3%, respectively. Groups I and II were more likely to subsequently use donor eggs (14.5% and 10.9%). Group II had the highest use of ICSI (73.3%); Group III had the lowest use of FET (8.9%). Course of treatment in the first ART cycle is related to different cumulative live-birth delivery rates and eventual use of donor egg, ICSI, and FET. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Assisted reproductive technology use and outcomes among women with a history of cancer†

    Science.gov (United States)

    Luke, Barbara; Brown, Morton B.; Missmer, Stacey A.; Spector, Logan G.; Leach, Richard E.; Williams, Melanie; Koch, Lori; Smith, Yolanda R.; Stern, Judy E.; David Ball, G.; Schymura, Maria J.

    2016-01-01

    STUDY QUESTION How do the assisted reproductive technology (ART) outcomes of women presenting for ART after cancer diagnosis compare to women without cancer? SUMMARY ANSWER The likelihood of a live birth after ART among women with prior cancer using autologous oocytes is reduced and varies by cancer diagnosis but is similar to women without cancer when donor oocytes are used. WHAT IS KNOWN ALREADY Premenopausal patients faced with a cancer diagnosis frequently present for fertility preservation. STUDY DESIGN, SIZE, DURATION Population-based cohort study of women treated with ART in NY, TX and IL, USA. PARTICIPANTS/MATERIALS, SETTING, METHODS Women with their first ART treatment between 2004 and 2009 were identified from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database and linked to their respective State Cancer Registries based on name, date of birth and social security number. Years were rounded, i.e. year 1 = 6–18 months before treatment. This study used reports of cancer from 5 years, 6 months prior to treatment until 6 months after first ART treatment. Women who only presented for embryo banking were omitted from the analysis. The likelihood of pregnancy and of live birth with ART using autologous oocytes was modeled using logistic regression, with women without prior cancer as the reference group, adjusted for woman's age, parity, cumulative FSH dosage, infertility diagnosis, number of diagnoses, number of ART cycles, State of residency and year of ART treatment. Results of the modeling are reported as adjusted odds ratios (AORs) and (95% confidence intervals). MAIN RESULTS AND THE ROLE OF CHANCE The study population included 53 426 women; 441 women were diagnosed with cancer within 5 years prior to ART cycle start. Mean (±SD) age at cancer diagnosis was 33.4 ± 5.7 years; age at start of ART treatment was 34.9 ± 5.8 for women with cancer compared with 35.3 ± 5.3 years for women without cancer (P = 0.03). Live

  11. Oocyte activation and phospholipase C zeta (PLCζ: diagnostic and therapeutic implications for assisted reproductive technology

    Directory of Open Access Journals (Sweden)

    Ramadan Walaa M

    2012-07-01

    Full Text Available Abstract Infertility affects one in seven couples globally and has recently been classified as a disease by the World Health Organisation (WHO. While in-vitro fertilisation (IVF offers effective treatment for many infertile couples, cases exhibiting severe male infertility (19–57% often remain difficult, if not impossible to treat. In such cases, intracytoplasmic sperm injection (ICSI, a technique in which a single sperm is microinjected into the oocyte, is implemented. However, 1–5% of ICSI cycles still fail to fertilise, affecting over 1000 couples per year in the UK alone. Pregnancy and delivery rates for IVF and ICSI rarely exceed 30% and 23% respectively. It is therefore imperative that Assisted Reproductive Technology (ART protocols are constantly modified by associated research programmes, in order to provide patients with the best chances of conception. Prior to fertilisation, mature oocytes are arrested in the metaphase stage of the second meiotic division (MII, which must be alleviated to allow the cell cycle, and subsequent embryogenesis, to proceed. Alleviation occurs through a series of concurrent events, collectively termed ‘oocyte activation’. In mammals, oocytes are activated by a series of intracellular calcium (Ca2+ oscillations following gamete fusion. Recent evidence implicates a sperm-specific phospholipase C, PLCzeta (PLCζ, introduced into the oocyte following membrane fusion as the factor responsible. This review summarises our current understanding of oocyte activation failure in human males, and describes recent advances in our knowledge linking certain cases of male infertility with defects in PLCζ expression and activity. Systematic literature searches were performed using PubMed and the ISI-Web of Knowledge. Databases compiled by the United Nations and World Health Organisation databases (UNWHO, and the Human Fertilization and Embryology Authority (HFEA were also scrutinised. It is clear that PLCζ plays a

  12. Stress, distress and outcome of assisted reproductive technology (ART): a meta-analysis.

    Science.gov (United States)

    Matthiesen, S M S; Frederiksen, Y; Ingerslev, H J; Zachariae, R

    2011-10-01

    A number of studies have investigated the relationship between psychological factors such as stress and distress (measured as anxiety and depression) and outcomes of assisted reproductive technology (ART). The results, however, are inconsistent, and the strength of any associations remains to be clarified. We conducted a systematic review and meta-analysis of the results of studies reporting on the associations between stress, anxiety, and depression and ART outcomes. Prospective studies reporting data on associations between stress or distress in female patients and ART outcome were identified and evaluated by two independent researchers according to an a priori developed codebook. Authors were contacted in cases of insufficient data reporting. Stress was defined as perceived stress, work-related stress, minor life events or major life events, and distress was defined as anxiety or depression. A total of 31 prospective studies were included. Small, statistically significant, pooled effect sizes were found for stress [ESr, effect size correlation) = -0.08; P = 0.02, 95% confidence interval (CI): -0.15, -0.01], trait anxiety (ESr = -0.14; P = 0.02, 95% CI: -0.25, -0.03) and state anxiety (ESr = -0.10, P = 0.03, 95% CI: -0.19, -0.01), indicating negative associations with clinical pregnancy rates. A non-significant trend (Esr = -0.11, P = 0.06) was found for an association between depression and clinical pregnancy. For serum pregnancy tests and live birth rates, associations between trait anxiety or state anxiety were not significant. The fail safe number did not exceed the suggested criterion in any analyses, between-study heterogeneity was considerable and the mean age, mean duration of infertility and percentage of first time ART attenders in the study samples were found to moderate several of the associations. Small but significant associations were found between stress and distress and reduced pregnancy chances with ART. However, there were a limited number of

  13. Assisted Reproductive Technology and Newborn Size in Singletons Resulting from Fresh and Cryopreserved Embryos Transfer.

    Directory of Open Access Journals (Sweden)

    Galit Levi Dunietz

    Full Text Available The aim of this study was two-fold: to investigate the association of Assisted Reproductive Technology (ART and small newborn size, using standardized measures; and to examine within strata of fresh and cryopreserved embryos transfer, whether this association is influenced by parental infertility diagnoses. We used a population-based retrospective cohort from Michigan (2000-2009, Florida and Massachusetts (2000-2010. Our sample included 28,946 ART singletons conceived with non-donor oocytes and 4,263,846 non-ART singletons.Regression models were used to examine the association of ART and newborn size, measured as small for gestational age (SGA and birth-weight-z-score, among four mutually exclusive infertility groups: female infertility only, male infertility only, combined female and male infertility, and unexplained infertility, stratified by fresh and cryopreserved embryos transfer.We found increased SGA odds among ART singletons from fresh embryos transfer compared with non-ART singletons, with little difference by infertility source [adjusted odds-ratio for SGA among female infertility only: 1.18 (95% CI 1.10, 1.26, male infertility only: 1.20 (95% CI 1.10, 1.32, male and female infertility: 1.18 (95% CI 1.06, 1.31 and unexplained infertility: 1.24 (95% CI 1.10, 1.38]. Conversely, ART singletons, born following cryopreserved embryos transfer, had lower SGA odds compared with non-ART singletons, with mild variation by infertility source [adjusted odds-ratio for SGA among female infertility only: 0.56 (95% CI 0.45, 0.71, male infertility only: 0.64 (95% CI 0.47, 0.86, male and female infertility: 0.52 (95% CI 0.36, 0.77 and unexplained infertility: 0.71 (95% CI 0.47, 1.06]. Birth-weight-z-score was significantly lower for ART singletons born following fresh embryos transfer than non-ART singletons, regardless of infertility diagnoses.

  14. Assisted reproductive technology and risk of congenital malformations: a meta-analysis based on cohort studies.

    Science.gov (United States)

    Qin, Jiabi; Sheng, Xiaoqi; Wang, Hua; Liang, Desheng; Tan, Hongzhuan; Xia, Jiahui

    2015-10-01

    To assess the association between assisted reproductive technology (ART) and risk of congenital malformations (CM) by conducting a meta-analysis of cohort studies. PubMed, Google Scholar, Cochrane Libraries and Chinese database were searched through August 2014 to identify studies that met pre-stated inclusion criteria. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. Subgroup analysis was performed to explore potential heterogeneity moderators. Fifty-seven studies involving 119,874 infants conceived following ART and 1,212,320 infants conceived naturally were included in the analysis. The ART-conceived infants were associated with a higher risk of CM [relative risk (RR) = 1.33; 95 % confidence interval (CI) 1.24-1.43] when compared with those conceived naturally. When data were restricted to singleton births (RR = 1.38; 95 % CI 1.30-1.47), major CM (RR = 1.47; 95 % CI 1.29-1.68), matched/adjusted studies (RR = 1.37; 95 % CI 1.27-1.47) or high quality studies (RR = 1.40; 95 % CI 1.27-1.55), the increased risk of CM still existed in ART pregnancies. Additionally, an increased risk of CM was also found when the ART twin (RR = 1.18; 95 % CI 1.06-1.32) or multiple births (RR = 1.16; 95 % CI 1.05-1.27) were separately compared with spontaneously conceived twin or multiple births. Substantial heterogeneity was observed across studies (I (2) = 68, 44, 39, and 33 % for all infants, singletons, twins and multiples, respectively). Whether confounding factors were matched or adjusted, study quality and sample size as the first three of the most relevant heterogeneity moderators have been identified. No evidence of publication bias was observed (P > 0.10). The ART-conceived infants have a higher risk of CM compared with those conceived naturally. However, these estimates have to be viewed with caution because of heterogeneity.

  15. Gestational age-specific perinatal mortality rates for assisted reproductive technology (ART) and other births.

    Science.gov (United States)

    Chughtai, Abrar A; Wang, Alex Y; Hilder, Lisa; Li, Zhuoyang; Lui, Kei; Farquhar, Cindy; Sullivan, Elizabeth A

    2018-02-01

    Is perinatal mortality rate higher among births born following assisted reproductive technology (ART) compared to non-ART births? Overall perinatal mortality rates in ART births was higher compared to non-ART births, but gestational age-specific perinatal mortality rate of ART births was lower for very preterm and moderate to late preterm births. Births born following ART are reported to have higher risk of adverse perinatal outcomes compared to non-ART births. This population-based retrospective cohort study included 407 368 babies (391 952 non-ART and 15 416 ART)-393 491 singletons and 10 877 twins or high order multiples. All births (≥20 weeks of gestation and/or ≥400 g of birthweight) in five states and territories in Australia during the period 2007-2009 were included in the study, using National Perinatal Data Collection (NPDC). Primary outcome measures were rates of stillbirth, neonatal and perinatal deaths. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to estimate the likelihood of perinatal death. Rates of multiple birth and low birthweight were significantly higher in ART group compared to the non-ART group (P ART births (16.5 per 1000 births, 95% CI 14.5-18.6), compared to non-ART births (11.3 per 1000 births, 95% CI 11.0-11.6) (AOR 1.45, 95% CI 1.26-1.68). However, gestational age-specific perinatal mortality rate of ART births (including both singletons and multiples) was lower for very preterm (ART births. Congenital abnormality and spontaneous preterm were the most common causes of neonatal deaths in both ART and non-ART group. Due to different cut-off limit for perinatal period in Australia, the results of this study should be interpreted with cautions for other countries. Australian definition of perinatal period commences at 20 completed weeks (140 days) of gestation and ends 27 completed days after birth which is different from the definition by World Health Organisation (commences at 22 completed weeks (154 days) of

  16. Maqasid al-Shariah as a Complementary Framework for Conventional Bioethics: Application in Malaysian Assisted Reproductive Technology (ART) Fatwa.

    Science.gov (United States)

    Ibrahim, Abdul Halim; Rahman, Noor Naemah Abdul; Saifuddeen, Shaikh Mohd

    2017-09-11

    Rapid development in the area of assisted reproductive technology (ART), has benefited mankind by addressing reproductive problems. However, the emergence of new technologies and techniques raises various issues and discussions among physicians and the masses, especially on issues related to bioethics. Apart from solutions provided using conventional bioethics framework, solutions can also be derived via a complementary framework of bioethics based on the Higher Objectives of the Divine Law (Maqasid al-Shariah) in tackling these problems. This approach in the Islamic World has been applied and localised in the Malaysian context. Thus, this paper highlights a conceptual theoretical framework for solving current bioethical issues, with a special focus on ART in the Malaysian context, and compares this theory with conventional theories of bioethics.

  17. Factors associated with monozygosity in assisted reproductive technology pregnancies and the risk of recurrence using linked cycles.

    Science.gov (United States)

    Luke, Barbara; Brown, Morton B; Wantman, Ethan; Stern, Judy E

    2014-03-01

    To evaluate factors associated with monozygosity (MZ) (number of fetal heartbeats on early ultrasound greater than the number of embryos transferred) and the risk of recurrence in subsequent pregnancies using a national assisted reproduction database. Historical cohort study. Clinic-based data. 197,327 pregnancies (including 2,824 with evidence of MZ) from cycles reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) between 2004 and 2010. None. Evidence of MZ, adjusted odds ratios and their 95% confidence intervals computed from logistic regression models. In the univariate analysis, the risk of MZ was increased with ovulation disorders, donor oocytes, gonadotropin-releasing hormone agonist (GnRH-a) suppression, assisted hatching (AZH), and day 5-6 transfer, and was decreased with higher follicle-stimulating hormone (FSH) doses (≥3,000 IU). In the multivariate analysis, the risk of MZ was increased with GnRH-a suppression, AZH, and decreased with intracytoplasmic sperm injection (ICSI) and higher FSH dose. The interaction showed that although MZ was more likely with day 5-6 embryos, AZH had a minimal nonsignificant effect, whereas in day 2-3 embryos, AZH had a substantial statistically significant effect. Only one woman had a recurrence of MZ in a subsequent assisted reproduction pregnancy, which is consistent with randomness. The risk of MZ was higher with fresh day 5-6 embryos, donor oocytes, GnRH-a suppression, lower FSH doses, and AZH (particularly with day 2-3 embryos). Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. The role of mitochondrial activity in female fertility and assisted reproductive technologies: overview and current insights.

    Science.gov (United States)

    Cecchino, Gustavo Nardini; Seli, Emre; Alves da Motta, Eduardo Leme; García-Velasco, Juan Antonio

    2018-03-08

    Mitochondria have been implicated as key factors regulating female reproductive processes. Notable progress has been made in determining the role of mitochondria with respect to oocyte maturation, fertilization and early embryo development. In addition, mitochondrial function and dysfunction has been the subject of various studies in ovarian ageing and metabolic stress models. However, the overall mitochondrial impact on female fertility is yet to be uncovered. The mitochondrial DNA content of granulosa, cumulus and trophectoderm cells is being explored as a biomarker of oocyte quality and embryo viability. As growing evidence suggests that embryo potential could be related to the ability of oocyte mitochondria to generate energy, efforts have been made to investigate the possibility of improving mitochondrial capacity in women with poor outcomes after treatment with assistedreproductive technologies. Thus far, therapeutic attempts have focused mainly on using nutrients to restore mitochondrial function and transferring mitochondria from autologous germline precursor cells. Moreover, new perspectives on optimizing infertility treatments have arisen with modern mitochondrial replacement therapies, which are being applied in women with mitochondrial disease-causing mutations. This review explores aspects of the distinctive contribution of mitochondria to reproductive processes and discusses current and emerging clinical implications. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies.

    Science.gov (United States)

    Boivin, J; Griffiths, E; Venetis, C A

    2011-02-23

    To examine whether pretreatment emotional distress in women is associated with achievement of pregnancy after a cycle of assisted reproductive technology. Meta-analysis of prospective psychosocial studies. PubMed, Medline, Embase, PsycINFO, PsychNET, ISI Web of Knowledge, and ISI Web of Science were searched for articles published from 1985 to March 2010 (inclusive). We also undertook a hand search of reference lists and contacted 29 authors. Eligible studies were prospective studies reporting a test of the association between pretreatment emotional distress (anxiety or depression) and pregnancy in women undergoing a single cycle of assisted reproductive technology. Review methods Two authors independently assessed the studies for eligibility and quality (using criteria adapted from the Newcastle-Ottawa quality scale) and extracted data. Authors contributed additional data not included in original publication. Fourteen studies with 3583 infertile women undergoing a cycle of fertility treatment were included in the meta-analysis. The effect size used was the standardised mean difference (adjusted for small sample size) in pretreatment anxiety or depression (priority on anxiety where both measured) between women who achieved a pregnancy (defined as a positive pregnancy test, positive fetal heart scan, or live birth) and those who did not. Pretreatment emotional distress was not associated with treatment outcome after a cycle of assisted reproductive technology (standardised mean difference -0.04, 95% confidence interval -0.11 to 0.03 (fixed effects model); heterogeneity I²=14%, P=0.30). Subgroup analyses according to previous experience of assisted reproductive technology, composition of the not pregnant group, and timing of the emotional assessment were not significant. The effect size did not vary according to study quality, but a significant subgroup analysis on timing of the pregnancy test, a contour enhanced funnel plot, and Egger's test indicated the presence

  20. Risk and safety management in infertility and assisted reproductive technology (ART): from the doctor's office to the ART procedure.

    Science.gov (United States)

    de Ziegler, Dominique; Gambone, Joseph C; Meldrum, David R; Chapron, Charles

    2013-12-01

    Risk and safety management (RSM) is receiving increasing attention in medicine, with the goals of reducing medical error and increasing quality of care. The principles and tools of RSM can and should be applied to assisted reproductive technology (ART), a field that has already made significant progress in reducing the undesirable and sometimes dangerous consequences of treatment. ART is a prime area of medicine to contribute and help to lead the application of RSM and patient safety because it has been ahead of many other fields of medicine in standardizing treatment, certifying and auditing practitioners, and reporting standardized outcomes, and because treatments are applied to otherwise healthy individuals where exposure to risk may be less acceptable. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Culture media for human pre-implantation embryos in assisted reproductive technology cycles.

    Science.gov (United States)

    Youssef, Mohamed M A; Mantikou, Eleni; van Wely, Madelon; Van der Veen, Fulco; Al-Inany, Hesham G; Repping, Sjoerd; Mastenbroek, Sebastiaan

    2015-11-20

    Many media are commercially available for culturing pre-implantation human embryos in assisted reproductive technology (ART) cycles. It is unknown which culture medium leads to the best success rates after ART. To evaluate the safety and effectiveness of different human pre-implantation embryo culture media in used for in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) cycles. We searched the Cochrane Menstrual Disorders and Subfertility Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the National Research Register, the Medical Research Council's Clinical Trials Register and the NHS Center for Reviews and Dissemination databases from January 1985 to March 2015. We also examined the reference lists of all known primary studies, review articles, citation lists of relevant publications and abstracts of major scientific meetings. We included all randomised controlled trials which randomised women, oocytes or embryos and compared any two commercially available culture media for human pre-implantation embryos in an IVF or ICSI programme. Two review authors independently selected the studies, assessed their risk of bias and extracted data. We sought additional information from the authors if necessary. We assessed the quality of the evidence using Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methods. The primary review outcome was live birth or ongoing pregnancy. We included 32 studies in this review. Seventeen studies randomised women (total 3666), three randomised cycles (total 1018) and twelve randomised oocytes (over 15,230). It was not possible to pool any of the data because each study compared different culture media.Only seven studies reported live birth or ongoing pregnancy. Four of these studies found no evidence of a difference between the media compared, for either day three or day five embryo transfer. The data from the fifth study did not appear reliable

  2. Differential effect of assisted reproductive technology and small-for-gestational age on fetal cardiac remodeling.

    Science.gov (United States)

    Valenzuela-Alcaraz, B; Crispi, F; Cruz-Lemini, M; Bijnens, B; García-Otero, L; Sitges, M; Balasch, J; Gratacós, E

    2017-07-01

    Fetuses conceived by assisted reproductive technology (ART) and those that are small-for-gestational age (SGA) show cardiovascular remodeling in utero; however, these two conditions are often associated. We aimed to evaluate the differential effect of ART and SGA on fetal cardiac remodeling. This was a prospective cohort study of term singleton pregnancies seen at our department between April 2011 and September 2013. The cohort was divided according to fetal growth and mode of conception into the following four groups: 102 appropriate-for-gestational-age (AGA) fetuses conceived spontaneously (controls), 72 AGA fetuses conceived by ART (ART-AGA), 31 SGA fetuses conceived by ART (ART-SGA) and 28 SGA fetuses conceived naturally (Spont-SGA). SGA was defined as birth weight Fetal echocardiography was performed at 28-32 weeks to assess cardiac dimensions, geometry and function. ART fetuses had dilated atria (mean left atrium-to-heart area ratio: controls, 15 ± 2.7%; ART-AGA, 18 ± 4.1%; Spont-SGA, 14 ± 3.7%) and more globular ventricles (left ventricular sphericity index: controls, 1.77 ± 0.2; ART-AGA, 1.68 ± 0.2; Spont-SGA, 1.72 ± 0.2), with normally sized hearts. In contrast, SGA fetuses had enlarged hearts (cardiothoracic ratio: controls, 24 ± 3%; ART-AGA, 24 ± 4%; Spont-SGA, 29 ± 6%), preserved atrial size, more globular and concentric hypertrophic ventricles (left ventricle relative wall thickness: controls, 0.48 ± 0.17; ART-AGA, 0.54 ± 0.13; Spont-SGA, 0.63 ± 0.23). Both ART and SGA fetuses had decreased longitudinal motion (tricuspid annular ring displacement: controls, 6.5 ± 0.8 mm; ART-AGA, 5.5 ± 0.7 mm; Spont-SGA, 5.9 ± 0.6 mm) and impaired relaxation (left isovolumetric relaxation time: controls, 47.0 ± 7.3 ms; ART-AGA, 50.0 ± 7.9 ms; Spont-SGA, 49.5 ± 9.3 ms). ART-SGA fetuses presented a combination of features from both ART and SGA groups. SGA and conception with ART

  3. Validation of birth outcomes from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS): population-based analysis from the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART).

    Science.gov (United States)

    Stern, Judy E; Gopal, Daksha; Liberman, Rebecca F; Anderka, Marlene; Kotelchuck, Milton; Luke, Barbara

    2016-09-01

    To assess the validity of outcome data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) compared with data from vital records and the birth defects registry in Massachusetts. Longitudinal cohort. Not applicable. A total of 342,035 live births and fetal deaths from Massachusetts mothers giving birth in the state from July 1, 2004, to December 31, 2008; 9,092 births and fetal deaths were from mothers who had conceived with the use of assisted reproductive technology (ART) and whose cycle data had been reported to the SART CORS. Not applicable. Percentage agreement between maternal race and ethnicity, delivery outcome (live birth or fetal death), plurality (singleton, twin, or triplet+), delivery date, and singleton birth weight reported in the SART CORS versus vital records; sensitivity and specificity for birth defects among singletons as reported in the SART CORS versus the Massachusetts Birth Defects Monitoring Program (BDMP). There was >95% agreement between the SART CORS and vital records for fields of maternal race/ethnicity, live birth/fetal death, and plurality; birth outcome date was within 1 day with 94.9% agreement and birth weight was within 100 g with 89.6% agreement. In contrast, sensitivity for report of any birth defect was 38.6%, with a range of 18.4%-50.0%, for specific birth defect categories. Although most SART CORS outcome fields are accurately reported, birth defect variables showed poor sensitivity compared with the gold standard data from the BDMP. We suggest that reporting of birth defects be discontinued. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. What's the message? A content analysis of newspaper articles about assisted reproductive technology from 2005 to 2011.

    Science.gov (United States)

    King, L; Tulandi, T; Whitley, R; Constantinescu, T; Ells, C; Zelkowitz, P

    2014-06-01

    Infertility and its treatment is the subject of considerable media coverage. In order to evaluate the representation of assisted reproductive technology (ART) in the popular media, we conducted a content analysis of North American newspaper articles. We also explored whether different themes emerged in relation to the implementation of public funding for ART in Quebec, Canada. Print and online newspaper articles from 2005 to 2011 were retrieved using the terms "in-vitro fertilization", "infertility treatment", "assisted reproductive technology", and "IVF treatment". Totally, 719 newspaper articles met inclusion criteria and were coded according to predetermined categories. Risks (63%) and ethical issues (61%) related to ART were most commonly featured. Quebec-based articles were mostly concerned with the politics and financial issues governing ART, and were less likely to report the risks and emotional impact of ART than other North American press. Newspapers tended to emphasize extreme scenarios as well as controversial cases that may not represent the everyday realities of ART. Changes in public policy may also engender shifts in the tone and content of media reports. It is important to establish resources that can inform the public as well as prospective infertility patients about their condition and potential treatment options.

  5. Assessment of Anxiety in Pregnancy Following Assisted Reproductive Technology (ART) and Associated Infertility Factors in Women Commencing Treatment.

    Science.gov (United States)

    Hashemieh, Chehreha; Neisani Samani, Leila; Taghinejad, Hamid

    2013-12-01

    Successful pregnancy is the ultimate goal of almost all couples. However, this pleasant event is usually accompanied psychological and behavioral changes and can result in stress in women, particularly women who pregnant by assisted reproductive technology methods (ARTs). This study aims to determine the anxiety level during pregnancy and its relation with infertility factors in women who has been pregnant by Assisted Reproduction Technology (ART) methods. A total number of 100 ARTs pregnant women who came to three infertility centers in Tehran from August to November 2009 participated in this descriptive cross sectional study. The rational for selecting the subjects was their availability to the researcher at the time of the research. Anxiety was measured by Beck Anxiety Inventory and for obtaining the infertility data, a questionnaire designed by the researcher was given to the subjects. Data were statistically analyzed using the inferential statistic of chi-square. Study results showed that 34 % of subjects were anxious (moderate and sever levels in total). There are significant relations between infertility duration, history of treatment failure and anxiety level (P = 0.03) (P = 0.02). There were no statistically significant relationships with regard to other variables. Infertility duration and history of treatment failure in ARTs pregnant women are two factors that affect the anxiety level during pregnancy.

  6. Live birth outcome, spontaneous pregnancy and adoption up to five years after undergoing assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Volgsten, Helena; Schmidt, Lone

    2017-01-01

    INTRODUCTION: This study is part of a longitudinal cohort undertaken in both women and men to describe live birth outcome after undergoing assisted reproductive technology (ART) treatment in a clinical setting. Another objective was to follow women and men living with children from other alternat......INTRODUCTION: This study is part of a longitudinal cohort undertaken in both women and men to describe live birth outcome after undergoing assisted reproductive technology (ART) treatment in a clinical setting. Another objective was to follow women and men living with children from other...... alternatives after ART, such as adoption. MATERIAL AND METHODS: A total of 439 (80.5%) women and 423 (77.6%) men were included in the baseline cohort (2005-2007). Live birth rate after ART was 24.8% at baseline. Up to 5 years later (2010-2011) the same participants were sent individual postal questionnaires (n...... birth after ART and more than one of four (28.0%) after spontaneous pregnancies or both. Of these, 52 (26.1%) women had a subsequent live birth after successful ART and 26 (32.9%) women after unsuccessful ART. Nineteen (6.8%) women and 13 (7.1%) men had a child after adoption. Almost one of five (19...

  7. Dietary folate and reproductive success among women undergoing assisted reproduction.

    Science.gov (United States)

    Gaskins, Audrey J; Afeiche, Myriam C; Wright, Diane L; Toth, Thomas L; Williams, Paige L; Gillman, Matthew W; Hauser, Russ; Chavarro, Jorge E

    2014-10-01

    To prospectively evaluate the associations of folate with assisted reproductive technology outcomes within a population in the United States. This analysis included women (n=232) in a prospective cohort study at the Massachusetts General Hospital Fertility Center. Diet was assessed before assisted reproductive technology treatment using a validated food frequency questionnaire. Intermediate and clinical endpoints of assisted reproductive technology were abstracted from medical records. Generalized linear mixed models with random intercepts to account for multiple cycles per woman were used to evaluate the association of folate intake with assisted reproductive technology outcomes adjusting for calorie intake, age, body mass index, race, smoking status, infertility diagnosis, and protocol type. Among the 232 women (median age 35.2 years, median folate intake 1,778 micrograms/day), higher folate intake was associated with higher rates of implantation, clinical pregnancy, and live birth. The adjusted percentage (95% confidence interval [CI]) of initiated assisted reproductive technology cycles resulting in a live birth for women in increasing quartiles of folate intake were 30% (95% CI 21-42%), 47% (95% CI 35-59%), 42% (95% CI 30-35%) and 56% (95% CI 43-67%) (P for trend=0.01). Live birth rates were 20% (95% CI 8-31%) higher among women in the highest quartile of supplemental folate intake (more than 800 micrograms/day) than among women in the lowest quartile (less than 400 micrograms/day). Higher supplemental folate intake was associated with higher fertilization rates and lower cycle failure rates before embryo transfer (P for trend=0.03 and 0.02). Higher intake of supplemental folate was associated with higher live birth rates after assisted reproductive technology treatment. : II.

  8. Assisted reproductive technology in Japan: a summary report of 1992-2014 by the Ethics Committee, Japan Society of Obstetrics and Gynecology.

    Science.gov (United States)

    Irahara, Minoru; Kuwahara, Akira; Iwasa, Takeshi; Ishikawa, Tomonori; Ishihara, Osamu; Kugu, Koji; Sawa, Rintaro; Banno, Kouji; Saito, Hidekazu

    2017-04-01

    The Japan Society of Obstetrics and Gynecology implemented a registry report system for the clinical practice of assisted reproductive technology in 1986. The aggregated results from 1992 to 2014 are reported herein. The total number of registered treatments was 393 745 cycles, of which 66 550 were pregnancy cycles and 46 008 were cycles with a live birth. Compared to the number of registered treatments in 2008, when the cycle-based registry was newly introduced, there was a 2.07-fold increase in the total number of treatments and a 2.25-fold increase in the number of cycles with a live birth. As the average age of patients who receive assisted reproductive technology has become markedly higher year by year, the most common age of those patients who received assisted reproductive technology in 2014 was 40 years. The total numbers of both assisted reproductive technology treatments and assisted reproductive technology live births are likely to be higher in the future. In addition, the trend toward aging patients seems to be continuing into the future.

  9. Outcome of assisted reproductive technology (ART) and subsequent self-reported life satisfaction.

    Science.gov (United States)

    Kuivasaari-Pirinen, Paula; Koivumaa-Honkanen, Heli; Hippeläinen, Maritta; Raatikainen, Kaisa; Heinonen, Seppo

    2014-01-01

    To compare life satisfaction between women with successful or unsuccessful outcome after assisted reproductive treatment (ART) by taking into account the time since the last ART. Cohort study. Tertiary hospital. A total of 987 consecutive women who had undergone ART during 1996-2007 were invited and altogether 505 women participated in the study. A postal enquiry with a life satisfaction scale. Self-reported life satisfaction in respect to the time since the last ART. In general, women who achieved a live birth after ART had a significantly higher life satisfaction than those who had unsuccessful ART, especially when compared in the first three years. The difference disappeared in the time period of 6-9 years after ART. The unsuccessfully treated women who had a child by some other means before or after the unsuccessful ART had comparable life satisfaction with successfully treated women even earlier. Even if unsuccessful ART outcome is associated with subsequent lower level of life satisfaction, it does not seem to threaten the long-term wellbeing.

  10. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology.

    Science.gov (United States)

    Glujovsky, Demián; Farquhar, Cindy; Quinteiro Retamar, Andrea Marta; Alvarez Sedo, Cristian Roberto; Blake, Deborah

    2016-06-30

    pregnancy rates derived from fresh and frozen-thawed cycles following a single oocyte retrieval, but the evidence for this outcome was very low quality. Thus, although there is a benefit favouring blastocyst transfer in fresh cycles, it remains unclear whether the day of transfer impacts on cumulative live birth and pregnancy rates. Future RCTs should report rates of live birth, cumulative live birth, and miscarriage to enable couples or women undergoing assisted reproductive technology (ART) and service providers to make well informed decisions on the best treatment option available.

  11. Past performance of assisted reproduction technologies as a model to predict future progress: a proposed addendum to Moore's law.

    Science.gov (United States)

    Cohen, Jacques; Alikani, Mina; Bisignano, Alexander

    2012-12-01

    The ultimate goal of IVF is to achieve healthy, single, live births following each single-embryo transfer. A timeline for this eventuality has never been defined. National implantation rates from 2003-2010 provided by the Society for Assisted Reproductive Technologies (SART) in the USA were evaluated. Regression analysis was applied to the annual trends. A high correlation was noted showing a linear increase from year to year ranging between 0.3% and 1.5% when maternal age was not higher than 42. This relationship can be retrospectively applied to earlier SART data reports. This incline may be partly technology driven and resembles Moore's law, which describes annual improvements in microchip performance. Based on the assumption that technology will continue to drive progress, the length of time required to reach 100% implantation was calculated. The interval varied between 43 years (AD 2053) for the youngest age group (Assisted Reproductive Technologies (SART; www.sart.org). Through SART, individual clinic's outcomes may be assessed. Although live birth and pregnancy are considered the gold standard of success, the investigators took the approach that those outcomes are often biased due to transfer of multiple embryos. The present analysis was therefore performed on individual embryos, by using the implantation rate to compare national and individual clinic datasets. National implantation rates show a linear increase from year to year ranging between 0.3% and 1.5% for patients aged technology driven. This is an intriguing effect also seen in the computer industry where there has been a doubling of computer speed and memory for the past 47 years, a phenomenon anticipated by Moore's law. We predict that the annual increase in implantation will also continue as new technologies become available. Based on current trends, the length of time for 100% implantation rates was calculated. Time to achieving 100% implantation varied between 43 years (AD 2053) for the youngest

  12. Embryo transfer practices in the United States: a survey of clinics registered with the Society for Assisted Reproductive Technology.

