Experiences of women undergoing infertility treatment from embryo transfer until pregnancy test and their conceptualization of their embryo

2021 ◽  
pp. 1-12
Author(s):  
Esra Şahiner ◽  
İlkay Boz
Keyword(s):  
Embryo Transfer ◽  
Infertility Treatment ◽  
Pregnancy Test ◽  
Experiences Of Women

Hope and anxiety: The study of female embodied experience with assisted reproductive technology

2021 ◽  
Vol 7 (2) ◽  
pp. 138-170
Author(s):  
Chengpu Yu ◽  
Wanlin Li ◽  
Mingfen Deng
Keyword(s):  
Assisted Reproductive Technology ◽  
Social Factors ◽  
Cultural Context ◽  
Infertility Treatment ◽  
Reproductive Technology ◽  
The Body ◽  
Local Culture ◽  
Embodied Experience ◽  
Experiences Of Women ◽  
Infertile Patients

Assisted reproductive technology (ART) is hailed as “the holy grail” for infertile patients in the mainstream narrative. The existing studies have clearly demonstrated how external social factors shape how ART is to be used, but they ignore the recipients of the technologies, and especially the experiences of women. Based on an investigation conducted in Z hospital’s reproductive center, this article regards embodiment as the methodological orientation for integrating socio-cultural context with female embodied experience in order to show their bio-social entanglement. As fieldwork evidence indicates, ART in practice is far from simple “hope technology”; instead, it throws women into a paradoxical world in which hope and anxiety coexist. Embodied experience, hope, and anxiety are transmitted through the bodies of women, which reveals the inscription of social-cultural context and technical uncertainty on the female body and, meanwhile, women actively learn strategies by which to cope with the technical uncertainty and moral pressures from local culture (including healing the body, folk religion, etc.), so as to hold onto infertility treatment with hope.

scholarly journals Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033675
Author(s):  
Satoshi Shinohara ◽  
Shuji Hirata ◽  
Kohta Suzuki
Keyword(s):  
Cohort Study ◽  
Multilevel Analysis ◽  
Embryo Transfer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Infertility Treatment ◽  
Growth Trajectories ◽  
Fresh Embryo Transfer ◽  
Intrauterine Growth ◽  
Spontaneous Conception

ObjectivesThis study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories.DesignRetrospective cohort study.SettingA single primary and tertiary medical centre in Japan.ParticipantsThis study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET).InterventionsDifferences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring.Primary outcome measureEstimated fetal weight (EFW) assessed by ultrasound examination.ResultsWe assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW.ConclusionsThis study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth.

O-017 Appeased embryo transfer with hypnosis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
D Lelaidier
Keyword(s):  
Embryo Transfer ◽  
Infertility Treatment ◽  
Solid Support ◽  
Traumatic Experiences ◽  
Medical Procedure ◽  
Home Practice ◽  
Medical File ◽  
Self Confidence ◽  
Back Ground ◽  
Intra Uterine Insemination

Abstract text Objective , We report in this presentation the use for couples undergoing infertility treatment of a new way of accompaniment. Hypnosis associated with learning of self-hypnosis is a solid support to valid an appeased uptake of an infertility program and lower the emotional charge associated with such treatments. Main enhance emotional comfort in couples undergoing infertility treatment. Secondary patients feelings after results of the attempt (whether failure or success), pregnancy rates. Contains During a first meeting family and historical back ground is analyzed as well as medical file and causes for infertility. Then a first specific session is proposed in relation with underlying problems using ericksonian hypnosis. For example sessions using amnesia can be used in patients having had traumatic experiences. Comfort and wellbeing suggestions are used after each hypnosis session. Two other sessions can be proposed at office, one called “the two chests” first one to pack all past failures and second to collect present or past successes regarding all fields. These successes will be resourceful to refer to. The second session will be to enhance self-confidence using contes. In order to enhance autonomy patients are given 4 audio sessions prerecorded to home practice. Three of them are specific to intra uterine insemination or embryo transfer. One is called FIVETE to listen the day before medical procedure, one is called SIMPLE INDUCTION to start just before and throughout the procedure. One to do after procedure at home called DO NOTHING. Patients are called few weeks after the attempt for debrief and results.

