ART in Europe, 2016: results generated from European registries by ESHRE†

Abstract STUDY QUESTION What are the reported data on cycles in ART, IUI and fertility preservation (FP) interventions in 2016 as compared to previous years, as well as the main trends over the years? SUMMARY ANSWER The 20th ESHRE report on ART and IUI shows a progressive increase in reported treatment cycle numbers in Europe, with a decrease in the number of transfers with more than one embryo causing a reduction of multiple delivery rates (DR), as well as higher pregnancy rates and DR after frozen embryo replacement (FER) compared to fresh IVF and ICSI cycles, while the outcomes for IUI cycles remained stable. WHAT IS KNOWN ALREADY Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been collected, analysed by the European IVF-monitoring Consortium (EIM) and reported in 19 manuscripts published in Human Reproduction and Human Reproduction Open. STUDY DESIGN, SIZE, DURATION Yearly collection of European medically assisted reproduction (MAR) data by EIM for ESHRE. The data on treatments performed between 1 January and 31 December 2016 in 40 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organizations. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 1347 clinics offering ART services in 40 countries reported a total of 918 159 treatment cycles, involving 156 002 with IVF, 407 222 with ICSI, 248 407 with FER, 27 069 with preimplantation genetic testing, 73 927 with egg donation (ED), 654 with IVM of oocytes and 4878 cycles with frozen oocyte replacement (FOR). European data on IUI using husband/partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 1197 institutions offering IUI in 29 and 24 countries, respectively. A total of 162 948 treatments with IUI-H and 50 467 treatments with IUI-D were included. A total of 13 689 FP interventions from 11 countries including oocyte, ovarian tissue, semen and testicular tissue banking in pre-and postpubertal patients were reported. MAIN RESULTS AND THE ROLE OF CHANCE In 20 countries (18 in 2015) with a total population of approximately 325 million inhabitants, in which all ART clinics reported to the registry, a total of 461 401 treatment cycles were performed, corresponding to a mean of 1410 cycles per million inhabitants (range 82–3088 per million inhabitants). In the 40 reporting countries, after IVF the clinical pregnancy rates (PR) per aspiration and per transfer in 2016 were similar to those observed in 2015 (28.0% and 34.8% vs 28.5% and 34.6%, respectively). After ICSI, the corresponding rates were also similar to those achieved in 2015 (25% and 33.2% vs 26.2% and 33.2%). After FER with own embryos, the PR per thawing is still on the rise, from 29.2% in 2015 to 30.9% in 2016. After ED, the PR per fresh embryo transfer was 49.4% (49.6% in 2015) and per FOR 43.6% (43.4% in 2015). In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 41.5%, 51.9%, 6.2% and 0.4% of all treatments, respectively (corresponding to 37.7%, 53.9%, 7.9% and 0.5% in 2015). This resulted in a proportion of singleton, twin and triplet DRs of 84.8%, 14.9% and 0.3%, respectively (compared to 83.1%, 16.5% and 0.4%, respectively in 2015). Treatments with FER in 2016 resulted in twin and triplet DR of 11.9% and 0.2%, respectively (vs 12.3% and 0.3% in 2015). After IUI, the DRs remained similar at 8.9% after IUI-H (7.8% in 2015) and at 12.4% after IUI-D (12.0% in 2015). Twin and triplet DRs after IUI-H were 8.8% and 0.3%, respectively (in 2015: 8.9% and 0.5%) and 7.7% and 0.4% after IUI-D (in 2015: 7.3% and 0.6%). The majority of FP interventions included the cryopreservation of ejaculated sperm (n = 7877 from 11 countries) and of oocytes (n = 4907 from eight countries). LIMITATIONS, REASONS FOR CAUTION As the methods of data collection and levels of completeness of reported data vary among European countries, the results should be interpreted with caution. A number of countries failed to provide adequate data about the number of initiated cycles and deliveries. WIDER IMPLICATIONS OF THE FINDINGS The 20th ESHRE report on ART and IUI shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Being already the largest data collection on MAR in Europe, continuous efforts to stimulate data collection and reporting strive for future quality control of the data, transparency and vigilance in the field of reproductive medicine. STUDY FUNDING/COMPETING INTEREST(S) The study has no external funding and all costs were covered by ESHRE. There are no competing interests.