    Science.gov (United States)

    Jungheim, Emily S; Ryan, Ginny L; Levens, Eric D; Cunningham, Alexandra F; Macones, George A; Carson, Kenneth R; Beltsos, Angeline N; Odem, Randall R

    2010-09-01

    To gain a better understanding of factors influencing clinicians' embryo transfer practices. Cross-sectional survey. Web-based survey conducted in December 2008 of individuals practicing IVF in centers registered with the Society for Assisted Reproductive Technology (SART). None. None. Prevalence of clinicians reporting following embryo transfer guidelines recommended by the American Society for Reproductive Medicine (ASRM), prevalence among these clinicians to deviate from ASRM guidelines in commonly encountered clinical scenarios, and practice patterns related to single embryo transfer. Six percent of respondents reported following their own, independent guidelines for the number of embryos to transfer after IVF. Of the 94% of respondents who reported routinely following ASRM embryo transfer guidelines, 52% would deviate from these guidelines for patient request, 51% for cycles involving the transfer of frozen embryos, and 70% for patients with previously failed IVF cycles. All respondents reported routinely discussing the risks of multiple gestations associated with standard embryo transfer practices, whereas only 34% reported routinely discussing single embryo transfer with all patients. Although the majority of clinicians responding to our survey reported following ASRM embryo transfer guidelines, at least half would deviate from these guidelines in a number of different situations. Copyright (c) 2010 American Society for Reproductive Medicine. All rights reserved.

  13. Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?

    Science.gov (United States)

    Sejbaek, Camilla S; Pinborg, Anja; Hageman, Ida; Forman, Julie L; Hougaard, Charlotte Ø; Schmidt, Lone

    2015-10-01

    Previous studies have shown conflicting results as to whether unsuccessful medically assisted reproduction is a risk factor for depression among women. This study therefore investigated if women with no live birth after assisted reproductive technology (ART) treatment had a higher risk of unipolar depression compared with women with a live birth after ART treatment. The Danish National ART-Couple (DANAC) Cohort is a national register-based cohort study that consists of women who received ART treatment from 1 January 1994 to 30 September 2009, in Denmark (n = 41 050). Information on unipolar depression was obtained from the Danish Psychiatric Central Research Register. The analyses were conducted in Cox regression analysis. During the 308 494 person-years of follow up, 552 women were diagnosed with unipolar depression. A Cox proportional hazards model showed that women in ART treatment, with no live birth yet, had a lower risk of unipolar depression compared with women with a live birth. Women had the highest risk of unipolar depression 0-42 days after a live birth (adjusted hazard ratio 5.08, 95% CI 3.11-8.29) compared with women with no live birth. A lower, but still increased, risk of unipolar depression, was found in women 43 days to 1 year and >1 year after a live birth compared with women with no live birth yet. Motherhood is an important trigger of unipolar depression in women conceiving after ART treatment. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  14. The effect of auriculotherapy on the stress and the outcomes of assistant reproductive technologies in infertile women

    Directory of Open Access Journals (Sweden)

    Mozhgan Saffari

    2018-01-01

    Full Text Available Background: Infertility means failure to achieve pregnancy after one year of regular unprotected sexual intercourse. Infertile women may experience severe stress and depression. Numerous studies have indicated that auriculotherapy could reduce stress. Thus, the aim of the present study was to determine the effect of auriculotherapy on the stress and the outcome assisted reproductive technology in infertile women. Materials and Methods: The present study was a clinical trial that was conducted on 56 infertile women aged 20–45, who were assigned into two groups of intervention and control, from November 2014 to November 2015. The control group only received the routine treatments, while the intervention group, in addition to their routine treatment, received auriculotherapy for 8–10 sessions during menstrual cycle. Both groups completed Newton's Fertility Problem Inventory in three stages. The datasets collected for the study were analyzed using independent t-test, repeated-measures analysis of variance, and Chi-square test. Results: The mean score of stress in the intervention group decreased significantly, compared to the control group prior to the embryo transfer and pregnancy test stages. Although insignificant, the rate of pregnancy in the intervention group was higher than the control group. There was a significant increase in the rate of clinical pregnancy in the intervention group, compared to the control. Conclusions: The results indicated that auriculotherapy might be effective in reducing stress and improving the outcome of assisted reproductive treatment.

  15. Prenatal screening at 11-13+6 weeks in assisted reproductive technology singleton pregnancies and those conceived naturally.

    Science.gov (United States)

    Gong, Meng; Shi, Hua; Zhang, Yu-guo; Ming, Lei

    2015-10-01

    To investigate whether assisted reproductive technology (ART) increases the risk of fetal chromosomal abnormalities. A total of 2034 singleton pregnant women were included in this retrospective study. They were divided into ART (574 fetuses) and control groups (1460 fetuses conceived naturally). All pregnant women received screening according to the Fetal Medicine Foundation, London 2004 Kypros H. Nicolaides guidelines at 11-13+6 weeks of gestation. Accordingly, women with value at risk of chromosomal abnormalities >1:250 underwent chorionic villus sampling or amniocentesis. Mean body mass index was 22.83 ± 3.27 versus 21.29 ± 2.81 kg/m(2) in the ART and control groups, respectively (P fetal chromosomal abnormalities. Additionally, fetus size in the ART group was bigger than that in the natural conception group. © 2015 Japan Society of Obstetrics and Gynecology.

  16. Demographic and Obstetric Outcomes of Pregnancies conceived by Assisted Reproductive Technology (ART) compared to Non-ART Pregnancies.

    Science.gov (United States)

    Johnston, Robert; Fong, Alex; Lovell, Sarah; Sobolewski, Paul S; Rad, Steve; Turner, Aaron

    2015-02-01

    Use of assisted reproductive technology has increased steadily, yet multiple socioeconomic and demographic disparities remain between the general population and those with infertility. Additionally, both mothers and infants experience higher rates of adverse outcomes compared to their non-ART counterparts. Using International Classification of Diseases, Ninth Revision (ICD-9) coding, we performed a retrospective review of all ART-conceived deliveries in California in 2009. A total of 551 ART pregnancies were compared to Non-ART pregnancies (n=406,885). The majority of ART deliveries belonged to women of advanced maternal age (AMA) and Caucasian or Asian race. Nearly half of all ART deliveries were multiple gestations. Compared to non-ART deliveries, ART pregnancies were associated with placenta previa, placental abruption, mild preeclampsia, and fetal growth restriction. While not powered to detect all outcomes, our study highlights significant racial and ethnic disparities between ART and Non-ART pregnancies.

  17. The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: an international analysis.

    Science.gov (United States)

    Chambers, Georgina M; Hoang, Van Phuong; Sullivan, Elizabeth A; Chapman, Michael G; Ishihara, Osamu; Zegers-Hochschild, Fernando; Nygren, Karl G; Adamson, G David

    2014-01-01

    To systematically quantify the impact of consumer cost on assisted reproduction technology (ART) utilization and numbers of embryos transferred. Ordinary least squared (OLS) regression models were constructed to measure the independent impact of ART affordability-measured as consumer cost relative to average disposable income-on ART utilization and embryo transfer practices. Not applicable. Women undergoing ART treatment. None. OLS regression coefficient for ART affordability, which estimates the independent effect of consumer cost relative to income on utilization and number of embryos transferred. ART affordability was independently and positively associated with ART utilization with a mean OLS coefficient of 0.032. This indicates that, on average, a decrease in the cost of a cycle of 1 percentage point of disposable income predicts a 3.2% increase in utilization. ART affordability was independently and negatively associated with the number of embryos transferred, indicating that a decrease in the cost of a cycle of 10 percentage points of disposable income predicts a 5.1% increase in single-embryo transfer cycles. The relative cost that consumers pay for ART treatment predicts the level of access and number of embryos transferred. Policies that affect ART funding should be informed by these findings to ensure equitable access to treatment and clinically responsible embryo transfer practices. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. New Zealand University students' knowledge of fertility decline in women via natural pregnancy and assisted reproductive technologies.

    Science.gov (United States)

    Lucas, Nathanael; Rosario, Roseanne; Shelling, Andrew

    2015-09-01

    Female fertility declines with age. University students are the group of people most likely to postpone parenthood, yet several international studies have shown that they overestimate their fertility. We designed a questionnaire based on a previous study in Israel, where university students were asked to answer questions related to their awareness of fertility decline in spontaneous and in vitro fertilisation (IVF) pregnancies, and methods they considered would prolong their reproductive lifespan. Our study has shown that New Zealand University students overestimated the rates of pregnancy for both spontaneous natural and IVF pregnancies. Students are mainly aware of the availability of assisted reproductive technologies (ARTs), but overestimate their effectiveness. Few students mentioned non-medical or well-being initiatives as measures to prolong parenthood. It is important that university students are aware of the rate of fertility decline in women, as although ARTs can be effective at times, they are not a guaranteed solution to an ageing woman's fertility. New Zealand University students, like other cohorts, overestimated the chances of a woman getting pregnant and predicted the fertility decline to occur much later than it does in reality.

  19. Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study.

    Science.gov (United States)

    Henningsen, Anna-Karina Aaris; Pinborg, Anja; Lidegaard, Øjvind; Vestergaard, Christina; Forman, Julie Lyng; Andersen, Anders Nyboe

    2011-03-01

    To compare the perinatal outcome of singleton siblings conceived differently. National population-based registry study. Denmark, from 1994 to 2008. Pairs of siblings (13,692 pairs; n = 27,384 children) conceived after IVF, intracytoplasmatic sperm injection (ICSI), frozen embryo replacement (FER), or spontaneous conception subcategorized into five groups according to succession: [1] IVF-ICSI vs. spontaneous conception (n = 7,758), [2] IVF-ICSI vs. FER (n = 716), [3] FER vs. FER (n = 34), [4] IVF-ICSI vs. IVF-ICSI (n = 2,876), and [5] spontaneous conception vs. spontaneous conception (n = 16,000). Observations were obtained from national registries. Birth weight, gestational age, low birth weight (conception method. Higher risk of low birth weight with (odds ratio [OR], 1.4; 95%CI, 1.1-1.7] and preterm birth (OR, 1.3; 95% CI, 1.1-1.6] was observed in IVF/ICSI compared with spontaneous conception. When differentiating between order and mode of conception, it seems that assisted reproductive technology plays a role in mean birth weight and risk of low birth weight and preterm birth. Birth weight was higher in siblings born after FER compared with fresh embryos replacement. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Race matters: a systematic review of racial/ethnic disparity in Society for Assisted Reproductive Technology reported outcomes.

    Science.gov (United States)

    Wellons, Melissa F; Fujimoto, Victor Y; Baker, Valerie L; Barrington, Debbie S; Broomfield, Diana; Catherino, William H; Richard-Davis, Gloria; Ryan, Mary; Thornton, Kim; Armstrong, Alicia Y

    2012-08-01

    To systematically review the reporting of race/ethnicity in Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System (CORS) publications. Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology of literature published in PubMed on race/ethnicity that includes data from SART CORS. Not applicable. Not applicable. In vitro fertilization cycles reported to SART. Any outcomes reported in SART CORS. Seven publications were identified that assessed racial/ethnic disparities in IVF outcomes using SART data. All reported a racial/ethnic disparity. However, more than 35% of cycles were excluded from analysis because of missing race/ethnicity data. Review of current publications of SART data suggests significant racial/ethnic disparities in IVF outcomes. However, the potential for selection bias limits confidence in these findings, given that fewer than 65% of SART reported cycles include race/ethnicity. Our understanding of how race/ethnicity influences ART outcome could be greatly improved if information on race/ethnicity was available for all reported cycles. Copyright © 2012 American Society for Reproductive Medicine. All rights reserved.

  1. Temporal and geospatial trends in male factor infertility with assisted reproductive technology in the United States from 1999-2010.

    Science.gov (United States)

    Odisho, Anobel Y; Nangia, Ajay K; Katz, Patricia P; Smith, James F

    2014-08-01

    To estimate the prevalence of male factor infertility diagnosis within the context of assisted reproductive technology (ART) clinics and its geographic and temporal distribution from 1999-2010. Population study based on patients presenting for care at ART centers. Clinics providing ART services. All male patients seeking infertility care at ART clinics. Data were obtained from the Centers for Disease Control and Prevention, analyzed, geocoded, and mapped. Prevalence of male factor infertility diagnosis in a couple seeking infertility care. Between 1999 and 2010, 1,057,402 cycles of ART using nonfrozen, nondonor eggs were performed, increasing from 62,809 cycles in 1999 to 99,289 cycles in 2010. Nationwide in ART clinics, the period prevalence of isolated male factor infertility was 17.1% and the prevalence of overall male factor infertility diagnoses was 34.6%. The highest prevalence was reported in New Mexico (56.4%) and lowest in Mississippi (24.2%). The prevalence of male factor infertility diagnosis varies significantly by time and space within the United States, whereas its overall prevalence has remained remarkably stable. This study provides the spatial analytic framework for future research to explore factors associated with male factor infertility. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Assisted reproduction for postmenopausal women.

    Science.gov (United States)

    Ekberg, Merryn Elizabeth

    2014-09-01

    With increasing longevity, an ageing population and advances in assisted reproductive technologies (ART), a greater number of women are deciding to have a child and become a mother in their later years. With this social and demographic change, an important social and ethical debate has emerged over whether single and/or married postmenopausal women should have access to ARTs. The aim of this paper is to address this question and review critically the arguments that have been advanced to support or oppose the use of ART by older women. The arguments presented consider the consequences for the individual, the family and wider society. They cover the potential physical and emotional harm to the older woman, the possible impact on the welfare and wellbeing of the future child, and the impact on the norms, values, customs and traditions of society. After reviewing the evidence, and weighing the opposing arguments, this paper concludes that there is no moral justification for a restriction on the use of ART by postmenopausal women. Allowing access to ART for postmenopausal women is an extension of reproductive autonomy and procreative rights in an age where the promotion of agency, autonomy, individual choice and human rights is paramount.

  3. Damages at Japanese assisted reproductive technology clinics by the Great Eastern Japan Earthquake of 2011.

    Science.gov (United States)

    Ishihara, Osamu; Yoshimura, Yasunori

    2011-06-30

    The Great Eastern Japan Earthquake of 2011 and consequent tsunami affected many IVF clinics in northeastern Japan. Twelve clinics lost at least one embryo, but all the frozen embryos stored in liquid nitrogen tanks were safe. Emergency power supply is the first priority issue in an unpredictable natural disaster. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Religious aspects of assisted reproduction

    Science.gov (United States)

    Sallam, H N; Sallam, N H

    2016-03-28

    Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation. Orthodox Christians are less strict than Catholic Christians but still refuse third party involvement. Interestingly, in contrast to Sunni Islam, Shi'a Islam accepts gamete donation and has made provisions to institutionalize it. Chinese culture is strongly influenced by Confucianism, which accepts all forms of assisted reproduction that do not involve third parties. Other communities follow the law of the land, which is usually dictated by the religious group(s) that make(s) the majority of that specific community. The debate will certainly continue as long as new developments arise in the ever-evolving field of assisted reproduction.

  5. Religious aspects of assisted reproduction

    Science.gov (United States)

    Sallam, HN; Sallam, NH

    2016-01-01

    Abstract Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation. Orthodox Christians are less strict than Catholic Christians but still refuse third party involvement. Interestingly, in contrast to Sunni Islam, Shi’a Islam accepts gamete donation and has made provisions to institutionalize it. Chinese culture is strongly influenced by Confucianism, which accepts all forms of assisted reproduction that do not involve third parties. Other communities follow the law of the land, which is usually dictated by the religious group(s) that make(s) the majority of that specific community. The debate will certainly continue as long as new developments arise in the ever-evolving field of assisted reproduction. PMID:27822349

  6. Are assisted reproduction technologies associated with categorical or dimensional aspects of psychopathology in childhood, adolescence or early adulthood? Results from a Danish prospective nationwide cohort study

    DEFF Research Database (Denmark)

    Klausen, T; Juul Hansen, K.; Munk-Jørgensen, P.

    2017-01-01

    An increasing number of children are conceived using assisted reproduction technologies (ART), but little is known about the long-term risk in terms of mental health outcomes. All twin and singleton children conceived via ART and born in 1995 were sampled from the Danish in vitro fertilization...

  7. Parental Age and Assisted Reproductive Technology in Autism Spectrum Disorders, Attention Deficit Hyperactivity Disorder, and Tourette Syndrome in a Japanese Population

    Science.gov (United States)

    Shimada, Takafumi; Kitamoto, Atsushi; Todokoro, Ayako; Ishii-Takahashi, Ayaka; Kuwabara, Hitoshi; Kim, Soo-Yung; Watanabe, Kei-ichiro; Minowa, Iwao; Someya, Toshikazu; Ohtsu, Hiroshi; Osuga, Yutaka; Kano, Yukiko; Kasai, Kiyoto; Kato, Nobumasa; Sasaki, Tsukasa

    2012-01-01

    We investigated whether advanced parental age and assisted reproductive technology (ART) are risk factors in autism spectrum disorders (ASDs), attention deficit hyperactivity disorder (ADHD), and Tourette syndrome (TS). Clinical charts of Japanese outpatients with ASD (n = 552), ADHD (n = 87), and TS (n = 123) were reviewed. Parental age of…

  8. The incidence of monozygotic twinning in assisted reproductive technology: analysis based on results from the 2010 Japanese ART national registry.

    Science.gov (United States)

    Nakasuji, Takashi; Saito, Hidekazu; Araki, Ryuichiro; Nakaza, Aritoshi; Nakashima, Akira; Kuwahara, Akira; Ishihara, Osamu; Irahara, Minoru; Kubota, Toshiro; Yoshimura, Yasunori; Sakumoto, Tetsuro

    2014-07-01

    To assess the incidence of monozygotic twinning (MZT) among cases undergoing assisted reproductive technology (ART) treatment. We performed a retrospective observational study and analyzed the data of patients who were registered in the national ART registry system of Japan from January to December 2010; only the data of patients with single embryo transfer (ET) were included. Of 30,405 pregnancies, 425 resulted in MZT following fresh and frozenthawed ET. The MZT incidence among women undergoing ART was 1.4 %. Multiple logistic regression analysis indicated that cases undergoing fresh and frozen-thawed ET, blastocyst transfer had a significantly increased MZT rate (P < 0.01). Assisted hatching (AH) and frozen-thawed ET and maternal age did not significantly affect the MZT incidence. Of 8510 fresh ET pregnancies, 104 resulted in MZT. Multiple logistic regression analysis indicated that blastocyst transfer significantly increased the MZT rate in cases undergoing fresh ET. Ovarian stimulation, intracytoplasmic sperm injection, AH, and maternal age did not significantly affect the MZT incidence. Blastocyst transfer was associated with an increased MZT incidence. We have to be aware of the potential risk of MZT caused by blastocyst transfer. However, further studies are required to assess the correlation among specific AH types, embryo culture conditions, and MZT incidence.

  9. Cultural and Ethical Challenges of Assisted Reproductive ...

    African Journals Online (AJOL)

    This paper discusses the cultural and ethical issues arising from the use of Assisted Reproductive Health Technologies. ... Legitimacy of children born through ART, religious obligation, patriarchy, polygamy and value of children are cultural issues surrounding ARTs while decision making about it, discrimination against ...

  10. Improving embryo quality in assisted reproduction

    NARCIS (Netherlands)

    Mantikou, E.

    2013-01-01

    The goal of this thesis was to improve embryo quality in assisted reproductive technologies by gaining more insight into human preimplantation embryo development and by improving in vitro culture conditions. To do so, we investigated an intriguing feature of the human preimplantation embryo, i.e.

  11. Use of metformin before and during assisted reproductive technology in non-obese young infertile women with polycystic ovary syndrome: a prospective, randomized, double-blind, multi-centre study

    DEFF Research Database (Denmark)

    Kjøtrød, S B; Carlsen, S M; Rasmussen, P E

    2011-01-01

    To study the effect of metformin before and during assisted reproductive technology (ART) on the clinical pregnancy rate (CPR) in non-obese women with polycystic ovary syndrome (PCOS).......To study the effect of metformin before and during assisted reproductive technology (ART) on the clinical pregnancy rate (CPR) in non-obese women with polycystic ovary syndrome (PCOS)....

  12. Birthweight percentiles by gestational age for births following assisted reproductive technology in Australia and New Zealand, 2002-2010.

    Science.gov (United States)

    Li, Zhuoyang; Wang, Yueping A; Ledger, William; Sullivan, Elizabeth A

    2014-08-01

    What is the standard of birthweight for gestational age for babies following assisted reproductive technology (ART) treatment? Birthweight for gestational age percentile charts were developed for singleton births following ART treatment using population-based data. Small for gestational age (SGA) and large for gestational age (LGA) births are at increased risks of perinatal morbidity and mortality. A birthweight percentile chart allows the detection of neonates at high risk, and can help inform the need for special care if required. This population study used data from the Australian and New Zealand Assisted Reproduction Database (ANZARD) for 72 694 live born singletons following ART treatment between January 2002 and December 2010 in Australia and New Zealand. A total of 69 315 births (35 580 males and 33 735 females) following ART treatment were analysed for the birthweight percentile. Exact percentiles of birthweight in grams were calculated for each gestational week between Week 25 and 42 for fresh and thaw cycles by infant sex. Univariate analysis was used to determine the exact birthweight percentile values. Student t-test was used to examine the mean birthweight difference between male and female infants, between single embryo transfer (SET) and double embryo transfer (DET) and between fresh and thaw cycles. Preterm births (birth before 37 completed weeks of gestation) and low birthweight (fetal growth standards but only the weight of live born infants at birth. The comparison of birthweight percentile charts for ART births and general population births provide evidence that the proportion of SGA births following ART treatment was comparable to the general population for SET fresh cycles and significantly lower for thaw cycles. Both fresh and thaw cycles showed better outcomes for singleton births following SET compared with DET. Policies to promote single embryo transfer should be considered in order to minimize the adverse perinatal outcomes associated

  13. Genomic imprinting and assisted reproduction

    Directory of Open Access Journals (Sweden)

    Chaillet J Richard

    2004-10-01

    Full Text Available Abstract Imprinted genes exhibit a parent-of-origin specific pattern of expression. Such genes have been shown to be targets of molecular defects in particular genetic syndromes such as Beckwith-Wiedemann and Angelman syndromes. Recent reports have raised concern about the possibility that assisted reproduction techniques, such as in vitro fertilization or intracytoplasmic sperm injection, might cause genomic imprinting disorders. The number of reported cases of those disorders is still too small to draw firm conclusions and the safety of these widely used assisted reproduction techniques needs to be further evaluated.

  14. [The risk of congenital malformations and genomic imprinting defects in assisted reproductive technologies and nuclear transfer cloning].

    Science.gov (United States)

    Valenzuela, Carlos Y

    2005-09-01

    Recent studies show that assisted reproductive technologies (ART), whether in vitro fertilization (IVF) or intra-cytoplasmatic sperm injection (ICSI) or applied to cloning by somatic cell nuclear transfer (SCNT) are associated to a higher risk of congenital malformations and errors in deprogramming, maintenance or reprogramming genomic imprinting in humans and animals. IVF and ICSI are also associated to an increased admission to neonatal intensive care units and more need for health care resources in infancy. A mutagenic effect of a chemical used in SCNT has been reported and gene depression was found in bovine embryos obtained by IVF or SCNT. The causes of these anomalies could be pathological conditions for which ART is applied, a direct effect of technologies on the zygotes or embryos, avoidance for zygotes or embryos of the oviduct path that is needed to elicit necessary immunity or genomic programming processes, or adaptive selective steps acquired during thousands of millions of generations in evolution. The knowledge of evolution is emphasized as essential in the scientific ethical analysis.

  15. Methylation changes in mature sperm deoxyribonucleic acid from oligozoospermic men: assessment of genetic variants and assisted reproductive technology outcome.

    Science.gov (United States)

    Montjean, Debbie; Ravel, Célia; Benkhalifa, Moncef; Cohen-Bacrie, Paul; Berthaut, Isabelle; Bashamboo, Anu; McElreavey, Kenneth

    2013-11-01

    To characterize a potential genetic cause for methylation errors described in oligozoospermia. Analysis of PEG1/MEST-DMR and H19-DMR methylation level in sperm, in parallel with the study of several genes on the Y chromosome, DNMT3A, and DNMT3L. Clinical outcome was also looked at regarding PEG1/MEST-DMR and H19-DMR methylation level in sperm. Research and diagnostic laboratories. One hundred nineteen normospermic and 175 oligozoospermic men consulting for couple infertility. We studied PEG1/MEST-DMR and H19-DMR methylation profiles in 294 men. We searched for Y chromosome gene aberrations and for mutations in both DNMT3A and DNMT3L genes in men showing epimutations. Assisted reproductive technology (ART) outcomes were also investigated. Sperm samples were collected from 294 volunteers for genomic DNA isolation that was used to study methylation profiles in imprinted loci and Y chromosome SMCY, DNMT3A, and DNMT3L genes. Pregnancy rate was also studied after ART treatment using sperm showing epimutations. Epimutations in H19-DMR and PEG1/MEST-DMR were found in 20% and 3% of oligozoospermic men, respectively. We identified an amino acid change in DNMT3A in one case and in DNMT3L in eight men with altered methylation profiles. No mutations were detected in SMCY or in selected Y chromsome genes. No correlation between ART outcome and epimutations was found. We observed epimethylations in spermatozoa of oligozoospermic individuals, but no association was found with genetic variants or in the ART outcome. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Altered DNA methylation and expression of PLAGL1 in cord blood from assisted reproductive technology pregnancies compared with natural conceptions.

    Science.gov (United States)

    Vincent, Rebecca N; Gooding, Luke D; Louie, Kenny; Chan Wong, Edgar; Ma, Sai

    2016-09-01

    To investigate DNA methylation and expression of imprinted genes and an imprinted gene network (IGN) in neonates conceived via assisted reproductive technology (ART). Case control. Research institution. Two hundred sixty-four cases of cord blood and/or placental villi from neonates (101 IVF, 81 ICSI, 82 naturally conceived). Placentas were obtained at birth for biopsy and cord blood extraction. DNA methylation and expression of imprinted genes. DNA methylation at the PLAGL1 differentially methylated region (DMR) was significantly higher in IVF cord blood (48.0%) compared with controls (46.0%). No differences were found in DNA methylation between conception modes for KvDMR1 and LINE-1 in cord blood and placenta as well as PLAGL1 and PEG10 in placenta villi. PLAGL1 expression was lower in both IVF and ICSI cord blood groups than in controls (relative quantification of 0.65, 0.74, 0.89, respectively). Analyzing the expression of 3 genes in a PLAGL1 regulated IGN revealed different expression between conception modes and a significant correlation to PLAGL1 expression in only one (KCNQ1OT1). Our results suggest a stability of DNA methylation at imprinted DMRs; however, we show PLAGL1 methylation/expression to be altered after ART. As PLAGL1 expression correlated with only one of the three IGN genes in cord blood, we propose there is a more complex mechanism of regulating the IGN that may involve other genes and epigenetic modifications in this tissue. Further research investigating IGN-implicated genes in various neonatal tissues is warranted to elucidate the full effects ART-induced alterations to PLAGL1 and the IGN may have on fetal growth/development. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Full in vitro fertilization laboratory mechanization: toward robotic assisted reproduction?

    DEFF Research Database (Denmark)

    Meseguer, Marcos; Krühne, Ulrich; Laursen, Steen

    2012-01-01

    Objective: To describe the current efforts made to standardize different steps of assisted reproductive technology processes by the introduction of new technologies for the nonsubjective sperm selection process, oocyte denudation by mechanical removal of cumulus cells, oocyte positioning, sperm...

  18. Assisted reproductive technologies in Ghana : Transnational undertakings, local practices and ‘more affordable’ IVF

    NARCIS (Netherlands)

    Gerrits, T.

    The article sketches the origins and development of IVF in Ghana as a highly transnational undertaking. Movements are from and to Africa, involving human beings (providers and users), and also refer to other entities such as technologies, skills and knowledge. None of these movements are paid for

  19. [Planned children--supporting and inhibiting influences on the development of personality and relationships after technology-assisted reproduction].

    Science.gov (United States)

    Lebersorger, Karin J

    2016-03-01

    In the western industrial countries more and more couples with an unfulfilled desire for a child use assisted reproductive technology (ART). This focusses on physical processes and doesn't sufficiently provide necessary supportive psychological/psychotherapeutic guidance.Neglecting the psychological dimension causes ART to enhance the risk for negative processes of emotional development of a child.After a brief overview of prevalence and summarizing the legal situation three areas will be discussed which involve a high risk potential and their influences on relationship- and personality development will be described: • The psychological burden for potential parents during the treatment. • Wishes of perfection and high expectations concerning the child which can turn normative crises into severe problems. • The frequent handling of the treatment as a taboo which can become a destructive family secret between parents and child.The paper will conclude with thoughts concerning prevention and treatment.Every person working in the field of childhood and adolescence can contribute to a healthy psychological development of these children. This means acknowledging and working through the emotional burden and the wishes and explaining about the dangers of taboos like in foster care and adoption.

  20. Granulocyte Macrophage Colony Stimulating Factor Supplementation in Culture Media for Subfertile Women Undergoing Assisted Reproduction Technologies: A Systematic Review

    Science.gov (United States)

    Siristatidis, Charalampos; Vogiatzi, Paraskevi; Salamalekis, George; Creatsa, Maria; Vrachnis, Nikos; Glujovsky, Demián; Iliodromiti, Zoe; Chrelias, Charalampos

    2013-01-01

    Granulocyte macrophage colony stimulating factor (GM-CSF) is a cytokine/growth factor produced by epithelial cells that exerts embryotrophic effects during the early stages of embryo development. We performed a systematic review, and six studies that were performed in humans undergoing assisted reproduction technologies (ART) were located. We wanted to evaluate if embryo culture media supplementation with GM-CSF could improve success rates. As the type of studies and the outcome parameters investigated were heterogeneous, we decided not to perform a meta-analysis. Most of them had a trend favoring the supplementation with GM-CSF, when outcomes were measured in terms of increased percentage of good-quality embryos reaching the blastocyst stage, improved hatching initiation and number of cells in the blastocyst, and reduction of cell death. However, no statistically significant differences were found in implantation and pregnancy rates in all apart from one large multicenter trial, which reported favorable outcomes, in terms of implantation and live birth rates. We propose properly conducted and adequately powered randomized controlled trials (RCTs) to further validate and extrapolate the current findings with the live birth rate to be the primary outcome measure. PMID:23509457

  1. Evaluation of the efficacy of atosiban in pregnant women with threatened preterm labor associated with assisted reproductive technology.

    Science.gov (United States)

    Xu, Y-J; Ran, L-M; Zhai, S-S; Luo, X-H; Zhang, Y-Y; Zhou, Z-Y; Liu, Y-H; Ren, L-D; Hong, T; Liu, R

    2016-05-01

    The present study aimed to investigate the effectiveness of atosiban in treating women with threatened preterm labor who had become pregnant through assisted reproductive technology (ART) and the corresponding pregnancy outcomes. Seventy pregnant women with threatened preterm labor after ART were randomly divided into two groups, with 35 cases in the atosiban group and 35 in the ritodrine group. The post-treatment effects and the corresponding pregnancy outcomes were observed. The efficacy of extending gestational age by 48 hours was significantly higher in the atosiban group than in the ritodrine group (p0.05). There was no significant difference between the atosiban and ritodrine groups in the average gestational age at birth (pwomen was higher in the ritodrine group than in the atosiban group (p0.05). Both the perinatal mortality rate and the prevalence of neonatal asphyxia were significantly lower in the atosiban group than in the ritodrine group (p0.05). Administration of atosiban has a comparatively better effect than that of ritodrine on pregnant women who underwent ART and is safe and effective at preventing immediate preterm birth. Atosiban is significantly better than ritodrine at reducing the rates of perinatal mortality and neonatal pneumonia, and the perinatal outcomes for those who began to use atosiban at a gestational age of fewer than 28 weeks were even better.

  2. Assisted reproductive technology use, embryo transfer practices, and birth outcomes after infertility insurance mandates: New Jersey and Connecticut.

    Science.gov (United States)

    Crawford, Sara; Boulet, Sheree L; Jamieson, Denise J; Stone, Carol; Mullen, Jewel; Kissin, Dmitry M

    2016-02-01

    To explore whether recently enacted infertility mandates including coverage for assisted reproductive technology (ART) treatment in New Jersey (2001) and Connecticut (2005) increased ART use, improved embryo transfer practices, and decreased multiple birth rates. Retrospective cohort study using data from the National ART Surveillance System. We explored trends in ART use, embryo transfer practices and birth outcomes, and compared changes in practices and outcomes during a 2-year period before and after passing the mandate between mandate and non-mandate states. Not applicable. Cycles of ART performed in the United States between 1996 and 2013. Infertility insurance mandates including coverage for ART treatment passed in New Jersey (2001) and Connecticut (2005). Number of ART cycles performed, number of embryos transferred, multiple live birth rates. Both New Jersey and Connecticut experienced an increase in ART use greater than the non-mandate states. The mean number of embryos transferred decreased significantly in New Jersey and Connecticut; however, the magnitudes were not significantly different from non-mandate states. There was no significant change in ART birth outcomes in either mandate state except for an increase in live births in Connecticut; the magnitude was not different from non-mandate states. The infertility insurance mandates passed in New Jersey and Connecticut were associated with increased ART treatment use but not a decrease in the number of embryos transferred or the rate of multiples; however, applicability of the mandates was limited. Published by Elsevier Inc.

  3. Remifentanil versus Fentanyl for Assisted Reproductive Technologies:Effect on Hemodynamic Recovery from Anesthesia and Outcome of ART Cycles

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Jarahzadeh

    2011-01-01

    Full Text Available Background: We conducted this study to compare the outcome of assisted reproductive technology(ART procedures and recovery from anesthesia in women who received opioid analgesia withremifentanil versus fentanyl.Materials and Methods: This double-blind, randomized clinical trial was carried out inthe Yazd Research and Clinical Center for Infertility, Yazd, Iran. We studied 145 womenwho were participants in an ART program. During the first phase of the study, all patientsunderwent induction of anesthesia with thiopental and received analgesia with remifentanilor fentanyl. The primary endpoint was pregnancy rate per transfer. The numbers of oocytescollected, fertilized and cleaved were recorded, as was the number of oocytes transferredand recovery profile. In the second phase of the study, all patients were followed foroutcome of ART cycle.Results: This study suggested that in women undergoing transvaginal ultrasound-guided oocyteretrieval procedures, the likelihood of a successful pregnancy was higher with a remifentanil-basedmonitored anesthesia care (MAC technique than with a fentanyl-based MAC technique. Therecovery from anesthesia was significantly better in the remifentanil group versus fentanyl group.Conclusion: The results of this study suggest that remifentanil in clinical practice is superior tofentanyl (Registeration Number: IRCT201009283468N3.

