Not Yet a Woman: The Influence of Socio-Political Constructions of Motherhood on Experiences of Female Infertility

2019 ◽  
Vol 50 (3) ◽  
pp. 890-907
Author(s):  
Hannah Wells ◽  
Milena Heinsch
Keyword(s):  
Social Work ◽  
Scoping Review ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
Support Needs ◽  
Infertile Women ◽  
Interdisciplinary Knowledge ◽  
Systemic Factors ◽  
Feminine Ideals

AbstractIn contemporary pronatalist societies, motherhood and childbearing are constructed as inevitable fulfilments of the female identity, resulting in the stigmatisation of women who do not conform to these feminine ‘ideals’. This article reports on the findings of a scoping review, which explored constructions of women and motherhood in Western societies, and how they influence women’s experiences of infertility. Three key themes were identified: (i) the ‘women as mothers’ discourse; (ii) medicalisation and the ‘female biological fault’; and (iii) ‘deviant’ mothers and infertility. While these themes facilitate a deeper understanding of the ways social ideologies can influence the identity and life-course of infertile women, the current literature was found to be overwhelmingly medical in focus, centred on the concept of Assisted Reproductive Technologies. This article aims to expand narrow discourses on female infertility by exploring women’s support needs and the socio-political impacts on their experience. It extends the interdisciplinary knowledge base in this area by considering the contributions social work can make in addressing these systemic factors.

scholarly journals Safety of Ovaleap® (Follitropin Alfa) in Infertile Women Undergoing Superovulation for Assisted Reproductive Technologies: A Multinational Comparative, Prospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sigal Kaplan ◽  
Rachel Levy-Toledano ◽  
Miranda Davies ◽  
Debabrata Roy ◽  
Colin M. Howles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Assisted Reproductive Technologies ◽  
Follicle Stimulating Hormone ◽  
Reproductive Technologies ◽  
Birth Rates ◽  
Infertile Women ◽  
Live Birth Rates ◽  
Follitropin Alfa ◽  
Incidence Proportion

BackgroundOvaleap® (follitropin alfa), a recombinant human follicle stimulating hormone, is a biosimilar medicinal product to Gonal-f® and is used for ovarian stimulation. The main objective of this study was to assess the safety and effectiveness of Ovaleap® compared to Gonal-f® in one treatment cycle in routine clinical practice.MethodsSafety of Ovaleap® Follitropin alfa in Infertile women undergoing superovulation for Assisted reproductive technologies (SOFIA) was a prospective cohort study conducted in six European countries. Eligible patients were infertile women undergoing superovulation for assisted reproductive technology, who were administered Ovaleap® or Gonal-f® for ovarian stimulation and were naïve to follicle stimulating hormone treatment. The recruitment ratio was 1:1. The primary endpoint was incidence proportion of ovarian hyperstimulation syndrome (OHSS) and the secondary endpoint was OHSS severity (Grades I, II, III). The effect of risk factors or potential confounders on the odds ratio for OHSS incidence as well as treatment effect on OHSS incidence was explored using univariate logistic regression. Pregnancy and live birth rates were also assessed.ResultsA total of 408 women who were administered Ovaleap® and 409 women who were administered Gonal-f® were eligible for analysis. The incidence proportion of OHSS was 5.1% (95% CI: 3.4, 7.7) in the Ovaleap® cohort and 3.2% (95% CI: 1.9, 5.4) in the Gonal-f® cohort. This difference in OHSS incidence proportion between the two cohorts was not statistically significant neither before (p = 0.159) nor after univariate adjustment for each potential confounder (p > 0.05). The incidence proportion of OHSS severity grades was similar in the two treatment groups (3.4% versus 2.0% for Grade I, 1.2% versus 1.0% for Grade II, and 0.5% versus 0.2% for Grade III, in the Ovaleap® and Gonal-f® cohorts, respectively), without a significant statistical difference (p = 0.865, for each grade). Among patients who had embryo transfer, clinical pregnancy rates were 33% and 31% and live birth rates were 27% and 26%, in the two cohorts, respectively.ConclusionsFindings from the SOFIA study indicate that the incidence proportions of OHSS and OHSS severity, as well as pregnancy and live birth rates, are similar between Ovaleap® and Gonal-f® treatments and corroborate the safety and effectiveness of Ovaleap® as a biosimilar to Gonal-f®.