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O-042 Assisted Reproductive Technology (ART) in Europe 2018 and development of a strategy of vigilance. preliminary results generated from european registers by ESHRE

Human Reproduction ◽

10.1093/humrep/deab126.041 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

C Wyns ◽

CH De Geyter ◽

C Calhaz-Jorge ◽

MS Kupka ◽

T Motrenko ◽

...

Keyword(s):

Data Collection ◽

Fertility Preservation ◽

Ovarian Tissue ◽

Testicular Tissue ◽

European Countries ◽

Human Reproduction ◽

Fresh Embryo Transfer ◽

Preimplantation Genetic Testing ◽

Continuous Increase ◽

Reported Data

Abstract Study question What are the reported data on cycles in ART, IUI and fertility preservation interventions in 2018 as compared to previous years, as well as the main trends over the years? Summary answer AUTHOR: The 22th ESHRE report on ART and IUI shows a progressive increase in reported treatment cycle numbers in Europe, a small decrease in the number of transfers (IVF + ICSI) with more than one embryo with a trend to decreasing multiple delivery rates, higher pregnancy and delivery rates after FER compared to fresh IVF and ICSI cycles, and outcomes for IUI cycles similar to previous years. What is known already Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been collected, analysed by the European IVF-monitoring Consortium (EIM) and reported in 21 manuscripts published in Human Reproduction and Human Reproduction Open. Study design, size, duration Yearly collection of European medically assisted reproduction (MAR) data by EIM for ESHRE. The data on treatments performed between January 1 and December 31 2018 in 34 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organisations. Participants/materials, setting, methods In all, 1004 clinics offering ART services in 34 countries reported a total of 827 545 treatment cycles, involving 132 332 with IVF, 342 589 with ICSI, 260 013 with frozen embryo replacement (FER), 44 854 with preimplantation genetic testing (PGT), 42 869 with egg donation (ED), 406 with IVM of oocytes and 4482 cycles with frozen oocyte replacement (FOR). European data on IUI using husband/partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 783 institutions offering IUI in 24 and 20 countries, respectively. A total of 132 624 treatments with IUI-H and 43 140 treatments with IUI-D were included. A total of 12 609 fertility preservation (FP) interventions from 13 countries including oocyte, ovarian tissue, semen and testicular tissue banking in pre-and postpubertal patients were reported. Main results and the role of chance In total, 1004 IVF clinics participated (93.4% of registered clinics in the participating countries). Next to these also 783 IUI units reported their data. In the 34 reporting countries, after IVF the clinical pregnancy rates (PR) per aspiration and per transfer in 2018 were similar to those observed in 2017 (28.7% and 41.6% versus 29.4% and 39.0%, respectively). After ICSI the corresponding rates were also similar to those achieved in 2017 (26.3% en 40.9% versus 27.3% and 40.2%). After FER with own embryos the PR per thawing is still on the rise, from 30.2% in 2017 to 33.0% in 2018. After ED the PR per fresh embryo transfer was 49.8% (49.2% in 2017) and per FOR 39.6% (43.3% in 2017). In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 51.1%, 45.4%, 3.4% and 0.1% of all treatments, respectively (corresponding to 46.0%, 49.2%, 4.5% and 0.3% in 2017). This resulted in a proportion of singleton, twin and triplet DRs of 86.9%, 12.8% and 0.3%, respectively (compared to 85.5%, 14.2% and 0.3%, respectively in 2017). Treatments with FER in 2017 resulted in twin and triplet DR of 9.3% and 0.1%, respectively (versus 11.2% and 0.2% in 2017). After IUI, the DRs remained similar at 9.1% after IUI-H (8.9% in 2017) and at 12.3% after IUI-D (12.4% in 2017). Twin and triplet DRs after IUI-H were 8.4% and 0.3%, respectively (in 2017: 8.1% and 0.3%) and 6.7% and 0.2% after IUI-D (in 2017: 6.9% and 0.2%). The majority of FP interventions included the cryopreservation of ejaculated sperm (n = 8 257 from 13 countries) and of oocytes (n = 3230 from 13 countries). Limitations, reasons for caution As the methods of data collection and levels of completeness of reported data vary among European countries, the results should be interpreted with caution. For this abstract a number of countries was not able to provide adequate data about the number of centers and initiated cycles and deliveries. Wider implications of the findings The 22nd ESHRE report on ART and IUI shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Being already the largest data collection on MAR in Europe, continuous efforts to stimulate data collection and reporting strive for future quality control and completeness of the data and offer higher transparency and vigilance in the field of reproductive medicine. Trial registration number: Study funding: Funding source:

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ART in Europe, 2015: results generated from European registries by ESHRE†

Human Reproduction Open ◽

10.1093/hropen/hoz038 ◽

2020 ◽

Vol 2020 (1) ◽

Cited By ~ 26

Author(s):

C De Geyter ◽

C Calhaz-Jorge ◽

M S Kupka ◽

C Wyns ◽

E Mocanu ◽

...

Keyword(s):

Data Collection ◽

European Countries ◽

Human Reproduction ◽

Treatment Modalities ◽

Birth Rates ◽

Preimplantation Genetic Testing ◽

Aggregated Data ◽

European Data ◽

Embryo Replacement ◽

Competing Interest

Abstract STUDY QUESTION What are the European trends and developments in ART and IUI in 2015 as compared to previous years? SUMMARY ANSWER The 19th ESHRE report on ART shows a continuing expansion of treatment numbers in Europe, and this increase, the variability in treatment modalities and the rising contribution to the birth rates in most participating countries all point towards the increasing impact of ART on European society. WHAT IS KNOWN ALREADY Since 1997, the ART data generated by national registries have been collected, analysed and reported in 18 manuscripts published in Human Reproduction. STUDY DESIGN, SIZE, DURATION Collection of European data by the European IVF-Monitoring Consortium (EIM) for ESHRE. The data for treatments performed between 1 January and 31 December 2015 in 38 European countries were provided by national registries or on a voluntary basis by clinics or professional societies. PARTICIPANTS/MATERIALS, SETTINGS, METHODS From 1343 institutions in 38 countries offering ART services a total of 849 811 treatment cycles, involving 155 960 with IVF, 385676 with ICSI, 218098 with frozen embryo replacement (FER), 21 041 with preimplantation genetic testing (PGT), 64 477 with egg donation (ED), 265 with IVM and 4294 with FOR were recorded. European data on IUI using husband/partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 1352 institutions offering IUI in 25 countries and 21 countries, respectively. A total of 139 050 treatments with IUI-H and 49 001 treatments with IUI-D were included. MAIN RESULTS AND THE ROLE OF CHANCE In 18 countries (14 in 2014) with a population of approximately 286 million inhabitants, in which all institutions contributed to their respective national registers, a total of 409 771 treatment cycles were performed, corresponding to 1432 cycles per million inhabitants (range: 727–3068 per million). After IVF the clinical pregnancy rates (PRs) per aspiration and per transfer were slightly lower in 2015 as compared to 2014, at 28.5 and 34.6% versus 29.9 and 35.8%, respectively. After ICSI, the corresponding PR achieved per aspiration and per transfer in 2015 were also slightly lower than those achieved in 2014 (26.2 and 33.2% versus 28.4 and 35.0%, respectively). On the other hand, after FER with own embryos the PR per thawing continued to rise from 27.6% in 2014 to 29.2% in 2015. After ED a slightly lower PR per embryo transfer was achieved: 49.6% per fresh transfer (50.3% in 2014) and 43.4% for FOR (48.7% in 2014). The delivery rates (DRs) after IUI remained stable at 7.8% after IUI-H (8.5% in 2014) and at 12.0% after IUI-D (11.6% in 2014). In IVF and ICSI together, 1, 2, 3 and ≥4 embryos were transferred in 37.7, 53.9, 7.9 and in 0.5% of all treatments, respectively (corresponding to 34.9, 54.5, 9.9 and in 0.7% in 2014). This evolution towards the transfer of fewer embryos in both IVF and ICSI resulted in a proportion of singleton, twin and triplet DR of 83.1, 16.5 and 0.4%, respectively (compared to 82.5, 17.0 and 0.5%, respectively, in 2014). Treatments with FER in 2015 resulted in twin and triplet DR of 12.3 and 0.3%, respectively (versus 12.4 and 0.3% in 2014). Twin and triplet delivery rates after IUI-H were 8.9 and 0.5%, respectively (in 2014: 9.5 and 0.3%), and 7.3 and 0.6% after IUI-D (in 2014: 7.7 and 0.3%). LIMITATIONS, REASONS FOR CAUTION The methods of data collection and reporting vary among European countries. The EIM receives aggregated data from various countries with variable levels of completeness. Registries from a number of countries have failed to provide adequate data about the number of initiated cycles and deliveries. As long as incomplete data are provided, the results should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS The 19th EIM report on ART shows a continuing expansion of treatment numbers in Europe. The number of treatments reported, the variability in treatment modalities and the rising contribution to the birth rates in most participating countries point towards the increasing impact of ART on reproduction in Europe. Being the largest data collection on ART worldwide, detailed information about ongoing developments in the field is provided. STUDY FUNDING/COMPETING INTEREST(S) The study has no external funding and all costs are covered by ESHRE. There are no competing interests.