  4. A retrospective study of New Zealand case law involving assisted reproduction technology and the social recognition of 'new' family.

    Science.gov (United States)

    Legge, M; Fitzgerald, R; Frank, N

    2007-01-01

    The New Zealand Human Assisted Reproductive Technology (HART) Act became law in 2004. In this article, we provide a retrospective analysis of New Zealand case law from September 1990 to March 2004, leading up to the creation of the HART Act. We examine the new understandings of parenting (developed through the routine use of ART in New Zealand) which the case law attempted to test. We examine these concepts against the previous understandings of family enshrined in the pre-existing legislation, which formed the basis for judicial rulings in the various cases to which we refer. In conclusion, we provide a brief summary of the 2004 HART legislation and draw comparisons between the old and new legislative and bureaucratic frameworks that define and support New Zealand family structure. We suggest that a change in cultural backdrop is occurring from the traditional western ideology of the nuclear family towards the traditional Maori concept of family formation, which includes a well-accepted traditional practice of guardianship and a more open and extended family structure. This 'new' structure reflects the contemporary lived experience of family kinship in western societies as individualized and open to choice.

  5. [Management of assisted reproductive technology (ART) in case of endometriosis related infertility: CNGOF-HAS Endometriosis Guidelines].

    Science.gov (United States)

    Santulli, P; Collinet, P; Fritel, X; Canis, M; d'Argent, E M; Chauffour, C; Cohen, J; Pouly, J L; Boujenah, J; Poncelet, C; Decanter, C; Borghese, B; Chapron, C

    2018-03-01

    The management of endometriosis related infertility requires a global approach. In this context, the prescription of an anti-gonadotropic hormonal treatment does not increase the rate of non-ART (assisted reproductive technologies) pregnancies and it is not recommended. In case of endometriosis related infertility, the results of IVF management in terms of pregnancy and birth rates are not negatively affected by the existence of endometriosis. Controlled ovarian stimulation during IVF does not increase the risk of endometriosis associated symptoms worsening, nor accelerate the intrinsic progression of endometriosis and does not increase the rate of recurrence. However, in the context of IVF management for women with endometriosis, pre-treatment with GnRH agonist or with oestrogen/progestin contraception improve IVF outcomes. There is currently no evidence of a positive or negative effect of endometriosis surgery on IVF outcomes. Information on the possibilities of preserving fertility should be considered, especially before surgery. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  6. Association of cardiac development with assisted reproductive technology in childhood: a prospective single-blind pilot study.

    Science.gov (United States)

    Zhou, Jie; Liu, Hong; Gu, Hai-tao; Cui, Yu-gui; Zhao, Nan-nan; Chen, Juan; Gao, Li; Zhang, Yuan; Liu, Jia-yin

    2014-01-01

    To examine the pattern and extent of cardiovascular developmental alterations among children conceived by assisted reproductive technology (ART) and its association with potential confounders. The present study was a prospective single-blind pilot design lasting 15 months. The ART group was recruited by a non-random, consecutive sample on the basis of the unique personal identification number assigned to ART children, whereas spontaneous conception controls were recruited by a population-based random sample from the same hospital by age. Echocardiography was available for the measurement of 128 ART children and 100 controls with respect to cardiovascular geometric morphology and cardiac function. The majority of cardiac geometric morphology parameters were comparable among the study groups (P>0.05), except for significant increases in left ventricular (LV) relative wall thickness (P=0.038), LV mass index (P=0.005) and LV remodeling index (P=0.005) in ART children after adjustment for age, gender, body surface area and heart rate. The results showed similarity in LV systolic function characterized by ejection fraction (P=0.140) and shortening fraction (P=0.167) between the groups. However, ART children had a significant tendency toward a decrease in mitral A (P=0.008) and mitral E' (P=0.012) compared with controls after adjusting for confounders. Additionally, Cox analysis suggested an independent association (Pchildren compared with controls, which may be independently associated with the anthropometrics and perinatal outcomes in addition to the ART procedure. © 2014 S. Karger AG, Basel.

  7. PARTIALLY CONSTRAINED SEX ALLOCATION AND THE INDIRECT EFFECTS OF ASSISTED REPRODUCTIVE TECHNOLOGIES ON THE HUMAN SEX RATIO.

    Science.gov (United States)

    Hardy, Ian C W; Maalouf, Walid E

    2017-05-01

    Infertility affects around 15% of human couples and in many countries approximately 1-4% of babies are born following Assisted Reproductive Technologies (ART). Several ART techniques are used and these differentially affect the sex ratio of offspring successfully produced. These direct effects on sex ratio also have the potential to influence, indirectly, the sex ratios of offspring born to untreated couples. This is of concern because human sex ratio bias may adversely affect public health. Here the extent of indirect effects of ART that could operate, via Fisherian frequency-dependent natural selection, on the progeny sex ratio of unassisted members of a population is heuristically modelled. Given the degrees to which ART techniques bias sex ratios directly, it is predicted that well over 20% of couples would have to reproduce via ART for there to be any discernible effect on the sex ratios produced, in response, by the remainder of the population. This value is greater than the estimated prevalence of infertility problems among human couples. It is concluded that providing ART to couples with fertility problems does not currently generate significant ethical issues or public health concern in terms of indirect effects on the offspring sex ratios of untreated couples.

  8. Quality of information about success rates provided on assisted reproductive technology clinic websites in Australia and New Zealand.

    Science.gov (United States)

    Hammarberg, Karin; Prentice, Tess; Purcell, Isabelle; Johnson, Louise

    2017-11-12

    Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success. To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation. Desktop audits of websites of ART clinics in Australia and New Zealand were conducted in 2016 and 2017 and available information about success rates was scored using a matrix with eight variables and a possible range of scores of 0-9. Of the 54 clinic websites identified in 2016, 32 had unique information and were eligible to be audited. Of these, 29 were also eligible to be audited in 2017. While there was a slight improvement in the mean score from 2016 to 2017 (4.93-5.28), this was not statistically significantly different. Of the 29 clinics, 14 had the same score on both occasions, 10 had a higher and five a lower information quality score in 2017. To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  9. Granulocyte Macrophage Colony Stimulating Factor Supplementation in Culture Media for Subfertile Women Undergoing Assisted Reproduction Technologies: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Charalampos Siristatidis

    2013-01-01

    Full Text Available Granulocyte macrophage colony stimulating factor (GM-CSF is a cytokine/growth factor produced by epithelial cells that exerts embryotrophic effects during the early stages of embryo development. We performed a systematic review, and six studies that were performed in humans undergoing assisted reproduction technologies (ART were located. We wanted to evaluate if embryo culture media supplementation with GM-CSF could improve success rates. As the type of studies and the outcome parameters investigated were heterogeneous, we decided not to perform a meta-analysis. Most of them had a trend favoring the supplementation with GM-CSF, when outcomes were measured in terms of increased percentage of good-quality embryos reaching the blastocyst stage, improved hatching initiation and number of cells in the blastocyst, and reduction of cell death. However, no statistically significant differences were found in implantation and pregnancy rates in all apart from one large multicenter trial, which reported favorable outcomes, in terms of implantation and live birth rates. We propose properly conducted and adequately powered randomized controlled trials (RCTs to further validate and extrapolate the current findings with the live birth rate to be the primary outcome measure.

  10. A systematic review and meta-analysis of metformin among patients with polycystic ovary syndrome undergoing assisted reproductive technology procedures.

    Science.gov (United States)

    Huang, Xiaman; Wang, Pin; Tal, Reshef; Lv, Fang; Li, Yuanyuan; Zhang, Xiaomei

    2015-11-01

    Metformin is used among patients with polycystic ovary syndrome (PCOS), but findings for its effects on outcomes of assisted reproductive technology (ART) have been conflicting. To compare ART outcomes among women with PCOS who were and were not given metformin. Databases were searched for reports published in English between 2002 and 2013, using combinations of the terms "polycystic ovary syndrome," "PCOS," "insulin-sensitizing," and "metformin." Randomized controlled trials of metformin versus placebo among women with PCOS undergoing ART were included if they assessed rates of pregnancy, live birth, spontaneous abortion, multiple pregnancy, and/or ovarian hyperstimulation syndrome (OHSS). Data were extracted from included studies. The Mantel-Haenzel random-effects model was used for meta-analyses. Twelve studies (1516 participants) were included. No significant differences were recorded between metformin and placebo groups for rates of pregnancy (risk ratio [RR] 1.11, 95% CI 0.92-1.33), live birth (RR 1.12, 0.92-1.36), spontaneous abortion (RR 1.00, 0.60-1.67), or multiple pregnancy (RR 0.96, 0.47-1.96). However, OHSS rate was significantly lower among patients who received metformin than among those who received placebo (RR 0.44, 0.26-0.77). Metformin does not improve ART outcomes among patients with PCOS, but does significantly reduce their risk of OHSS. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

  11. A twin sibling with Prader-Willi syndrome caused by type 2 microdeletion following assisted reproductive technology: A case report.

    Science.gov (United States)

    Han, Ji Yoon; Park, Joonhong; Jang, Woori; Chae, Hyojin; Kim, Myungshin; Kim, Yonggoo

    2016-07-01

    Prader-Willi syndrome (PWS) is a neurobehavioral imprinting disorder, which arises due to an absence of paternally expressed genes within the 15q11.2-q13 region. This occurs via one of the three main genetic mechanisms, as follows: Deletion of the paternally inherited 15q11.2-q13 region, maternal uniparental disomy and imprinting defect. Recent studies have reported an association between imprinting disorders and assisted reproductive technologies (ART). The current study presents a 6-year-old female patient who is a dizygotic twin, in which one was born with de novo microdeletion at 15q11.2-q13.1 following in vitro fertilization. The patient had characteristic facial features including narrow bifrontal diameter, strabismus, downturned mouth, feeding problems and generalized hypotonia during infancy, developmental delay, mental retardation and rapid weight gain. Based upon phenotypic resemblance and the medical records, methylation-specific multiplex ligation-dependent probe amplification and array-based comparative genome hybridization analyses demonstrate type 2 microdeletion between breaking point 2 (BP2) and BP3, which occur from MKRN3 through HERC2 at 15q11.2-q13.1. To the best of our knowledge, the present study is the first to report a PWS case born following ART reported in South Korea. In addition to previous studies, the present study contributes to the consensus regarding genotype-phenotype comparisons in this respect.

  12. Comparison of perinatal outcomes of vanishing twin and twin pregnancies conceived following assisted reproductive technology: A retrospective analysis

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    Sujata Pradhan

    2016-12-01

    Full Text Available Objective: The purpose of this study was to compare the perinatal outcomes of vanishing twin (VT pregnancies with twin pregnancies following assisted reproductive technology treatment (ART. Design: Retrospective analysis. Setting: Infertility unit of a university level hospital. Materials and methods: We included all the women with dichorionic diamniotic twin pregnancies conceived following ART from Jan 2010 to Dec 2014 in our unit. We matched the VT group and twin group for maternal age and body mass index. Results: A total of 63 vanishing twin and 135 twin pregnancies were followed up. The vanishing twin rate was 31.8%. The live birth rate at term was significantly higher in VT group compared to twin group (69.8% vs. 16.3%, P 2500 g in VT group than in twin group (77.8% vs. 25.4%, P < 0.001. The miscarriage, Cesarean and congenital anomaly rates were similar in both the groups. Conclusion: Our study finding suggests better perinatal outcomes for ART pregnancies undergoing spontaneous reduction in first trimester compared to those pregnancies which continue as twins.

  13. "Will they be good enough parents?": Ethical dilemmas, views, and decisions among assisted reproductive technology (ART) providers.

    Science.gov (United States)

    Klitzman, Robert

    2017-01-01

    Many adults may make less-than-ideal parents, but important ethical questions arise concerning whether assisted reproductive technology (ART) providers should thus ever refuse treatment to certain patients, and if so, when, and how to decide. In-depth interviews of approximately 1 hour each were conducted with 27 ART providers (17 physicians, and 10 other health providers). Clinicians often struggle with whether to attempt to assess and predict patients' potential future parenting abilities, and if so, how, and how to proceed if doubts arise. Providers face profound ethical tensions between adults' rights to reproduce and best interests of the eventual children (i.e., to be born into "stable" homes), and questions about the extent of professional responsibilities toward potential parents versus toward future offspring. Providers generally feel uncomfortable with this role, and hence don't want it, partly since they lack training for it, but also because of inherent empirical and ethical uncertainties. Concerns about discrimination based on the mere presence or history of certain diagnoses or traits (e.g., single marital status or past depression) also arise. Clinicians frequently seek to resolve these tensions through various strategies-for example, referring these decisions to others; hoping that patients drop out of treatment; assessing and increasing social support (e.g., arranging for possible co-parents); assisting the patient psychotherapeutically; or seeking to communicate concerns to patients only indirectly or implicitly. Clinics vary in how they make and approach these decisions-whether they rely on a formal ethics or other committee. These data, the first to explore several critical aspects of in vitro fertilization (IVF) providers' views and decision making about assessing the quality of patients' potential future parenting, have critical implications for future practice, education, research, and guidelines. Further empirical and normative scholarship

  14. Are children born after assisted reproductive technology at increased risk of autism spectrum disorders? A systematic review.

    Science.gov (United States)

    Conti, E; Mazzotti, S; Calderoni, S; Saviozzi, I; Guzzetta, A

    2013-12-01

    Are children born after assisted reproductive technology (ART) at increased risk of autism spectrum disorders (ASD)? There is no evidence that ART significantly increases the risk of ASD in the offspring. A few systematic reviews have explored the correlation between assisted conception and ASD with inconclusive results, partly due to the heterogeneity of diagnostic criteria and methodology in the different studies. Systematic review of 7 observational studies (2 cohort and 5 case-control) encompassing 9216 subjects diagnosed with ASD published since 2000. Literature searches were conducted to retrieve observational studies on the risk of ASD in ART population. Databases searched included PubMed, EMBASE and PsycINFO. In order to obtain more consistent results, we only included the studies in which (i) subjects with either infantile autism or ASD could be identified according to international classification systems and (ii) the diagnosis was obtained from hospital records. Seven studies matched the inclusion criteria. Four out of seven studies, including the two with the best quality scores, did not show an association between ART and ASD. The two papers supporting an increased risk of autism following ART had the lowest quality scores, due to major methodological limitations. Only one paper showed a protective role of ART. In spite of the strict inclusion criteria applied as to the diagnosis of ASD, the papers selected are heterogeneous in many aspects including study design, definitions of ART, data source and analysed confounders. At present, there is no evidence that ART is significantly associated with ASD and hence that current health policies should be modified. The divergent results of some of the studies suggest that further prospective, large and high-quality studies are still needed. This work was supported, in part, by the Italian Ministry of Health and by Tuscany Region. The authors have no competing interests to declare. N/A.

  15. Islam, Assisted Reproduction, and the Bioethical Aftermath.

    Science.gov (United States)

    Inhorn, Marcia C; Tremayne, Soraya

    2016-04-01

    Assisted reproductive technologies (ARTs), including in vitro fertilization to overcome infertility, are now widely available across the Middle East. Islamic fatwas emerging from the Sunni Islamic countries have permitted many ARTs, while prohibiting others. However, recent religious rulings emanating from Shia Muslim-dominant Iran have created unique avenues for infertile Muslim couples to obtain donor gametes through third-party reproductive assistance. The opening of Iran to gamete donation has had major impacts in Shia-dominant Lebanon and has led to so-called reproductive tourism of Sunni Muslim couples who are searching for donor gametes across national and international borders. This paper explores the "bioethical aftermath" of donor technologies in the Muslim Middle East. Other unexpected outcomes include new forms of sex selection and fetal "reduction." In general, assisted reproduction in the Muslim world has been a key site for understanding how emerging biomedical technologies are generating new Islamic bioethical discourses and local moral responses, as ARTs are used in novel and unexpected ways.

  16. Antimüllerian hormone as a predictor of live birth following assisted reproduction: an analysis of 85,062 fresh and thawed cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013.

    Science.gov (United States)

    Tal, Reshef; Seifer, David B; Wantman, Ethan; Baker, Valerie; Tal, Oded

    2018-02-01

    To determine if serum antimüllerian hormone (AMH) is associated with and/or predictive of live birth assisted reproductive technology (ART) outcomes. Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database from 2012 to 2013. Not applicable. A total of 69,336 (81.8%) fresh and 15,458 (18.2%) frozen embryo transfer (FET) cycles with AMH values. None. Live birth. A total of 85,062 out of 259,499 (32.7%) fresh and frozen-thawed autologous non-preimplantation genetic diagnosis cycles had AMH reported for cycles over this 2-year period. Of those, 70,565 cycles which had embryo transfers were included in the analysis. Serum AMH was significantly associated with live birth outcome per transfer in both fresh and FET cycles. Multiple logistic regression demonstrated that AMH is an independent predictor of live birth in fresh transfer cycles and FET cycles when controlling for age, body mass index, race, day of transfer, and number of embryos transferred. Receiver operating characteristic (ROC) curves demonstrated that the areas under the curve (AUC) for AMH as predictors of live birth in fresh cycles and thawed cycles were 0.631 and 0.540, respectively, suggesting that AMH alone is a weak independent predictor of live birth after ART. Similar ROC curves were obtained also when elective single-embryo transfer (eSET) cycles were analyzed separately in either fresh (AUC 0.655) or FET (AUC 0.533) cycles, although AMH was not found to be an independent predictor in eSET cycles. AMH is a poor independent predictor of live birth outcome in either fresh or frozen embryo transfer for both eSET and non-SET transfers. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Individualised controlled ovarian stimulation (iCOS: maximising success rates for assisted reproductive technology patients

    Directory of Open Access Journals (Sweden)

    Bosch Ernesto

    2011-06-01

    patient's specific characteristics. As new objective endocrine, paracrine, functional and/or genetic biomarkers of response are developed, iCOS can be refined further still, and this will be a significant step towards a personalised approach for IVF. Conclusions A variety of COS protocols have been adopted, with mixed success, but no single approach is appropriate for all patients within a given population. We suggest that treatment protocols should be adapted for individual patients through iCOS; this approach promises to be one of the first steps towards implementing personalised medicine in reproductive science.

  18. Varicocele repair in the era of modern assisted reproductive techniques.

    Science.gov (United States)

    McIntyre, Matthew; Hsieh, Tung-Chin; Lipshultz, Larry

    2012-11-01

    This review looks at the literature on varicocele repair and its effect on assisted reproductive techniques. The effects of varicocele correction on improved sperm production have been well documented with semen analysis data. What remain to be elucidated are the causes of the varicocele effect and how correction of the resultant pathophysiology may affect the outcomes of modern assisted reproductive technology. Basic science research shows us that varicoceles exert deleterious effects on Leydig cells, Sertoli cells, and germ cells via very different mechanisms. The effects of varicocele correction on the reproductive potential of sperm are less well understood. Clinical research has shown improved semen parameters, DNA integrity, and assisted reproductive technology outcomes after varicocele repair. Varicocele correction presents a possible method to optimize a couples' reproductive potential or decrease the need for complex assisted reproductive technology.

  19. Risk of stillbirth and infant deaths after assisted reproductive technology: a Nordic study from the CoNARTaS group.

    Science.gov (United States)

    Henningsen, A A; Wennerholm, U B; Gissler, M; Romundstad, L B; Nygren, K G; Tiitinen, A; Skjaerven, R; Nyboe Andersen, A; Lidegaard, Ø; Forman, J L; Pinborg, A

    2014-05-01

    Is the risk of stillbirth and perinatal deaths increased after assisted reproductive technology (ART) compared with pregnancies established by spontaneous conception (SC)? A significantly increased risk of stillbirth in ART singletons was only observed before 28 + 0 gestational weeks. The current literature indicates that children born after ART have an increased risk of perinatal death. The knowledge on stillbirth in ART pregnancies is limited. A population based case-control study. A total of 62 485 singletons and 29 793 twins born after ART in Denmark, Finland, Norway and Sweden, from 1982 to 2007, were compared with 362 798 spontaneously conceived (SC) singletons and 132 181 twins. The adjusted rate ratio for stillbirth at gestational weeks 22 + 0 to 27 + 6 was 2.08 [95% confidence interval (CI) 1.55-2.78] for ART versus SC singletons. After 28 + 0 gestational weeks there was no significant difference in the risk of stillbirth between ART and SC singletons. ART twins had a lower risk of stillbirth compared with SC twins, but when restricting the analysis to opposite-sex twins and excluding all monozygotic twins, there was no significant difference between the groups. Singletons conceived by ART had an overall increased risk of early neonatal death (adjusted odds ratio 1.54, 95% CI 1.28-1.85) and death within the first year after birth (1.45, 1.26-1.68). No difference regarding these two parameters was found when further adjusting for the gestational age [(0.97, 0.80-1.18) and (0.99, 0.85-1.16), respectively]. ART twins had a lower risk of early neonatal and infant deaths than SC twins, but no difference was found when restricting the analyses to opposite-sex twins. We were not able to adjust for potential confounders, such as a prior history of stillbirth, induction of labour, body mass index or smoking. The risk of stillbirth in ART versus SC singletons was only increased for very early gestational ages (before 28 weeks). This might indicate that the current

  20. Poor recovery of households from out-of-pocket payment for assisted reproductive technology.

    Science.gov (United States)

    Dyer, Silke J; Vinoos, Latiefa; Ataguba, John E

    2017-12-01

    was below 50% for four of five strategies evaluated: 23.1% of households had re-purchased a sold asset; 23.5% had normalized a previous reduction in household spending, 33.8% had regained their savings, and 48.7% were no longer bolstering income through additional work. Two-thirds of households (60.0%) had repaid all loans and debts. The poorest households showed lower rates of recovery when compared to households in the richest tertile. Complete recovery from all strategies initiated was reported by only 10 households (13.7%): 1 of 19 in the lowest tertile, 3 of 30 in the middle and by 6 of 24 households in the richest tertile (P > 0.05). No association was found between the degree of financial recovery and additional cost burdens incurred, including related to babies born; or between the degree of recovery and ongoing pursuit of ART. The sample size was limited. The participation rate was just over 50%. Results were dependent on participants' narrative and recall. The willingness of patients to pay for ART does not necessarily imply the ability to pay. As a result, the lack of comprehensive third-party funding for ART can create immediate and long-term financial hardship which is more pronounced among poorer households. While more data on the impact of out-of-pocket payment for ART are needed to illustrate the problem in other low resource settings, the results from South Africa provide useful information for similar developing countries. The current absence of more extensive data should therefore not be a barrier to the promotion of financial risk protection for infertile couples, especially the poorest, in need of ART. The study was supported by a Masters Student Grant from the Faculty of Health Sciences, University of Cape Town. The authors had no competing interests. Not applicable. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e

  1. Risk of hypertensive disorders in pregnancies following assisted reproductive technology: a cohort study from the CoNARTaS group.

    Science.gov (United States)

    Opdahl, S; Henningsen, A A; Tiitinen, A; Bergh, C; Pinborg, A; Romundstad, P R; Wennerholm, U B; Gissler, M; Skjærven, R; Romundstad, L B

    2015-07-01

    Is the risk of hypertensive disorders in pregnancies conceived following specific assisted reproductive technology (ART) procedures different from the risk in spontaneously conceived (SC) pregnancies? ART pregnancies had a higher risk of hypertensive disorders, in particular following cryopreservation, with the highest risk seen in twin pregnancies following frozen-thawed cycles. The risk of hypertensive disorders is higher in ART pregnancies than in SC pregnancies. The increased risk may be partly explained by multiple pregnancies and underlying infertility, but a contribution from specific ART procedures has not been excluded. Population-based cohort study, including sibling design with nationwide data from health registers in Sweden, Denmark and Norway. All registered ART pregnancies and a sample of SC pregnancies with gestational age ≥22 weeks from 1988 to 2007 were included. ART singleton pregnancies (n = 47 088) were compared with SC singleton pregnancies (n = 268 599), matched on parity and birth year. ART twin pregnancies (n = 10 918) were compared with SC twin pregnancies (46 674). We used logistic regression to estimate adjusted odds ratios and risk differences for hypertensive disorders in pregnancies following IVF, ICSI and fresh or frozen-thawed cycles. We also compared fresh and frozen-thawed cycles within mothers who had conceived following both procedures using conditional logistic regression (sibling analysis). Hypertensive disorders were reported in 5.9% of ART singleton and 12.6% of ART twin pregnancies. Comparing singleton pregnancies, the risk of hypertensive disorders was higher after all ART procedures. The highest risk in singleton pregnancies was seen after frozen-thawed cycles [risk 7.0%, risk difference 1.8%, 95% confidence interval (CI) 1.2-2.8]. Comparing twin pregnancies, the risk was higher after frozen-thawed cycles (risk 19.6%, risk difference 5.1%, 95% CI 3.0-7.1), but not after fresh cycles. In siblings, the risk was higher

  2. Utilization and success rates of unstimulated in vitro fertilization in the United States: an analysis of the Society for Assisted Reproductive Technology database.

    Science.gov (United States)

    Gordon, John David; DiMattina, Michael; Reh, Andrea; Botes, Awie; Celia, Gerard; Payson, Mark

    2013-08-01

    To examine the utilization and outcomes of natural cycle (unstimulated) IVF as reported to the Society of Assisted Reproductive Technology (SART) in 2006 and 2007. Retrospective analysis. Dataset analysis from the SART Clinical Outcome Reporting System national database. All patients undergoing IVF as reported to SART in 2006 and 2007. None. Utilization of unstimulated IVF; description of patient demographics; and comparison of implantation and pregnancy rates between unstimulated and stimulated IVF cycles. During 2006 and 2007 a total of 795 unstimulated IVF cycles were initiated. Success rates were age dependent, with patients Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. First-trimester screening in pregnancies conceived by assisted reproductive technology: significance of gestational dating by oocyte retrieval or sonographic measurement of crown-rump length

    DEFF Research Database (Denmark)

    Gjerris, A.C.; Loft, A.; Pinborg, A.

    2008-01-01

    OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers or the perfo......OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers......). Weight-corrected log multiples of the median (MoM) marker distributions specific for IVF pregnancy were established using multiple log regression and compared for DOA- and CRL-based GA calculation. RESULTS: GA determined by CRL was significantly larger, albeit slightly, than was GA determined by DOA...

  4. Risk of stillbirth and infant deaths after assisted reproductive technology: a Nordic study from the CoNARTaS group

    DEFF Research Database (Denmark)

    Henningsen, Anna-Karina Aaris; Wennerholm, U. B.; Gissler, M.

    2014-01-01

    Society for Human Reproduction and Embryology (ESHRE), the University of Copenhagen, Denmark, the Danish Agency for Science, Technology and Innovation and Sahlgrenska University Hospital, Gothenburg, Sweden supported the project. The CoNARTaS group has received travel and meeting funding from the Nordic...

  5. Authors' reply to comment on "Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?"

    DEFF Research Database (Denmark)

    Sejbaek, Camilla S.; Pinborg, Anja; Hageman, Ida

    2016-01-01

    The aim of our national register-based study (1) was to investigate the risk of a new episode of unipolar depression among women treated with assisted reproductive technology (ART) in regards to whether they had achieved a live birth (as a result of treatment or spontaneous conception) or not. He...... compared to women having conceived spontaneously. This article is protected by copyright. All rights reserved....

  6. Assisted reproductive technology and risk of adverse obstetric outcomes in dichorionic twin pregnancies: a systematic review and meta-analysis.

    Science.gov (United States)

    Qin, Jiabi B; Wang, Hua; Sheng, Xiaoqi; Xie, Qiong; Gao, Shiyou

    2016-05-01

    To examine whether dichorionic twin pregnancies after assisted reproductive technology (ART) were at higher risk of adverse obstetric outcomes compared with those conceived naturally. Meta-analysis. University-affiliated teaching hospital. Dichorionic twin pregnancies conceived with ART and naturally. Studies comparing obstetric outcomes in dichorionic twin pregnancies conceived by ART and naturally were identified by searching PubMed, Google Scholar, Cochrane Libraries, and Chinese databases through July 2015 with no restrictions. Either a fixed-effects or a random-effects model was used to calculate the overall combined risk estimates. Subgroup analysis was performed to explore potential heterogeneity moderators. Maternal complications and adverse pregnancy outcomes. Fifteen cohort studies involving 6,420 dichorionic twins after ART and 13,650 dichorionic twins conceived naturally were included. Most of maternal complications were similar in both groups, but placenta previa (relative risk [RR] = 2.99, 95% confidence interval [CI] 1.51-5.92; I(2) = 0) was significantly more common in the ART group. For neonatal outcomes, the ART group experienced higher risk of preterm birth (RR = 1.13, 95% CI 1.00-1.29; I(2) = 75%), very preterm birth (RR = 1.39, 95% CI 1.07-1.82; I(2) = 71%), low birth weight (RR = 1.11, 95% CI 1.00-1.23; I(2) = 61%), and congenital malformations (RR = 1.26, 95% CI 1.09-1.46; I(2) = 26%). In addition, the ART group had a higher proportion of elective cesarean sections (RR = 1.79, 95% CI 1.49-2.16; I(2) = 60%), but had a similar proportion for emergency cesarean sections. Relevant heterogeneity moderators have been identified by subgroup analysis. No evidence of publication bias was observed. The rates of placenta previa, elective cesarean section, preterm birth, very preterm birth, low birth weight, and congenital malformations were significantly higher in dichorionic twin pregnancies after ART. Copyright © 2016 American Society for

  7. Trends and factors associated with the Day 5 embryo transfer, assisted reproductive technology surveillance, USA, 2001-2009.

    Science.gov (United States)

    Marsh, Courtney A; Farr, Sherry L; Chang, Jeani; Kissin, Dmitry M; Grainger, David A; Posner, Samuel F; Macaluso, Maurizio; Jamieson, Denise J

    2012-08-01

    What characteristics are associated with a Day 5 embryo transfer? The use of the Day 5 embryo transfer has increased over time, with clinicians allowing women with typically 'poorer' prognostic characteristics to undergo a Day 5 embryo transfer. The mean number of embryos per Day 5 transfer decreased from 2001 to 2009, although the prevalence of the Day 5 single embryo transfer remains low and the rate of multiple births remains substantial. Day 5 embryo transfer may reduce the rate of multiple gestation pregnancy. US trends over time in the prevalence of the Day 5 transfer, changes in characteristics of patients receiving Day 5 transfer, and number of embryos transferred are unknown. We used 2001-2009 US National assisted reproductive technology (ART) Surveillance System (NASS) data on 620,295 fresh IVF cycles derived from autologous oocytes with a Day 3 or 5 embryo transfer. Trends in the mean number of embryos transferred from 2001 to 2009 were assessed by the day of transfer. For 349,947 cycles from clinics performing both Days 3 and 5 embryo transfers, multivariable logistic regression was used to determine the characteristics associated with the Day 5 embryo transfer. We also compared the characteristics of the Day 5 embryo cycles in 2001 and 2009. Overall, the proportion of ART cycles using the Day 5 embryo transfer increased from 12% in 2001 to 36% in 2009 (Psingle embryo transfer tripled from 4.5% in 2001 to 14.8% in 2009 (PWomen undergoing multiple ART cycles over time are not linked. We ran multivariable logistic regression to lessen the effects of the confounding factors. Cycle cancelation rates by the day of embryo transfer are unknown. Generalizable to ART clinics included in NASS. This study was funded by the Centres for Disease Control. The authors have no competing interests to declare.

  8. Maternal age and birth defects after the use of assisted reproductive technology in Japan, 2004-2010.

    Science.gov (United States)

    Ooki, Syuichi

    2013-01-01

    Older mothers are becoming more common in Japan. One reason for this is the widespread use of assisted reproductive technology (ART). This study assesses the relationship between maternal age and the risk of birth defects after ART. Nationwide data on ART between 2004 and 2010 in Japan were analyzed. Diseases that were classified as code Q00-Q99 (ie, congenital malformations, deformations, and chromosomal abnormalities) in the International Classification of Diseases, tenth edition, were selected. There were 219,185 pregnancies and 153,791 live births in total ART. Of these, 1943 abortions, stillbirths, or live births with birth defects were recorded. Percentage of multiple birth defects in total birth defects, the prevalence, crude relative risk and 95% confidence interval per 10,000 pregnancies and per 10,000 live births were analyzed according to the maternal age class (ie, 25-29, 30-34 (reference), 35-39, and 40+ years). Multiple birth defects were observed among 14% of the 25-29 year old class, and 8% among other classes when chromosomal abnormalities were excluded. The prevalence of chromosomal abnormalities per pregnancy and per live birth became significantly and rapidly higher in mothers in the age classes of 30-35 and 40+ years. Nonchromosomal birth defects per pregnancy decreased linearly with advanced maternal age, while the number of nonchromosomal birth defects per live birth formed a gradual U-shaped distribution. The prevalence per pregnancy of congenital malformations of the nervous system was significantly lower with advanced maternal age. The relative risk per live birth was significant regarding congenital malformations of the circulatory system for a maternal age of 40+ years. Some other significant associations between maternal age and birth defects were observed. Maternal age is associated with several birth defects; however, older maternal age in itself does not produce noticeable extra risk for nonchromosomal birth defects overall.

  9. Birth defects after assisted reproductive technology according to the method of treatment in Japan: nationwide data between 2004 and 2012.

    Science.gov (United States)

    Ooki, Syuichi

    2015-11-01

    The purpose of the present study was to analyze birth defects (congenital anomalies) after assisted reproductive technology (ART) according to the method of treatment, namely in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and frozen-thawed embryo transfer (FET). Individual lists of all ART pregnancies resulting in birth defects from birth year 2004 to 2012 presented in the annual reports by the Japan Society of Obstetrics and Gynecology were used as the initial sources of information. Relative risks (RRs) with the corresponding 95 % confidence intervals (CIs) were calculated with IVF as the reference group when calculating RR of ICSI for IVF, and with FET as the reference group when calculating the RR of fresh embryo transfer for FET. In total, 2725 stillbirths or live births with birth defects were analyzed. The prevalence of birth defects was slightly yet significantly higher in ICSI compared with IVF throughout the study period (RR = 1.15, 95 % CI 1.02-1.29) and in the 2004-2006 period (RR = 1.26, 95 % CI 1.00-1.58). The prevalence of birth defects was significantly higher for fresh embryo transfer compared with FET in the 2004-2006 period (RR = 1.39, 95 % CI 1.12-1.72). The prevalence of birth defects in multiple births was significantly lower in fresh embryo transfer compared with FET (RR = 0.70, 95 % CI 0.55-0.90, live births of 2007-2012). The present descriptive epidemiological study suggests that the impacts of different ART methods on birth defects might differ.