P–500 Euploid embryo-transfer reduces advanced maternal age patients’ anxiety in the waiting period before the pregnancy-test

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Forte ◽  
F Faustini ◽  
R Venturella ◽  
E Rania ◽  
E Alviggi ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Maternal Age ◽  
Genetic Diagnosis ◽  
Advanced Maternal Age ◽  
Single Embryo Transfer ◽  
Pregnancy Test ◽  
Waiting Period ◽  
Infertile Women ◽  
The Difference ◽  
Euploid Embryo

Abstract Study question Can PGT-A reduce the anxiety generally experienced by infertile women undergoing IVF in the waiting period between embryo transfer and the pregnancy test? Summary answer PGT-A reduces anxiety in infertile women after embryo transfer, probably due to a gain of confidence in their treatment route. What is known already The waiting period, i.e. the time between embryo-transfer and the pregnancy-test, is considered unpredictable and unmanageable, thus figuring amongst the most stressful steps of an IVF treatment. This is mainly imputable to women’s lost sense of control over the outcome. Uncertainty is in fact a source of fear and elevated distress. PGT-A has been shown to improve live birth rate per embryo transfer and reduce miscarriage rate per clinical pregnancy across several trials and observational studies worldwide, especially in advanced maternal age (AMA) women. Here, we investigated if euploid embryo transfer does involve also lower emotional burden over untested one. Study design, size, duration Prospective observational study evaluating the level of anxiety in the waiting period among women undergoing euploid or untested embryo transfer. Data were collected between September 2019 and September 2020 in a public hospital. A total of 48 infertile women were recruited: 25 undergoing euploid single embryo transfer after trophectoderm biopsy and NGS, and 23 undergoing untested single embryo transfer. Participants/materials, setting, methods To measure the level of anxiety, the two groups completed the STAI (State Trait Anxiety Inventory) questionnaire at two time points: before starting the ovarian stimulation (T0), and at day 8 after embryo transfer (T1). The chosen questionnaire has been previously validated to capture the level of patients’ anxiety during the waiting period. Outcomes of T0 were used to control for individual level state of anxiety at T1. Main results and the role of chance The two groups showed similar reproductive history and sociodemographic characteristics except for female age, which was higher in the PGT-A group (37.7±3.2 yr versus 32.3±2.2 yr in the control). This is due to AMA (maternal age >35 yr) being the main indication to PGT-A. Conversely, the duration of infertility was similar in the two groups (3.8±2.2 yr versus 3.7±1.9 in the control). At T0 all patients showed similar levels of anxiety (46.4 points versus 49.9 in the control, 95%CI of the difference: from –9.97 to 3.03 points, p = 0.3). Remarkably, at T1 instead, the women undergoing euploid embryo transfer showed a significantly decreased level of anxiety with respect to the control (39.9 points versus 53.4; 95% CI of the difference: from –18.26 to –8.69, p < 0.01). This difference remained significant also after controlling for the baseline value at T0, and adjusting for potential confounding factors in a multivariate analysis (adjusted p-value<0.01). Limitations, reasons for caution The sample size is small, yet the study resulted powered enough to reveal the considerable advantage of PGT-A toward the primary outcome. We analysed only the waiting period here. Therefore, data will be collected in the future at subsequent gestational stages, such as when prenatal genetic diagnosis is usually conducted. Wider implications of the findings: Women undergoing PGT-A seem reassured by the technique. This is probably due to the gain of confidence and control derived from an increased expectation of success. From this perspective, assessing women’s wellbeing and attitude towards all different clinical procedures should become a critical part of their treatment. Trial registration number None

Early pregnancy loss in patients with polycystic ovary syndrome after IVM versus standard ovarian stimulation for IVF/ICSI