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ESHRE PGT Consortium data collection XVI–XVIII: cycles from 2013 to 2015†

Human Reproduction Open ◽

10.1093/hropen/hoaa043 ◽

2020 ◽

Vol 2020 (4) ◽

Cited By ~ 1

Author(s):

E Coonen ◽

A van Montfoort ◽

F Carvalho ◽

G Kokkali ◽

C Moutou ◽

...

Keyword(s):

Data Collection ◽

Single Gene ◽

Oocyte Retrieval ◽

Blastocyst Stage ◽

Data Sets ◽

Preimplantation Genetic Testing ◽

Testing Technology ◽

Competing Interest ◽

Reported Data ◽

Data Collections

Abstract STUDY QUESTION What are the trends and developments in preimplantation genetic testing (PGT) in 2013–2015 as compared to previous years? SUMMARY ANSWER The main trends observed in the retrospective data collections 2013–2015, representing valuable data on PGT activity in (mainly) Europe, are the increased application of trophectoderm biopsy at the cost of cleavage stage biopsy and the continuing expansion of comprehensive testing technology in PGT for chromosomal structural rearrangements and for aneuploidies (PGT-SR and PGT-A). WHAT IS KNOWN ALREADY Since it was established in 1997, the ESHRE PGT Consortium has been collecting data from international PGT centres. To date, 15 data sets and an overview of the first 10 years of data collections have been published. STUDY DESIGN, SIZE, DURATION Collection of (mainly) European data by the PGT Consortium for ESHRE. The data for PGT cycles performed between 1 January 2013 and 31 December 2015 were provided by participating centres on a voluntary basis. For the collection of cycle, pregnancy and baby data, separate, pre-designed MS Excel tables were used. PARTICIPANTS/MATERIALS, SETTING, METHODS Data were submitted by 59, 60 and 59 centres respectively for 2013, 2014 and 2015 (full PGT Consortium members). Records with incomplete or inconsistent data were excluded from the calculations. Corrections, calculations, figures and tables were made by expert co-authors. MAIN RESULTS AND THE ROLE OF CHANCE For data collection XVI/XVII/XVIII, 59/60/59 centres reported data on 8164/9769/11 120 cycles with oocyte retrieval: 5020/6278/7155 cycles for PGT-A, 2026/2243/2661 cycles for PGT for monogenic/single gene defects, 1039/1189/1231 cycles for PGT-SR and 79/59/73 cycles for sexing for X-linked diseases. From 2013 until 2015, the uptake of biopsy at the blastocyst stage was mainly observed in cycles for PGT-A (from 23% to 36%) and PGT-SR (from 22% to 36%), alongside the increased application of comprehensive testing technology (from 66% to 75% in PGT-A and from 36% to 58% in PGT-SR). LIMITATIONS, REASONS FOR CAUTION The findings apply to the 59/60/59 participating centres and may not represent worldwide trends in PGT. Data were collected retrospectively and no details of the follow-up on PGT pregnancies and babies born were provided. WIDER IMPLICATIONS OF THE FINDINGS Being the largest data collection on PGT worldwide, detailed information about ongoing developments in the field is provided. STUDY FUNDING/COMPETING INTEREST(S) The study has no external funding and all costs are covered by ESHRE. There are no competing interests declared. TRIAL REGISTRATION NUMBER N/A.