Effect of piroxicam administration in infertile women undergoing assisted reproductive technologies: A systematic review and meta-analysis

2021 ◽  
pp. 1-7
Author(s):  
Rehab Abdelhamid Aboshama ◽  
Bassem Aly Islam ◽  
Ahmed Osama Abdel Motaal ◽  
Kareem Labib ◽  
Amr Salah Mohamed Hegab ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assisted Reproductive Technologies ◽  
Meta Analysis ◽  
Reproductive Technologies ◽  
Infertile Women

scholarly journals Corpus luteal contribution to maternal pregnancy physiology and outcomes in assisted reproductive technologies

2013 ◽  
Vol 304 (2) ◽  
pp. R69-R72 ◽  
Author(s):  
Kirk P. Conrad ◽  
Valerie L. Baker
Keyword(s):  
Embryo Transfer ◽  
Assisted Reproductive Technologies ◽  
Plasma Osmolality ◽  
Reproductive Technologies ◽  
Fresh Embryo Transfer ◽  
Pregnant Rats ◽  
Infertile Women ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Donor Eggs

Investigations in the rat model of pregnancy indicate an important role for the corpus luteal (CL) hormone relaxin in the maternal circulatory and osmoregulatory changes in pregnancy, which are epitomized by profound vasodilation and modest hypoosmolality, respectively. In a pilot study of infertile women who became pregnant through donor eggs, in vitro fertilization, and embryo transfer, the gestational rise in glomerular filtration and fall in plasma osmolality were markedly subdued. Because these women were infertile, they lacked a CL and circulating relaxin (and possibly other vasoactive CL hormones). Based on these findings in pregnant rats and women, we hypothesize that infertile women conceiving through donor eggs will have overall subdued circulatory changes (e.g., attenuated reduction in systemic vascular resistance and subdued increase in cardiac output) particularly during early pregnancy when CL hormones predominate before the full development and maturation of the placenta. In contrast, infertile women conceiving by autologous eggs retrieved after ovarian stimulation and fresh embryo transfer may have a relatively hyperdynamic circulation due to the presence of many CL (up to 20 or more) and higher circulating levels of vasodilatory ovarian hormones such as relaxin. Emerging evidence suggests that women undergoing Assisted Reproductive Technologies (ART) have increased risk for adverse pregnancy outcomes such as preeclampsia and small for gestational-age babies. This increased risk may be partly caused by the maternal milieu, which is not physiological in ART pregnancies due to the abnormal status of the CL.

scholarly journals Using Uterine Biophysical Profile as a Predictor of Endometrial Receptivity and Pregnancy in Stimulated IUI Cycles

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Rawaa Saad Hasan Abunayla ◽  
◽  
Lubna Amer Al-Anbari ◽  
Muayad S, Abood ◽  
Huda A. R. Hussaini ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Reproductive Technologies ◽  
Endometrial Receptivity ◽  
Infertile Women ◽  
Biophysical Profile ◽  
The Mean

Implantation failure and disorders of endometrial receptivity represent an essential cause of infertility; multiple parameters were needed to predict the uterine receptivity understanding that no sole parameter could predict the same. A score was termed as (Uterine Biophysical Profile) could be utilized as a predictor of endometrial receptivity. To evaluate the predictive potential of Uterine biophysical profile of both endometrial receptivity and pregnancy outcome in infertile women undergoing Intrauterine Insemination (IUI). The current cross-sectional study was conducted in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in Al Nahrain University, Baghdad, Iraq from the 1st of Oct. 2018 till 1st of May 2019 involving seventy women of infertile couples with the same inclusion and exclusion criteria. Uterine biophysical profile was evaluated using a doppler ultrasound examination and then a score was calculated and correlated to pregnancy outcome. The mean Uterine Artery Pulsatility Index (UAPI) was significantly lower in women with positive pregnancy in comparison to women with negative pregnancy, 2.10±0.19 versus 2.47±0.65, respectively (P=0.032). Moreover, no women with Pulsatility Index (PI) score (0) succeeded to get pregnant and the higher the score, the higher the rate of pregnancy (P=0.006). Furthermore, Spearman correlation showed significant positive correlation between positive pregnancy outcome and UAPI (r=0.365; P=0.002). The mean total score was significantly higher for pregnant women than in women with negative pregnancy, 18.27±1.33 versus 16.35±2.47, respectively (P=0.005). The cutoff value was >17 with an acceptable accuracy level of 74.2. The sensitivity of that cutoff vale was 80 % and the specificity was 65.5%. Uterine artery pulsatility index and total uterine biophysical score are the principal predictors of positive pregnancy outcomes in infertile women undergoing IUI.

