scholarly journals Never too late? Quadruplets at the age of 65 years

2021 ◽  
Author(s):  
Larry Hinkson ◽  
Christof Dame ◽  
Thorsten Braun ◽  
Irit Nachtigall ◽  
Wolfgang Henrich
Keyword(s):  
Multiple Pregnancy ◽  
Neurodevelopmental Outcome ◽  
Reproductive Technology ◽  
Reproductive Age ◽  
Case Presentation ◽  
Cross Border ◽  
Advanced Reproductive Age ◽  
Post Menopausal ◽  
Donor Eggs

Abstract Background We discuss the challenges of multiple pregnancy at very advanced reproductive age. Case presentation We present the case of a quadruplet pregnancy at the maternal age of 65 following in-vitro fertilization (IVF) with donor eggs and sperm, involving cross-border reproductive care. All children born were at 25 weeks’ gestation and survived; however, poor neurodevelopmental outcome remains a major concern in one child. Conclusions The use of reproductive technology to achieve a multiple pregnancy at such an advanced post-menopausal age generated a debate on ethical, psychosocial and medical questions. We share this debate and highlight the need to reconsider international guidelines for women of advanced reproductive age.

scholarly journals Never too late? - Quadruplets at the age of 65 years

2021 ◽  
Author(s):  
Larry Hinkson ◽  
Christof Dame ◽  
Thorsten Braun ◽  
Irit Nachtigall ◽  
Wolfgang Henrich
Keyword(s):  
Multiple Pregnancy ◽  
Neurodevelopmental Outcome ◽  
Reproductive Technology ◽  
Reproductive Age ◽  
Case Presentation ◽  
Cross Border ◽  
Advanced Reproductive Age ◽  
Post Menopausal ◽  
Donor Eggs

Abstract Background We discuss the challenges of multiple pregnancy at very advanced reproductive age. Case Presentation We present the case of a quadruplet pregnancy at the maternal age of 65 following in-vitro fertilization (IVF) with donor eggs and sperm, involving cross-border reproductive care. All children born were at 25 weeks gestation and survived; however, poor neurodevelopmental outcome remains a major concern in one child. Conclusions The use of reproductive technology to achieve a multiple pregnancy at such an advanced post-menopausal age generated a debate on ethical, psychosocial and medical questions. We share this debate and highlight the need to reconsider international guidelines for women of advanced reproductive age.

scholarly journals Poor ovarian reserve and male infertility in a rural in vitro fertilization setup: a case report

2021 ◽  
Vol 10 (10) ◽  
pp. 4020
Author(s):  
Neha V. Harne ◽  
Vaibhav K. Nadkarni ◽  
Purnima Nadkarni ◽  
Jigna Garasia
Keyword(s):  
Semen Analysis ◽  
Oocyte Quality ◽  
Reproductive Age ◽  
Vitro Fertilization ◽  
Advanced Reproductive Age ◽  
Sperm Chromosomes ◽  
Definition Of ◽  
Poor Ovarian Reserve ◽  
Strict Definition

Female fertility begins to decline many years prior to the onset of menopause despite continued regular ovulatory cycles. Although there is no strict definition of advanced reproductive age in women, infertility becomes more pronounced after the age of 35. In the female, the number of oocytes decreases with age until the menopause. Oocyte quality also diminishes, due in part to increased aneuploidy because of factors such as changes in spindle integrity. Although older male age affects the likelihood of conception, abnormalities in sperm chromosomes and in some components of the semen analysis are less important than the frequency of intercourse. Age is as accurate as any other predictor of conception with assisted reproductive technology.

scholarly journals Recombinant FSH glycoforms are bioactive in mouse preantral ovarian follicles