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20 years of the European IVF-monitoring Consortium registry: what have we learned? A comparison with registries from two other regions

Human Reproduction ◽

10.1093/humrep/deaa250 ◽

2020 ◽

Vol 35 (12) ◽

pp. 2832-2849

Author(s):

Ch De Geyter ◽

C Wyns ◽

C Calhaz-Jorge ◽

J de Mouzon ◽

A P Ferraretti ◽

...

Keyword(s):

New Zealand ◽

Data Collection ◽

Adverse Events ◽

European Countries ◽

Human Reproduction ◽

Treatment Modalities ◽

Published Data ◽

Data Sets ◽

The Usa ◽

Over Time

Abstract STUDY QUESTION How has the performance of the European regional register of the European IVF-monitoring Consortium (EIM)/European Society of Human Reproduction and Embryology (ESHRE) evolved from 1997 to 2016, as compared to the register of the Centres for Disease Control and Prevention (CDC) of the USA and the Australia and New Zealand Assisted Reproduction Database (ANZARD)? SUMMARY ANSWER It was found that coherent and analogous changes are recorded in the three regional registers over time, with a different intensity and pace, that new technologies are taken up with considerable delay and that incidental complications and adverse events are only recorded sporadically. WHAT IS KNOWN ALREADY European data on ART have been collected since 1997 by EIM. Data collection on ART in Europe is particularly difficult due to its fragmented political and legal landscape. In 1997, approximately 78.1% of all known institutions offering ART services in 23 European countries submitted data and in 2016 this number rose to 91.8% in 40 countries. STUDY DESIGN, SIZE, DURATION We compared the changes in European ART data as published in the EIM reports (2001–2020) with those of the USA, as published by CDC, and with those of Australia and New Zealand, as published by ANZARD. PARTICIPANTS/MATERIALS, SETTING, METHODS We performed a retrospective analysis of the published EIM data sets spanning the 20 years observance period from 1997 to 2016, together with the published data sets of the USA as well as of Australia and New Zealand. By comparing the data sets in these three large registers, we analysed differences in the completeness of the recordings together with differences in the time intervals on the occurrence of important trends in each of them. Effects of suspected over- and under-reporting were also compared between the three registers. X2 log-rank analysis was used to assess differences in the data sets. MAIN RESULTS AND THE ROLE OF CHANCE During the period 1997–2016, the numbers of recorded ART treatments increased considerably (5.3-fold in Europe, 4.6-fold in the USA, 3.0-fold in Australia and New Zealand), while the number of registered treatment modalities rose from 3 to 7 in Europe, from 4 to 10 in the USA and from 5 to 8 in Australia and New Zealand, as published by EIM, CDC and ANZARD, respectively. The uptake of new treatment modalities over time has been very different in the three registers. There is a considerable degree of underreporting of the number of initiated treatment cycles in Europe. The relationship between IVF and ICSI and between fresh and thawing cycles evolved similarly in the three geographical areas. The freeze-all strategy is increasingly being adopted by all areas, but in Europe with much delay. Fewer cycles with the transfer of two or more embryos were reported in all three geographical areas. The delivery rate per embryo transfer in thawing cycles bypassed that in fresh cycles in the USA in 2012, in Australia and New Zealand in 2013, but not yet in Europe. As a result of these changing approaches, fewer multiple deliveries have been reported. Since 2012, the most documented adverse event of ART in all three registers has been premature birth (<37 weeks). Some adverse events, such as maternal death, ovarian hyperstimulation syndrome, haemorrhage and infections, were only recorded by EIM and ANZARD. LIMITATIONS, REASONS FOR CAUTION The methods of data collection and reporting were very different among European countries, but also among the three registers. The better the legal background on ART surveillance, the more complete are the data sets. Until the legal obligation to report is installed in all European countries together with an appropriate quality control of the submitted data the reported numbers and incidences should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS The growing number of reported treatments in ART, the higher variability in treatment modalities and the rising contribution to the birth rates over the last 20 years point towards the increasing impact of ART. High levels of completeness in data reporting have been reached, but inconsistencies and inaccuracies still remain and need to be identified and quantified. The current trend towards a higher diversity in treatment modalities and the rising impact of cryostorage, resulting in improved safety during and after ART treatment, require changes in the organization of surveillance in ART. The present comparison must stimulate all stakeholders in ART to optimize surveillance and data quality assurance in ART. STUDY FUNDING/COMPETING INTEREST(S) This study has no external funding and all costs are covered by ESHRE. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.