2020 ◽  
Vol 35 (12) ◽  
pp. 2763-2773
Author(s):  
S Mackens ◽  
L Mostinckx ◽  
P Drakopoulos ◽  
I Segers ◽  
S Santos-Ribeiro ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Embryo Transfer ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
Polycystic Ovary ◽  
Early Pregnancy Loss ◽  
Fresh Embryo Transfer ◽  
Ovary Syndrome ◽  
Pregnancy Test ◽  
Positive Pregnancy Test

Abstract STUDY QUESTION Is the incidence of early pregnancy loss (EPL) in patients with polycystic ovary syndrome (PCOS) higher after IVM of oocytes than after ovarian stimulation (OS) for IVF/ICSI? SUMMARY ANSWER Women with PCOS who are pregnant after fresh embryo transfer have a higher probability of EPL following IVM, but after frozen embryo transfer (FET), no significant difference in the incidence of EPL was observed following IVM compared to OS. WHAT IS KNOWN ALREADY There is conflicting evidence in the current literature with regard to the risk of EPL after IVM of oocytes when compared with OS. Because of the limited sample size in previous studies, the use of different IVM systems and the possible bias introduced by patient characteristics and treatment type, firm conclusions cannot be drawn. STUDY DESIGN, SIZE, DURATION This was a retrospective cohort study evaluating 800 women, with a diagnosis of infertility and PCOS as defined by Rotterdam criteria, who had a first positive pregnancy test after fresh or FET following IVM or OS between January 2010 and December 2017 in a tertiary care academic medical centre. PARTICIPANTS/MATERIALS, SETTING, METHODS Pregnancies after non-hCG triggered IVM following a short course of highly purified human menopausal gonadotropin were compared with those after conventional OS. The primary outcome was EPL, defined as a spontaneous pregnancy loss before 10 weeks of gestation. MAIN RESULTS AND THE ROLE OF CHANCE In total, 329 patients with a positive pregnancy test after IVM and 471 patients with a positive pregnancy test after OS were included. Women who were pregnant after IVM were younger (28.6 ± 3.4 years vs 29.3 ± 3.6 years, P = 0.005) and had higher serum anti-Mullerian hormone levels (11.5 ± 8.1 ng/ml vs 7.2 ± 4.1 ng/ml, P < 0.001) compared to those who were pregnant after OS. The distribution of PCOS phenotypes was significantly different among women in the IVM group compared to those in the OS group and women who were pregnant after OS had previously suffered EPL more often (28% vs 17.6%, P = 0.003). EPL was significantly higher after fresh embryo transfer following IVM compared to OS (57/122 (46.7%) vs 53/305 (17.4%), P < 0.001), while the results were comparable after FET (63/207 (30.4%) vs 60/166 (36.1%), respectively, P = 0.24). In the multivariate logistic regression analysis evaluating fresh embryo transfer cycles, IVM was the only independent factor (adjusted odds ratio (aOR) 4.24, 95% CI 2.44–7.37, P < 0.001)) significantly associated with increased odds of EPL. On the other hand, when the same model was applied to FET cycles, the type of treatment (IVM vs OS) was not significantly associated with EPL (aOR 0.73, 95% CI 0.43–1.25, P = 0.25). LIMITATIONS, REASONS FOR CAUTION The current data are limited by the retrospective nature of the study and the potential of bias due to unmeasured confounders. WIDER IMPLICATIONS OF THE FINDINGS The increased risk of EPL after fresh embryo transfer following IVM may point towards inadequate endometrial development in IVM cycles. Adopting a freeze-all strategy after IVM seems more appropriate. Future studies are needed to ascertain the underlying cause of this observation. STUDY FUNDING/COMPETING INTEREST(S) The Clinical IVM research has been supported by research grants from Cook Medical and Besins Healthcare. All authors declared no conflict of interest. TRIAL REGISTRATION NUMBER N/A.

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