scholarly journals The altered immunological status of children conceived by assisted reproductive technology

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xin Xu ◽  
Han Wu ◽  
Yuehong Bian ◽  
Linlin Cui ◽  
Yuanyuan Man ◽  
...  
Keyword(s):  
T Cells ◽  
Assisted Reproductive Technology ◽  
Embryo Transfer ◽  
Reproductive Technology ◽  
Fresh Embryo Transfer ◽  
Potential Health ◽  
Immunological Status ◽  
Cytokine Levels ◽  
Ifn Γ ◽  
The Impact

Abstract Background With the increased use of assisted reproductive technology (ART), assessing the potential health risks of children conceived on ART important to public health. Most research in this area has focused on the effects of ART on perinatal, metabolic, and oncological risks in children. Although an increased risk of immune-related diseases has been reported in children born after ART, there are no studies on the immunological status of these children. This study aimed to evaluate the impact of different embryo transfer methods and fertilization strategies on the immune status of the offspring. Methods A total of 69 children born to women treated with ART and a matched control group of 17 naturally conceived (NC) children, all aged from 3 to 6 years, were recruited in the reproductive hospital affiliated to Shandong University. The frequency of immune cells in the peripheral blood was assayed using flow cytometry; plasma cytokine levels were determined by multiplex cytokine immunoassay with human cytokine magnetic beads. Results Compared to children born after natural conception, children born after ART had elevated interferon-γ (IFN-γ) levels, regardless of embryo transfer and fertilization strategies. Children in the fresh-embryo transfer group had significantly higher IL-4 levels and a lower ratio of IFN-γ to IL-4 than those in the NC group ((P = 0.004, 10.41 ± 5.76 pg/mL vs 18.40 ± 7.01 pg/mL, P = 0.023, 1.00 ± 0.48 vs 0.67 ± 0.32, respectively). Similar results were shown in either the in vitro fertilization (IVF) group or the intra-cytoplasmic sperm injection (ICSI) group (P < 0.05 and P = 0.08 for IVF; P < 0.05 and P < 0.05 for ICSI, respectively). These alterations in IL-4 concentrations and the ratio of IFN-γ to IL-4 were statistically significantly correlated with supra-physical E2 (estradiol) levels on the day of hCG administration (R = 0.502, P = 0.017; R = − 0.537, P = 0.010, respectively). Consistently, the frozen embryo transfer did not result in alterations of these immune indicators in the offspring. Overall, there were no significant differences between the ART group and NC group in the frequencies of T cells, B cells, natural killer (NK) cells, CD4+T cells, CD8+T cells, T helper (TH)1 cells, TH17 cells, and regulatory T (Treg) cells and cytokine levels of IL-10 and IL-17a (all P > 0.05). Conclusions Immunological alterations existed in children born after the use of ART. The elevated E2 levels before embryo implantation contributed to the increased IL-4 levels in children conceived by fresh embryo transfer. The assessment of immunological alteration is of importance to children conceived by ART for early monitoring and intervention.

scholarly journals Clinical Efficacy of Follitropin Alfa in GnRH-Antagonist Protocols: A Prospective Observational Phase IV Study on the Use of Biosimilar Follitropin Alfa r-hFSH in Assisted Reproductive Technology in a Routine Care Setting

2021 ◽  
Author(s):  
Georg Griesinger ◽  
Thilo Schill ◽  
Michael Sator ◽  
Michael Schenk ◽  
Jan-Steffen Krüssel
Keyword(s):  
Assisted Reproductive Technology ◽  
Embryo Transfer ◽  
Care Setting ◽  
Gnrh Antagonist ◽  
Routine Care ◽  
Reproductive Technology ◽  
Fresh Embryo Transfer ◽  
Follitropin Alfa ◽  
Follicular Puncture ◽  
Phase Iv

Background: This phase IV routine care study evaluated ovarian responses when using a biosimilar follitropin alfa r-hFSH (Bemfola®) for controlled ovarian stimulation (COS) in women undergoing assisted reproductive technology (ART) treatment who were pituitary-suppressed with a gonadotrophin-releasing hormone (GnRH) antagonist. Methods: This multicenter, prospective, non-comparative, non-interventional study (Germany/Austria) was conducted with 885 women (Mean age of 34.0±4.4 years) for whom COS with Bemfola® and GnRH-antagonist for pituitary suppression were applied  as part of in vitro fertilization (IVF) treatment with/without intracytoplasmic sperm injection (ICSI) observing routine clinical-practice protocols. Primary endpoint was the number of retrieved cumulus-oocyte-complexes (COCs). Results: Among 986 ART cycles, COS was given for 9.9±1.8 days (First-day r-hFSH dose of 220.7±68.9 IU; mean total dose of 2184.3±837.5 IU). It was revealed that 99.1% of cycles resulted in follicular puncture, with mean of 10.7±6.6 oocytes retrieved. Successful fertilization took place after IVF/ICSI in 93.8% of follicular punctures. Freeze-all was performed in 14.2% of cycles. Fresh embryo transfer was performed in 76.9% of cycles with follicular puncture; mean day of transfer was 3.5±1.3 and average number of transferred embryos was 1.76±0.50. Clinical pregnancy rate was 30.2% of embryo-transfer cycles and 23.4% of started cycles. Sixty-nine reports of ovarian hy-perstimulation syndrome (7.0% of started cycles) were documented. Conclusion: COS with Bemfola® in GnRH-antagonist IVF/ICSI protocols in a routine care setting led to an appropriate ovarian response allowing oocyte retrieval in 99.1% of initiated cases.