Reproduction ◽  
2019 ◽  
Vol 158 (6) ◽  
pp. 517-527 ◽  
Author(s):  
Leah E Simon ◽  
Zhenghui Liu ◽  
George R Bousfield ◽  
T Rajendra Kumar ◽  
Francesca E Duncan
Keyword(s):  
Older Women ◽  
Ovarian Follicle ◽  
Expression Patterns ◽  
Reproductive Age ◽  
Reproductive Aging ◽  
Recombinant Fsh ◽  
Younger Women ◽  
Advanced Reproductive Age

Female reproductive aging is characterized by a rise in follicle-stimulating hormone (FSH) levels during peri-menopause. N-linked glycans are co-translationally attached to the Asn7 and Asn24 residues on the FSHβ subunit. Differences in the number of N-glycans on the FSHβ subunit result in distinct glycoforms: hypo-glycosylated (FSH21/18, glycans absent on either Asn24 or Asn7, respectively) or fully-glycosylated (FSH24, glycans present on both Asn7 and Asn24). The relative abundance of FSH glycoforms changes with advanced reproductive age, shifting from predominantly FSH21/18 in younger women to FSH24 in older women. Previous in vitro studies in granulosa cell lines and in vivo studies using Fshb-null mice showed these glycoforms elicit differential bioactivities. However, the direct effects of FSH glycoforms on the mouse ovarian follicle have not yet been determined. In this study, we isolated secondary follicles from pre-pubertal mice and treated them with 20- or 100 ng/mL purified recombinant FSH glycoforms for 1 h or 18–20 h. Analysis of phosphorylated PKA substrates showed that glycoforms were bioactive in follicles following 1-h treatment, although differential bioactivity was only observed with the 100 ng/mL dose. Treatment of follicles with 100 ng/mL of each glycoform also induced distinct expression patterns of FSH-responsive genes as assessed by qPCR, consistent with differential function. Our results, therefore, indicate that FSH glycoforms are bioactive in isolated murine follicles.

Specific characteristics of multiple pregnancies after in vitro fertilization

2020 ◽  
Vol 19 (5) ◽  
pp. 114-123
Author(s):  
S.A. Kalashnikov ◽  
Keyword(s):  
Birth Weight ◽  
In Vitro Fertilization ◽  
Premature Birth ◽  
Multiple Pregnancy ◽  
Research Problem ◽  
Reproductive Age ◽  
Extremely Low Birth Weight ◽  
Multiple Pregnancies ◽  
Vitro Fertilization

Multiple pregnancy is currently considered an important social and research problem, because it is often associated with a number of complications, such as premature birth and extremely low birth weight. Multiple pregnancies are facilitated by late reproductive age of the mother and in vitro fertilization (IVF) with the transfer of several embryos. In this review, we analyze specific characteristics of multiple pregnancies after IVF. Key words: twins, neonatal outcomes, in vitro fertilization

Opting for Twins in In Vitro Fertilization

2016 ◽  
Author(s):  
Bonnie Steinbock
Keyword(s):  
Learning Disabilities ◽  
Multiple Pregnancy ◽  
Reproductive Technology ◽  
Multiple Births ◽  
Fertility Treatment ◽  
Ethical Question ◽  
Multiple Pregnancies ◽  
Vitro Fertilization ◽  
Twin Pregnancies

Multiple births are an unfortunate consequence of assisted reproductive technology, causing risks to both fetuses and pregnant women. The central ethical issue raised by multiple pregnancy is the conflict between the fertility patient’s desire to get pregnant and the increased risks to offspring. Although extreme cases in which many embryos are transferred to the woman’s uterus are very rare—and represent negligence—twin pregnancies are still common. Many women undergoing fertility treatment reportedly express a preference for twin pregnancies to reduce the costs and risks of the procedure while increasing their opportunities for having more than one child. However, risks to the offspring are significant and underappreciated, including prematurity, low birth weight, cerebral palsy, and learning disabilities. Even though many multiple pregnancies result in good outcomes, the ethical question is whether the risks are justifiable in order to improve the chances of pregnancy when transfer of a singleton embryo is an available alternative.

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