  10. Trends in incidence and mortality for triplets in Norway 1967-2006: the influence of assisted reproductive technologies.

    Science.gov (United States)

    Tandberg, A; Bjørge, T; Nygård, O; Børdahl, P E; Skjaerven, R

    2010-05-01

    To assess changes in incidence rates and outcomes of triplets over 40 years with a particular focus on the influence of assisted reproductive technology (ART). Population-based cohort study. The Medical Birth Registry of Norway. 2.18 million pregnancies, including 448 sets of triplets and 27,575 twin pairs, covering the years 1967-2006. Since 1988, pregnancies from ART have been available through a separate registry and linked with the birth record. Incidence rates and outcomes for triplets were analysed and compared with those for singletons and twins. Relative risks were estimated between time periods and between ART and non-ART pregnancies. Incidence rates, birthweight, gestational age and perinatal mortality. The total triplet rate per 10,000 pregnancies increased from 1.0 during 1967-71 to 3.5 during 1987-92, followed by a decline to 2.7 during 2002-06. After excluding ART pregnancies, the incidence was more than doubled at the end of the study period. The mean gestational age and birthweight of triplets were significantly lower during 1988-2006 than 1967-87, but similar for ART and non-ART triplets in the last period. The caesarean rate in triplets increased from 47 to 92%. The relative risk of perinatal death in triplets relative to singletons did not change after the introduction of ART [before: relative risk, 8.9 (95% confidence interval, 6.8-11.7); after: relative risk, 10.4 (95% confidence interval, 8.3-13.0)]. The triplet incidence rate in Norway has more than doubled during the last 40 years, even after excluding ART pregnancies. The risk of perinatal death in triplets is ten times higher relative to singletons and has not changed during this 40-year period, independent of the introduction of ART.

  11. Live birth outcome, spontaneous pregnancy and adoption up to five years after undergoing assisted reproductive technology treatment.

    Science.gov (United States)

    Volgsten, Helena; Schmidt, Lone

    2017-08-01

    This study is part of a longitudinal cohort undertaken in both women and men to describe live birth outcome after undergoing assisted reproductive technology (ART) treatment in a clinical setting. Another objective was to follow women and men living with children from other alternatives after ART, such as adoption. A total of 439 (80.5%) women and 423 (77.6%) men were included in the baseline cohort (2005-2007). Live birth rate after ART was 24.8% at baseline. Up to 5 years later (2010-2011) the same participants were sent individual postal questionnaires (n = 439). Overall, 278 (63.3%) women and 183 (41.7%) men filled in and returned the questionnaire at follow up. The majority of women (91.7%) and men (93.4%) were living with children. A total of 225 (80.9%) women had a live birth at follow up. Of these, almost three of four (71.6%) had a live birth after ART and more than one of four (28.0%) after spontaneous pregnancies or both. Of these, 52 (26.1%) women had a subsequent live birth after successful ART and 26 (32.9%) women after unsuccessful ART. Nineteen (6.8%) women and 13 (7.1%) men had a child after adoption. Almost one of five (19.1%) women had no live birth at follow up. The majority of women and men were living with children, resulting from a live birth after ART, spontaneous pregnancy and/or adoption up to 5 years later. However, almost one of five had no live birth at follow up. © 2017 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  12. Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis: a systematic review and meta-analysis.

    Science.gov (United States)

    Gasparri, Maria Luisa; Nirgianakis, Konstantinos; Taghavi, Katayoun; Papadia, Andrea; Mueller, Michael D

    2018-03-30

    Recent evidence suggests that assisted reproductive technology (ART) increases the risk of adverse pregnancy outcomes, including placental disorders. Similarly, endometriosis resulted detrimental on placenta previa. However, up to 50% of women with endometriosis suffer from infertility, thus requiring ART. The aim of our metanalysis is to compare women with and without endometriosis undergoing ART in terms of placenta disorders events, to establish if ART itself or endometriosis, as an indication to ART, increases the risk of placenta previa. Literature searches were conducted in January 2018 using electronic databases (PubMed, Medline, Scopus, Embase, Science Direct, and the Cochrane Library Scopus). Series comparing pregnancy outcome after ART in women with and without endometriosis were screened and data on placenta previa and placental abruption were extracted. Five retrospective case-control studies met the inclusion criteria. The meta-analysis revealed that endometriosis is associated with an increased risk of placenta previa in pregnancies achieved through ART (OR 2.96 (95% CI 1.25-7.03); p = 0.01, I 2  =69%, random-effect model). No differences in placental abruption incidence were found (OR 0.44 (95% CI 0.10-1.87); p = 0.26, I 2  = 0%, fixed-effect model). Patients with endometriosis undergoing ART may have additional risk of placenta previa. Despite the inability to determine if endometriosis alone or endometriosis plus ART increase the risk, physicians should be aware of the potential additional risk that endometriosis patients undergoing ART harbor.

  13. Devising assisted reproductive technologies for wild-derived strains of mice: 37 strains from five subspecies of Mus musculus.

    Directory of Open Access Journals (Sweden)

    Keiji Mochida

    Full Text Available Wild-derived mice have long offered invaluable experimental models for mouse genetics because of their high evolutionary divergence from laboratory mice. A number of wild-derived strains are available from the RIKEN BioResource Center (BRC, but they have been maintained as living stocks because of the unavailability of assisted reproductive technology (ART. In this study, we sought to devise ART for 37 wild-derived strains from five subspecies of Mus musculus maintained at the BRC. Superovulation of females was effective (more than 15 oocytes per female for 34 out of 37 strains by treatment with either equine chorionic gonadotropin or anti-inhibin serum, depending on their genetic background (subspecies. The collected oocytes could be fertilized in vitro at mean rates of 79.0% and 54.6% by the optimized protocol using fresh or frozen-thawed spermatozoa, respectively. They were cryopreserved at the 2-cell stage by vitrification with an ethylene glycol-based solution. In total, 94.6% of cryopreserved embryos survived the vitrification procedure and restored their normal morphology after warming. A conventional embryo transfer protocol could be applied to 25 out of the 35 strains tested. In the remaining 10 strains, live offspring could be obtained by a modified embryo transfer protocol using cyclosporin A treatment and co-transfer of ICR (laboratory mouse strain embryos. Thus, ART for 37 wild-derived strains was devised successfully and is now routinely used for their preservation and transportation. The information provided here might facilitate broader use and wider distribution of wild-derived mice for biomedical research.

  14. Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder: a national cohort study.

    Science.gov (United States)

    Ebdrup, Ninna H; Assens, Maria; Hougaard, Charlotte O; Pinborg, Anja; Hageman, Ida; Schmidt, Lone

    2014-06-01

    To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders. We used a national register-based cohort of 42,915 Danish women in ART treatment from 1.1.1994 to 30.9.2009. All women with a diagnosis of schizophrenia or related psychotic disorders before, during or after their ART treatment were identified by individual-level linkage of nationwide registers of ART treatment, psychiatric admission, birth and socio-demographic status. The comparison group (N=42,671) consisted of all women in the study cohort never diagnosed with psychotic disorders. Conventional descriptive methods were used for the statistical analyses. Two hundred and forty-four (0.6%) women in the study cohort received a diagnosis of psychotic disorder before (N=135-55.3%), during (N=7-2.9%) or after (N=102-41.8%) ART treatment. The mean time from last diagnosis of psychotic disorder to their first ART treatment in the 135 women with a psychiatric diagnosis prior to their first ART treatment was 7.1 ± 5.6 years (25-75% percentile: ±2.8-10.4 years). The most frequent diagnoses were acute and transient psychotic disorder. Women with a diagnosis of schizophrenia or related psychotic disorder before their first ART treatment had a lower ART treatment success rate as significantly fewer women obtained a live birth (40.0% vs. 51.9%, PART treatment have a lower fertility treatment success rate compared to women without psychotic disorder. Women with a psychotic disorder achieving delivery show similar obstetric outcomes to women with no psychotic disorder. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Congenital Malformations in Singleton Infants Conceived by Assisted Reproductive Technologies and Singleton Infants by Natural Conception in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Ramin Mozafari Kermani

    2017-10-01

    Full Text Available Background: Multiple pregnancies occur more frequently in assisted reproductive technology (ART compared to normal conception (NC. It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally. Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations (MCM in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran’s ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome. Results: We found 40 infants with MCM 29 (4.4% NC infants and 14 (8.3% ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM (P=0.046. After adjusting individually for maternal age, infant gender, prior stillbirth, mother’s history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority (95.1% of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization (IVF and intracytoplasmic sperm injection (ICSI. We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants. Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip (DDH, and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification.

  16. Association of Cardiac Development with Assisted Reproductive Technology in Childhood: A Prospective Single-Blind Pilot Study

    Directory of Open Access Journals (Sweden)

    Jie Zhou

    2014-08-01

    Full Text Available Aims: To examine the pattern and extent of cardiovascular developmental alterations among children conceived by assisted reproductive technology (ART and its association with potential confounders. Methods: The present study was a prospective single-blind pilot design lasting 15 months. The ART group was recruited by a non-random, consecutive sample on the basis of the unique personal identification number assigned to ART children, whereas spontaneous conception controls were recruited by a population-based random sample from the same hospital by age. Echocardiography was available for the measurement of 128 ART children and 100 controls with respect to cardiovascular geometric morphology and cardiac function. Results: The majority of cardiac geometric morphology parameters were comparable among the study groups (P>0.05, except for significant increases in left ventricular (LV relative wall thickness (P=0.038, LV mass index (P=0.005 and LV remodeling index (P=0.005 in ART children after adjustment for age, gender, body surface area and heart rate. The results showed similarity in LV systolic function characterized by ejection fraction (P=0.140 and shortening fraction (P=0.167 between the groups. However, ART children had a significant tendency toward a decrease in mitral A (P=0.008 and mitral E′ (P=0.012 compared with controls after adjusting for confounders. Additionally, Cox analysis suggested an independent association (PConclusion: Our findings support the presence of remodeling in the left cardiac geometric morphology and diastolic dysfunction and the absence of any change to the aortocoronary morphometry or systolic function in ART children compared with controls, which may be independently associated with the anthropometrics and perinatal outcomes in addition to the ART procedure.

  17. Fertility preservation for men with testicular cancer: Is sperm cryopreservation cost effective in the era of assisted reproductive technology?

    Science.gov (United States)

    Gilbert, Kirven; Nangia, Ajay K; Dupree, James M; Smith, James F; Mehta, Akanksha

    2018-03-01

    Many patients do not cryopreserve sperm before undergoing cancer treatment because of high perceived costs of cryopreservation. We sought to investigate the cost-effectiveness of fertility preservation compared to posttherapeutic fertility treatment in testicular cancer patients. We performed a systematic search of the PubMed database for the following: risk of azoospermia 12 months after surveillance, chemotherapy, retroperitoneal lymph node dissection, and radiation therapy (RT); rates of natural conception, and rates of conception with the use of intrauterine insemination or assisted reproductive technology, with or without microsurgical testicular sperm extraction (microTESE). A decision tree was constructed using the TreePlan add-in for Microsoft Excel (TreePlan Software, San Francisco, California). Cost-effectiveness was calculated as the overall cost of a given management branch, divided by likelihood of pregnancy. Calculations accounted for variable number of years of cryopreservation, and variable costs of microTESE. 1,113 articles were identified; 44 were included in the final analysis. Overall probability of pregnancy was higher among couples who cryopreserved sperm, versus those who did not. In patients undergoing active surveillance or retroperitoneal lymph node dissection, cryopreservation was more cost-effective if storage time was short (cost was high (>7,000). Cryopreservation prior to chemotherapy was more cost-effective unless microTESE cost was low (cost-effective in almost all scenarios. Sperm cryopreservation prior to undergoing chemotherapy or RT remains the most cost-effective strategy for fertility preservation, across a range of possible costs associated with surgical sperm retrieval and in vitro fertilization/intracytoplasmic sperm injection. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Are intracytoplasmic sperm injection and high serum estradiol compounding risk factors for adverse obstetric outcomes in assisted reproductive technology?

    Science.gov (United States)

    Royster, Greene Donald; Krishnamoorthy, Kavitha; Csokmay, John M; Yauger, Belinda J; Chason, Rebecca J; DeCherney, Alan H; Wolff, Erin F; Hill, Micah J

    2016-08-01

    To evaluate whether intracytoplasmic sperm injection (ICSI) use and E2 on the final day of assisted reproductive technology (ART) stimulation are associated with adverse obstetric complications related to placentation. Retrospective cohort study. Large private ART practice. A total of 383 women who underwent ART resulting in a singleton live birth. None. Adverse placental outcomes composed of placenta accreta, placental abruption, placenta previa, intrauterine growth restriction, preeclampsia, gestational hypertension, and small for gestational age infants. Patients with adverse placental outcomes had higher peak serum E2 levels and were three times more likely to have used ICSI. Adverse placental outcomes were associated with increasing E2 (odds ratio 1.36, 95% confidence interval 1.13-1.65) and ICSI (odds ratio 3.86, 95% confidence interval 1.61-9.27). Adverse outcomes increased when E2 was >3,000 pg/mL and continued to increase in a linear fashion until E2 was >5,000 pg/mL. The association of ICSI with adverse outcomes was independent of male factor infertility. Interaction testing suggested the adverse effect of E2 was primarily seen in ICSI cycles, but not in conventional IVF cycles. Estradiol >5,000 pg/mL was associated with adverse placental events in 36% of all ART cycles and 52% of ICSI cycles. ICSI and elevated E2 on the day of hCG trigger were associated with adverse obstetric outcomes related to placentation. The finding of a potential interaction of E2 and ICSI with adverse placental events is novel and warrants further investigation. Published by Elsevier Inc.

  19. Assisted reproduction and distributive justice.

    Science.gov (United States)

    Panitch, Vida

    2015-02-01

    The Canadian province of Quebec recently amended its Health Insurance Act to cover the costs of In Vitro Fertilization (IVF). The province of Ontario recently de-insured IVF. Both provinces cited cost-effectiveness as their grounds, but the question as to whether a public health insurance system ought to cover IVF raises the deeper question of how we should understand reproduction at the social level, and whether its costs should be a matter of individual or collective responsibility. In this article I examine three strategies for justifying collective provisions in a liberal society and assess whether public reproductive assistance can be defended on any of these accounts. I begin by considering, and rejecting, rights-based and needs-based approaches. I go on to argue that instead we ought to address assisted reproduction from the perspective of the contractarian insurance-based model for public health coverage, according to which we select items for inclusion based on their unpredictability in nature and cost. I argue that infertility qualifies as an unpredictable incident against which rational agents would choose to insure under ideal conditions and that assisted reproduction is thereby a matter of collective responsibility, but only in cases of medical necessity or inability to pay. The policy I endorse by appeal to this approach is a means-tested system of coverage resembling neither Ontario nor Quebec's, and I conclude that it constitutes a promising alternative worthy of serious consideration by bioethicists, political philosophers, and policy-makers alike. © 2013 John Wiley & Sons Ltd.

  20. Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System.

    Science.gov (United States)

    Baker, Valerie L; Luke, Barbara; Brown, Morton B; Alvero, Ruben; Frattarelli, John L; Usadi, Rebecca; Grainger, David A; Armstrong, Alicia Y

    2010-09-01

    To evaluate factors predictive of clinical pregnancy and of pregnancy loss from assisted reproductive technology (ART) using data from the Society for Assisted Reproductive Technology database for 2004-2006. Retrospective cohort. Clinic-based data. The study population included 225,889 fresh embryo transfer cycles using autologous oocytes and partner semen. None. Clinical intrauterine gestation (presence of gestational sac) and live birth (>or=22 weeks gestation and >or=300 g birth weight). Increasing maternal age was significantly associated with a reduced odds of conception and increased fetal loss until 19 weeks gestation, but not with later pregnancy loss. Intracytoplasmic sperm injection (ICSI), assisted hatching, and increasing number of embryos transferred had significant positive effects on the odds of conception and pregnancy continuation through the first trimester, but did not affect the risk of later loss. Blacks, Asians, and Hispanics had significantly lower odds of clinical pregnancy compared with whites. Also compared with whites, Hispanics and Asians had a significantly greater risk of pregnancy loss in the second and third trimesters, and blacks had a significantly greater risk of pregnancy loss in all trimesters. Certain demographic and ART treatment parameters influenced chance of conception and early pregnancy loss, whereas black race and Hispanic ethnicity were also significantly associated with late pregnancy loss in ART-conceived pregnancies. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Use of assisted reproductive technology to separate sperm from human immunodeficiency virus infected men resulting in pregnancy among serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Alessandro Schuffner

    Full Text Available Due to HIV care improvement, discordant couples more frequently seek help in order to conceive their own biological child. Besides the advance of antiretroviral therapy, unprotected intercourse is not a complete safe option, carrying a low but still present risk of HIV transmission. We report 10 serodiscordant couples in whom the male partner is HIV positive, submitted to sperm washing and intrauterine insemination. The procedure resulted in four pregnancies and no HIV transmission to mother or child was observed. Techniques of assisted reproduction can help HIV discordant couples to conceive biological offspring and is a safer option than unprotected intercourse.

  2. ABO hemolytic disease of the fetus and newborn: an iatrogenic complication of heterologous assisted reproductive technology-induced pregnancy.

    Science.gov (United States)

    Zuppa, Antonio Alberto; Cardiello, Valentina; Lai, Marco; Cataldi, Luigi; D'Andrea, Vito; Romagnoli, Costantino

    2010-10-01

    ABO hemolytic disease of the fetus and newborn (ABO HDFN) may manifest itself in cases of mothers belonging to blood group O and newborns of groups A or B and more frequently in group A and less so in group B. The case subjects are twin-birth newborns with ABO HDFN, of group AB born to a mother of group O. These cases of ABO HDFN prove inconsistent with Mendel's law of segregation. This case study finds its explanation in new methods of assisted reproduction, particularly heterologous in vitro fertilization with ovodonation. © 2010 American Association of Blood Banks.

  3. Assisted reproductive technologies and the issue of risks to women and embryos: the tip of the iceberg

    Directory of Open Access Journals (Sweden)

    Kalline Carvalho Gonçalves Eler

    2016-10-01

    Full Text Available In assisted reproduction, not everything that is technically possible is ethically acceptable or socially desirable. The impact it has on women and embryos needs to be considered. The risk to women involves the ingestion of hormones, which can cause potentially serious complications. As regards embryos, there are risks of prematurity, low birth weight and other diseases. This article advocates a strong protective guardianship for women and the extracorporeal embryo. Faced with new bioethical dilemmas, the essence of the human being is in question. It is therefore the task of all spheres of knowledge to make a distinction between the personalizing and depersonalizing of human beings.

  4. INFORMATION TECHNOLOGIES IN THE ASSESSMENT OF THE PREIMPLANTATION GENETIC DIAGNOSIS EFFICIENCY IN THE FIELD OF ASSISTED REPRODUCTIVE TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    S. V. Denysenko

    2012-11-01

    Full Text Available Application of the information technologies is becoming increasingly important in the practice of molecular and cytogenetic analysis of chromosomal abnormalities in particular on the preimplantation level. Capacity of preimplantation diagnosis is based on fluorescent in situ hybridization (FISH and comparative genomic hybridization (CGH. Interpretation of FISH/CGH results is performed with the help of Applied Cytovision System.

  5. Pregnancy outcomes after assisted human reproduction.

    Science.gov (United States)

    Okun, Nanette; Sierra, Sony

    2014-01-01

    To review the effect of assisted human reproduction (AHR) on perinatal outcomes, to identify areas requiring further research with regard to birth outcomes and AHR, and to provide guidelines to optimize obstetrical management and counselling of prospective Canadian parents. This document compares perinatal outcomes of different types of AHR pregnancies with each other and with those of spontaneously conceived pregnancies. Clinicians will be better informed about the adverse outcomes that have been documented in association with AHR, including obstetrical complications, adverse perinatal outcomes, multiple gestations, structural congenital abnormalities, chromosomal abnormalities, and imprinting disorders. Published literature was retrieved through searches of MEDLINE and the Cochrane Library from January 2005 to December 2012 using appropriate controlled vocabulary and key words (assisted reproduction, assisted reproductive technology, ovulation induction, intracytoplasmic sperm injection, embryo transfer, and in vitro fertilization). Results were not restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies; studies of all designs published in English from January 2005 to December 2012 were reviewed, and additional publications were identified from the bibliographies of these articles. Searches were updated on a regular basis and incorporated in the guideline to August 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Summary Statements 1. There is increasing evidence that infertility or subfertility is an

  6. Disinvestment policy and the public funding of assisted reproductive technologies: outcomes of deliberative engagements with three key stakeholder groups.

    Science.gov (United States)

    Hodgetts, Katherine; Hiller, Janet E; Street, Jackie M; Carter, Drew; Braunack-Mayer, Annette J; Watt, Amber M; Moss, John R; Elshaug, Adam G

    2014-05-05

    Measures to improve the quality and sustainability of healthcare practice and provision have become a policy concern. In addition, the involvement of stakeholders in health policy decision-making has been advocated, as complex questions arise around the structure of funding arrangements in a context of limited resources. Using a case study of assisted reproductive technologies (ART), deliberative engagements with a range of stakeholder groups were held on the topic of how best to structure the distribution of Australian public funding in this domain. Deliberative engagements were carried out with groups of ART consumers, clinicians and community members. The forums were informed by a systematic review of ART treatment safety and effectiveness (focusing, in particular, on maternal age and number of treatment cycles), as well as by international policy comparisons, and ethical and cost analyses. Forum discussions were transcribed and subject to thematic analysis. Each forum demonstrated stakeholders' capacity to understand concepts of choice under resource scarcity and disinvestment, and to countenance options for ART funding not always aligned with their interests. Deliberations in each engagement identified concerns around 'equity' and 'patient responsibility', culminating in a broad preference for (potential) ART subsidy restrictions to be based upon individual factors rather than maternal age or number of treatment cycles. Community participants were open to restrictions based upon measures of body mass index (BMI) and smoking status, while consumers and clinicians saw support to improve these factors as part of an ART treatment program, as distinct from a funding criterion. All groups advocated continued patient co-payments, with measures in place to provide treatment access to those unable to pay (namely, equity of access). Deliberations yielded qualitative, socially-negotiated evidence required to inform ethical, accountable policy decisions in the specific

  7. [Value of anti-Müllerian hormone in predicting pregnant outcomes of polycystic ovary syndrome patients undergone assisted reproductive technology].

    Science.gov (United States)

    Li, Y; Tan, J Q; Mai, Z Y; Yang, D Z

    2018-01-25

    Objective: Explore the value of anti-Müllerian hormone (AMH) in predicting pregnant outcomes of polycystic ovary syndrome (PCOS) patients undergone assisted reproductive technology. Methods: The study totally recruited 1 697 patients who underwent the first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle in Sun Yat-sen Memorial Hospital from the January 2014 to December 2015. The patients were divided into two groups based on the age<35 ( n= 758) and ≥35 years old ( n= 939) , compare the basic data and pregnant outcomes of controlled ovarian hyerstimulation. Spearman correlation method was conducted to analyze the relations between AMH and clinical outcomes. The logistic regression method and partial correlation analysis were used to judge the main factors which determine pregnancy outcomes by controlled the confounding factors. The receiver operating characteristic curve (ROC) was used to evaluate the predictive sensitivity and specificity of AMH. Results: In the group of PCOS patient younger than 35 years, AMH were correlated with the number of antral follicles ( r= 0.388) and retrieved oocytes ( r= 0.235) . When the effect of total dosage and starting dosage of gonadotropin were controlled, AMH was still significantly associated with the number of retrieved oocytes ( P< 0.05) . AMH had no predictive value for the clinical pregnancy of PCOS patient younger than 35 years (area under ROC curve=0.481, P= 0.768) . In the group of PCOS patient≥35 years old, AMH were correlated with the number of antral follicles ( r= 0.450) , retrieved oocytes ( r= 0.399) , available embryo ( r= 0.336) and high quality embryo ( r= 0.235) . When the effect of total dosage and starting dosage of gonadotropin were controlled, the correlations were still significant between those indexes (all P< 0.05) . AMH had no predictive value for the clinical pregnancy of PCOS patient ≥35 years old (area under ROC curve=0.535, P= 0.560) . However, the clinical

  8. Cervical conization doubles the risk of preterm and very preterm birth in assisted reproductive technology twin pregnancies.

    Science.gov (United States)

    Pinborg, A; Ortoft, G; Loft, A; Rasmussen, S C; Ingerslev, H J

    2015-01-01

    Does cervical conization add an additional risk of preterm birth (PTB) in assisted reproduction technology (ART) singleton and twin pregnancies? Cervical conization doubles the risk of preterm and very PTB in ART twin pregnancies. ART and cervical conization are both risk factors for PTB. In this national population-based controlled cohort study, we included all ART singletons and twin deliveries from 1995 to 2009 in Denmark by cross-linkage of maternal and child data from the National IVF register and the Medical Birth register. Furthermore, control groups of naturally conceived (NC) singletons and twins were extracted. Cervical diagnoses were obtained from the Danish Pathology register. Cervical conization included both cold knife cone and LEEP (loop electrosurgical excision procedure) but not cervical biopsies. The main outcomes measures were PTB (PTB ≤ 37 + 0 gestational weeks), very preterm birth (VPTB ≤ 32 + 0 gestational weeks) and preterm premature rupture of membranes (PPROM). In all 16 923 ART singletons and 4829 ART twin deliveries were included. A random sample of NC singletons, 2-fold the size of the ART singleton group matched by date and year of birth (n = 33 835) and all NC twin deliveries (n = 15 112), was also extracted. Multiple logistic regression analyses were performed to adjust for the following confounders: maternal age, parity, year of child birth and sex of child. Cervical morbidity (dysplasia and conization) was more often observed in ART pregnancies (6.2% of ART singletons and 5.4% ART twins) than in NC pregnancies (4.2% for NC singletons and 4.5% for NC twins), both for singletons and twins. In ART singleton deliveries, the PTB rate was 13.1 versus 8.2% in women with and without conization, respectively, with an adjusted odds ratio (aOR) of 1.56 [95% confidence interval (CI) 1.21-2.01]. In ART twin deliveries, the prevalence of PTB was 58.2 versus 41.3% in women with and without conization, respectively, with an aOR 1.94 (95% CI 1

  9. Association of assisted reproductive technology (ART) treatment and parental infertility diagnosis with autism in ART-conceived children.

    Science.gov (United States)

    Kissin, D M; Zhang, Y; Boulet, S L; Fountain, C; Bearman, P; Schieve, L; Yeargin-Allsopp, M; Jamieson, D J

    2015-02-01

    Are assisted reproductive technology (ART) treatment factors or infertility diagnoses associated with autism among ART-conceived children? Our study suggests that the incidence of autism diagnosis in ART-conceived children during the first 5 years of life was higher when intracytoplasmic sperm injection (ICSI) was used compared with conventional IVF, and lower when parents had unexplained infertility (among singletons) or tubal factor infertility (among multiples) compared with other types of infertility. Some studies found an increased risk of autism among ART-conceived infants compared with spontaneously-conceived infants. However, few studies, and none in the USA, have examined the associations between types of ART procedures and parental infertility diagnoses with autism among ART-conceived children. Population-based retrospective cohort study using linkages between National ART Surveillance System (NASS) data for 1996-2006, California Birth Certificate data for 1997-2006, and California Department of Developmental Services (DDS) Autism Caseload data for 1997-2011. All live born ART-conceived infants born in California in 1997-2006 (n = 42 383) with 5-year observation period were included in the study. We assessed the annual incidence of autism diagnosis documented in DDS, which includes information on the vast majority of persons with autism in California, and the association of autism diagnosis with ART treatment factors and infertility diagnoses. Among ART-conceived singletons born in California between 1997 and 2006, the incidence of autism diagnosis remained at ∼0.8% (P for trend 0.19) and was lower with parental diagnosis of unexplained infertility (adjusted hazard risk ratio [aHRR]; 95% confidence interval: 0.38; 0.15-0.94) and higher when ICSI was used (aHRR 1.65; 1.08-2.52), when compared with cases without these patient and treatment characteristics. Among ART-conceived multiples, the incidence of autism diagnosis between 1997 and 2006 remained at

  10. Parental disclosure of assisted reproductive technology (ART) conception to their children: a systematic and meta-analytic review.

    Science.gov (United States)

    Tallandini, Maria Anna; Zanchettin, Liviana; Gronchi, Giorgio; Morsan, Valentina

    2016-06-01

    Does a genetic link and/or a child's age influence a parent's willingness to talk to a child about how they were conceived? The presence/absence of a biological link and the child's age clearly influences the disclosure process. The research published to date has yielded diverse findings on autologous and donor assisted reproductive technology (ART) parents' disclosure of the conception method to their children and on the ages at which the children are informed, if told. A systematic review and meta-analysis were carried out. A search of MEDLINE and PUBMED was run for English-language studies published from January 1996 through January 2015. A total of 26 studies were included in the systematic review, 19 of which were included in the meta-analysis. A total of 2814 parent responses were included in the systematic review. Two authors independently assessed the studies for review inclusion. Selection criteria were: peer-reviewed studies, quantitative studies only, research conducted after the birth of ART-conceived children, number of parent responses on disclosure status reported in terms of Told, Plan to tell, Uncertain, Plan to not tell. Thirty-two (32) study-level effect size statistics were included in the meta-analysis. Three authors independently assessed the risk of bias. Among parents who responded, 23% of the total number of parent responses indicated that they had already Told; 44% were Planning to tell; 13% were Uncertain and 20% were Planning to not tell their children about their ART conception. Meta-analysis gave no statistically significant differences between autologous and donor ART in the ART (Cohen's h = 0.86): Planning to tell showed a higher probability in the 10 years age group for the autologous ART subsample, than in the donor ART subsample (Cohen's h = 0.89). All parents participated voluntarily in the studies and may have influenced the data in the direction of disclosure thereby. The reviewed studies, moreover, differed in terms of

  11. The Use of Proteomics in Assisted Reproduction.

    Science.gov (United States)

    Kosteria, Ioanna; Anagnostopoulos, Athanasios K; Kanaka-Gantenbein, Christina; Chrousos, George P; Tsangaris, George T

    2017-01-01

    Despite the explosive increase in the use of Assisted Reproductive Technologies (ART) over the last 30 years, their success rates remain suboptimal. Proteomics is a rapidly-evolving technology-driven science that has already been widely applied in the exploration of human reproduction and fertility, providing useful insights into its physiology and leading to the identification of numerous proteins that may be potential biomarkers and/or treatment targets of a successful ART pregnancy. Here we present a brief overview of the techniques used in proteomic analyses and attempt a comprehensive presentation of recent data from mass spectrometry-based proteomic studies in humans, regarding all components of ARTs, including the male and female gamete, the derived zygote and embryo, the endometrium and, finally, the ART offspring both pre- and postnatally. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  12. Infertility-related stress, anxiety and ovarian stimulation: can couples be reassured about the effects of psychological factors on biological responses to assisted reproductive technology?

    Directory of Open Access Journals (Sweden)

    Zaira Donarelli

    2016-12-01

    Full Text Available The aim of this prospective, longitudinal study was to examine the association between couples’ pre-treatment psychological characteristics (state anxiety and infertility-related stress levels of both partners and ovarian response during assisted reproductive technology treatment in a well-controlled sample. A total of 217 heterosexual couples (434 patients, suffering from primary infertility and undergoing their first assisted reproductive technology treatment at the Reproductive Medicine Unit of ANDROS Day Surgery Clinic in Palermo (Italy, were recruited. Psychological variables were assessed using the State Scale of State-Trait Anxiety Inventory (STAI-S and the Fertility Problem Inventory (FPI. The number of follicles ≥16 mm in diameter, evaluated by transvaginal ultrasound scan on the eleventh day of the workup, was chosen as the outcome measure. No association between women’s level of anxiety and infertility-related stress, and the number of follicles ≥16 mm in diameter was found. Moreover, the male partner’s infertility stress and anxiety did not influence the relationship between the woman’s infertility-related stress, anxiety level and ovarian response. Fertility staff should reassure couples that the woman’s biological response to ovarian stimulation is not influenced by either partner’s level of psychological distress.

  13. Patient and cycle characteristics predicting high pregnancy rates with single-embryo transfer: an analysis of the Society for Assisted Reproductive Technology outcomes between 2004 and 2013.

    Science.gov (United States)

    Mersereau, Jennifer; Stanhiser, Jamie; Coddington, Charles; Jones, Tiffany; Luke, Barbara; Brown, Morton B

    2017-11-01

    To analyze factors associated with high live birth rate and low multiple birth rate in fresh and frozen-thawed assisted reproductive technology (ART) cycles. Retrospective cohort analysis. Not applicable. The study population included 181,523 women undergoing in vitro fertilization with autologous fresh first cycles, 27,033 with fresh first oocyte donor cycles, 37,658 with fresh second cycles, and 35,446 with frozen-thawed second cycles. None. Live birth rate and multiple birth rate after single-embryo transfer (SET) and double embryo transfer (DET) were measured, in addition to cycle characteristics. In patients with favorable prognostic factors, including younger maternal age, transfer of a blastocyst, and additional embryos cryopreserved, the gain in the live birth rate from SET to DET was approximately 10%-15%; however, the multiple birth rate increased from approximately 2% to greater than 49% in both autologous and donor fresh and frozen-thawed transfer cycles. This study reports a 10%-15% reduction in live birth rate and a 47% decrement in multiple birth rate with SET compared with DET in the setting of favorable patient prognostic factors. Our findings present an opportunity to increase the rate of SET across the United States and thereby reduce the multiple birth rate and its associated poor perinatal outcomes with assisted reproductive technology pregnancies. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Calculating length of gestation from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database versus vital records may alter reported rates of prematurity.