scholarly journals Reproductive technologies, female infertility, and the risk of imprinting-related disorders

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Patricia Fauque ◽  
Jacques De Mouzon ◽  
Aviva Devaux ◽  
Sylvie Epelboin ◽  
Marie-José Gervoise-Boyer ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
Global Risk ◽  
Vitro Fertilization ◽  
Increased Risk ◽  
Genomic Imprints

Abstract Background Epidemiological studies suggest that singletons born from assisted reproductive technologies (ART) have a high risk of adverse perinatal outcomes, specifically for imprinting disorders. Because ART processes take place at times when epigenetic reprogramming/imprinting are occurring, there is concern that ART can affect genomic imprints. However, little is currently known about the risk of imprinting defects according to the type of ART or the type of underlying female infertility. From the French national health database, a cohort of 3,501,495 singletons born over a 5-year period (2013–2017) following fresh embryo or frozen embryo transfers (fresh-ET or FET from in vitro fertilization), intrauterine insemination, or natural conception was followed up to early childhood. Based on clinical features, several syndromes/diseases involving imprinted genes were monitored. The effects of ART conception and the underlying cause of female infertility were assessed. Results Compared with infants conceived naturally, children born after fresh-ET had a higher prevalence of imprinting-related diseases, with an aOR of 1.43 [95% CI 1.13–1.81, p = 0.003]. Namely, we observed an increased risk of neonatal diabetes mellitus (1.96 aOR [95% CI 1.43–2.70], p < 0.001). There was an overall independent increase in risk of imprinting diseases for children with mothers diagnosed with endometriosis (1.38 aOR [95% CI 1.06–1.80], p = 0.02). Young and advanced maternal age, primiparity, obesity, smoking, and history of high blood pressure or diabetes were also associated with high global risk. Conclusions This prospective epidemiological study showed that the risk of clinically diagnosed imprinting-related diseases is increased in children conceived after fresh embryo transfers or from mothers with endometriosis. The increased perturbations in genomic imprinting could be caused by controlled ovarian hyperstimulation and potentially endometriosis through the impairment of endometrial receptivity and placentation, leading to epigenetic feto-placental changes. Further studies are now needed to improve understanding of the underlying molecular mechanisms (i.e. genetic or epigenetic causes).

Medical-biological and social significance of female infertility

2020 ◽  
pp. 29-38
Author(s):  
Essedulla M. OSMANOV ◽  
Aleksey Yu. PROKOPOV
Keyword(s):  
Birth Rate ◽  
Family Income ◽  
Assisted Reproductive Technologies ◽  
Pension System ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
High Rate ◽  
Sexual Life ◽  
Social Significance ◽  
Demographic Situation

As a result of the decline in the population, Russia has faced a number of economic and social problems related to the reduction of the working-age population, as well as the need to reform the existing pension system, one of the measures aimed at improving the demographic situation is the increase in the birth rate. The aim of the study is to study the medical, biological and social significance of female infertility on the basis of a literary review. The results of the review showed a high level of infertility both in Russia and around the world. Among the main medical and biological risk factors for female infertility are the high prevalence of harmful habits, the earlier age of entry into sexual life of the high rate of sexually transmitted infections, gynaecological incidence, the high rate of abortion, the postponement of the birth of children to an older age. Social factors include low family income, poor quality of life, poor relationships with spouses and dissatisfaction with sexual intimacy. The increase in the number of families with infertility indicates an increasing need for assisted reproductive technologies. In developed countries, assisted reproductive technologies produce between 0.4 and 4.0 % children. In Russia, 160836 children were born with assisted reproductive technologies from 2007 to 2013, and the contribution of assisted reproductive technologies to annual fertility increased almost 40 times (from 0.04 to 1.55 %). The conclusion: the restoration of women's reproductive health is one of the promising directions in raising the birth rate and restoring the demographic situation.