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How to increase the value of self-reported health service data by using data linkage: a case study

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1279 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

W Peng ◽

J Maguire ◽

A Hayen ◽

J Adams ◽

D Sibbritt

Keyword(s):

Data Collection ◽

Health Service ◽

Health Services ◽

Stroke Prevention ◽

Data Linkage ◽

Recurrent Stroke ◽

Service Planning ◽

Stroke Survivors ◽

Reported Data

Abstract Background This is a case study for recurrent stroke prevention. Lifestyle factors account for about 80% of the risk of recurrent stroke. Most health services studies examining stroke prevention rely on stroke survivors' self-reported lifestyle behaviour data. How can researchers increase the value of collected self-reported data to provide additional information for more comprehensive assessments? Methods 45 and Up Study is the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. This case study linked self-reported longitudinal lifestyle data in the 45 and Up Study, with corresponding mortality data (i.e. NSW Registry of Births, Deaths and Marriages & NSW Cause of Death Unit Record File) and hospital data (i.e. NSW Admitted Patient Data Collection) via the Centre for Health Record Linkage (CHeReL). The main outcome measures are health services, clinical outcomes, and mortality rates for stroke care. The analyses will include descriptive analysis, multivariate regression analysis, and survival analysis. Results A total of 8410 stroke survivors who participated in the 45 and Up Study were included in this data linkage study. From January 2006 to December 2015, 99249 hospital claims (mean: 13 times admission to hospital per person) and 2656 death registration records have been linked to these participants. The mean age of the stroke survivors was 72 (SD = 11) years, with 56% being males. These results are preliminary and more analyses will be conducted by using quality of life status, clinical diagnosis, comorbidities, and procedures. Conclusions Data linkage enables researchers to generate comprehensive findings on health services studies and gain a more holistic understanding of the determinants and outcomes of stroke prevention with lower data collection costs and less burden on participants. Key messages Data linkage brings about a new opportunity for self-reported data on health services utilisation. It is a cost-effective way to enhance existing self-reported data via the data linkage approach to increase its usefulness for informing health service planning.