    Science.gov (United States)

    Stern, Judy E; Kotelchuck, Milton; Luke, Barbara; Declercq, Eugene; Cabral, Howard; Diop, Hafsatou

    2014-05-01

    To compare length of gestation after assisted reproductive technology (ART) as calculated by three methods from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) and vital records (birth and fetal death) in the Massachusetts Pregnancy to Early Life Longitudinal Data System (PELL). Historical cohort study. Database linkage analysis. Live or stillborn deliveries. None. ART deliveries were linked to live birth or fetal death certificates. Length of gestation in 7,171 deliveries from fresh autologous ART cycles (2004-2008) was calculated and compared with that of SART CORS with the use of methods: M1 = outcome date - cycle start date; M2 = outcome date - transfer date + 17 days; and M3 = outcome date - transfer date + 14 days + day of transfer. Generalized estimating equation models were used to compare methods. Singleton and multiple deliveries were included. Overall prematurity (delivery 45% of deliveries and by more than 1 week in >22% of deliveries. Each method differed from each other. Estimates of preterm birth in ART vary depending on source of data and method of calculation. Some estimates may overestimate preterm birth rates for ART conceptions. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Geographic access to assisted reproductive technology health care in the United States: a population-based cross-sectional study.

    Science.gov (United States)

    Harris, John A; Menke, Marie N; Haefner, Jessica K; Moniz, Michelle H; Perumalswami, Chithra R

    2017-04-01

    To evaluate the geographic distribution of assisted reproductive technology (ART) clinics and the number of ART clinics within U.S. Census metropolitan areas and to estimate the number of reproductive-age women who have geographic access to ART services in the United States. A population-based cross-sectional study. Not applicable. None. None. Number of U.S. reproductive-age women living in areas with no ART clinic, a single ART clinic, or more than one ART clinic. There were 510 ART clinics in the United States in 2009-2013. Multiple ART clinics were present in 76 metropolitan areas (median population of 1.45 million people), where a total of 442 clinics were located. A single ART clinic was present in 68 metropolitan areas (median population of 454,000 people). Among U.S. reproductive-age women in 2010, 38.1 million (60.4% of the U.S. population) lived in an area with multiple ART clinics, 6.8 million (10.8% of the U.S. population) lived in an area with a single clinic, and 18.2 million (28.8% of the U.S. population) lived in an area (metropolitan and nonmetropolitan) with no ART clinics. Nearby geographic access to ART services is limited or absent for more than 25 million reproductive-age women (39.6% of the U.S. population) in the United States. This population estimate should spur continued policy and technological progress to increase access to ART services. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Ascites in the Puerperium in the Context of a Woman with Turner Syndrome Who Conceived through Assisted Reproductive Technology

    Directory of Open Access Journals (Sweden)

    Nikolaos Tsagkas

    2015-01-01

    Full Text Available The case is about a young female who delivered twins by caesarean section (CS. On the 4th postoperative day, she presented with ascites which was resistant to empirical antibiotic and diuretic treatment. The woman was affected by Turner syndrome (TS; she had a medical background of chronic use of hormonal medication since puberty and conceived through ART- (assisted reproduction techniques- IVF-oocyte donation. It is important to exhibit high suspicion for clot formation in the hepatic vasculature during the puerperium, especially in the case of history of chronic hormone treatment. Ascites albumin gradient and Doppler values lead to the diagnosis of thrombosis and the administration of high doses of anticoagulants is considered to be fundamental.

  17. Birth defects and congenital health risks in children conceived through assisted reproduction technology (ART): a meeting report.

    Science.gov (United States)

    2014-08-01

    Assisted Reproduction Treatment (ART) is here to stay. This review addresses the parental background of birth defects, before, during and after conception and focuses both on the underlying subfertility and on the question whether ART as a treatment is an additional contributing factor. Searches were performed in Medline and other databases. Summaries were discussed in a Delphi panel set-up by the European Society of Human Reproduction and Embryology (ESHRE). Several birth defects and adult diseases arise during the earliest stages of ovarian development and oocyte differentiation: this is the case of cleft palate disorders in offspring from female rat exposed to Dioxin during fetal life or the polycystic ovary diseases in female offspring (primates) exposed to elevated androgen concentration during fetal life. Human oocytes and embryos often fail to stop the propagation of aneuploid cells but maintain their ability to repair DNA damages including those introduced by the fertilizing sperm. There is a 29 % increased risk of birth defects in the newborns spontaneously conceived by subfertile couples and the risk is further increased (34 %) when conception is achieved by treating infertlity with ART (Danish IVF Registry). Periconceptional conditions are critical for ART babies: their birth weight is in general smaller (Norvegian Registry) but a more prolonged culture time doubled the number of large babies (Finnish Registry). The long-term developmental effects of ART on child and subsequent health as an adult remains a subject worthy of futher monitoring and investigation.

  18. Assisted reproduction developments in the Islamic world.

    Science.gov (United States)

    Serour, G I; Dickens, B M

    2001-08-01

    A November 2000 workshop organized by the International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, considered use of assisted reproduction technologies (ART) in the Islamic world. The workshop reinforced a 1997 recommendation that a Standing Committee for Shari'a Medical Ethics be constituted to monitor and assess developments in ART practice. Among issues the workshop addressed were equitable access to services for infertile couples of modest means, and regulation of standards of equipment and personnel that ART centers should satisfy to gain approval to offer services. Acceptable uses of preimplantation genetic diagnosis were proposed, and follicular maturation research in animals, including in vitro maturation and in vitro growth of oocytes, was encouraged, leading to human applications. Embryo implantation following a husband's death, induced postmenopausal pregnancy, uterine transplantation and gene therapy were addressed and human reproductive cloning condemned, but cloning human embryos for stem cell research was considered acceptable.

  19. The ethics of assisted reproduction.

    Science.gov (United States)

    Chatzinikolaou, Nikolaos

    2010-05-01

    Issues concerning the beginning of life and medical intervention in the onset of human existence are very delicate in their nature; they involve multi-dimensional knowledge, they are difficult to comprehend and sensitive to handle. When pure scientific elements are combined with profound emotions, when the genius of technological discoveries touches upon human dignity and sanctity, when passion for the technological achievement intervenes in basic human rights, then the sense of inadequacy and ignorance becomes intense and critical. Silence seems more sought-after than words, and willingness to learn more prudent than the desire to speak. Fear of the inconceivable consequences and even more so the inability to assess them, experiments with the unknown, the likelihood that basic historical, ethical and social values may change forever, but mainly the replacement of God in His wondrous work of creation--the onset of human life--places the ethics of reproductive technologies on the frontline of contemporary bioethics. This opinion paper does not deal with dangers, insults, fears, threats, "speed limits" or ethical controversies, but rather with the very mystery of life. Although there are no generally accepted replies to the various questions being posed, some thoughts and reservations, which can shed some light upon complicated dilemmas are presented. Firstly, the content of reproductive technologies, the problem of infertility today, the methods of fertility treatment, and of prenatal and pre-implantation testing are described, and then the social impact of IVF, complicated cases, deontological dilemmas and some ethical concerns are discussed. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Assisted reproduction and child neurodevelopmental outcomes

    DEFF Research Database (Denmark)

    Bay, Bjørn; Mortensen, Erik Lykke; Kesmodel, Ulrik Schiøler

    2013-01-01

    To systematically review the existing literature on neurodevelopmental outcomes in children born after medically assisted reproduction compared with those of children born after spontaneous conception.......To systematically review the existing literature on neurodevelopmental outcomes in children born after medically assisted reproduction compared with those of children born after spontaneous conception....

  1. [Criminal code and assisted human reproduction].

    Science.gov (United States)

    Cortés Bechiarelli, Emilio

    2009-01-01

    The Spanish Criminal Code punishes in the article 161 the crime of assisted reproduction of the woman without her assent as a form of crime relative to the genetic manipulation. The crime protects a specific area of the freedom of decision of the woman, which is the one that she has dealing with the right to the procreation at the moment of being fertilized. The sentence would include the damages to the health provoked by the birth or the abortion. The crime is a common one--everyone can commit it--and it is not required a result of pregnancy, but it is consumed by the mere intervention on the body of the woman, and its interpretation is contained on the Law 14/2006, of may 26, on technologies of human assisted reproduction. The aim of the work is to propose to consider valid the assent given by the sixteen-year-old women (and older) in coherence with the Project of Law about sexual and reproductive health and voluntary interruption of the pregnancy that is studied at this moment, in Spain, in order to harmonize the legal systems.

  2. e-Therapy to reduce emotional distress in women undergoing assisted reproductive technology (ART): a feasibility randomized controlled trial.

    Science.gov (United States)

    van Dongen, Angelique J C M; Nelen, Willianne L D M; IntHout, Joanna; Kremer, Jan A M; Verhaak, Christianne M

    2016-05-01

    Is it feasible to evaluate a personalized e-therapy program (Internet based) for women during fertility treatment aimed to reduce the chance of having clinically relevant symptoms of anxiety and/or depression after unsuccessful assisted reproductive technology (ART) treatment within a randomized controlled trial (RCT)? The evaluation of a personalized e-therapy program is feasible, reflected by good acceptability and integration within current guidelines, but adjustments to the e-therapy program and study design of the RCT have to be made to enhance demand, practicality and efficacy. Internet-based interventions are promising in reducing psychological distress, especially when treatment is personalized to specific risk profiles of patients. However in fertility care, the beneficial effects of personalized e-therapy on psychological distress and its implementation in daily clinical care still have to be evaluated. To evaluate the feasibility of a personalized e-therapy program, we conducted a two-arm, parallel group, single-blind feasibility randomized controlled trial with a 1:1 allocation. Feasibility was assessed in terms of demand, acceptability, practicality, implementation, integration and limited efficacy. Women were included between 1 February 2011 and 1 June 2013. Women in the control group received care as usual, whereas women in the intervention group received in addition to their usual care access to a personalized e-therapy program. Women were monitored until 3 months after the start of their first ART cycle. In a university hospital in the Netherlands women who were screened as at risk for emotional adjustment problems and intended to start their first ART cycle were invited, and of them 120 were randomized. Of these women, 48% in the intervention group were compliant to the intervention. Outcome measures associated with the feasibility to analyse this e-therapy program within an RCT were assessed. It is feasible to evaluate a personalized e

  3. Treatment period and medical care costs to achieve the first live birth by assisted reproductive technology are lower in the single embryo transfer period than in the double embryo transfer period: a retrospective analysis of women younger than 40 years of age.

    Science.gov (United States)

    Kawahara, Shunsuke; Ueda, Akane; Nakahori, Takashi; Honda, Tetsuro

    2017-04-01

    It was examined whether the single embryo transfer policy makes the treatment period longer for couples to achieve their first live birth by assisted reproductive technology. This study retrospectively analyzed women who started assisted reproductive technology at younger than 40 years of age in the authors' organization. The treatment periods for couples to achieve the first live birth by assisted reproductive technology, between the women who started assisted reproductive technology from 2004 to 2009 (the double embryo transfer period group, n=250), in which the double embryo transfer was predominant, and the women who started assisted reproductive technology from 2010 to 2015 (the single embryo transfer period group, n=298), in which the single embryo transfer was predominant, were compared. The age at the start of assisted reproductive technology, pregnancy rate per embryo transfer, and rate of women who achieved a live birth by assisted reproductive technology per number of women who tried assisted reproductive technology were all significantly higher in the single embryo transfer period group. Among the women who achieved a live birth by assisted reproductive technology, the incidence of multiple births and severe ovarian hyperstimulation syndrome, the treatment period, and medical care costs needed to achieve the first live birth were all significantly lower in the single embryo transfer period group. In the single embryo transfer period group, those women who were younger than 40 years of age achieved their first live birth by assisted reproductive technology more safely, quickly, and reasonably.

  4. The use of anti-Müllerian hormone (AMH) for controlled ovarian stimulation in assisted reproductive technology and for fertility assessment and -counselling

    DEFF Research Database (Denmark)

    Pilsgaard, Fie; Grynnerup, Anna Garcia-Alix; Loessl, Kristine

    2018-01-01

    Ovarian reserve can be determined by serum anti-Müllerian hormone (AMH) level and/or antral follicle count prior to controlled ovarian stimulation. The aim of controlled ovarian stimulation is to achieve an appropriate number of mature follicles and avoid complications such as ovarian hyperstimul......Ovarian reserve can be determined by serum anti-Müllerian hormone (AMH) level and/or antral follicle count prior to controlled ovarian stimulation. The aim of controlled ovarian stimulation is to achieve an appropriate number of mature follicles and avoid complications such as ovarian....... Currently, no international standardised assays exist. AMH is a valid predictor of the ovarian response to controlled ovarian stimulation and to some extent the chance of pregnancy in relation to assisted reproductive technology, but AMH is less optimal in prediction of spontaneous pregnancy and live birth...... after assisted reproductive technology. Accordingly, AMH can be used to optimize gonadotrophin stimulation in fertility treatment, but is not recommended as a screening tool in the general population. This article is protected by copyright. All rights reserved....

  5. Genetic and epigenetic risks of assisted reproduction.

    Science.gov (United States)

    Jiang, Ziru; Wang, Yinyu; Lin, Jing; Xu, Jingjing; Ding, Guolian; Huang, Hefeng

    2017-10-01

    Assisted reproductive technology (ART) is used primarily for infertility treatments to achieve pregnancy and involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and cryopreservation. Moreover, preimplantation genetic diagnosis (PGD) of ART is used in couples for genetic reasons. In ART treatments, gametes and zygotes are exposed to a series of non-physiological processes and culture media. Although the majority of children born with this treatment are healthy, some concerns remain regarding the safety of this technology. Animal studies and follow-up studies of ART-borne children suggested that ART was associated with an increased incidence of genetic, physical, or developmental abnormalities, although there are also observations that contradict these findings. As IVF, ICSI, frozen-thawed embryo transfer, and PGD manipulate gametes and embryo at a time that is important for reprogramming, they may affect epigenetic stability, leading to gamete/embryo origins of adult diseases. In fact, ART offspring have been reported to have an increased risk of gamete/embryo origins of adult diseases, such as early-onset diabetes, cardiovascular disease, and so on. In this review, we will discuss evidence related to genetic, especially epigenetic, risks of assisted reproduction. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Posthumous Assisted Reproduction from Islamic Perspective

    Directory of Open Access Journals (Sweden)

    Reza Omani Samani

    2008-01-01

    Full Text Available Rapid development in assisted reproductive techniques along with relieving the pain of childlessnesshas brought new ethical and policy dilemmas. Posthumous assisted reproduction is the mostchallenging, difficult and sensitive issue to be discussed ethically and religiously. In this paper theacceptability of the posthumous reproduction in Islamic contexts is evaluated and major concernslike Consent and ownership of the gametes after death, Family and Marriage vision and Welfareof the child are discussed together with some international legislation. We can conclude that uponIslamic vision to assisted reproductive techniques as treatment of families and relieving the seriousproblem of childlessness, posthumous assisted reproduction is unacceptable even with previouslyfrozen gametes or embryos. Also, Islamic vision to marriage, consent and welfare of the childconfirms the unacceptability. There must be some law or legislation to ban this procedure in Islamiccontexts.

  7. Microscopical advances in assisted reproduction.

    Science.gov (United States)

    Baccetti, B

    2004-01-01

    In a series of papers carried out by this laboratory it was demonstrated that the quality of sterile males sperm, assessed submicroscopically and mathematically, is closely correlated with the success of the various procedures of assisted reproduction. If we attempt to select hypothetically optimal spermatozoa destined to the ICSI by light inverted microscopy, a considerable amount of ultrastructural information is lost and our selection is merely based on the motility. In this study we apply polarization microscopy to the ICSI technique, introducing polarizing and analyzing lenses in an inverted microscope model, operating in a transparent container. The retardation of the birefringence in the various organelles is evaluated by compensators, and the images are transmitted to a video system, and stored in a computer. Spermatozoa are maintained alive and perfectly motile in this polarizing inverted microscope, and the character of the birefringence is the same as in fixed and sectioned biological material examined by polarization microscopy. The birefringence of the sperm structures allows a sperm analysis closer to TEM than to phase contrast light microscopy analysis.

  8. Use of preimplantation genetic diagnosis and preimplantation genetic screening in the United States: a Society for Assisted Reproductive Technology Writing Group paper.

    Science.gov (United States)

    Ginsburg, Elizabeth S; Baker, Valerie L; Racowsky, Catherine; Wantman, Ethan; Goldfarb, James; Stern, Judy E

    2011-10-01

    To comprehensively report Society for Assisted Reproductive Technology (SART) member program usage of preimplantation genetic testing (PGT), preimplantation genetic diagnosis (PGD) for diagnosis of specific conditions, and preimplantation genetic screening for aneuploidy (PGS). Retrospective study. United States SART cohort data. Women undergoing a PGT cycle in which at least one embryo underwent biopsy. PGT. PGT use, indications, and delivery rates. Of 190,260 fresh, nondonor assisted reproductive technology (ART) cycles reported to SART CORS in 2007-2008, 8,337 included PGT. Of 6,971 cycles with a defined indication, 1,382 cycles were for genetic diagnosis, 3,645 for aneuploidy screening (PGS), 527 for translocation, and 1,417 for elective sex election. Although the total number of fresh, autologous cycles increased by 3.6% from 2007 to 2008, the percentage of cycles with PGT decreased by 5.8% (4,293 in 2007 and 4,044 in 2008). As a percentage of fresh, nondonor ART cycles, use dropped from 4.6% (4,293/93,433) in 2007 to 4.2% (4,044/96,827) in 2008. The primary indication for PGT was PGS: cycles performed for this indication decreased (-8.0%). PGD use for single-gene defects (+3.2%), elective sex selection (+5.3%), and translocation analysis (+0.5%) increased. PGT usage varied significantly by geographical region. PGT usage in the United States decreased between 2007 and 2008 owing to a decrease in PGS. Use of elective sex selection increased. High transfer cancellation rates correlated with reduced live-birth rates for some PGT indications. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy.

    Science.gov (United States)

    Babore, Alessandra; Stuppia, Liborio; Trumello, Carmen; Candelori, Carla; Antonucci, Ivana

    2017-04-01

    To investigate the association between male factor infertility and openness to discussing assisted reproductive technology (ART) treatment with levels of depression among men undergoing infertility treatment. Cross-sectional. Not applicable. Three hundred forty participants (170 men and their partners) undergoing ART treatments. Administration of a set of questionnaires. Depressive symptoms were detected by means of the Zung Depression Self-Rating Scale. Participants' willingness to share their infertility treatment experience with other people was assessed by means of self-report questionnaires. In this study, 51.8% of males chose not to discuss their ART treatments with people other than their partner. In addition, the decision to discuss or not discuss the ART treatments with others was significantly associated with men's depressive symptoms. Male factor infertility was significantly associated with depression when considered together with the decision not to discuss ART treatments with others. A general disposition characterized by a lack of openness with others seemed to be a significant predictor of depression. There is a need for routine fertility care to pay greater attention to men's emotional needs. Before commencing reproductive treatment, male patients may benefit from undergoing routine screening for variables (i.e., male factor infertility and openness to others about ART) that may affect their risk of depression. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. What is the quality of information on social oocyte cryopreservation provided by websites of Society for Assisted Reproductive Technology member fertility clinics?

    Science.gov (United States)

    Avraham, Sarit; Machtinger, Ronit; Cahan, Tal; Sokolov, Amit; Racowsky, Catherine; Seidman, Daniel S

    2014-01-01

    To evaluate adequacy and adherence to American Society for Reproductive Medicine (ASRM) guidelines of internet information provided by Society for Assisted Reproductive Technology (SART)-affiliated clinics regarding social oocyte cryopreservation (SOC). Systematic evaluation of websites of all SART member fertility clinics. The internet. None. All websites offering SOC services were scored using a 0-13 scale, based on 10 questions designed to assess website quality and adherence to the ASRM/SART guidelines. The websites were analyzed independently by two authors. Whenever disagreement occurred, a third investigator determined the score. Scores defined website quality as excellent, ≥9; moderate, 5-8; or poor, ≤4 points. Of the 387 clinics registered as SART members, 200 offered oocyte cryopreservation services for either medical or social reasons; 147 of these advertised SOC. The average website scores of those clinics offering SOC was 3.4 ± 2.1 (range, 2-11) points. There was no significant difference in scores between private versus academic clinics or clinics performing more or less than 500 cycles per year. The majority of the websites do not follow the SART/ASRM guidelines for SOC, indicating that there is a need to improve the type and quality of information provided on SOC by SART member websites. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Restricting Access to ART on the Basis of Criminal Record : An Ethical Analysis of a State-Enforced "Presumption Against Treatment" With Regard to Assisted Reproductive Technologies.

    Science.gov (United States)

    Thompson, Kara; McDougall, Rosalind

    2015-09-01

    As assisted reproductive technologies (ART) become increasingly popular, debate has intensified over the ethical justification for restricting access to ART based on various medical and non-medical factors. In 2010, the Australian state of Victoria enacted world-first legislation that denies access to ART for all patients with certain criminal or child protection histories. Patients and their partners are identified via a compulsory police and child protection check prior to commencing ART and, if found to have a previous relevant conviction or child protection order, are given a "presumption against treatment." This article reviews the legislation and identifies arguments that may be used to justify restricting access to ART for various reasons. The arguments reviewed include limitations of reproductive rights, inheriting undesirable genetic traits, distributive justice, and the welfare of the future child. We show that none of these arguments justifies restricting access to ART in the context of past criminal history. We show that a "presumption against treatment" is an unjustified infringement on reproductive freedom and that it creates various inconsistencies in current social, medical, and legal policy. We argue that a state-enforced policy of restricting access to ART based on the non-medical factor of past criminal history is an example of unjust discrimination and cannot be ethically justified, with one important exception: in cases where ART treatment may be considered futile on the basis that the parents are not expected to raise the resulting child.

  12. Comprehensive evaluation of contemporary assisted reproduction technology laboratory operations to determine staffing levels that promote patient safety and quality care.

    Science.gov (United States)

    Alikani, Mina; Go, Kathryn J; McCaffrey, Caroline; McCulloh, David H

    2014-11-01

    To consider how staffing requirements have changed with evolving and increasingly more complex assisted reproduction technology (ART) laboratory practice. Analysis by four laboratory directors from three different ART programs of the level of complexity and time requirements for contemporary ART laboratory activities to determine adequate staffing levels. University-based and private ART programs. None. None. Human resource requirements for ART procedures. Both complexity and time required for completion of a contemporary ART cycle have increased significantly compared with the same requirements for the "traditional cycle" of the past. The latter required roughly 9 personnel hours, but a contemporary cycle can require up to 20 hours for completion. Consistent with this increase, a quantitative analysis shows that the number of embryologists required for safe and efficient operation of the ART laboratory has also increased. This number depends on not only the volume but also the types of procedures performed: the higher the number of complex procedures, the more personnel required. An interactive Personnel Calculator is introduced that can help determine staffing needs. The increased complexity of the contemporary ART laboratory requires a new look at the allocation of human resources. Our work provides laboratory directors with a practical, individualized tool to determine their staffing requirements with a view to increasing the safety and efficiency of operations. The work could serve as the basis for revision of the 2008 American Society for Reproductive Medicine (ASRM) staffing guidelines. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Methodological quality of systematic reviews in subfertility: a comparison of Cochrane and non-Cochrane systematic reviews in assisted reproductive technologies.

    Science.gov (United States)

    Windsor, B; Popovich, I; Jordan, V; Showell, M; Shea, B; Farquhar, C

    2012-12-01

    Are there differences in the methodological quality of Cochrane systematic reviews (CRs) and non-Cochrane systematic reviews (NCRs) of assisted reproductive technologies? CRs on assisted reproduction are of higher methodological quality than similar reviews published in other journals. The quality of systematic reviews varies. This was a cross-sectional study of 30 CR and 30 NCR systematic reviews that were randomly selected from the eligible reviews identified from a literature search for the years 2007-2011. We extracted data on the reporting and methodological characteristics of the included systematic reviews. We assessed the methodological quality of the reviews using the 11-domain Measurement Tool to Assess the Methodological Quality of Systematic Reviews (AMSTAR) tool and subsequently compared CR and NCR systematic reviews. The AMSTAR quality assessment found that CRs were superior to NCRs. For 10 of 11 AMSTAR domains, the requirements were met in >50% of CRs, but only 4 of 11 domains showed requirements being met in >50% of NCRs. The strengths of CRs are the a priori study design, comprehensive literature search, explicit lists of included and excluded studies and assessments of internal validity. Significant failings in the CRs were found in duplicate study selection and data extraction (67% meeting requirements), assessment for publication bias (53% meeting requirements) and reporting of conflicts of interest (47% meeting requirements). NCRs were more likely to contain methodological weaknesses as the majority of the domains showed Auckland.

  14. Attitudes towards new assisted reproductive technologies in Sweden: a survey in women 30-39 years of age.

    Science.gov (United States)

    Wennberg, Anna-Lena; Rodriguez-Wallberg, Kenny A; Milsom, Ian; Brännström, Mats

    2016-01-01

    Novel pathways to parenthood [oocyte cryopreservation, allowance of surrogacy, uterus transplantation, and assisted reproductive treatments (ART) for single women] are currently being discussed. This study investigates women's attitudes towards oocyte cryopreservation and ART procedures that are not allowed or are still under investigation in Sweden, and whether the attitudes differ between urban women and women from a national cohort. Two thousand randomly selected Swedish females aged 30-39 years, 1000 residents of Stockholm (urban cohort) and 1000 from the remainder of Sweden (national cohort), were invited to complete a postal questionnaire on attitudes about existing and novel ARTs. Response rates for the national and urban cohorts were 52.1% and 48.9%. Ninety-four per cent of women were positive towards oocyte cryopreservation for medical reasons. Seventy per cent considered that this treatment was also indicated for social reasons. Seventy-six per cent found it acceptable to offer ART to single women. Uterus transplantation was found to be more acceptable than surrogacy (80% vs. 47%). Urban women were more positive to both oocyte cryopreservation for social reasons and fertility treatment of single women than the national cohort. Urban women were also more tolerant regarding age limits for attempting pregnancy with cryopreserved gametes and regarding permission for a longer duration of maintaining cryopreserved gametes. Swedish women have a high acceptance of most new ARTs, with the exception of surrogacy. Urban women seem to have a greater acceptance for social egg-freezing, longer duration of cryopreservation of oocytes, and higher age limit for their use. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Congenital Malformations in Infants of Mothers Undergoing Assisted Reproductive Technologies: A Systematic Review and Meta-analysis Study

    Science.gov (United States)

    2017-01-01

    Objectives This meta-analysis aimed to evaluate congenital malformations in infants conceived by assisted reproductive techniques (ART), compared with infants conceived spontaneously. Methods In this study, available resources searched to find relevant articles included PubMed, ScienceDirect, Scopus, Google Scholar, Cochrane, ProQuest, Iranmedex, Magiran, and Scientific Information Database. After extracting the necessary information from evaluated articles, meta-analysis on the articles’ data was performed using Stata version 11.2. Results In this study, from a total of 339 articles, extracted from the initial investigation, ultimately 30 articles were selected for meta-analysis that assessed the use of ART on the risk of congenital abnormalities and some birth complications on 5 470 181 infants (315 402 cases and 5 154 779 controls). The odds ratio (95% confidence interval [CI]) for low birth weight was 1.89 (95% CI, 1.36 to 2.62), preterm labor 1.79 (95% CI, 1.21 to 2.63), cardiac abnormalities 1.43 (95% CI, 1.27 to 1.62), central nervous system abnormalities 1.36 (95% CI, 1.10 to 1.70), urogenital system abnormalities 1.58 (95% CI, 1.28 to 1.94), musculoskeletal disorders 1.35 (95% CI, 1.12 to 1.64), and chromosomal abnormalities in infants conceived by ART was 1.14 (95% CI, 0.90 to 1.44), which were all statistically significant, except chromosomal abnormalities. Conclusions The risk of congenital abnormalities and some birth complications were significantly higher in ART than normal conception, while chromosomal abnormalities were not; therefore, the application of ART should be selected individually for patients by detailed assessment to reduce such risks in the population. PMID:29207452

  16. From esterilología to reproductive biology: The story of the Mexican assisted reproduction business

    Directory of Open Access Journals (Sweden)

    Sandra P González-Santos

    2016-06-01

    Full Text Available This paper provides the first overview of how assisted reproduction emerged and developed in Mexico. In doing so it addresses two broad points: when and how treatments using assisted reproductive technology became common practice within reproductive medicine; and how the Mexican assisted reproduction industry emerged. The paper begins in 1949, when the first medical association dedicated to esterilología – the biomedical area focused on the study of infertility – was established, thus providing the epistemic and professional ground upon which assisted reproductive technology would later thrive. The paper then traces the way in which this biomedical industry developed, from individual doctors in their practices to networks of clinics and from a clinical practice to a reproductive industry. It also describes the different ways in which the professional community and the government have worked towards developing a regulatory frame for the practice of assisted reproduction. The paper is informed by ethnographic work conducted at clinics, conferences, online forums and websites, as well as by analysis of the contemporary national media, government documents and national medical journals from the early mid-twentieth century to the those published today.

  17. Assistive Technology (Moldinclud)

    OpenAIRE

    Luján Mora, Sergio

    2011-01-01

    Slides of the seminar "Assistive Technology" taught at the Institul de Stat de Instruire Continua (Chisinau, Moldova) in november 2011. Transparencias del seminario "Assistive Technology" impartido en el Institul de Stat de Instruire Continua (Chisinau, Moldavia) en noviembre 2011. Tempus project: MOLDINCLUD, Teaching Training Centre for Inclusive Education (TEMPUS 158980-2009).

  18. Quality of life and psychosocial and physical well-being among 1,023 women during their first assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Toftager, Mette; Sylvest, Randi; Schmidt, Lone

    2018-01-01

    , open-label, randomized controlled trial. Four times during treatment a questionnaire on self-reported physical well-being was completed. Further, a questionnaire on self-reported quality of life and psychosocial well-being was completed at the day of hCG testing. SETTING: Fertility clinics......OBJECTIVE: To compare self-reported quality of life, psychosocial well-being, and physical well-being during assisted reproductive technology (ART) treatment in 1,023 women allocated to either a short GnRH antagonist or long GnRH agonist protocol. DESIGN: Secondary outcome of a prospective phase 4...... at university hospitals. PATIENT(S): Women referred for their first ART treatment were randomized in a 1:1 ratio and started standardized ART protocols. INTERVENTION(S): Gonadotropin-releasing hormone analogue; 528 women allocated to a short GnRH antagonist protocol and 495 women allocated to a long Gn...

  19. Mental distress and personality in women undergoing GnRH agonist versus GnRH antagonist protocols for assisted reproductive technology

    DEFF Research Database (Denmark)

    Stenbæk, D. S.; Toftager, M.; Hjordt, L. V.

    2015-01-01

    . Rather, our data highlight the potential importance of (i) rapid increases in ovarian steroids and (ii) addressing personality traits indexing negative emotionality, i.e. Neuroticism, in women undergoing ART treatment, to optimize both emotional adjustment and, possibly, the chances of obtaining......STUDY QUESTION: Do mental distress and mood fluctuations in women undergoing GnRH agonist and GnRH antagonist protocols for assisted reproductive technology (ART) differ depending on protocol and the personality trait, neuroticism? SUMMARY ANSWER: ART treatment did not induce elevated levels...... characteristics, such as personality traits indexing negative emotionality, e.g. neuroticism, are likely to affect mental distress during ART treatment. STUDY DESIGN, SIZE, DURATION: A total of 83 women undergoing their first ART cycle were consecutively randomized 1:1 to GnRH antagonist (n = 42) or GnRH agonist...

  20. 21 CFR 884.6200 - Assisted reproduction laser system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction laser system. 884.6200... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6200 Assisted reproduction laser system. (a) Identification. The assisted reproduction laser system is a device...

  1. 21 CFR 884.6100 - Assisted reproduction needles.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction needles. 884.6100 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6100 Assisted reproduction needles. (a) Identification. Assisted reproduction needles are devices used in in...

  2. 21 CFR 884.6160 - Assisted reproduction labware.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction labware. 884.6160 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6160 Assisted reproduction labware. (a) Identification. Assisted reproduction labware consists of laboratory...

  3. 21 CFR 884.6130 - Assisted reproduction microtools.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction microtools. 884.6130 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6130 Assisted reproduction microtools. (a) Identification. Assisted reproduction microtools are pipettes or...

  4. 21 CFR 884.6120 - Assisted reproduction accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction accessories. 884.6120... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6120 Assisted reproduction accessories. (a) Identification. Assisted reproduction accessories are a group of...

  5. 21 CFR 884.6110 - Assisted reproduction catheters.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction catheters. 884.6110 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6110 Assisted reproduction catheters. (a) Identification. Assisted reproduction catheters are devices used in in...

  6. Pregnancy outcomes decline in recipients over age 44: an analysis of 27,959 fresh donor oocyte in vitro fertilization cycles from the Society for Assisted Reproductive Technology.

    Science.gov (United States)

    Yeh, Jason S; Steward, Ryan G; Dude, Annie M; Shah, Anish A; Goldfarb, James M; Muasher, Suheil J

    2014-05-01

    To use a large and recent national registry to provide an updated report on the effect of recipient age on the outcome of donor oocyte in vitro fertilization (IVF) cycles. Retrospective cohort study. United States national registry for assisted reproductive technology. Recipients of donor oocyte treatment cycles between 2008 and 2010, with cycles segregated into five age cohorts: ≤34, 35 to 39, 40 to 44, 45 to 49, and ≥50 years. None. Implantation, clinical pregnancy, live-birth, and miscarriage rates. In donor oocyte IVF cycles, all age cohorts ≤39 years had similar rates of implantation, clinical pregnancy, and live birth when compared with the 40- to 44-year-old reference group. Patients in the two oldest age groups (45 to 49, ≥50 years) experienced statistically significantly lower rates of implantation, clinical pregnancy, and live birth compared with the reference group. Additionally, all outcomes in the ≥50-year-old group were statistically significantly worse than the 45- to 49-year-old group, demonstrating progressive decline with advancing age. Recent national registry data suggest that donor oocyte recipients have stable rates of pregnancy outcomes before age 45, after which there is a small but steady and significant decline. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Lessons from reproductive technology research.