scholarly journals Live birth after in vitro maturation versus standard in vitro fertilisation for women with polycystic ovary syndrome: protocol for a non-inferiority randomised clinical trial

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035334
Author(s):  
Xiaoying Zheng ◽  
Wei Guo ◽  
Lin Zeng ◽  
Danni Zheng ◽  
Shuo Yang ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Live Birth ◽  
In Vitro Maturation ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Ovary Syndrome ◽  
Infertile Women

IntroductionPolycystic ovary syndrome (PCOS) is the first common cause of anovulatory infertility. Currently, in vitro fertilisation (IVF) is recommended when conventional attempts have failed. In vitro maturation (IVM) of human oocytes is an emerging treatment option in infertile women with PCOS. It is a patient-friendly intervention, avoiding the risk of ovarian hyperstimulation syndrome, which is a serious complication of controlled ovarian stimulation in the standard IVF procedure. We plan a randomised controlled trial (RCT) to evaluate whether IVM is non-inferior to the standard IVF for live birth in women with PCOS.Methods and analysisThis is a single-centre, open-label, non-inferiority RCT performed in a large reproductive medicine centre in China. Infertile women with PCOS will be randomised to receive either IVM or standard IVF in a 1:1 treatment ratio after informed consent. IVF procedures used in our study are all standard treatments and other standard-assisted reproductive technologies will be similar between the two groups. The primary outcome is ongoing pregnancy leading to live birth within 6 months of the first oocyte retrieval cycle after randomisation. Pregnancy outcome, maternal safety and obstetric and perinatal complications will be secondary outcomes. The planned sample size is 350 (175 per group).Ethics and disseminationEthical permission was acquired from the Ethics Committee of Peking University Third Hospital. The results will be issued to publications through scientific journals and conference reports.Trial registration numberNCT03463772.

scholarly journals The Impact of Female Genital Microbiota on Fertility and Assisted Reproductive Treatments

2020 ◽  
Author(s):  
Pedro Brandão ◽  
Manuel Gonçalves-Henriques
Keyword(s):  
Mediterranean Diet ◽  
Assisted Reproductive Technologies ◽  
Smoking Habit ◽  
Reproductive Technologies ◽  
Cross Sectional Study ◽  
Unhealthy Lifestyle ◽  
Cross Sectional ◽  
Infertile Women ◽  
The Mediterranean ◽  
The Impact

Objective: The preconception period is largely neglected, whereas it represents an opportunity to identify and modify clinical and behavioral risks, particularly in infertile women characterized by an unfavorable vascular burden. The present study was performed to strengthen previous findings and to increase the awareness of clinicians who should envision a broader preconception approach in infertile women, beyond their reproductive health. Materials and methods: In this cross-sectional study, we investigated 1003 Caucasian women, referred to the Internal Medicine Clinic at the Assisted Reproductive Technologies Center, Florence. Results: A high prevalence of dyslipidemia (57.4%), overweight/obesity (29.1%) and, smoking habit (26.6%) were found. We provided evidence of unhealthy lifestyle habits, represented by a closer adherence to the Mediterranean diet in the 9.5% only and by a sedentary behavior in 73%. A significant correlation between the Mediterranean Diet score and both anthropometric and metabolic parameters was found. We also observed a lower score adherence with both metabolic syndrome and diabetes (for both p=0.02), but not with hypertension. Conclusion: Before infertility treatment, the correction and the management of modifiable and non-modifiable cardiovascular risk factors are mandatory and represent the main goal for a safe pregnancy, and lifetime women’s health.

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