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O-034 Infertility treatment law making in Europe: the clash of knowledge, ethics and business

Human Reproduction ◽

10.1093/humrep/deab126.033 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

A Wilinska-Zelek

Keyword(s):

Genetic Diagnosis ◽

Medical Knowledge ◽

Infertility Treatment ◽

Oocyte Donation ◽

European Countries ◽

Human Reproduction ◽

Main Concern ◽

Eligibility Criteria ◽

The Law ◽

Law Making

Abstract text Infertility treatment law making in Europe: the clash of knowledge, ethics and business Today, there is no common European set of rules for Assisted Reproduction Technology (ART). ART is now controlled by legislation in almost all European countries, substantial variations exist within the detail of that legislation. Main legal differences between countries relate to: embryo selection, particularly by genetic screening, embryo freezing and embryo transfer, preimplantation genetic diagnosis (PGD), oocyte donation, anonymity of gamete donors, surrogacy, patient eligibility criteria (eg, sexual orientation, age), reimbursement and state funding. The most complete survey ever of the ART legal and funding framework of 43 European countries was published in the ESHRE medical journal Human Reproduction Open: Calhaz-Jorge C, De Geyter C, Kupka MS, et al. Survey on ART and IUI: Legislation, regulation, funding and registries in European countries. Hum Reprod Open 2020; doi:10.1093/hropen/hoz044. Unfortunately, changes of legislation are so dynamic that much of the information in this article is no longer up-to-date. Lawyers observe that one of the most important rule of law “When the Law ceases to reflect the realities of Life, it is the Law that will Change” does not work in ART. In regard to this matter dominant rule is: “The Law will change only when it ceases to reflect the government’s point of view and lobbyists’ needs”. Modern medical knowledge and the society’s needs are often not the main concern during the law making discussion. The speech discusses the issues related to infertility treatment law making in Europe with a focus of the problem that modern medical knowledge in this process is not taken into account at all. The author diagnoses numerous problem related to determining the border between medical knowledge, ethics and business in law making process. The observed problems will be discussed on selected examples (from Poland, Greece and the United Kingdom) during presentation at the ESHRE on-line 37th Annual Meeting.

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Fertility Preservation

10.2310/obg.19100 ◽

2018 ◽

Author(s):

Chantae S Sullivan-Pyke ◽

Clarisa Gracia

Keyword(s):

Fertility Preservation ◽

Ovarian Tissue ◽

Testicular Tissue ◽

Mature Oocyte ◽

Gonadotropin Releasing Hormone ◽

Oocyte Cryopreservation ◽

Ovarian Tissue Cryopreservation ◽

Embryo Cryopreservation ◽

Gonadotropin Releasing Hormone Agonist ◽

Tissue Cryopreservation

Fertility preservation has becoming increasingly important for patients at risk for gonadal failure, including those needing treatment for cancer or autoimmune conditions, genetic conditions that predispose to gonadal insufficiency, and age-related fertility decline. Embryo cryopreservation and mature oocyte cryopreservation are the standards for fertility preservation in postpubertal women. Ovarian tissue cryopreservation and gonadotropin-releasing hormone agonist use for ovarian suppression are experimental methods that may be offered to patients for whom embryo and/or mature oocyte cryopreservation are not applicable. The cryopreservation of spermatozoa is the standard for fertility preservation in postpubertal males, but testicular tissue cryopreservation may be offered to prepubertal males. This review contains 10 figures, 6 tables and 53 references Key words: controlled ovarian stimulation, embryo cryopreservation, gonadotropin-releasing hormone agonist, in vitro maturation, oocyte cryopreservation, ovarian tissue cryopreservation, sperm extraction, testicular tissue cryopreservation

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The morphology of fetal gonads of spontaneous mouse hermaphrodites

Development ◽

10.1242/dev.52.1.63 ◽

1979 ◽

Vol 52 (1) ◽

pp. 63-78

Author(s):