    Science.gov (United States)

    Seidel, George E

    2015-01-01

    A plethora of assisted reproductive technologies (ARTs) have come into routine use over the past half century. Some of these procedures were used much earlier experimentally. For example, Spallanzani performed artificial insemination in the dog in the late 1700s, and Heape did successful embryo transfer in the rabbit in 1890. Truly revolutionary tools and concepts important for ART occur at approximately half-decade intervals, for example, recombinant DNA procedures, transgenic technology, somatic cell nuclear transplantation, the polymerase chain reaction, and microRNAs. Similarly, obvious technologies sometimes take decades to come into practical use, such as sexing sperm and in vitro fertilization. I have categorized ARTs into five somewhat arbitrary categories in terms of perceived difficulty and feasibility: (a) when the seemingly possible turns out to be (essentially) impossible, e.g., homozygous, uniparental females; (b) when the seemingly impossible becomes possible, e.g., cryopreservation of embryos and transgenesis; (c) when the seemingly difficult turns out to be relatively easy, e.g., cryopreservation of sperm; (d) when the seemingly easy turns out to be difficult in key species, e.g., in vitro fertilization; and (e) when the seemingly difficult remains difficult, e.g., making true embryonic stem cells. The adage that "it is easy when you know how" applies repeatedly. The boundaries between what appears impossible/possible and difficult/easy change constantly owing to new tools and insights, one of the more important lessons learned. ARTs frequently are synergistic with each other. For example, somatic cell nuclear transplantation has made many kinds of experiments feasible that otherwise were impractical. Another example is that sexing sperm is useless for application without artificial insemination or in vitro fertilization. ARTs frequently are perceived as neat tricks and stimulate further thinking. This is useful for both teaching and research.

  8. Association Between Pesticide Residue Intake From Consumption of Fruits and Vegetables and Pregnancy Outcomes Among Women Undergoing Infertility Treatment With Assisted Reproductive Technology.

    Science.gov (United States)

    Chiu, Yu-Han; Williams, Paige L; Gillman, Matthew W; Gaskins, Audrey J; Mínguez-Alarcón, Lidia; Souter, Irene; Toth, Thomas L; Ford, Jennifer B; Hauser, Russ; Chavarro, Jorge E

    2018-01-01

    Animal experiments suggest that ingestion of pesticide mixtures at environmentally relevant concentrations decreases the number of live-born offspring. Whether the same is true in humans is unknown. To examine the association of preconception intake of pesticide residues in fruits and vegetables (FVs) with outcomes of infertility treatment with assisted reproductive technologies (ART). This analysis included 325 women who completed a diet assessment and subsequently underwent 541 ART cycles in the Environment and Reproductive Health (EARTH) prospective cohort study (2007-2016) at a fertility center at a teaching hospital. We categorized FVs as having high or low pesticide residues using a validated method based on surveillance data from the US Department of Agriculture. Cluster-weighted generalized estimating equations were used to analyze associations of high- and low-pesticide residue FV intake with ART outcomes. Adjusted probabilities of clinical pregnancy and live birth per treatment cycle. In the 325 participants (mean [SD] age, 35.1 [4.0] y; body mass index, 24.1 [4.3]), mean (SD) intakes of high- and low-pesticide residue FVs were 1.7 (1.0) and 2.8 (1.6) servings/d, respectively. Greater intake of high-pesticide residue FVs was associated with a lower probability of clinical pregnancy and live birth. Compared with women in the lowest quartile of high-pesticide FV intake (women in the highest quartile (≥2.3 servings/d) had 18% (95% CI, 5%-30%) lower probability of clinical pregnancy and 26% (95% CI, 13%-37%) lower probability of live birth. Intake of low-pesticide residue FVs was not significantly related to ART outcomes. Higher consumption of high-pesticide residue FVs was associated with lower probabilities of pregnancy and live birth following infertility treatment with ART. These data suggest that dietary pesticide exposure within the range of typical human exposure may be associated with adverse reproductive consequences.

  9. Calibration of redox potential in sperm wash media and evaluation of oxidation-reduction potential values in various assisted reproductive technology culture media using MiOXSYS system.

    Science.gov (United States)

    Panner Selvam, M K; Henkel, R; Sharma, R; Agarwal, A

    2018-03-01

    Oxidation-reduction potential describes the balance between the oxidants and antioxidants in fluids including semen. Various artificial culture media are used in andrology and IVF laboratories for sperm preparation and to support the development of fertilized oocytes under in vitro conditions. The composition and conditions of these media are vital for optimal functioning of the gametes. Currently, there are no data on the status of redox potential of sperm processing and assisted reproduction media. The purpose of this study was to compare the oxidation-reduction potential values of the different media and to calibrate the oxidation-reduction potential values of the sperm wash medium using oxidative stress inducer cumene hydroperoxide and antioxidant ascorbic acid. Redox potential was measured in 10 different media ranging from sperm wash media, freezing media and assisted reproductive technology one-step medium to sequential media. Oxidation-reduction potential values of the sequential culture medium and one-step culture medium were lower and significantly different (p media. Calibration of the sperm wash media using the oxidant cumene hydroperoxide and antioxidant ascorbic acid demonstrated that oxidation-reduction potential and the concentration of oxidant or antioxidant are logarithmically dependent. This study highlights the importance of calibrating the oxidation-reduction potential levels of the sperm wash media in order to utilize it as a reference value to identify the physiological range of oxidation-reduction potential that does not have any adverse effect on normal physiological sperm function. © 2017 American Society of Andrology and European Academy of Andrology.

  10. Comparative study of the psychosocial risks associated with families with multiple births resulting from assisted reproductive technology (ART) and without ART.

    Science.gov (United States)

    Roca-de Bes, Montserrat; Gutierrez-Maldonado, José; Gris-Martínez, José M

    2011-07-01

    To determine whether the psychosocial risks associated with multiple births are increased as a consequence of the use of assisted reproductive technology (ART) in comparison with those not resulting from ART. Cross-sectional study. Fertility units of a university hospital and a private hospital. Parents of single children and multiples (twins and triplets) between 6 months and 4 years of age (n = 636) were divided into two groups: those who conceived through ART (n = 265) and those who conceived through non-ART (n = 371). Administration of six scales, in office or by mail. Measurement scales of material necessities, social stigma, marital satisfaction, perceived stress, depression, quality of life, and their subscales. The analysis of variance, Student's t-test, and χ(2)-test were applied. No effect was observed based on the use of ART in the psychosocial variables studied. Significant differences were obtained between the groups of single (SB) and multiple births (MB) with respect to material necessities, social stigma, marital satisfaction, depression, and quality of life. Having more than one child per birth, whether resulting from the use of ART or not, increases psychosocial risks for the parents. Assisted reproduction centers should include this information with the obstetric and neonatal risks, stressing the advantages of having one child per birth. Psychosocial risks are not increased as a result of having used ART, but the goal of avoiding the repeated use of ART does influence the desire to transfer the maximum number of embryos possible. Psychological counseling should be included before initiating ART, as well as when a multiple pregnancy is confirmed. Copyright © 2011. Published by Elsevier Inc.

  11. Assisted reproduction laboratory cost-drivers in South Africa: value ...

    African Journals Online (AJOL)

    An overview is given on selected cost-drivers within an assisted reproduction technology (ART) laboratory, such as procedural costs; sperm preparations; laboratory supplies including embryo culture media and cryopreservation. Depending on the nature of an ART unit, i.e. private vs. public/tertiary, the structure of the unit ...

  12. Role of Antioxidants in Assisted Reproductive Techniques

    Directory of Open Access Journals (Sweden)

    Ashok Agarwal

    2017-08-01

    Full Text Available Oxidative stress (OS has been recognized as a significant cause of suboptimal assisted reproductive outcome. Many of the sperm preparation and manipulation procedures that are necessary in the in vitro environment can result in excessive production of reactive oxygen species (ROS thereby exposing the gametes and growing embryos to significant oxidative damage. Antioxidants have long been utilized in the management of male subfertility as they can counterbalance the elevated levels of ROS inducing a high state of OS. Few studies have looked into the clinical effectiveness of antioxidants in patients undergoing assisted reproduction. While an overall favorable outcome has been perceived, the specific clinical indication and optimal antioxidant regimen remain unknown. The goal of our review is to explore the sources of ROS in the in vitro environment and provide a clinical scenario-based approach to identify the circumstances where antioxidant supplementation is most beneficial to enhance the outcome of assisted reproduction.

  13. Role of Antioxidants in Assisted Reproductive Techniques.

    Science.gov (United States)

    Agarwal, Ashok; Majzoub, Ahmad

    2017-08-01

    Oxidative stress (OS) has been recognized as a significant cause of suboptimal assisted reproductive outcome. Many of the sperm preparation and manipulation procedures that are necessary in the in vitro environment can result in excessive production of reactive oxygen species (ROS) thereby exposing the gametes and growing embryos to significant oxidative damage. Antioxidants have long been utilized in the management of male subfertility as they can counterbalance the elevated levels of ROS inducing a high state of OS. Few studies have looked into the clinical effectiveness of antioxidants in patients undergoing assisted reproduction. While an overall favorable outcome has been perceived, the specific clinical indication and optimal antioxidant regimen remain unknown. The goal of our review is to explore the sources of ROS in the in vitro environment and provide a clinical scenario-based approach to identify the circumstances where antioxidant supplementation is most beneficial to enhance the outcome of assisted reproduction. Copyright © 2017 Korean Society for Sexual Medicine and Andrology.

  14. The relational ecology of the transition to parenthood in couples that conceived spontaneously or through Assisted Reproductive Technologies

    OpenAIRE

    Gameiro, Carla Sofia Marques Rodrigues

    2009-01-01

    Tese de doutoramento em Psicologia, especialidade de Psicologia da Saúde, apresentada à Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra Background. Infertility is a reproductive health problem defined by the World Health Organization as the inability of a couple to achieve conception or to bring a pregnancy to term after a year or more of regular, unprotected intercourse (WHO, 1992), that affects 9% of the population worldwide (Boivin, Bunting, Collins, & Ny...

  15. Coste de las técnicas de reproducción asistida en un hospital público Cost of assisted reproduction technology in a public hospital

    Directory of Open Access Journals (Sweden)

    José Luis Navarro Espigares

    2006-10-01

    Full Text Available Objetivos: La mayoría de trabajos sobre costes de las técnicas de reproducción asistida (TRA identifican el coste directo del procedimiento, sin considerar elementos como los costes estructurales o intermedios, de gran importancia. El objetivo de este trabajo es calcular el coste por proceso de las TRA realizadas en un hospital público en 2003 y compararlo con los resultados de 1998 en el mismo centro. Métodos: El estudio se realiza en la Unidad de Reproducción Humana (URH del Hospital Universitario Virgen de las Nieves de Granada en 1998 y 2003. Partiendo de los costes totales de dicha unidad, y mediante una metodología de distribución de costes basada en la estructura de costes, calculamos el coste por proceso de las TRA realizadas en este centro, considerando los costes completos. Resultados: Entre 1998 y 2003, la actividad y los costes de la URH analizada evolucionan de forma distinta. El análisis de la actividad muestra la consolidación de técnicas, como la microinyección espermática (ICSI y la desaparición de otras (ciclo sin reproducción asistida e inseminación artificial conyugal intracervical. En todos los procesos, los costes unitarios por ciclo y por embarazo disminuyen en el período analizado. Conclusiones: Se han producido importantes cambios en la estructura de costes de las TRA de la URH-HUVN entre 1998-2003. Mientras algunos procesos desaparecen, otros se consolidan con una elevada actividad. Los avances técnicos y las innovaciones organizativas, junto con un «efecto aprendizaje», han alterado la estructura de costes de las TRA.Objectives: Most studies on the costs of assisted reproductive technologies (ART identify the total cost of the procedure with the direct cost, without considering important items such as overhead or intermediate costs. The objective of this study was to determine the cost per ART procedure in a public hospital in 2003 and to compare the results with those in the same hospital in 1998

  16. Assisted reproductive technologies in Portuguese law--commentary to the Judgment no. 101/2009, of March the 3rd of the Portuguese Constitutional Court.

    Science.gov (United States)

    Raposo, Vera Lúcia; Vale e Reis, Rafael

    2009-01-01

    Recently the Portuguese Constitutional Court was asked to analyze the constitutionality of the law on assisted reproduction, Law nr 32/2006. The request was presented by a conservative group, arguing, basically, that the law disregarded the juridical protection due to the embryo and to the participants in reproductive techniques. The main critics pointed out were related with the legitimacy of using reproductive techniques, the absence of a maximum age for beneficiaries, the authorization of embryo experimentation, the decision of not criminalizing every contract of surrogate motherhood, among some other critics. However, the Court concluded that none of the pointed norms went against Constitutional rules and principles.

  17. [Mexican National Consensus on Assisted Reproduction Treatment].

    Science.gov (United States)

    Kably Ambe, Alberto; López Ortiz, Carlos Salazar; Serviere Zaragoza, Claudio; Velázquez Cornejo, Gerardo; Pérez Peña, Efrain; Santos Haliscack, Roberto; Luna Rojas, Martha; Valerio, Emilio; Santana, Héctor; Gaviño Gaviño, Fernando

    2012-09-01

    It is estimated that 15% of couples living in industrialized countries are infertile, ie have failed to conceive, reproductive age, after 12 months ormore of regular intercourse without contraception. During the past decade has increased the demand for fertility treatments because they believe are moreeffective now. To unify the therapeutic approach and service to patients and set a precedent for a Mexican Official Standard respect and support for the legislation of these procedures. Consensus by technical experts group panel with the participation of 34 national centers accredited for use in assisted reproduction. He organized seven workshops with the following themes: 1) selection of patients for assisted reproduction treatment, 2) schemes controlled ovarian stimulation for assisted reproduction techniques of high complexity, 3) preparation and egg retrieval technique, 4) transferembryo; 5) luteal phase supplementation; 6) indications and techniques of cryopreservation and 7) informed consent. Each table had a coordinator who wrote and presented the findings to the full, it made a number of observations until they reached unanimity of criteria, which are reflected in this document. Patient selection for assisted reproduction techniques is the first step of the process. Proper selection lead to success, in the same way that a bad pick up for failure. In the case of egg donation the most important recommendation is that only one to two embryos transferred in order to reduce multiple pregnancy rates and maintaining high pregnancy rates.

  18. Assistive Technologies for Reading

    Science.gov (United States)

    Ruffin, Tiece M.

    2012-01-01

    Twenty-first century teachers working with diverse readers are often faced with the question of how to integrate technology in reading instruction that meets the needs of the techno-generation. Are today's teachers equipped with the knowledge of how to effectively use Assistive Technologies (AT) for reading? This position paper discusses AT for…

  19. [Adoption: an alternative to assisted reproductive techniques?].

    Science.gov (United States)

    Blanchy, S

    2011-09-01

    Information on adoption must be given to couples who seek treatment for medically-assisted procreation. But is adoption a real alternative? What are the chances for a couple who consults to see its desire for adoption be achieved according to its own situation, the characteristics of the child he wants, and the general situation of adoption? Can adoption, just like assisted procreation, often described by the couples as a "obstacle course", go parallel? Or should one try adoption once assisted reproduction failed? Is the couple willing to suffer the social and legal control of adoption after having supported the medical control of the ART? In all cases, the reality is that two out of three couples engaged in assisted reproduction will have a child whereas scarcely more than one candidate to adoption will be offered to adopt a child after three or four-years procedure. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  20. Melatonin supplementation during controlled ovarian stimulation for women undergoing assisted reproductive technology: systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Seko, Ludimila M D; Moroni, Rafael M; Leitao, Valeria M S; Teixeira, Danielle M; Nastri, Carolina O; Martins, Wellington P

    2014-01-01

    To examine the best evidence available regarding the effect of melatonin supplementation during controlled ovarian stimulation (COS) on the main assisted reproductive technology (ART) outcomes. Systematic review and meta-analysis of randomized clinical trials (RCT). Not applicable. Women undergoing COS for ART. Melatonin supplementation during COS for women undergoing ART. Live birth rate, clinical pregnancy rate, number of retrieved oocytes, miscarriage rate, ovarian hyperstimulation syndrome (OHSS) rate, and number of congenital abnormalities. Comparisons were performed using risk ratio (RR) or mean difference (MD). Five RCTs were considered eligible, and their data were extracted and included in a meta-analysis. No studies reported live-birth or congenital abnormalities. Our estimates were imprecise for distinguishing between no effect and benefit considering clinical pregnancy (RR, 1.21; 95% confidence interval [CI], 0.98-1.50, five studies, 680 women, low quality-evidence) and the number of oocytes retrieved (MD, 0.6; 95% CI, -0.2-2.2, five studies, 680 women, low quality-evidence). Our estimates were imprecise for distinguishing among harm, no effect, and benefit considering miscarriage (RR, 1.07; 95% CI, 0.43-2.68, two studies, 143 clinical pregnancies, low quality-evidence) and interventions to reduce the risk of OHSS (RR,1.01; 95% CI, 0.33-3.08, one study, 358 women, low quality-evidence). More studies investigating the role of melatonin supplementation are still needed before recommending its use in clinical practice. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Luteal phase support for assisted reproduction cycles

    NARCIS (Netherlands)

    Linden, M. van der; Buckingham, K.; Farquhar, C.; Kremer, J.A.M.; Metwally, M.

    2015-01-01

    BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin(hCG) produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques(ART), progesterone and/or hCG

  2. Luteal phase support for assisted reproduction cycles

    NARCIS (Netherlands)

    Linden, M. Van der; Buckingham, K.; Farquhar, C.; Kremer, J.A.M.; Metwally, M.

    2011-01-01

    BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin (hCG), which is produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques (ART) the progesterone

  3. Computer-assisted reproductive surgery: microsurgery for the digital age.

    Science.gov (United States)

    Choussein, S; Srouji, S S; Lipskind, S T; Gargiulo, A R

    2014-02-01

    Although considerable progress has been made in the field of medically assisted reproduction, minimally invasive surgery remains of vital importance in optimizing and preserving fertility, as well as treating infertility. By definition, reproductive surgery employs microsurgical techniques with the objective of restoring natural fertility or enhancing assisted reproductive technologies. The avant-garde minimalist philosophy of this branch of gynecology has made it the natural trailblazer of laparoscopic surgery. Minimally invasive conservative treatment of uterine, tubal, ovarian and peritoneal pathology has long been the gold standard for women of reproductive age and those seeking fertility preservation. Robust surgical outcome data acknowledge clear advantages of advanced laparoscopic surgery over laparotomy. However, this comes at the cost of significant technical challenges. Computer-assisted laparoscopy, also known as robotic surgery, is posed to address the practical limitations of conventional laparoscopic surgery and bridge this technical gap. This enabling technology is a conceptual fusion of the practicality of conventional open surgery and the minimally invasive nature of laparoscopic surgery. With this comes the promise of simplifying complex minimally invasive fertility-sparing procedures so that they can be performed in a safe and reproducible manner by reproductive specialists.

  4. Pharmaceutical costs of assisted reproduction in Spain.

    Science.gov (United States)

    Lorente, Maria-Reyes; Hernández, Juana; Antoñanzas, Fernando

    2013-11-01

    Assisted reproduction is one of the health services currently being considered for possible limitation or exclusion from the public health services portfolio in Spain. One of the main reasons claimed for this is the impact on the budget for pharmaceutical expenditure. The objective of this study was to assess the significance of the pharmaceutical costs of assisted reproduction in Spain. This study focused on medical practice in Spain, and is based on the opinions of experts in assisted reproduction and the results provided by professional societies' publications. The reference year is 2012 and the setting was secondary care. We have included all existing pharmaceutical modalities for assisted reproduction, as well as the most common drug for each modality. We have considered the pharmaceutical cost per cycle for artificial insemination, in vitro fertilisation with or without intracytoplasmic sperm injection (IVF_ICSI), and cryotransfer and donated fresh oocytes reception. In Spain, artificial insemination has a pharmaceutical cost per cycle of between €69.36 and €873.79. This amounts to an average cycle cost of €364.87 for partner's sperm and €327.10 for donor sperm. The pharmaceutical cost of IVF_ICSI ranges between €278.16 and €1,902.66, giving an average cost per cycle of €1,139.65. In the case of cryotransfer and donated fresh oocytes reception, the pharmaceutical cost per cycle is between €22.61 and €58.73, yielding an average cost of €40.67. The budgetary impact of pharmaceutical expenditure for assisted reproduction in Spain for the year 2012 was estimated at €98.7 million. In Spain, the total pharmaceutical cost of assisted reproduction is substantial. According to our results, we can say that about 29% of the total pharmaceutical expenditure for assisted reproduction techniques is funded by the National Health System and the rest represents 2.4% of the total annual out-of-pocket family expenditure on drugs.

  5. In vitro fertilization in Japan - early days of in vitro fertilization and embryo transfer and future prospects for assisted reproductive technology.

    Science.gov (United States)

    Suzuki, Masakuni

    2014-01-01

    Assisted reproductive technology (ART) such as in vitro fertilization (IVF) and embryo transfer (ET) has been essential in the treatment of infertility. The world's first IVF-ET baby was born in 1978 based on the technique developed by Dr. Robert Edwards and Dr. Patrick Steptoe. In Japan, the first IVF-ET birth was reported in 1983 by Prof. Masakuni Suzuki at Tohoku University School of Medicine. IVF-ET is a procedure used to achieve pregnancy that consists of extracting oocytes from an infertile woman, fertilizing them in vitro, and transferring fertilized eggs into the patient's uterine cavity (Fig. 1). Since the first report of successful IVF-ET, numerous techniques related to ART, such as cryopreservation of oocytes and embryos, gamete intrafallopian transfer (GIFT), and microinsemination, have been developed and refined (Table 1). Herein we describe the history of basic research in IVF-ET that led to human applications, how the birth of the first IVF-ET baby was achieved in Japan, the current status of ART in Japan, issues related to ART, and future prospects for ART.

  6. Efficacy, safety, and trends in assisted reproductive technology in Japan-analysis of four-year data from the national registry system.

    Science.gov (United States)

    Takeshima, Kazumi; Saito, Hidekazu; Nakaza, Aritoshi; Kuwahara, Akira; Ishihara, Osamu; Irahara, Minoru; Hirahara, Humiki; Yoshimura, Yasunori; Sakumoto, Tetsuro

    2014-04-01

    This study aimed to evaluate the efficacy, safety, and trends in assisted reproductive technology (ART) in Japan. Data pertaining to treatment cycles, pregnancy rate, live birth rate, age distribution, single embryo transfer rate, and multiple pregnancy rate were analyzed for patients registered in the national ART registry system of Japan from 2007 to 2010. The total number of treatment cycles was 161,164, 190,613, 213,800, and 242,161 in 2007, 2008, 2009, and 2010, respectively. The number of ART treatments administered to patients aged ≥40 years was 31.2 %, 32.1 %, 33.4 %, and 35.7 %, respectively, showing an increasing trend from 2007 to 2010. In each of these years, the total pregnancy rate per embryo transfer was 24.4 %, 21.9 %, 22.3 %, and 21.9 % for fresh cycles, respectively, and 32.0 %, 32.1 %, 32.5 %, and 33.7 % for frozen cycles, respectively. The single embryo transfer rate was 49.9 %, 63.6 %, 70.6 %, and 73.0 %, respectively, showing an increasing trend, while the multiple pregnancy rate was 11.5 %, 6.8 %, 5.3 %, and 4.8 %, respectively, showing a decreasing trend. From 2007 to 2010 in Japan, the number of ART treatment cycles, number of elderly patients treated, and the single embryo transfer rate increased, while the multiple pregnancy rate decreased. However, the overall pregnancy rate remained stable during the study period.

  7. Impact of the Great East Japan Earthquake and Fukushima Nuclear Power Plant Accident on Assisted Reproductive Technology in Fukushima Prefecture: The Fukushima Health Management Survey.

    Science.gov (United States)

    Hayashi, Masako; Fujimori, Keiya; Yasumura, Seiji; Nakai, Akihito

    2017-09-01

    The aim of the study was to evaluate the incidences and obstetric outcomes of women who conceived using assisted reproductive technology (ART) procedures in Fukushima Prefecture before and after the Great East Japan Earthquake and Fukushima nuclear power plant accident. Information was collected and analyzed from 12,070 women who conceived with or without ART in Fukushima Prefecture during the 9 months before and after the disaster. During the 9 months before and after the disaster, 138 (2.0%) and 102 (1.9%) women conceived with in vitro fertilization-embryo transfer (IVF-ET), respectively. The proportion of women who conceived with IVF-ET decreased during the 2 months immediately after the disaster, but returned to pre-disaster levels 3 months after the disaster. In the case of women who conceived without IVF-ET, the incidences of preterm birth and low birth weight increased after the disaster. In contrast, women who conceived with IVF-ET did not differ significantly in obstetric outcomes before and after the disaster but had a higher incidence of cesarean section and low birth weight compared to those conceived without IVF-ET, regardless of the study period. The influence of the disaster on woman who conceived using ART procedures was minimal.

  8. Assisted reproductive technology in Japan: a summary report for 2015 by The Ethics Committee of The Japan Society of Obstetrics and Gynecology.

    Science.gov (United States)

    Saito, Hidekazu; Jwa, Seung Chik; Kuwahara, Akira; Saito, Kazuki; Ishikawa, Tomonori; Ishihara, Osamu; Kugu, Koji; Sawa, Rintaro; Banno, Kouji; Irahara, Minoru

    2018-01-01

    The Japan Society of Obstetrics and Gynecology (JSOG) implemented an assisted reproductive technology (ART) registry system in 1986. Here are reported the characteristics and treatment outcomes of ART cycles that were registered in 2015. JSOG has requested all participating ART facilities to register cycle-specific information for all ART cycles since 2007. A descriptive analysis was performed by using the registry database for 2015. In total, 424 151 cycles and 51 001 neonates (1 in 19.7 neonates born in Japan) were registered in 2015. The patients' mean age was 38.2 years (standard deviation = 4.5). Among the fresh cycles, 94 158 of 244 718 (38.5%) egg retrieval cycles were cycles with freeze-all embryos or oocytes, while fresh embryo transfer (ET) was performed in 70 254 cycles, signaling a decrease from 2014. There were 169 898 frozen-thawed ET cycles, resulting in 56 355 pregnancies and 40 599 neonates. Single ET was performed at a rate of 79.7% for fresh and 81.8% for frozen cycles and the singleton pregnancy/live birth rates were 96.9%/96.5% and 96.8%/96.4% for the respective cycles. The total ART cycles and live births resulting from ART has been increasing in Japan. Single ET was performed at a rate of almost 80% and ET cycles have shifted from fresh to frozen cycles.

  9. Association Between Endometriosis and Preterm Birth in Women With Spontaneous Conception or Using Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Pérez-López, Faustino R; Villagrasa-Boli, Pablo; Muñoz-Olarte, María; Morera-Grau, Álex; Cruz-Andrés, Pablo; Hernandez, Adrian V

    2018-03-01

    To perform a systematic review and meta-analysis to estimate the effect of endometriosis on preterm birth (PB) risk. Searches were conducted in PubMed-MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, Google Scholar, and SciELO for studies published in all languages from inception through April 2017. We included cohort studies evaluating pregnant women with and without endometriosis and conception either by spontaneous conception (SC) or with assisted reproductive technology (ART). Primary outcome was PB (women with endometriosis, the PB risk was significantly increased in both SC (OR: 1.59; 95% CI: 1.32-1.90) and ART (OR: 1.43; 95% CI: 1.14-1.79). The SGA risk was increased in women with endometriosis (OR: 1.16; 95% CI: 1.05-1.28), while the IUGR and low birthweight risks and birthweight were not affected by endometriosis. Endometriosis is associated with increased PB risk in both SC and women who obtained pregnancy using ART. Prospective studies evaluating relevant outcomes are needed to confirm these results.

  10. Prolonged gonadotropin stimulation for assisted reproductive technology cycles is associated with decreased pregnancy rates for all women except for women with polycystic ovary syndrome.

    Science.gov (United States)

    Ryan, Amanda; Wang, Shunping; Alvero, Ruben; Polotsky, Alex J

    2014-07-01

    To determine if etiology of infertility modifies the relationship between the duration of ovarian stimulation and success during assisted reproductive technology (ART) cycles. A prospectively collected database was analyzed in an academic infertility practice. Eight hundred and twelve infertile women undergoing their initial fresh embryo, non-donor in vitro fertilization (IVF) or Intracytoplasmic Sperm Injection ICSI) cycle between January 1999 and December 2010 were evaluated. Clinical pregnancy was the main outcome measured. Out of 663 cycles resulting in oocyte retrieval, 299 produced a clinical pregnancy (45.1%). Women who achieved a clinical pregnancy had a significantly shorter stimulation length (11.9 vs. 12.1 days, p = 0.047). Polycystic ovary syndrome (PCOS) was the only etiology of infertility that was significantly associated with a higher chance for clinical pregnancy and was a significant confounder for the association of duration and success of treatment. Women with 13 days or longer of stimulation had a 34 % lower chance of clinical pregnancy as compared to those who had a shorter cycle (OR 0.66, 95% CI:0.46-0.95) after adjustment for age, ovarian reserve, number of oocytes retrieved, embryos transferred and PCOS diagnosis. Prolonged duration of stimulation is associated with decreased ART success for all couples, except for women with PCOS.

  11. Effects of the use of assisted reproductive technologies and an obesogenic environment on resistance artery function and diabetes biomarkers in mice offspring.

    Directory of Open Access Journals (Sweden)

    Francisco I Ramirez-Perez

    Full Text Available Maternal obesity affects the incidence of cardiovascular disease and diabetes in offspring. Also the use of assisted reproductive technologies (ART has been associated with cardiovascular deficiencies in offspring. Obese women often suffer from infertility and use ART to achieve a pregnancy, but the combined effects of maternal obesity and ART on cardiovascular health and incidence of diabetes in the offspring is not known. Here, we report the effects of the use of ART within an obesogenic environment, consisting of feeding a western diet (WD to dams and offspring, on resistance artery function and presence of diabetes biomarkers in juvenile mice offspring. Our results indicate that WD and ART interacted to induce endothelial dysfunction in mesenteric resistance arteries isolated from 7-week-old mice offspring. This was determined by presence of a reduced acetylcholine-induced dilation compared to controls. The arteries from these WD-ART mice also had greater wall cross-sectional areas and wall to lumen ratios indicative of vascular hypertrophic remodeling. Of the diabetes biomarkers measured, only resistin was affected by a WD×ART interaction. Serum resistin was significantly greater in WD-ART offspring compared to controls. Diet and sex effects were observed in other diabetes biomarkers. Our conclusion is that in mice the use of ART within an obesogenic environment interacts to favor the development of endothelial dysfunction in the resistance arteries of juvenile offspring, while having marginal effects on diabetes biomarkers.

  12. Analysis of the effects of polyphenols on human spermatozoa reveals unexpected impacts on mitochondrial membrane potential, oxidative stress and DNA integrity; implications for assisted reproductive technology.

    Science.gov (United States)

    Aitken, R J; Muscio, L; Whiting, S; Connaughton, H S; Fraser, B A; Nixon, B; Smith, N D; De Iuliis, G N

    2016-12-01

    The need to protect human spermatozoa from oxidative stress during assisted reproductive technology, has prompted a detailed analysis of the impacts of phenolic compounds on the functional integrity of these cells. Investigation of 16 individual compounds revealed a surprising variety of negative effects including: (i) a loss of mitochondrial membrane potential (Δψm) via mechanisms that were not related to opening of the permeability transition pore but associated with a reduction in thiol expression, (ii) a decline in intracellular reduced glutathione, (iii) the stimulation of pro-oxidant activity including the induction of ROS generation from mitochondrial and non-mitochondrial sources, (iv) stimulation of lipid peroxidation, (v) the generation of oxidative DNA damage, and (vi) impaired sperm motility. For most of the polyphenolic compounds examined, the loss of motility was gradual and highly correlated with the induction of lipid peroxidation (r=0.889). The exception was gossypol, which induced a rapid loss of motility due to its inherent alkylating activity; one consequence of which was a marked reduction in carboxymethyl lysine expression on the sperm tail; a post-translational modification that is known to play a key role in the regulation of sperm movement. The only polyphenols that did not appear to have adverse effects on spermatozoa were resveratrol, genistein and THP at doses below 100μM. These compounds could, therefore, have some therapeutic potential in a clinical setting. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Optimizing the number of cleavage stage embryos to transfer on day 3 in women 38 years of age and older: a Society for Assisted Reproductive Technology database study.

    Science.gov (United States)

    Stern, Judy E; Goldman, Marlene B; Hatasaka, Harry; MacKenzie, Todd A; Surrey, Eric S; Racowsky, Catherine

    2009-03-01

    To determine the optimal number of day 3 embryos to transfer in women >or=38 years by conducting an evidence-based evaluation. Retrospective analysis of 2000-2004 national SART data. National writing group. A total of 36,103 day 3 embryo transfers in women >or=38 years undergoing their first assisted reproductive technology cycle. None. Logistic regression was used to model the probability of pregnancy, delivery, and multiple births (twin or high order) based on age- and cycle-specific parameters. Pregnancy rates, delivery rates, and multiple rates increased up to transfer of three embryos in 38-year-olds and four in 39-year-olds; beyond this number, only multiple rates increased. In women >or=40 years, delivery rates and multiple rates climbed steadily with increasing numbers transferred. Multivariate analysis confirmed the statistically significant effect of age, number of oocytes retrieved, and embryo cryopreservation on delivery and multiple rates. Maximum FSH level was not an independent predictor by multivariate analysis. Use of intracytoplasmic sperm injection was associated with lowered delivery rate. No more than three or four embryos should be transferred in 38- and 39-year-olds, respectively, whereas up to five embryos could be transferred in >or=40-year-olds. Numbers of embryos to transfer should be adjusted according to number of oocytes retrieved and availability of excess embryos for cryopreservation.

  14. [Anti mullerian hormone (AMH)--is it a new reliable marker of the ovarian reserve? Its role in predicting the ovarian response in assisted reproductive technology (ART)].

    Science.gov (United States)

    Alshiek, Jonia Amer; Lessing, Joseph B; Amit, Ami; Azem, Foad

    2012-07-01

    Anti-Müllerian hormone (AMH) is predominantly known for its important role in the differentiation of the male and female sexual system during the early embryonic period. Recently, many animal and human researches have been studying the role of the AMH in the postnatal ovarian function. In the female, AMH is produced by the granulosa cells of early developing follicles. It plays a major role in the folliculogenesis and seems to be able to inhibit the initiation of the growth of primordial follicles and FSH-induced follicles. As AMH is expressed throughout the folliculogenesis, from the primary follicular stage to the antral stage, the serum levels of AMH may represent both the quantity and the quality of ovarian follicles. Thus, the AMH levels may be useful as a new potential marker of the ovarian reserve. As compared to other ovarian reserve tests, the AMH has unique characteristics which make it a favorable marker. The measurement of AMH levels may be useful in the prediction of poor response and cycle cancellation as well as hyper-response and the ovarian hyperstimulation syndrome in assisted reproductive technology (ART). We assume that the measurement of AMH Levels may play a role in the individualization of treatment strategies among patients who are treated by ART. However, the AMH cannot predict the qualitative ovarian response in ART. In men, the AMH was not found to have satisfactory clinical utility as a single marker of spermatogenesis.

