scholarly journals Dynamic Large-Scale Server Scheduling for IVF Queuing Network in Cloud Healthcare System

Complexity ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Yafei Li ◽  
Hongfeng Wang ◽  
Li Li ◽  
Yaping Fu
Keyword(s):  
General Hospital ◽  
Healthcare System ◽  
Large Scale ◽  
Queuing Network ◽  
Setup Cost ◽  
Vitro Fertilization ◽  
Penalty Cost ◽  
Traditional Service ◽  
Reward Functions

As one of the most effective medical technologies for the infertile patients, in vitro fertilization (IVF) has been more and more widely developed in recent years. However, prolonged waiting for IVF procedures has become a problem of great concern, since this technology is only mastered by the large general hospitals. To deal with the insufficiency of IVF service capacity, this paper studies an IVF queuing network in an integrated cloud healthcare system, where the two key medical services, that is, egg retrieval and transplantation, are assigned to accomplish in the general hospital, while the routine medical tests are assigned into the community hospital. Based on continuous-time Markov procedure, a dynamic large-scale server scheduling problem in this complicated service network is modeled with consideration of different arrival rates of multiple type of patients and different service capacities of multiple servers that can be defined as doctors of the general hospital. To solve this model, a reinforcement learning (RL) algorithm is proposed, where the reward functions are designed for four conflicting subcosts: setup cost, patient waiting cost, penalty cost for unsatisfied patient personal preferences, and medical cost of patient. The experimental results show that the optimal service rule of each server’s queue obtained by the RL method is significantly superior to the traditional service rule.

Embryo Glue: The Use of Hyaluronan in Embryo Transfer Media

2021 ◽  
Author(s):  
Beth Atkinson ◽  
Emma Woodland
Keyword(s):  
Embryo Transfer ◽  
Large Scale ◽  
Multiple Pregnancy ◽  
Single Embryo Transfer ◽  
Transfer Policy ◽  
Vitro Fertilization ◽  
Meta Analyses ◽  
Detrimental Impact ◽  
Robust Evidence

AbstractEmbryoGlue is available to patients at many in vitro fertilization clinics, usually at an additional cost. The efficacy of hyaluronan-enriched transfer medium (HETM) is supported by moderate quality evidence that indicates a significant improvement in clinical outcomes such as live birth rates for patients, including poorer prognosis women (i.e., maternal age factor [>35 years] and recurrent implantation failure). An increased multiple pregnancy rate has been reported with the use of HETM; therefore, a single embryo transfer policy should be considered in conjunction with the use of EmbryoGlue. There is no evidence to suggest that HETM has any detrimental impact, and therefore the use of HETM in clinics may be justified for a specific demographic of patients. Further robust evidence, in the form of meta-analyses or large-scale randomized controlled trials, is needed to build a sufficient consensus regarding the benefit of hyaluronan supplementation in embryo transfer media.

245 RISK OF TRANSMISSION OF BOVINE LEUKOSIS VIRUS (BLV) USING SEROPOSITIVE BULLS FOR IN VITRO FERTILIZATION EMBRYO PRODUCTION

2016 ◽  
Vol 28 (2) ◽  
pp. 245
Author(s):  
J. Stewart ◽  
M. Rubessa ◽  
K. Polkoff ◽  
S. Lotti ◽  
M. Wheeler
Keyword(s):  
Large Scale ◽  
The United States ◽  
Negative Control ◽  
Pathogen Transmission ◽  
Private Company ◽  
Vitro Fertilization ◽  
Standard Procedures ◽  
Bovine Leukosis ◽  
Bovine Leukosis Virus