Wesley K. Whitten ◽

Wesley G. Beamer ◽

Anne Grete Byskov

Keyword(s):

Ovarian Tissue ◽

Testicular Tissue ◽

Male Mice ◽

Left And Right ◽

The Right

The gonads of 107 spontaneous, chromosomal mosaic, day-15 fetal hermaphrodites derived from BALB/cWt strain male mice are described and photographs of seven gonads representative of the major types are presented. There were 16 ovaries, 15 testes, and 183 ovotestes. The ovotestes contained on the average more testicular tissue than ovarian, and the ovarian tissue was more frequently located at the gonad poles, particularly the craniad pole. There was no difference between left and right sides with regard to gonad type, but more pure gonads were found on the left than on the right side (21/10), Meioses were observed throughout the ovarian tissue and also in some testicular cords, particularly in the caudad pole of the gonad. Some meiotic figures contained sex vesicles. The significance of these findings is discussed in relation to several aspects of sexdetermination.

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DIVORCE THROUGH ADMINISTRATIVE PROCEDURE - SOCIAL ARGUMENTS

Jurnalul de Studii Juridice ◽

10.18662/jls/15.3-4/75 ◽

2020 ◽

Vol 15 (3-4) ◽

pp. 54-60

Author(s):

Iulian APOSTU

Keyword(s):

Qualitative Research ◽

Data Collection ◽

Cultural Influences ◽

Divorce Rate ◽

Structured Interview ◽

High Rate ◽

Continuous Increase ◽

Legal Proceedings ◽

Administrative Procedure ◽

General Indicator

Although in Romania the number of divorces is considered to be in a continuous increase, in reality, the data of the National Institute of Statistics show that in Romania, the divorce rate remains constant and in small shares. In 1990, the Romanian divorce rate was 1.42 ‰ and the latest national INS data show a general indicator of 1.39 ‰. The low divorce rate in Romania does not imply, at the same time, a high rate of marital happiness in the Romanian family. With many cultural influences, the condition of being divorced does not enjoy much tolerance, so some of the potential legal separation decisions are obscured by traditional imperatives that block or delay the divorce. However, the new legal proceedings after 2010 regarding the option of legal separation at a notary or before the registrar have created the premise of a simplified divorce that avoids the courts, long and frequent appearances, as well as greater exposure. The study aims to analyze the motivations of individuals for divorce at the notary or the registrar, starting from the dilemma of arguing a simplified legal procedure or a decision related to a better protection of privacy. The paper is based on a qualitative research, the method used being the sociological survey, and the research tool - the semi-structured interview. For the data collection, the technique of non-probabilistic qualitative sampling of convenience was used.

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Mapping Film Programming across Post-War Europe (1952)

Research Data Journal for the Humanities and Social Sciences ◽

10.1163/24523666-00502009 ◽

2020 ◽

Vol 5 (2) ◽

pp. 109-125

Author(s):

Thunnis van Oort ◽

Åsa Jernudd ◽

Kathleen Lotze ◽

Clara Pafort-Overduin ◽

Daniël Biltereyst ◽

...

Keyword(s):

United Kingdom ◽

Data Collection ◽

European Countries ◽

Global Level ◽

Research Projects ◽

Data Set ◽

Aggregated Data ◽

Feature Films ◽

Post War

Abstract This data paper and the data collection from which it emerges aim to present a fully harmonized data set originating in several research projects on post-war cinema programming. The paper will reflect on the collection and structure of this aggregated data set, that consists of titles of feature films screened for public viewing in cinemas in the cities Bari (Italy), Antwerp and Ghent (Belgium), Gothenburg (Sweden), Leicester (United Kingdom) and Rotterdam (Netherlands) for the year 1952. As comparisons of movie-going patterns between European countries are still rare, this paper offers a model for constructing a data set which can be replicated, scaled up and used to compare, contextualize, and eventually theorize practices of cinema-going across countries at a global level.

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