  15. New trends in combined use of gonadotropin-releasing hormone antagonists with gonadotropins or pulsatile gonadotropin-releasing hormone in ovulation induction and assisted reproductive technologies.

    Science.gov (United States)

    Gordon, K; Danforth, D R; Williams, R F; Hodgen, G D

    1992-10-01

    The use of gonadotropin-releasing hormone agonists as adjunctive therapy with gonadotropins for ovulation induction in in vitro fertilization and other assisted reproductive technologies has become common clinical practice. With the recent advent of potent gonadotropin-releasing hormone antagonists free from the marked histamine-release effects that stymied earlier compounds, an attractive alternative method may be available. We have established the feasibility of combining gonadotropin-releasing hormone antagonist-induced inhibition of endogenous gonadotropins with exogenous gonadotropin therapy for ovulation induction in a nonhuman primate model. Here, the principal benefits to be gained from using the gonadotropin-releasing hormone antagonist rather than the gonadotropin-releasing hormone agonist are the immediate inhibition of pituitary gonadotropin secretion without the "flare effect," which brings greater safety and convenience for patients and the medical team and saves time and money. We have also recently demonstrated the feasibility of combining gonadotropin-releasing hormone antagonist with pulsatile gonadotropin-releasing hormone therapy for the controlled restoration of gonadotropin secretion and gonadal steroidogenesis culminating in apparently normal (singleton) ovulatory cycles. This is feasible only with gonadotropin-releasing hormone antagonists because, unlike gonadotropin-releasing hormone agonists, they achieve control of the pituitary-ovarian axis without down regulation of the gonadotropin-releasing hormone receptor system. This capacity to override gonadotropin-releasing hormone antagonist-induced suppression of pituitary-ovarian function may allow new treatment modalities to be employed for women who suffer from chronic hyperandrogenemia with polycystic ovarian disease.

  16. No increased risk of major congenital anomalies or adverse pregnancy or neonatal outcomes following letrozole use in assisted reproductive technology.

    Science.gov (United States)

    Tatsumi, T; Jwa, S C; Kuwahara, A; Irahara, M; Kubota, T; Saito, H

    2017-01-01

    Does letrozole use increase the risk of major congenital anomalies and adverse pregnancy and neonatal outcomes in fresh, single-embryo transfer? Letrozole significantly decreases the risk of miscarriage and does not increase the risk of major congenital anomalies or adverse pregnancy or neonatal outcomes compared with natural cycles in patients undergoing ART. Letrozole is the most commonly used aromatase inhibitor for mild ovarian stimulation in ART. However, its safety in terms of pregnancy and neonatal outcomes is unclear. This retrospective cohort study used data from the Japanese national ART registry from 2011 to 2013. A total of 3136 natural cycles and 792 letrozole-induced cycles associated with fresh, single-embryo transfer and resulting in a clinical pregnancy were included in the analysis. The main pregnancy outcomes were miscarriage, ectopic pregnancy and still birth, and the neonatal outcomes were preterm delivery, low birth weight, small/large for gestational age and major congenital anomalies. Terminated pregnancies were included in the analysis of major congenital anomalies. Odds ratios (ORs) and 95% CIs were calculated using multivariate logistic regression analysis adjusted for maternal age and calendar year. The risk of miscarriage was significantly lower in women administered letrozole (adjusted OR [aOR], 0.37, 95% CI, 0.30-0.47, P women undergoing ART. Letrozole may thus be a safe option for mild ovarian stimulation. None. Not applicable. © 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.

  17. Outcomes of medical malpractice claims in assisted reproductive technology over a 10-year period from a single carrier.

    Science.gov (United States)

    Letterie, Gerard

    2017-04-01

    Medical malpractice claims vary by specialty. Contributory factors to malpractice in reproductive endocrinology and infertility (REI) are not well defined. We sought to determine claims' frequency, basis of claims, and outcomes of settled claims in REI. This is a retrospective, descriptive review of 10 years of claims. The setting is private practices. Claims were monitored within one malpractice carrier between 2006 and 2015 covering 10 practices and 184,015 IVF cycles. Total claims, basis of claims, and indemnity paid were evaluated. There were 176 incidents resulting in 30 settled claims with indemnity payments in 21. Categories of claims settled included misdiagnosis (N = 4), lack of informed consent (N = 5), embryology errors (N = 8), and surgical complications (N = 4). Total and average awards were $15,062,000 and $717,238, respectively. Misdiagnosis and lack of informed consent had highest total award amount at $11,583,000 accounting for 76% of award dollars. The two highest awards were $4.5 million and $3.0 million for cancer and genetic misdiagnosis, respectively. Excluding these two awards, payments totaled $7,562,000, ranged from $6000 to $900,000 and averaged $170,363. Errors in handling of embryos were highest in frequency accounting for 38% of claims paid for a total of $1,593,000 with average payment of $199,188. Settlements for surgical complications totaled $1,855,000 and averaged $463,750 per claim. Misdiagnosis and lack of informed consent are the highest award categories. Embryology lab errors are the most frequent causes of claims with the lowest award per settlement. The average cost for claims settled is relatively high compared to settlements in other specialties.

  18. Questioning the assumptions in the debate on assisted reproduction: comment on the House of Commons report Human Reproductive Technologies and the Law.

    Science.gov (United States)

    Pennings, Guido

    2005-08-01

    The House of Commons Science and Technology Committee has issued a series of non-dogmatic recommendations. Also regarding elective sex selection, it has adopted a controversial position. Sex selection should be allowed for family balancing. However, the acceptability of preimplantation genetic diagnosis as a method for selecting the embryos can be questioned on the basis of social harm. In countries with a shortage of medical personnel and a limited health care budget, elective procedures are a loss to society. This loss should be compensated by imposing a 'social compensation tax' for every application of elective sexing.

  19. Could we offer mitochondrial donation or similar assisted reproductive technology to South African patients with mitochondrial DNA disease?

    Science.gov (United States)

    Meldau, Surita; Riordan, Gillian; Van der Westhuizen, Francois; Elson, Joanna L; Smuts, Izelle; Pepper, Michael S; Soodyall, Himla

    2016-02-02

    The decision of the UK House of Commons in 2015 to endorse the use of pioneering in vitro fertilisation techniques to protect future generations from the risk of mitochondrial DNA (mtDNA) disease has sparked worldwide controversy and debate. The availability of such technologies could benefit women at risk of transmitting deleterious mutations. MtDNA disease certainly occurs in South Africa (SA) in all population groups. However, diagnostic strategies and practices for identifying individuals who would benefit from technologies such as IVF have in the past been suboptimal in this country. New developments in the molecular diagnostic services available to SA patients, as well as better education of referring clinicians and the implementation of more structured, population-appropriate diagnostic strategies, may open the floor to this debate in SA.

  20. Risk of ectopic pregnancy is linked to endometrial thickness in a retrospective cohort study of 8120 assisted reproduction technology cycles.

    Science.gov (United States)

    Rombauts, L; McMaster, R; Motteram, C; Fernando, S

    2015-12-01

    suggest that the directionality of the uterine peristalsis waves matters more than their frequency or amplitude. Combining the data from both studies we now hypothesize that increased ECT is a marker for increased fundus-to-cervix uterine peristalsis, explaining both the increased placenta praevia risk and the lower EP risk. Further prospective studies are required to confirm these observations. © The Author 2015. 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.

  1. 21 CFR 884.6140 - Assisted reproduction micropipette fabrication instruments.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction micropipette fabrication... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6140 Assisted reproduction micropipette fabrication instruments. (a) Identification...

  2. 21 CFR 884.6150 - Assisted reproduction micromanipulators and microinjectors.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction micromanipulators and... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6150 Assisted reproduction micromanipulators and microinjectors. (a) Identification...

  3. Assisted Reproduction versus Spontaneous Conception: A Comparison of the Developmental Outcomes in Twins

    Science.gov (United States)

    Kelly-Vance, Lisa; Anthis, Kristine S.; Needelman, Howard

    2004-01-01

    The use of assisted reproductive technology is increasing rapidly. Research, although sparse, has resulted in inconsistent findings as to the developmental prognosis for infants conceived by assisted reproductive techniques such as in vitro fertilization and the use of fertility drugs. In the present study, the authors compared twins who were…

  4. Using a Delphi consensus process to develop an acupuncture treatment protocol by consensus for women undergoing Assisted Reproductive Technology (ART) treatment.

    Science.gov (United States)

    Smith, Caroline A; Grant, Suzanne; Lyttleton, Jane; Cochrane, Suzanne

    2012-07-07

    Assisted reproductive technologies (ART) are increasingly utilised for resolving difficulties conceiving. These technologies are expensive to both the public purse and the individual consumers. Acupuncture is widely used as an adjunct to ART with indications that it may assist reducing the time to conception and increasing live birth rates. Heterogeneity is high between treatment protocols. The aim of this study was to examine what fertility acupuncturists consider key components of best practice acupuncture during an ART cycle, and to establish an acupuncture protocol by consensus. Fifteen international acupuncturists with extensive experience treating women during ART interventions participated in 3 rounds of Delphi questionnaires. The first round focused on identifying the parameters of acupuncture treatment as adjunct to ART, the second round evaluated statements derived from the earlier round, and the third evaluated specific parameters for a proposed trial protocol. Consensus was defined as greater than 80% agreement. Significant agreement was achieved on the parameters of best practice acupuncture, including an acupuncture protocol suitable for future research. Study participants confirmed the importance of needling aspects relating to the dose of acupuncture, the therapeutic relationship, tailoring treatment to the individual, and the role of co-interventions. From two rounds of the Delphi a consensus was achieved on seven treatment parameters for the design of the acupuncture treatment to be used in a clinical trial of acupuncture as an adjunct to ART. The treatment protocol includes the use of the traditional Chinese medicine acupuncture, use of manual acupuncture, a first treatment administered between day 6-8 of the stimulated ART cycle which is individualised to the participant, two treatments will be administered on the day of embryo transfer, and will include points SP8, SP10, LR3, ST29, CV4, and post transfer include: GV20, KD3, ST36, SP6, and PC6

  5. Resources and race: assisted reproduction in Ecuador

    Directory of Open Access Journals (Sweden)

    Elizabeth F.S. Roberts

    2016-06-01

    Full Text Available This article considers the early period of development of IVF in Ecuador, focusing on factors that shaped the decade after the nation's first successful IVF birth (1992–2002. It describes how a poorly resourced public healthcare sector compelled Ecuadorians towards private-sector medicine, which included assisted reproduction treatment, and how IVF clinics drew patients through the pervasive racial inequalities that characterise post-colonial Ecuadorian society. More generally, the development of assisted reproduction treatment in Ecuador exemplifies themes in 20th century healthcare provisioning and inequality in Latin America, making it essential to understand this larger picture when considering Ecuador’s IVF industry both within the region and also internationally.

  6. Legal issues of biomedical assisted reproduction: Reproductive tourism

    Directory of Open Access Journals (Sweden)

    Samardžić Sandra

    2011-01-01

    Full Text Available National laws represent a combination of customary and ethical, but also political and other opinions in a society. Particularly delicate, are the laws regulating the issue of assisted reproduction. In this area, broad social acceptance of legal solutions is an essential prerequisite for their use, while achieving the consent of the majority, especially the consensus is extremely difficult, almost impossible. As much as the laws seek to implement those views that are predominant, the adopted solutions will always remain incapable of granting wishes to a certain number of people. These persons, in an understandable effort to realize their desire for an offspring at any cost, will not hold back from seeking help at any place, even if it meant going to distant destinations and extracting large sums of money. In fact, many patients go to other countries which set less restrictive rules in the field of assisted reproduction, and it appears that in the near future we could not expect a reduction of this trend. This phenomenon, which is in theory called reproductive tourism, has long been a reality that one can see as a problem, while others view it as an irreplaceable solution. This paper seeks to highlight the main causes of this phenomenon, but also to try and give an answer as to, whether reproductive tourism should be prevented (and how or actually its maintenance in force reduces moral conflict in society through a mechanism that recognizes the right of everyone to a considerable extent of free will in decision making regarding the most significant issues which offspring certainly is.

  7. Cancer in children and young adults born after assisted reproductive technology: a Nordic cohort study from the Committee of Nordic ART and Safety (CoNARTaS).

    Science.gov (United States)

    Sundh, Karin Jerhamre; Henningsen, Anna-Karina A; Källen, Karin; Bergh, Christina; Romundstad, Liv Bente; Gissler, Mika; Pinborg, Anja; Skjaerven, Rolv; Tiitinen, Aila; Vassard, Ditte; Lannering, Birgitta; Wennerholm, Ulla-Britt

    2014-09-01

    Do children and young adults born after assisted reproductive technology (ART) have an increased risk of cancer? Children born after ART showed no overall increase in the rate of cancer when compared with children born as a result of spontaneous conception. Children born after ART have more adverse perinatal outcomes, i.e. preterm births, low birthweights and birth defects. Previous studies have shown divergent results regarding the risk of cancer among children born after ART. A retrospective Nordic population-based cohort study was performed, comprising all children born after ART in Sweden, Denmark, Finland and Norway between 1982 and 2007. The mean (±standard deviation) follow-up time was 9.5 (4.8) years. Children born after ART (n = 91 796) were compared with a control group of children born after spontaneous conception. This control group was almost 4-fold the size of the ART group (n = 358 419) and matched for parity, year of birth and country. Data on perinatal outcomes and cancer were obtained from the National Medical Birth Registries, the Cancer Registries, the Patient Registries and the Cause of Death Registries. The cancer diagnoses were divided into 12 main groups. Hazard ratios (HRs) and adjusted HR were calculated. Adjustments were carried out for country, maternal age, parity, sex, gestational age and birth defects. There was no significant increase in overall cancer rates among children born after ART when compared with children born after spontaneous conception (adjusted HR 1.08; 95% CI 0.91-1.27). Cancer, of any form, was found among 181 children born after ART (2.0/1000 children, 21.0/100 000 person-years) compared with 638 children born after spontaneous conception (1.8/1000 children, 18.8/100 000 person-years). Leukaemia was the most common type of cancer (n = 278, 0.62/1000 children) but no significantly increased incidence was found among children born after ART. An increased risk was observed for 2 of 12 cancer groups. They were central

  8. Prevention of vascular dysfunction and arterial hypertension in mice generated by assisted reproductive technologies by addition of melatonin to culture media.

    Science.gov (United States)

    Rexhaj, Emrush; Pireva, Agim; Paoloni-Giacobino, Ariane; Allemann, Yves; Cerny, David; Dessen, Pierre; Sartori, Claudio; Scherrer, Urs; Rimoldi, Stefano F

    2015-10-01

    Assisted reproductive technologies (ART) induce vascular dysfunction in humans and mice. In mice, ART-induced vascular dysfunction is related to epigenetic alteration of the endothelial nitric oxide synthase (eNOS) gene, resulting in decreased vascular eNOS expression and nitrite/nitrate synthesis. Melatonin is involved in epigenetic regulation, and its administration to sterile women improves the success rate of ART. We hypothesized that addition of melatonin to culture media may prevent ART-induced epigenetic and cardiovascular alterations in mice. We, therefore, assessed mesenteric-artery responses to acetylcholine and arterial blood pressure, together with DNA methylation of the eNOS gene promoter in vascular tissue and nitric oxide plasma concentration in 12-wk-old ART mice generated with and without addition of melatonin to culture media and in control mice. As expected, acetylcholine-induced mesenteric-artery dilation was impaired (P = 0.008 vs. control) and mean arterial blood pressure increased (109.5 ± 3.8 vs. 104.0 ± 4.7 mmHg, P = 0.002, ART vs. control) in ART compared with control mice. These alterations were associated with altered DNA methylation of the eNOS gene promoter (P culture media prevented eNOS dysmethylation (P = 0.005, vs. ART + vehicle), normalized nitric oxide plasma concentration (23.1 ± 14.6 μM, P = 0.002 vs. ART + vehicle) and mesentery-artery responsiveness to acetylcholine (P culture media prevents ART-induced vascular dysfunction. We speculate that this approach will also allow preventing ART-induced premature atherosclerosis in humans. Copyright © 2015 the American Physiological Society.

  9. Characterization of women with elevated antimüllerian hormone levels (AMH): correlation of AMH with polycystic ovarian syndrome phenotypes and assisted reproductive technology outcomes.

    Science.gov (United States)

    Tal, Reshef; Seifer, David B; Khanimov, Moisey; Malter, Henry E; Grazi, Richard V; Leader, Ben

    2014-07-01

    Serum Antimüllerian hormone (AMH) levels are elevated in polycystic ovarian syndrome and have been shown to be useful in its diagnosis. However, the clinical significance of extremely high AMH levels is understudied. We aimed to characterize a population of women with elevated AMH (>5 ng/mL). This was a retrospective cohort study of 134 women presenting to our fertility clinic for infertility evaluation and treatment who were found to have random serum AMH over 5 ng/mL. Women were divided into 3 groups according to AMH: 5-10 ng/mL, >10-14 ng/mL, and >14 ng/mL. Endocrine characteristics, polycystic ovarian syndrome (PCOS) phenotypes, fertilization rate, implantation rate, clinical pregnancy, and multiple pregnancy rates were compared between groups. AMH ranged between 5 to 48 ng/mL. Greater than 97% of women with ultrahigh AMH (>10 ng/mL) had PCOS. In addition, women with AMH >10 ng/mL had greater prevalence of polycystic ovarian morphology and oligoamenorrhea than women with AMH 5-10 ng/mL. Moreover, serum AMH correlated positively with luteinizing hormone, total testosterone, and dehydroepiandrosterone sulfate. Furthermore, AMH showed strong predictive ability for the presence of amenorrhea (area under the curve, 0.87; 95% confidence interval, 0.80-0.92; P women with AMH >10 ng/mL showed higher rates of ovarian hyperstimulation syndrome and clinical pregnancy rates compared with women with AMH 5-10 ng/mL. These data characterize a population of women with elevated AMH levels, demonstrating that the vast majority of women with AMH >10 ng/mL have PCOS. Increased AMH levels correlated with PCOS severity and are associated with greater ovarian stimulation and higher clinical pregnancy rates following assisted reproductive technology. Copyright © 2014 Mosby, Inc. All rights reserved.

  10. Ovarian Stimulators, Intrauterine Insemination, and Assisted Reproductive Technologies Use and the Risk of Major Congenital Malformations-The AtRISK Study.

    Science.gov (United States)

    Chaabane, Sonia; Sheehy, Odile; Monnier, Patricia; Bissonnette, François; Trasler, Jacquetta M; Fraser, William; Bérard, Anick

    2016-06-01

    To quantify the risk of major congenital malformations (MCMs) associated with the use of ovarian stimulators alone, intrauterine insemination (IUI), and assisted reproductive technologies (ARTs). We conducted a case-control analysis using a birth cohort, built with the linkage of data obtained by a self-administered questionnaire, medical, pharmaceutic, and birth databases. Cases were pregnancies with at least one live birth with an MCM. Controls were pregnancies that did not result in major or minor congenital malformations. Multiple logistic regression models were used to calculate the odds ratios (ORs) and confidence intervals (CIs). Among the 5021 pregnancies identified, 825 were cases of MCM and 4196 were controls. Compared with spontaneous conception, the use of ART increased the risk of major urogenital malformations (adjusted OR, 3.11; 95% CI, 1.33-7.27). The use of IUI was associated with an increased risk of major musculoskeletal malformations (adjusted OR, 2.02; 95% CI, 1.10-3.71). Among the 471 women who used fertility treatments for conception, the use of ART was associated with an increased risk of any MCM (adjusted OR, 1.66; 95% CI, 1.00-2.79) and urogenital malformations (adjusted OR, 7.18; 95% CI, 1.59-32.53) when compared with ovarian stimulators used alone. The use of ART and IUI was associated with an increased risk of major musculoskeletal and urogenital malformations. ART was associated with a higher risk of MCM compared to ovarian stimulators used alone. Even the adjustment, a contribution of the underlying subfertility problems cannot completely ruled out given the differences in the severity of subfertility. © 2016 Wiley Periodicals, Inc.

  11. Cell-free fetal DNA versus maternal serum screening for trisomy 21 in pregnant women with and without assisted reproduction technology: a prospective interventional study.

    Science.gov (United States)

    Costa, Jean-Marc; Letourneau, Alexandra; Favre, Romain; Bidat, Laurent; Belaisch-Allart, Joelle; Jouannic, Jean-Marie; Quarello, Edwin; Senat, Marie-Victoire; Broussin, Bernard; Tsatsaris, Vassilis; Demain, Adèle; Kleinfinger, Pascale; Lohmann, Laurence; Agostini, Hélène; Bouyer, Jean; Benachi, Alexandra

    2018-03-01

    PurposeCell-free DNA (cfDNA) as a primary screening test has been available for years but few studies have addressed this option in a prospective manner. The question is of interest after reports that maternal serum screening (MSS) is less accurate for pregnancies resulting from assisted reproduction technologies (ART) than for spontaneous pregnancies (SP).MethodsA prospective interventional study was designed to address the performances of cfDNA compared with MSS in pregnancies with or without ART. Each patient was offered both MSS and cfDNA testing. The primary analysis cohort ultimately included 794 patients with a spontaneous pregnancy (SP) (n = 472) or pregnancy obtained after ART (n = 322).ResultsOverall, the false-positive rate and positive predictive value were 6.6% and 8.8% for MSS but 0% and 100% for cfDNA. MSS false-positive rate and positive predictive values were clearly poorer in the ART group (11.7% and 2.6%) than in the SP group (3.2% and 21.1%). The global rates of invasive procedures were 1.9% (15/794) with cfDNA but 8.4% (65/794) if MSS alone was proposed.ConclusioncfDNA achieved better performance than MSS in both spontaneous and ART pregnancies, thus decreasing the number of invasive procedures. Our findings suggest that cfDNA should be considered for primary screening, especially in pregnancies obtained after ART.GENETICS in MEDICINE advance online publication, 1 March 2018; doi:10.1038/gim.2018.4.

  12. Preterm birth and Assisted Reproductive Technology/ART: maternal emotional wellbeing and quality of mother-newborn interaction during the first three months of life.

    Science.gov (United States)

    Tallandini, Maria A; Morsan, Valentina; Macagno, Franco

    2012-06-01

    Assisted Reproductive Technology (ART) and premature birth are stressful and difficult experiences for women. No research to date has examined the impact of ART on mother-child relationship in instances of preterm delivery. This study explored the psychological status of preterm infants' ART-mothers and the quality of mother-infant dyadic interaction, up to child age of three months (Corrected Age = CA). Forty-one ART-dyads and 53 Spontaneous Pregnancy (SP) dyads were enrolled. Mother and child were assessed at 5 to 7 days after birth (T1), at child discharge from hospital (T2), at one month after discharge (T3); and at 3 months CA (T4). The following measures were administered to the mothers: the Gordon Personal Profile Inventory, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Parenting Stress Index S-F. Mother-child interaction was coded by using the Nursing Child Assessment Feeding Scale. At childbirth, the control group mothers showed a higher level of anxiety than the ART-mothers did, but at T2, T3, T4, both groups' parenting stress levels were below threshold. Conversely, ART mothers more frequently provided suitable stimulation for their child's socio-emotional and cognitive development than the control group did. No significant between-group differences were observed in the mothers' capacity to respond to their children's distress, nor in sensitivity to child cues. Both infant groups showed equal ability to send clear signals and to respond to parent-provided care. ART and SP mothers with premature infants showed no differences in degree of emotional burden experienced during the neonatal period. Yet, dyadic interaction was qualitatively better in ART dyads than in SP dyads. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Assisted reproductive technology (ART) cumulative live birth rates following preimplantation genetic diagnosis for aneuploidy (PGD-A) or morphological assessment of embryos: A cohort analysis.

    Science.gov (United States)

    Lee, Evelyn; Chambers, Georgina Mary; Hale, Lyndon; Illingworth, Peter; Wilton, Leeanda

    2017-12-27

    Preimplantation genetic diagnosis for aneuploidy (PGD-A) for all 24 chromosomes improves implantation and clinical pregnancy rates per single assisted reproductive technology (ART) cycle. However, there is limited data on the live-birth rate of PGD-A over repeated cycles. To assess the cumulative live-birth rates (CLBR) of PGD-A compared with morphological assessment of embryos of up to three 'complete ART cycles' (fresh plus frozen/thaw cycles) in women aged 37 years or older. A retrospective cohort study of ART treatments undertaken by ART-naïve women at a large Australian fertility clinic between 2011 and 2014. Cohorts were assigned based on the embryo selection method used in their first fresh cycle [PGD-A, n = 110 women (PGD-A group); morphological assessment of embryos, n = 1983 women (control group)]. CLBR, time to clinical pregnancy and cycles needed to achieve a live birth were measured over multiple cycles. Compared to the control group, the PGD-A group achieved a higher per cycle live-birth rate (14.47% vs 9.12%, P ART cycles', the CLBR was comparable for the two groups (30.90% vs 26.77%, P = 0.34). This is the first study to assess the effectiveness of PGD-A over multiple ART cycles. These real-world findings suggest that PGD-A leads to better outcomes than using morphological assessment alone in women of advanced maternal age. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  14. Assisted reproductive technology and risk of asthma and allergy in the offspring: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Nwaru, Bright I; McCleary, Nicola; Erkkola, Maijaliisa; Kaila, Minna; Virtanen, Suvi M; Sheikh, Aziz

    2016-04-22

    The use of assisted reproductive technology (ART) procedures has increased globally over the last three decades. Recent observational studies suggest that children conceived through ART may be at increased risk of asthma and atopic disease compared with children conceived naturally, but findings are mixed. We aim to synthesise the evidence on the impact of ART on the risk of asthma and atopic disease in the offspring. We will identify relevant studies by searching MEDLINE, EMBASE, Cochrane Library, ISI Web of Science, CINAHL, Scopus, Google Scholar, AMED, Global Health, PsychINFO, CAB International and the WHO Global Health Library from 1978 to 2016. We will locate additional studies through searching databases of the proceedings of international conferences, contacting international experts in the field, and searching the references cited in identified studies. We will include analytic observational studies (cohort studies, case-control studies and cross-sectional studies) that have investigated the impact of any type of ART on offspring's asthma and atopic disease. Screening of identified records, data extraction from eligible studies and risk of bias assessment of eligible studies will be independently undertaken by two reviewers, with arbitration by a third reviewer. The Effective Public Health Practice Project will be employed for risk of bias assessment. Estimates from studies judged to be clinically, methodologically and statistically homogeneous will be synthesised using random-effects meta-analysis. As this study is based solely on the published literature, no ethics approval is required. We will publish our findings in a peer-reviewed scientific journal and present the results at national and international scientific conferences. We will register a detailed protocol for the review with the International Prospective Register of Systematic Reviews (PROSPERO) prior to starting the review. Published by the BMJ Publishing Group Limited. For permission to use

  15. Area under the curve of temporal estrogen and progesterone measurements during assisted reproductive technology: Which hormone is the main determinant of cycle outcome?

    Science.gov (United States)

    Ozkaya, Enis; Kutlu, Tayfun; Abide Yayla, Cigdem; Kayatas Eser, Semra; Sanverdi, Ilhan; Devranoglu, Belgin

    2018-02-01

    Is there any relationship between estrogen and progesterone concentrations during assisted reproductive technology (ART)? Which hormone is the main determinant of impaired endometrial receptivity? This study was conducted from July to December 2016 at the in vitro Fertilization/Intracytoplasmic Sperm Injection unit at Zeynep Kamil Women and Children's Health Training and Research Hospital. A total of 289 women who underwent ART were prospectively screened and areas under the curve of temporal estrogen (AUCEM) and progesterone measurements (AUCPM) were calculated for each participant. Women were included if they had regular menstrual cycles, normal serum prolactin levels and had not received hormone treatment within three months. ART was indicated in all patients for unexplained infertility. Patients were divided into two groups: with (n = 90) and without (n = 199) embryo implantation. The relationship between the two AUCs and ART success was assessed in terms of embryo implantation and clinical pregnancy. Implantation was successful in 90 (31.1%) women, and a fetal heart rate was detected in 83 (28.7%) cases. There was a significant correlation between AUCEM and AUCPM (r = 0.525, P < 0.001). Multivariate regression analysis showed significant associations between failure of implantation, lack of clinical pregnancy and AUCEM (beta coefficient = 0.311, P < 0.001; beta coefficient = 0.297, P < 0.001, respectively) after adjusting for AUCPM. Our data showed that the degree of endometrial estrogen exposure is the main factor functioning as a detrimental effect of ovarian stimulation on endometrial receptivity. © 2017 Japan Society of Obstetrics and Gynecology.

  16. [Results after assisted reproduction at a public fertility clinic].

    Science.gov (United States)

    Hanevik, Hans Ivar; Kahn, Jarl A; Bergh, Anette; Eriksen, Ellen; Friberg, Unn Mette; Haraldsen, Caroline Vegheim; Nilsen, Trine Gullhaug; Sydtveit, Astrid Helene; Rode, Paula

    2012-04-30

    Assisted reproduction is traditionally regarded as effective when it results in a high pregnancy rate per started treatment cycle. For the patients, it is more interesting to know how high the probability is of giving birth during a full course of assisted reproduction treatment. Retrospective series of 546 patients followed for three years of assisted reproduction at a public fertility clinic. During the follow-up period, 347 of the patients (63.6%) gave birth by means of assisted reproduction. Of the 199 remaining patients, 70 (12.8% of 546) stopped treatment because they had completed the three treatment cycles that are covered by public funding. Thirty seven patients (6.8% of 546) conceived without assisted reproduction. Assisted reproduction at public fertility clinics in Norway is as effective as that in our neighbouring countries. Over the past 18 years, the effectiveness of assisted reproduction has increased by about 50%.

  17. Assisted Reproductive Technology (ART) Surveillance

    Data.gov (United States)

    U.S. Department of Health & Human Services — In 1992, Congress enacted the Fertility Clinic Success Rate and Certification Act (FCSRCA). The act requires CDC to collect data from clinics and submit an annual...

  18. Assisted reproductive technology treatment outcomes.

    LENUS (Irish Health Repository)

    Naasan, M

    2012-05-01

    Information on the outcomes of ART treatments in Ireland is not readily available to Irish practitioners. The data for hospital affiliated clinics has been made available for many years and is included in the hospital reports. We present a 10-year analysis of the Irish ART results voluntarily reported by six out of seven IVF clinics. The data was collected from published ESHRE reports and from results (2007-8) not yet published. Data collected included: number of clinics and ART cycles, female age, clinical and multiple pregnancy rates and treatment complications. The clinical pregnancy rate per embryo transfer was 31.7% for IVF and 29.8% for ICSI. The proportion of singleton, twin and triplet deliveries for IVF and ICSI combined was 75%, 23.35% and 1.64%. The rate of ovarian hyperstimulation was 0.8%. ART practice in Ireland is safe, effective and responsible. Financial and societal savings could result from the introduction of state funded IVF with compulsory eSET where recommended.

  19. Fragmented and domesticated bodies in assisted reproduction

    Directory of Open Access Journals (Sweden)

    Martha Ramírez-Gálvez

    2010-01-01

    Full Text Available This article examines the mechanisms producing the meaning of infertility and the new ways of producing life through the use of conceptive reproductive technologies. The normative underpinnings of maternity and/or reproduction are highlighted, as well as the emergence and shaping of this field as a contemporary drive toward the commodification and consumption of biotechnology. Scientific progress, in this case, is incorporated in the techno-embryo, linked to the fetishization of the gene and the assertion of traditional values associated with consanguineous families.

  20. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate.

    Science.gov (United States)

    Racowsky, Catherine; Stern, Judy E; Gibbons, William E; Behr, Barry; Pomeroy, Kimball O; Biggers, John D

    2011-05-01

    To evaluate the validity of collecting day 3 embryo morphology variables into the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). Retrospective. National database-SART CORS. Fresh autologous assisted reproductive technology (ART) cycles from 2006-2007 in which embryos were transferred singly (n=1,020) or in pairs (n=6,508) and embryo morphology was collected. None. Relationship between live birth, maternal age, and morphology of transferred day 3 embryos as defined by cell number, fragmentation, and blastomere symmetry. Logistic multiple regressions and receiver operating characteristic curve analyses were applied to determine specificity and sensitivity for correctly classifying embryos as either failures or successes. Live birth rate was positively associated with increasing cell number up to eight cells (8 cells: 16.2%), but was negatively associated with maternal age, increasing fragmentation, and asymmetry scores. An area under the receiver operating curve of 0.753 (95% confidence interval 0.740-0.766) was derived, with a sensitivity of 45.0%, a specificity of 83.2%, and 76.4% of embryos being correctly classified with a cutoff probability of 0.3. This analysis provides support for the validity of collecting morphology fields for day 3 embryos into SART CORS. Standardization of morphology collections will assist in controlling for embryo quality in future database analyses. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. The Potential of Nanotechnology in Medically Assisted Reproduction

    Directory of Open Access Journals (Sweden)

    Mariana H. Remião

    2018-01-01

    Full Text Available Reproductive medicine is a field of science which searches for new alternatives not only to help couples achieve pregnancy and preserve fertility, but also to diagnose and treat diseases which can impair the normal operation of the reproductive tract. Assisted reproductive technology (ART is a set of methodologies applied to cases related to infertility. Despite being highly practiced worldwide, ART presents some challenges, which still require special attention. Nanotechnology, as a tool for reproductive medicine, has been considered to help overcome some of those impairments. Over recent years, nanotechnology approaches applied to reproductive medicine have provided strategies to improve diagnosis and increase specificity and sensitivity. For in vitro embryo production, studies in non-human models have been used to deliver molecules to gametes and embryos. The exploration of nanotechnology for ART would bring great advances. In this way, experiments in non-human models to test the development and safety of new protocols using nanomaterials are very important for informing potential future employment in humans. This paper presents recent developments in nanotechnology regarding impairments still faced by ART: ovary stimulation, multiple pregnancy, and genetic disorders. New perspectives for further use of nanotechnology in reproductive medicine studies are also discussed.