Bovine leukosis virus (BLV) is a pathogen that affects the bovine immune system and leads to lymphosarcoma, leukemia, decreased milk production, and increased culling rates in cattle. BLV-infected cattle herds can be found worldwide; in the United States, specifically, 38% of beef herds, 84% of all dairy herds, and 100% of large-scale dairy operation herds are infected (Buehring et al. 2014 Emerg. Infect. Dis. 5, 772–782). The main transmission between cattle in herds is affected leukocytes in blood. Several farm practices, such as dehorning, rectal palpation, and vaccinating can lead to the pathogen transmission. Due to international trade laws and biosecurity concerns, semen from a BLV-positive bull is illegal to sell within certain countries. Prior studies have looked at use of seropositive bulls in AI with little risk in affecting the dam (Burger et al. 2000 AVJR 60, 819). Other studies used semen that was artificially infected with the virus then used for IVF (Bielanski et al. 2000 Vet. Rec. 146, 255–256). The aim of this research was to evaluate naturally infected BLV donor semen using abattoir-derived oocytes and the possible contamination of in vitro-produced (IVP) embryos. Semen was collected and frozen by a private company. Three seropositive bulls and 1 negative control bull were selected. All positive bulls were selected based on availability of seropositive BLV status. Prior to the experiment, all bulls used were evaluated for motility, concentration, and morphology. The negative control was used in prior IVF experiments that produced acceptable results for use in this experiment. Frozen sperm were thawed at 37°C for 40 s and pelleted by centrifugation (25 min at 300 × g) on a Percoll discontinuous gradient (45–80% in Tyrode’s modified medium without glucose and BSA). The matured oocytes were purchased from DeSoto Biosciences (Seymour, TN, USA) and were IVF according to standard procedures (Rubessa et al. 2011 Theriogenology 76, 1347–1355). Using 200 oocytes per replicate, the 3 positive bulls and 1 control bull were allocated 50 oocytes per bull in each replicate. After 20 to 22 h of gametes co-incubation, zygotes were denuded and cultured for 7 days in SOF, followed by the evaluation of embryos (from tight morula until hatching blastocyst). Positive bull #1 produced and tested 48 embryos. Positive bull #2 produced and tested 41 embryos. Positive bull #3 produced and tested 46 embryos. The negative control produced and tested 55 embryos. Embryonic DNA extraction was performed using standard procedures (Sattar et al. 2011 Reprod. Domest. Anim. 46, 1090–1097). Nested PCR followed the Fechner evaluations methods (Fechner et al. 1996 J. Vet. Med. B 43, 621–630). To detect BLV presence, electrophoresis was used with a 2% agarose gel containing 0.1% ethidium bromide. A total of 190 embryos were evaluated that were produced in 3 replicates. All samples analysed showed no evidence of BLV. In conclusion, use of BLV seropositive donor semen showed no transmission of the virus upon IVF of the oocytes.

Large scale results for in-vitro fertilization (IVF) using mild stimulation. Outcome from over 19,000 cycles

2008 ◽  
Vol 90 ◽  
pp. S398
Author(s):  
T. Okimura ◽  
M. Kuwayama ◽  
M. Kikuchi ◽  
T. Segawa ◽  
Y. Takehara ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Large Scale ◽  
Vitro Fertilization ◽  
Mild Stimulation

scholarly journals Low sperm to egg ratio required for successful in vitro fertilization in a pair-spawning teleost, Senegalese sole ( Solea senegalensis )

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Sandra Ramos-Júdez ◽  
Wendy Ángela González-López ◽  
Jhons Huayanay Ostos ◽  
Noemí Cota Mamani ◽  
Carlos Marrero Alemán ◽  
...  
Keyword(s):  
Large Scale ◽  
Reproductive Behaviour ◽  
Poor Quality ◽  
Solea Senegalensis ◽  
Hatching Rate ◽  
Senegalese Sole ◽  
Single Male ◽  
Vitro Fertilization ◽  
Breeding Programmes

Cultured Senegalese sole ( Solea senegalensis ) breeders fail to spawn fertilized eggs. The implantation of large-scale in vitro fertilization protocols, to solve this problem, has been frustrated by low production of poor quality sperm. Cultured females were induced to ovulate with a 5 µg kg −1 single injection of gonadotropin-releasing hormone agonist (GnRHa) and viable eggs (82.6 ± 9.2% fertilization) were stripped 41:57 ± 1:46 h after the injection. Sperm was collected from cultured males, diluted in modified Leibovitz and used fresh to fertilize the eggs. Males were not treated with hormones. A nonlinear regression, an exponential rise to a maximum ( R = 0.93, p < 0.0001) described the number of motile spermatozoa required to fertilize a viable egg and 1617 motile spermatozoa were sufficient to fertilize 99 ± 12% (±95% CI) of viable eggs. Similar, spermatozoa egg −1 ratios of 592 ± 611 motile spermatozoa egg −1 were used in large-scale in vitro fertilizations (190 512 ± 38 471 eggs). The sperm from a single male (145 ± 50 µl or 8.0 ± 6.8 × 10 8 spermatozoa) was used to fertilize the eggs. The mean hatching rate was 70 ± 14% to provide 131 540 ± 34 448 larvae per fertilization. The viability of unfertilized eggs stored at room temperature decreased gradually, and the sooner eggs were fertilized after stripping, the higher the viability of the eggs. The collection of sperm directly into a syringe containing modified Leibovitz significantly increased the percentage of motile spermatozoa (33.4 ± 12.2%) compared with other collection methods. The spz egg −1 ratios for Senegalese sole were at the lower end of ratios required for fish. Senegalese sole have a pair-spawning reproductive behaviour characterized by gamete fertilization in close proximity with no sperm competition. The provision of a large-scale in vitro fertilization protocol (200 µl of sperm per 100 ml of eggs) will enable the industry to operate sustainably and implement breeding programmes to improve production.

scholarly journals Poor ovarian response to stimulation for in vitro fertilization

2015 ◽  
Vol 143 (5-6) ◽  
pp. 354-361
Author(s):  
Svetlana Spremovic-Radjenovic ◽  
Jovan Bila ◽  
Aleksandra Gudovic ◽  
Snezana Vidakovic ◽  
Milan Dokic ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Gnrh Agonist ◽  
Ovarian Reserve ◽  
Large Scale ◽  
Gnrh Antagonist ◽  
Poor Responders ◽  
Natural Cycle ◽  
Vitro Fertilization ◽  
Short Period

The term ?poor respond (POR) patients? is used for the group of women who respond badly to usual doses of gonadotropins in in vitro fertilization (IVF) treatments; the consequence is low pregnancy rate. A consensus was reached on the minimal criteria needed to define POR. At least two of the following three features must be present: 1. advanced maternal age (40 years or more) 2. previous POR (3 or less oocytes with a conventional stimulation protocol) 3. abnormal ovarian reserve (AMH 0.5-1.1 ng/ml or AFC 5-7). The aim is to find better therapeutic options for these patients. Increased levels of day 3 follicle stimulating hormone (FSH) and estradiol (E2), as well as decreased levels of anti-M?llerian hormone (AMH) and antral follicle count (AFC), can be used to assess ovarian reserve, as indirect predictive tests. A larger number of well designed, large scale, randomized, controlled trials are needed to assess the efficacy of different management strategies for poor responders: flare up gonadotropin releasing hormone (GnRH) agonist protocols, modified long GnRH agonist mini-dose protocols, luteal initiation GnRH agonist stop protocol, pretreatment with estradiol - GnRH antagonist in luteal phase, natural cycle aspiration or natural cycle aspiration GnRH antagonist controlled, adjuvant therapy with growth hormone or dehydroepiandrosterone (DHEA). The results of up to now used protocols are unsatisfactory and stimulation of the ovulation in poor responders remains a challenge, especially when bearing in mind that in the majority of cases the patients will be menopausal in relatively short period of time.

Progesterone Elevation and Preventive Strategies to Avoid Implantation Failure

2019 ◽  
Vol 37 (05/06) ◽  
pp. 265-272
Author(s):  
Gurkan Bozdag ◽  
Esengul Turkyilmaz ◽  
Sule Yildiz ◽  
Sezcan Mumusoglu ◽  
Hakan Yarali
Keyword(s):  
Large Scale ◽  
Negative Impact ◽  
Ovarian Response ◽  
Pregnancy Rates ◽  
Preventive Strategy ◽  
Vitro Fertilization ◽  
Thaw Cycle ◽  
Hydroxy Steroid ◽  
Steroid Dehydrogenase