  2. The effect of a 'vanishing twin' on biochemical and ultrasound first trimester screening markers for Down's syndrome in pregnancies conceived by assisted reproductive technology

    DEFF Research Database (Denmark)

    Gjerris, A C; Loft, A; Pinborg, Anja

    2008-01-01

    BACKGROUND: Previous studies have found that 1 in 10 in vitro fertilization (IVF) singletons originates from a twin gestation. First trimester Down's syndrome screening markers are altered in assisted reproductive techniques (ART) pregnancies compared with spontaneously conceived pregnancies...... not differ from those of other ART singleton pregnancies. In cases where the fetal demise was first diagnosed at the time of the NT scan, it is doubtful whether the serum risk assessment is as precise as it is in singleton ART pregnancies. No difference was seen for NT measurements Udgivelsesdato: 2009/1...

  3. Trends in perinatal health after assisted reproduction

    DEFF Research Database (Denmark)

    Henningsen, Anna-Karina Aaris; Gissler, M.; Skjaerven, R.

    2015-01-01

    to lowering the rate of multiples but also concerning the health of singletons. STUDY FUNDING/COMPETING INTEREST(S) The European Society for Human Reproduction and Embryology (ESHRE), the University of Copenhagen and the Danish Agency for Science, Technology and Innovation has supported the project. The Co......NARTaS group has received travel and meeting funding from the Nordic Federation of Obstetrics and Gynecology (NFOG). None of the authors has any competing interests to declare....

  4. Individualized recombinant human follicle-stimulating hormone dosing using the CONSORT calculator in assisted reproductive technology: a large, multicenter, observational study of routine clinical practice.

    Science.gov (United States)

    Naether, Olaf Gj; Tandler-Schneider, Andreas; Bilger, Wilma

    2015-01-01

    This postmarketing surveillance survey was conducted to investigate the utility of the CONsistency in r-FSH Starting dOses for individualized tReatmenT (CONSORT) calculator for individualizing recombinant human follicle-stimulating hormone (r-hFSH) starting doses for controlled ovarian stimulation (COS) in routine clinical practice. This was a 3-year, open-label, observational study evaluating data from women undergoing COS for assisted reproductive technology at 31 German fertility centers. Physicians stated their recommended r-hFSH starting dose, then generated a CONSORT-recommended r-hFSH starting dose. Physicians could prescribe any r-hFSH starting dose. The primary objective was to compare the r-hFSH starting dose recommended by the physician with the CONSORT-calculated dose and that prescribed. Statistical analyses were conducted post hoc. Data were collected from 2,579 patients; the mean (standard deviation [SD]) age was 30.5 (2.93) years (range: 19-40 years). The mean (SD) CONSORT-calculated r-hFSH starting dose was significantly lower than the physician-recommended dose (134.5 [38.0] IU versus 164.6 [47.1] IU; PCONSORT-calculated doses were prescribed for 27.3% (number [n] =677) of patients, and non-CONSORT-calculated doses prescribed for 72.7% (n=1,800). The mean (SD) number of oocytes retrieved per patient was 10.6 (6.15) and 11.4 (6.66) in the CONSORT and non-CONSORT groups, respectively; the mean (SD) number of embryos transferred per patient was 1.98 (0.41) and 2.03 (0.45), respectively. Clinical pregnancy rates per COS cycle were 38.8% (CONSORT) and 34.8% (non-CONSORT) (P=0.142); clinical pregnancy rates per embryos transferred were 45.0% and 39.5%, respectively (P=0.049). Miscarriage occurred in 14.8% of all clinical pregnancies ( 12.5%; non- 15.3%). The rate of grade 3 ovarian hyperstimulation syndrome (OHSS) was 0.3% (n=2) in the CONSORT group and 0.6% (n=11) in the non-CONSORT group. OHSS led to hospitalization in 0.81% (n=21) of cases (CONSORT

  5. Inter- and intra-individual variation in allele-specific DNA methylation and gene expression in children conceived using assisted reproductive technology.

    Directory of Open Access Journals (Sweden)

    Nahid Turan

    2010-07-01

    Full Text Available Epidemiological studies have reported a higher incidence of rare disorders involving imprinted genes among children conceived using assisted reproductive technology (ART, suggesting that ART procedures may be disruptive to imprinted gene methylation patterns. We examined intra- and inter-individual variation in DNA methylation at the differentially methylated regions (DMRs of the IGF2/H19 and IGF2R loci in a population of children conceived in vitro or in vivo. We found substantial variation in allele-specific methylation at both loci in both groups. Aberrant methylation of the maternal IGF2/H19 DMR was more common in the in vitro group, and the overall variance was also significantly greater in the in vitro group. We estimated the number of trophoblast stem cells in each group based on approximation of the variance of the binomial distribution of IGF2/H19 methylation ratios, as well as the distribution of X chromosome inactivation scores in placenta. Both of these independent measures indicated that placentas of the in vitro group were derived from fewer stem cells than the in vivo conceived group. Both IGF2 and H19 mRNAs were significantly lower in placenta from the in vitro group. Although average birth weight was lower in the in vitro group, we found no correlation between birth weight and IGF2 or IGF2R transcript levels or the ratio of IGF2/IGF2R transcript levels. Our results show that in vitro conception is associated with aberrant methylation patterns at the IGF2/H19 locus. However, very little of the inter- or intra-individual variation in H19 or IGF2 mRNA levels can be explained by differences in maternal DMR DNA methylation, in contrast to the expectations of current transcriptional imprinting models. Extraembryonic tissues of embryos cultured in vitro appear to be derived from fewer trophoblast stem cells. It is possible that this developmental difference has an effect on placental and fetal growth.

  6. Cost-Effectiveness Analysis of the Gonadotropin Treatments HP-hMG and rFSH for Assisted Reproductive Technology in France: A Markov Model Analysis.

    Science.gov (United States)

    Barriere, Paul; Porcu-Buisson, Géraldine; Hamamah, Samir

    2018-02-01

    The objectives of this study were to assess (1) the expected cost of a live birth (LB) after in vitro fertilization with two different gonadotropin treatments [high purified human menopausal gonadotropin (HP-hMG) and recombinant follicle-stimulating hormone (rFSH)] as the single cost variable, and (2) the cost effectiveness of HP-hMG relative to rFSH in the context of the routine practice of assisted reproductive technology (ART) in France. A Markov model was developed to simulate the therapeutic management, the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) courses, and the effects of complications in hypothetical cohorts of 30,000 patients undergoing IVF/ICSI with fresh embryo transfer (up to four attempts) using data from the MERIT and MEGASET clinical trials or from French routine ART practice. The cost per LB was estimated at €12,145 and at €14,247 with HP-hMG and rFSH, respectively, using efficacy data from published clinical trials. The resulting incremental cost-effectiveness ratio (ICER) was - €11,616 per LB. HP-hMG was less expensive by around €15.0 million and more effective by 1289 additional LBs. Using French clinical data, the cost per LB was €16,415 and €18,7531 with HP-hMG and rFSH, respectively. The ICER for HP-hMG versus rFSH was estimated at - €7,719 per LB with a saving of about €8.54 million and 1097 additional LBs. Deterministic sensitivity analyses showed that the main ICER drivers were the LB rate, followed by the total gonadotropin doses. The probabilistic sensitivity analysis indicated that HP-hMG was the dominant strategy in 71.2% of cases using the clinical trial data and in 50.2% of cases using the French data. This analysis indicates that compared with rFSH, HP-hMG is less costly for IVF/ICSI management from the French healthcare payer's viewpoint. The results of the present Markov model analysis are consistent with previous findings in other European countries.

  7. Assisted Reproductive Technology affects developmental kinetics, H19 Imprinting Control Region methylation and H19 gene expression in individual mouse embryos

    Directory of Open Access Journals (Sweden)

    Dandolo Luisa

    2007-10-01

    Full Text Available Abstract Background In the last few years, an increase in imprinting anomalies has been reported in children born from Assisted Reproductive Technology (ART. Various clinical and experimental studies also suggest alterations of embryo development after ART. Therefore, there is a need for studying early epigenetic anomalies which could result from ART manipulations, especially on single embryos. In this study, we evaluated the impact of superovulation, in vitro fertilization (IVF and embryo culture conditions on proper genomic imprinting and blastocyst development in single mouse embryos. In this study, different experimental groups were established to obtain embryos from superovulated and non-superovulated females, either from in vivo or in vitro fertilized oocytes, themselves grown in vitro or not. The embryos were cultured either in M16 medium or in G1.2/G2.2 sequential medium. The methylation status of H19 Imprinting Control Region (ICR and H19 promoter was assessed, as well as the gene expression level of H19, in individual blastocysts. In parallel, we have evaluated embryo cleavage kinetics and recorded morphological data. Results We show that: 1. The culture medium influences early embryo development with faster cleavage kinetics for culture in G1.2/G2.2 medium compared to M16 medium. 2. Epigenetic alterations of the H19 ICR and H19 PP are influenced by the fertilization method since methylation anomalies were observed only in the in vitro fertilized subgroup, however to different degrees according to the culture medium. 3. Superovulation clearly disrupted H19 gene expression in individual blastocysts. Moreover, when embryos were cultured in vitro after either in vivo or in vitro fertilization, the percentage of blastocysts which expressed H19 was higher in G1.2/G2.2 medium compared to M16. Conclusion Compared to previous reports utilizing pools of embryos, our study enables us to emphasize a high individual variability of blastocysts in

  8. Whether G-CSF administration has beneficial effect on the outcome after assisted reproductive technology? A systematic review and meta-analysis.

    Science.gov (United States)

    Zhao, J; Xu, B; Xie, S; Zhang, Q; Li, Y P

    2016-09-22

    Previous studies have explored the effect of granulocyte colony stimulating factor (G-CSF) administration on the outcome of assisted reproductive technology (ART), and came into controversial conclusions. The present meta-analysis aims to assess whether G-CSF administration has beneficial effect on the outcome after ART. The electronic databases Pubmed, Embase and Google Scholar were searched up to May 2016. Articles that studied the effect of G-CSF administration on the outcome after ART were included in the present meta-analysis. Odds ratio (OR) with 95 % confidence interval (95 % CI) were calculated to assess the effect of G-CSF administration on the outcome after ART. The outcomes of interest were implantation rate (IR) and pregnancy rate (PR). Four cohort studies with 1101 embryos transplantation assessed the effect of G-CSF administration on IR and 6 studies with 621 cycles assessed the role of G-CSF administration in PR. Meta-analysis did not found an increased embryo IR in G-CSF administration cycles [OR 1.59 (95 % CI 0.74-3.41). whereas the PR with G-CSF administration was significantly higher compared with cases without G-CSF administration [OR 2.03 (95 % CI 1.19-3.46)]. Additionally, we found that G-CSF administrated subcutaneously resulted in significantly higher PR [OR 3.12 (95 % CI 1.67-5.81)] and IR [OR 2.82 (95 % CI 1.29-6.15)] compared with control group, whereas G-CSF administrated via local uterine infusion had no beneficial effect on the PR [OR 1.42 (95 % CI 0.91-2.24)] and IR [OR 1.10 (95 % CI 0.76-1.60)] after ART. G-CSF administration may have beneficial effect on clinical pregnancy outcome after ART. Subcutaneous injection may be an optimal route of G-CSF administration. Further cohort studies are required to explore the mechanisms undergone the effect and investigate the best route and dose of G-CSF administration.

  9. The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy.

    Science.gov (United States)

    De Neubourg, D; Bogaerts, K; Wyns, C; Albert, A; Camus, M; Candeur, M; Degueldre, M; Delbaere, A; Delvigne, A; De Sutter, P; Dhont, M; Dubois, M; Englert, Y; Gillain, N; Gordts, S; Hautecoeur, W; Lesaffre, E; Lejeune, B; Leroy, F; Ombelet, W; Perrier D'Hauterive, S; Vandekerckhove, F; Van der Elst, J; D'Hooghe, T

    2013-10-01

    What is the effect of a legal limitation of the number of embryos that can be transferred in an assisted reproductive technology (ART) cycle on the multiple delivery rate? The Belgian national register shows that the introduction of reimbursement of ART laboratory costs in July 2003, and the imposition of a legal limitation of the number of embryos transferred in the same year, were associated with a >50% reduction of the multiple pregnancy rate from 27 to 11% between 2003 and the last assessment in 2010, without any reduction of the pregnancy rate per cycle. Individual Belgian IVF centres have published their results since the implementation of the law, and these show a decrease in the multiple pregnancy rate on a centre by centre basis. However, the overall national picture remains unpublished. Cohort study from 1990 to 2010 of all ART cycles in Belgium (2685 cycles in 1990 evolving to 19 110 cycles in 2010), with a retrospective analysis from 1990 to 2000 and prospective online data collection since 2001. Registration evolved from paper written reports per centre to a compulsory online registration of all ART cycles. From 2001 up to mid-2009, data were collected from Excel spread sheets or MS Access files into an MS Access database. Since mid-2009, data collection is done via a remote and secured web-based system (www.belrap.be) where centres can upload their data and get immediate feedback about missing data, errors and inconsistencies. National Belgian registration data show that reimbursement of IVF laboratory costs in July 2003, coupled to a legal limitation in the number of embryos transferred in utero, were associated with a 50% reduction of the multiple pregnancy rate from 27 to 11% without reduction of the pregnancy rate per cycle, and with an increase in the number of fresh and frozen ART cycles due to improved access to treatment. There is potential underreporting of complications of ART treatment, pregnancy outcome and neonatal health. Over the 20

  10. Risk of placenta praevia is linked to endometrial thickness in a retrospective cohort study of 4537 singleton assisted reproduction technology births.

    Science.gov (United States)

    Rombauts, L; Motteram, C; Berkowitz, E; Fernando, S

    2014-12-01

    Is endometrial thickness measured prior to embryo transfer associated with placenta praevia? Following IVF, the risk of placenta praevia is increased 4-fold in women with an endometrial thickness of >12 mm compared with women with an endometrial thickness of women who had 4537 singleton assisted reproduction technology (ART) births occurring between January 2006 and June 2012 with no loss to follow-up. The primary outcome measure was the diagnosis of placenta praevia, made by the treating obstetrician on a transvaginal ultrasound in the third trimester. Women who had singleton births following single embryo transfer performed at Monash IVF in Melbourne, Australia were included. Of the 4537 cycles leading to a singleton ART birth, 2951 were stimulated cycles with fresh embryo transfers; 355 were hormone replacement therapy frozen embryo transfers and 1231 were natural cycles with frozen embryo transfers. The dataset was analysed using binary logistic general estimating equations to calculate odds ratios for placenta praevia adjusted (aOR) for known confounders. The study groups did not differ significantly in age, BMI and aetiologies of infertility prior to IVF treatment. When compared with stimulated cycles, placenta praevia was less common in women undergoing natural cycles with frozen embryo transfers (OR 0.44, 95% confidence interval (CI) 0.27-0.70, P women with an endometrial thickness of women with an endometrial thickness of 9-12 mm had an aOR of 2.02 (95% CI 1.12-3.65, P = 0.02) and women with an endometrial thickness >12 mm had an aOR of 3.74 (95% CI 1.90-7.34, P women with no previous births. The study is retrospective in nature, not all confounders may have been accounted for and details on previous intrauterine surgery, a known risk factor, were not available. In addition, ultrasound assessments were carried out by several highly trained operators measuring the endometrial thickness, the main independent variable, in a two-dimensional plane and some

  11. Mental distress and personality in women undergoing GnRH agonist versus GnRH antagonist protocols for assisted reproductive technology.

    Science.gov (United States)

    Stenbæk, D S; Toftager, M; Hjordt, L V; Jensen, P S; Holst, K K; Bryndorf, T; Holland, T; Bogstad, J; Pinborg, A; Hornnes, P; Frokjaer, V G

    2015-01-01

    Do mental distress and mood fluctuations in women undergoing GnRH agonist and GnRH antagonist protocols for assisted reproductive technology (ART) differ depending on protocol and the personality trait, neuroticism? ART treatment did not induce elevated levels of mental distress in either GnRH antagonist or agonist protocols but neuroticism was positively associated with increased mental distress, independent of protocols. ART treatment may increase mental distress by mechanisms linked to sex hormone fluctuations. General psychological characteristics, such as personality traits indexing negative emotionality, e.g. neuroticism, are likely to affect mental distress during ART treatment. A total of 83 women undergoing their first ART cycle were consecutively randomized 1:1 to GnRH antagonist (n = 42) or GnRH agonist (n = 41) protocol. The study population was a subgroup of a larger ongoing Danish clinical randomized trial and was established as an add-on in the period 2010-2012. Women in the GnRH antagonist protocol received daily injections with recombinant follicle-stimulating hormone, Puregon(®) and subcutaneous injections with GnRH antagonist, Orgalutran(®). Women in the GnRH agonist protocol received nasal administration of the GnRH agonist, Synarela(®) and subcutaneous injections with FSH, Puregon(®). The study design did not allow for a blinding procedure. All women self-reported the Profile of Mood States, the Perceived Stress Scale, the Symptom Checklist-92-Revised, and the Major Depression Inventory questionnaires, at baseline, at ART cycle day 35, on the day of oocyte pick-up, and on the day of hCG testing. Also, a series of Profile of Mood States were reported daily during pharmacological treatment to monitor mood fluctuations. The personality trait Neuroticism was assessed at baseline by the self-reported NEO-PI-R questionnaire. ART did not induce within- or between-protocol changes in any of the applied measures of mental distress. However, the Gn

  12. Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160 000 pregnancies.

    Science.gov (United States)

    Santos-Ribeiro, Samuel; Tournaye, Herman; Polyzos, Nikolaos P

    2016-02-01

    Have the advancement of assisted reproductive technologies (ART) and changes in the incidence of specific causes of infertility-altered ectopic pregnancy (EP) rates following ART over time in the UK? EP rates in the UK following IVF/ICSI have progressively decreased, and this appears to be associated with a reduction in the incidence of tubal factor infertility and the increased use of both a lower number of embryos transferred and extended embryo culture. Historically, EP rates following ART are known to have increased over time. However, the impact of progress in ART procedures and changes in both policy and the incidence of specific causes of infertility on the overall EP rate in the UK has yet to be studied. A population-based retrospective analysis was carried out on all pregnancies following ART cycles carried out in the UK between 2000 and 2012 included in the anonymized database of the Human Fertilisation and Embryology Authority. Overall, 161 967 treatment cycles resulting in a pregnancy were included in the analysis. Among them, 8852 pregnancies occurred after intrauterine insemination (IUI) and 153 115 following IVF/ICSI. During this period of 12 years, ∼1.4% (n = 2244) of all pregnancies following ART were an EP. Crude EP rates were significantly higher after IVF/ICSI when compared with following IUI (1.4 versus 1.1%, P = 0.043). The incidence of EP decreased significantly over time for IVF/ICSI cycles [incidence rate ratios (IRR) 0.96 per year, 95% confidence interval (CI) 0.94-0.97], but not after IUI (IRR 0.96 per year, 95% CI 0.91-1.03).Among pregnancies resulting from IVF/ICSI, multivariable logistic regression analysis demonstrated that the major risk factor for EP was the presence of tubal infertility [adjusted odds ratio (aOR) 2.23, 95% CI 1.93-2.58), followed by the increased number of embryos transferred (aOR 1.29 for 2 versus 1 embryo transferred, 95% CI 1.11-1.49; aOR 1.69 for 3 or more versus 1 embryo transferred, 95% CI 1.35-2.11). The

  13. Assisted reproductive technology and the risk of pregnancy-related complications and adverse pregnancy outcomes in singleton pregnancies: a meta-analysis of cohort studies.

    Science.gov (United States)

    Qin, Jiabi; Liu, Xiaoying; Sheng, Xiaoqi; Wang, Hua; Gao, Shiyou

    2016-01-01

    To determine whether there are any increases in pregnancy-related complications and adverse pregnancy outcomes in singleton pregnancies after assisted reproductive technology (ART) compared with those conceived naturally. Meta-analysis. University-affiliated teaching hospital. Singleton pregnancies conceived with ART and naturally. PubMed, Google Scholar, Cochrane Libraries and Chinese database were searched through March 2015 to identify studies that met pre-stated inclusion criteria. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. Subgroup analysis was performed to explore potential heterogeneity moderators. Pregnancy-related complications and adverse pregnancy outcomes. Fifty cohort studies comprising 161,370 ART and 2,280,241 spontaneously conceived singleton pregnancies were identified. The ART singleton pregnancies had a significantly increased risk of pregnancy-induced hypertension (relative risk [RR] 1.30, 95% confidence interval [CI] 1.04-1.62; I(2) = 79%), gestational diabetes mellitus (RR 1.31, 95% CI 1.13-1.53; I(2) = 6%), placenta previa (RR 3.71, 95% CI 2.67-5.16; I(2) = 72%), placental abruption (RR 1.83, 95% CI 1.49-2.24; I(2) = 22%), antepartum hemorrhage (RR 2.11, 95% CI 1.86-2.38; I(2) = 47%), postpartum hemorrhage (RR 1.29, 95% CI 1.06-1.57; I(2) = 65%), polyhydramnios (RR 1.74, 95% CI 1.24-2.45; I(2) = 0%), oligohydramnios (RR 2.14, 95% CI 1.53-3.01; I(2) = 0%), cesarean sections (RR 1.58, 95% CI 1.48-1.70; I(2) = 92%), preterm birth (RR 1.71, 95% CI 1.59-1.83; I(2)=80%), very preterm birth (RR 2.12, 95% CI 1.73-2.59; I(2) = 90%), low birth weight (RR 1.61, 95% CI 1.49-1.75; I(2) = 80%), very low birth weight (RR 2.12, 95% CI 1.84-2.43; I(2) = 67%), small for gestational age (RR 1.35, 95% CI 1.20-1.52; I(2) = 82%), perinatal mortality (RR 1.64, 95% CI 1.41-1.90; I(2)=45%), and congenital malformation (RR 1.37, 95% CI 1.29-1.45; I(2)=41%). Relevant heterogeneity moderators have been identified

  14. Public and private regulation of reproductive technologies.

    Science.gov (United States)

    Byk, C

    1995-01-01

    Human reproduction is interrelated with privacy. However, in most countries where new reproductive technologies are used public regulations have been passed to provide a legal framework for such technologies. This interference in private life can be justified by the need to control medical intervention in the human reproductive process. But in order to find a balance between public regulations and other social regulations, this article analyses the impact private regulation may have on issues raised by reproductive technologies. It also addresses the issue of the influence of private bodies on the drafting of public regulations.

  15. [Ethical problems of research on medical-assisted reproduction].

    Science.gov (United States)

    Frontali, N; Zucco, F

    1998-01-01

    Research in the field of assisted reproduction technologies (ART) is today very active internationally and is aimed both at improving success chances of already consolidated techniques (in fact these chances are still considerably low), and at elaborating new methods like ICSI (intracytoplasmic sperm injection), oocyte cryoconservation, ovary tissue cultures. Some other techniques, connected to ART, are here considered, like preimplantation diagnosis, early sex determination, gene therapy in utero and cloning. All these subjects of research are here briefly mentioned in relation to the ethical debate which they have stirred or which they should stir according to the authors. These debates are in part mirrored in the different legislations.

  16. Advanced sperm selection techniques for assisted reproduction.

    Science.gov (United States)

    McDowell, Simon; Kroon, Ben; Ford, Emily; Hook, Ysanne; Glujovsky, Demián; Yazdani, Anusch

    2014-10-28

    Assisted reproductive technologies (ART) such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) bring together gametes outside of the body to enhance the probability of fertilisation and pregnancy. Advanced sperm selection techniques are increasingly being employed in ART, most commonly in cycles utilising ICSI. Advanced sperm selection techniques are thought to improve the chance that structurally intact and mature sperm with high DNA integrity are selected for fertilisation. Advanced sperm selection strategies include selection according to surface charge; sperm apoptosis; sperm birefringence; ability to bind to hyaluronic acid; and sperm morphology under ultra-high magnification. These techniques theoretically improve ART outcomes. To evaluate the impact of advanced sperm selection techniques on ART outcomes. Systematic search of electronic databases (Cochrane Menstrual Disorders and Subfertility Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Health Science Information Database (LILACS)), trials registers (ClinicalTrials.gov, Current Controlled Trials, World Health Organization International Clinical Trials Registry Platform), conference abstracts (Web of Knowledge) and grey literature (OpenGrey) for relevant randomised controlled trials. We handsearched the reference lists of included studies and similar reviews. The search was conducted in May 2014. We included randomised controlled trials (RCTs) comparing an advanced sperm selection technique versus standard IVF or ICSI or versus another advanced sperm selection technique. We excluded studies of sperm selection using ultra-high magnification (intracytoplasmic morphologically selected sperm injection, or IMSI), as they are the subject of a separate Cochrane review. Quasi-randomised and pseudo-randomised trials were

  17. Heterotopic pregnancy in an assisted reproduction conception; case ...

    African Journals Online (AJOL)

    Infertility management by assisted reproduction techniques has had rapid increase. While there is robust evidence supporting the efficacy and safety of assisted reproduction technique (ART), complications are encountered. Heterotopic pregnancy, defined as the presence of both an intrauterine and an ectopic gestation, ...

  18. Do assisted-reproduction twin pregnancies require additional antenatal care?

    Science.gov (United States)

    Jauniaux, E; Ben-Ami, I; Maymon, R

    2013-02-01

    Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. Following the birth of the first IVF baby, rumours started to spread in both the medical literature and the media about the long-term health effects for children born following assisted reproduction treatment. However, after more than 30 years, the most common complications associated with IVF treatment remain indirect and technical such as the failure of treatment and ovarian hyperstimulation. Iatrogenic twinning has become the main side-effect of assisted reproduction treatment and the increasing number of twin pregnancies, in particular in older women, has generated numerous debates on the need for additional healthcare provision. In this review, we have evaluated the evidence for additional care that assisted-conception twin pregnancies may require compared with spontaneous twin pregnancies. Twin pregnancies are

  19. Atopic diseases in twins born after assisted reproduction

    DEFF Research Database (Denmark)

    Jäderberg, Ida; Thomsen, Simon F; Kyvik, Kirsten Ohm

    2012-01-01

    Jäderberg I, Thomsen SF, Kyvik KO, Skytthe A, Backer V. Atopic diseases in twins born after assisted reproduction. Paediatric and Perinatal Epidemiology 2012; 26: 140-145. We examined the risk of atopic diseases in twins born after assisted reproduction. Data on atopic diseases and assisted...... reproduction in 9694 twin pairs, 3-20 years of age, from the Danish Twin Registry were collected via multidisciplinary questionnaires. The risk of atopic diseases in twins born after assisted reproduction was compared with the risk in twins born after spontaneous conception using logistic regression...... and variance components analysis. Children born after assisted reproduction did not have a different risk of atopic outcomes (adjusted odds ratios [95% confidence intervals] for asthma: 0.95 [0.85, 1.07], P = 0.403; hay fever: 1.01 [0.86, 1.18], P = 0.918; and atopic dermatitis: 1.02 [0.81, 1.11], P = 0...

  20. The Greek Orthodox position on the ethics of assisted reproduction.

    Science.gov (United States)

    Nikolaos, Metropolitan

    2008-01-01

    In dealing with reproduction, the Church believes that every human being has a beginning but has no end; this is why conception constitutes an event of unique importance. The exact moment of the beginning of life is unknown to man, but the logic of sexual intercourse without reproduction and of reproduction without sexual intercourse must be seen with concern. Irrespective of the way it is conceived, the embryo has both a human beginning and a human perspective and in it, along with cellular multiplication, another process takes place, the beginning and development of its soul. Although modern technology has greatly contributed to health research, its irrational use threatens to desacralize man and to treat him as a machine. For this reason, all modern techniques of artificial fertilization have ethical and spiritual parameters that compel the Church to state Her reservations. The Church cannot recommend assisted reproduction as the solution to infertility; instead, She proposes a non-secularized perception on life that guarantees simplicity, peace, abstinence and mutual trust between spouses. She does not oppose resorting to medical help, but, at the same time, suggests that men and women render their life into the hands of God.

  1. Luteal phase support for assisted reproduction cycles.

    Science.gov (United States)

    van der Linden, Michelle; Buckingham, Karen; Farquhar, Cindy; Kremer, Jan Am; Metwally, Mostafa

    2011-10-05

    Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin (hCG), which is produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques (ART) the progesterone or hCG levels, or both, are low and the natural process is insufficient, so the luteal phase is supported with either progesterone, hCG or gonadotropin releasing hormone (GnRH) agonists. Luteal phase support improves implantation rate and thus pregnancy rates but the ideal method is still unclear. This is an update of a Cochrane Review published in 2004 (Daya 2004). To determine the relative effectiveness and safety of methods of luteal phase support in subfertile women undergoing assisted reproductive technology. We searched the Cochrane Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Database of Abstracts of Reviews of Effects (DARE), LILACS, conference abstracts on the ISI Web of Knowledge, OpenSigle for grey literature from Europe, and ongoing clinical trials registered online. The final search was in February 2011. Randomised controlled trials of luteal phase support in ART investigating progesterone, hCG or GnRH agonist supplementation in in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles. Quasi-randomised trials and trials using frozen transfers or donor oocyte cycles were excluded. We extracted data per women and three review authors independently assessed risk of bias. We contacted the original authors when data were missing or the risk of bias was unclear. We entered all data in six different comparisons. We calculated the Peto odds ratio (Peto OR) for each comparison. Sixty-nine studies with a total of 16,327 women were included. We assessed most of the studies as having an unclear risk of bias, which we interpreted as a high risk

  2. Deficiencies in reporting results of lesbians and gays after donor intrauterine insemination and assisted reproductive technology treatments: a review of the first emerging studies.

    Science.gov (United States)

    Tarín, Juan J; García-Pérez, Miguel A; Cano, Antonio

    2015-05-29

    At a time when increasing numbers of lesbians and gays consider parenthood using reproductive assistance in infertility centers, the present review aims to summarize the results obtained so far by lesbians after intrauterine insemination (IUI) and in-vitro fertilization (IVF) using donor spermatozoa (D-IUI and D-IVF, respectively) and gays entering into gestational-surrogacy programs. Data show that gays display normal semen parameters and lesbians exhibit no specific causes of female infertility except perhaps for polycystic ovary syndrome (PCOS) and some PCOS-related factors. Pair-bonded lesbians entering into D-IUI programs, tend to have higher pregnancy and delivery percentages following spontaneous or induced ovulation than single or pair-bound heterosexual women. The only single study reporting success percentages of lesbians after D-IVF provides, however, puzzling results. In particular, pair-bonded lesbians have lower pregnancy and live-birth percentages than pair-bonded heterosexual women in fresh D-IVF cycles but percentages are similar in frozen/thawed D-IVF cycles. Like in lesbians after D-IUI, surrogate women recruited by pair-bonded gays/single men tend to have higher pregnancy percentages and lower miscarriage percentages than surrogate women recruited by heterosexual couples. Notably, all the reports reviewed in the present study are methodologically flawed because of sampling bias, small sample sizes and inadequate use of statistical methods to control for the effects of influential covariates including age, smoking habits, previous gynecological problems, hormonal stimulation type and protocol, and number of prior treatment types and pregnancies/deliveries. Clinicians, reproductive biologists and editors of fertility/infertility journals should make efforts to prevent these deficiencies in future data reporting.

  3. Effect of maternal height and weight on risk of preterm birth in singleton and twin births resulting from in vitro fertilization: a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcome Reporting System.

    Science.gov (United States)

    Dickey, Richard P; Xiong, Xu; Gee, Rebekah E; Pridjian, Gabriella

    2012-02-01

    To examine the effect of height, weight, and body mass index (BMI) on the risk of preterm birth of singleton and twin pregnancies conceived by vitro fertilization (IVF). Retrospective cohort study using 2006-2008 data from the Society for Reproductive Technology Clinic Outcome Reporting System (SART CORS). SART-associated assisted reproductive technology programs. 56,556 singleton and 23,804 twin live births resulting from fresh nondonor IVF cycles. None. Rates of very early preterm (VEPTB; risk of preterm birth. Maternal overweight and obesity were associated with significantly increased risk of VEPTB and VPTB in twin pregnancies. For very obese women (BMI > 35 kg/m(2)) twins were associated with a threefold increased risk of VEPTB (6.1% vs. 2.0%) and a twofold increased risk of VPTB (11.5% vs. 5.9%) compared with women of normal weight (BMI 18.4-24.9 kg/m(2)). Obesity and short stature significantly increase the risk of VEPTB and VPTB in twins conceived by IVF. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. 21 CFR 884.6190 - Assisted reproductive microscopes and microscope accessories.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction.... Assisted reproduction microscopes and microscope accessories (excluding microscope stage warmers, which are classified under assisted reproduction accessories) are optical instruments used to enlarge images of gametes...

  5. Student Technology Assistant Programs.

    Science.gov (United States)

    Van Eck, Rick; Marvin, Eric; Burr-McNeal, Blake; Jones, Marshall; Lowther, Deborah

    Schools face significant challenges in implementing computing technology within their curriculum. When technology support falters, the integrity of a school district's entire technology program is at risk. Teachers who have invested time to develop lesson plans using technology, especially those who are still newcomers, are less likely to continue…

  6. Health-Related Quality of Life and Primi-Gravid: A Comparative Study of Natural Conception and Conception by Assisted Reproduction Technologies (ARTs

    Directory of Open Access Journals (Sweden)

    Ashraf Kazemi

    2014-07-01

    Full Text Available Background: This study evaluated the impact of body mass index (BMI, total calorie intake and physical activity (PA as energy expenditure related factors on oxidative stress (OS in follicular fluid (FF. Materials and Methods: This prospective study conducted on 219 infertile women. We evaluated patients’ BMI, total calorie intake and PA in their assisted reproduction treatment cycles. Malondialdehyde (MDA and total antioxidant capacity (TAC in pooled FF at oocyte retrieval were additionally assessed. Results: There was no relation between OS biomarkers to total calorie intake and PA. The TAC levels in FF adjusted for age, duration of infertility, etiology of infertility, number of used gonadotrophin and PA showed a positive relation to BMI (p=0.001. The number of used gonadotrophin and PA had a negative relation to duration of infertility (p=0.03 and anovulation disorder as an etiology of infertility. The MDA level in FF had a positive association with anovulation disorder as the etiology of infertility (p=0.02. MDA in FF was unaffected by BMI. Conclusion: Increasing age, BMI and PA do not affect OS in FF. In women with longtime infertility and those with anovulation disorder as an etiology of infertility, decreased potent antioxidant defense in the follicular microenvironment may contribute to ovarian function. Therefore antioxidant supplements may be beneficial