AbstractDespite the wide utilization of gonadotropin-releasing hormone analogs, progesterone elevation (P4E) in the late follicular phase occurs in 5 to 30% of all ovarian stimulation (OS) cycles. Although the detrimental effect of P4E on pregnancy rates in fresh in vitro fertilization cycles is valid in all subsets of cases, higher levels of P4 and a longer duration of P4E may be needed in patients with a hyper-ovarian response in order for a negative impact on pregnancy rates to occur. Available preclinical and clinical data suggest that aggressive OS with high doses of follicle-stimulating hormone might increase 3β-hydroxy steroid dehydrogenase and 17β-hydroxy steroid dehydrogenase enzyme activity in human granulosa cells, which leads to high P4 production and hence a higher amount of leakage to the systemic circulation due to a lack of 17α-hydroxylase enzyme expression in human species. High P4 concentrations appear to alter gene expression in the endometrium; however, caution is necessary regarding its potential effect on oocyte/embryo quality with respect to the role of inherent follicular disruption in some women. In terms of the mechanism of overproduction in P4 synthesis, the main preventive strategy should be avoiding aggressive stimulation. Unfortunately, there is lack of large-scale randomized controlled trials for other approaches, including deferred embryo transfer in the thaw cycle. Since there is a significant inter-assay variability for P4 measurement, it may be wise to recommend that every center should define their own P4E and the level needed for harm to occur based on their own assays and datasets before deciding the best approach.

Legal and Ethical Issues in Newborn Screening

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 894-896
Author(s):  
James E. Bowman
Keyword(s):  
Prenatal Diagnosis ◽  
Newborn Screening ◽  
Supreme Court ◽  
Large Scale ◽  
Ethical Issues ◽  
Screening Program ◽  
Supreme Court Ruling ◽  
Vitro Fertilization ◽  
The Public

The development of techniques for newborn screening and for prenatal diagnosis of sickle hemoglobin and other hemoglobinopathies will have a profound effect on public health policy to a greater extent than did mass population testing that was initiated in the early 1970s. The subject of this conference is newborn screening; however, there is an old aphorism: "One cannot do one thing." Accordingly, when newborn screening for hemoglobinopathies is instituted on a large scale, the public policy consequences will extend far beyond newborn screening. We cannot anticipate all of the effects of such a policy, but some aftermaths may be predicted with near certainty. To understand the possible outcomes of a large-scale newborn screening program for sickle cell disease, some prior court and legislative decisions are pertinent. Legislation, court decisions, state and federal genetics programs, and scholars in the social sciences, humanities, law, medicine, and genetics support discoveries in genetics that now facilitate genetic testing, prenatal diagnosis and selective abortion of fetuses with genetic and other disorders, artificial insemination, and in vitro fertilization. Arguments for and against these procedures are reminiscent of debates about the use of the limited tools of the old eugenics to prevent the birth of children who were considered to be physically, mentally, or socially defective. Some examples of these court and legislative decisions follow: the Supreme Court verdict in Munn v Illinois established that the public interest supercedes the private interests of individuals; Buck v Bell, another Supreme Court ruling, upheld the constitutionality of mandatory sterilization.

scholarly journals A simple and economic protocol for efficient in vitro fertilization using cryopreserved mouse sperm

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259202
Author(s):  
Magdalena Wigger ◽  
Simon E. Tröder ◽  
Branko Zevnik
Keyword(s):  
Mouse Models ◽  
Large Scale ◽  
Cost Effective ◽  
Genetically Engineered ◽  
Vitro Fertilization ◽  
Embryo Freezing ◽  
Fertilization Rates ◽  
Highly Efficient ◽  
Colony Management

The advent of genome editing tools like CRISPR/Cas has substantially increased the number of genetically engineered mouse models in recent years. In support of refinement and reduction, sperm cryopreservation is advantageous compared to embryo freezing for archiving and distribution of such mouse models. The in vitro fertilization using cryopreserved sperm from the most widely used C57BL/6 strain has become highly efficient in recent years due to several improvements of the procedure. However, purchase of the necessary media for routine application of the current protocol poses a constant burden on budgetary constraints. In-house media preparation, instead, is complex and requires quality control of each batch. Here, we describe a cost-effective and easily adaptable approach for in vitro fertilization using cryopreserved C57BL/6 sperm. This is mainly achieved by modification of an affordable commercial fertilization medium and a step-by-step description of all other necessary reagents. Large-scale comparison of fertilization rates from independent lines of genetically engineered C57BL/6 mice upon cryopreservation and in vitro fertilization with our approach demonstrated equal or significantly superior fertilization rates to current protocols. Our novel SEcuRe (Simple Economical set-up for Rederivation) method provides an affordable, easily adaptable and harmonized protocol for highly efficient rederivation using cryopreserved C57BL/6 sperm for a broad application of colony management in the sense of the 3Rs.

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