scholarly journals The Effect of Male Sexual Abstinence Periods on the Clinical Outcomes of Fresh Embryo Transfer Cycles Following Assisted Reproductive Technology: A Meta-Analysis

2020 ◽  
Vol 14 (4) ◽  
pp. 155798832093375
Author(s):  
Jinhong Li ◽  
Qingquan Shi ◽  
Xiaohong Li ◽  
Junliang Guo ◽  
Long Zhang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technology ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Reproductive Technology ◽  
Sexual Abstinence ◽  
Fresh Embryo Transfer ◽  
Abstinence Period

A sexual abstinence period (SAP) lasting for 2–7 days is recommended before undertaking semen analyses. However, there is no consensus regarding the length of the SAP for couples using assisted reproductive technology (ART). Therefore, a meta-analysis was performed to compare the effect of short SAPs (less than 4 days) and long SAPs (4–7 days) on the clinical outcomes of fresh embryo transfer cycles after ART. A total of four studies were included in the meta-analysis. Although the fertilization rate in short SAP couples was higher than that in long SAP couples, a pooled analysis demonstrated that it was not statistically significant ( p = .09). The implantation rate was, however, significantly higher in short SAP couples ( p = .0001). The pooled analysis revealed that the pregnancy rate was significantly higher in short SAP couples than that in long SAP couples. The overall odds ratio (OR) for the pregnancy rate was 1.44 ( p = .0006). No significant difference in miscarriage rates between the short and long SAP couples was found ( p = .88). The meta-analysis indicates that a shorter abstinence period could result in higher implantation and pregnancy rates for patients undertaking ART treatments.

Assisted reproductive technology practice patterns and the impact of embryo transfer guidelines in the United States

2007 ◽  
Vol 88 (2) ◽  
pp. 275-282 ◽  
Author(s):  
Judy E. Stern ◽  
Marcelle I. Cedars ◽  
Tarun Jain ◽  
Nancy A. Klein ◽  
C. Martin Beaird ◽  
...  
Keyword(s):  
United States ◽  
Assisted Reproductive Technology ◽  
Embryo Transfer ◽  
Practice Patterns ◽  
The United States ◽  
Reproductive Technology ◽  
Technology Practice ◽  
The Impact

scholarly journals Batf3-Dependent Dendritic Cells Promote Optimal CD8 T Cell Responses against Respiratory Poxvirus Infection

2018 ◽  
Vol 92 (16) ◽  
Author(s):  
Pritesh Desai ◽  
Vikas Tahiliani ◽  
Georges Abboud ◽  
Jessica Stanfield ◽  
Shahram Salek-Ardakani
Keyword(s):  
T Cells ◽  
Dendritic Cells ◽  
T Cell ◽  
Vaccinia Virus ◽  
Respiratory Infection ◽  
Host Resistance ◽  
T Cell Responses ◽  
Cell Responses ◽  
Ifn Γ ◽  
The Impact

ABSTRACTRespiratory infection with vaccinia virus (VacV) elicits robust CD8+T cell responses that play an important role in host resistance. In the lung, VacV encounters multiple tissue-resident antigen-presenting cell (APC) populations, but which cell plays a dominant role in priming of virus-specific CD8+effector T cell responses remains poorly defined. We used Batf3−/−mice to investigate the impact of CD103+and CD8α+dendritic cell (DC) deficiency on anti-VacV CD8+T cell responses. We found that Batf3−/−mice were more susceptible to VacV infection, exhibiting profound weight loss, which correlated with impaired accumulation of gamma interferon (IFN-γ)-producing CD8+T cells in the lungs. This was largely due to defective priming since early in the response, antigen-specific CD8+T cells in the draining lymph nodes of Batf3−/−mice expressed significantly reduced levels of Ki67, CD25, and T-bet. These results underscore a specific role for Batf3-dependent DCs in regulating priming and expansion of effector CD8+T cells necessary for host resistance against acute respiratory VacV infection.IMPORTANCEDuring respiratory infection with vaccinia virus (VacV), a member ofPoxviridaefamily, CD8+T cells play important role in resolving the primary infection. Effector CD8+T cells clear the virus by accumulating in the infected lungs in large numbers and secreting molecules such as IFN-γ that kill virally infected cells. However, precise cell types that regulate the generation of effector CD8+T cells in the lungs are not well defined. Dendritic cells (DCs) are a heterogeneous population of immune cells that are recognized as key initiators and regulators of T-cell-mediated immunity. In this study, we reveal that a specific subset of DCs that are dependent on the transcription factor Batf3 for their development regulate the magnitude of CD8+T cell effector responses in the lungs, thereby providing protection during pulmonary VacV infection.

O-196 The impact of providing couples with their IVF-prognosis on the expectations and anxiety of women and men

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Devroe ◽  
K Peeraer ◽  
T D’Hooghe ◽  
J Boivin ◽  
J Vriens ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Mixed Models ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Linear Mixed Models ◽  
Gender Effect ◽  
Prognostic Models ◽  
Fresh Embryo Transfer ◽  
Random Factor ◽  
The Impact

Abstract Study question What is the impact of providing couples with their IVF-prognosis on expectations and anxiety in women and men on the day of embryo transfer? Summary answer Only couples with a less than average IVF-prognosis updated their high expectations and IVF-prognosis was negatively associated with anxiety, especially in women. What is known already Female IVF-patients are known to expect a pregnancy rate per IVF-cycle of no less than 49-55%. Qualitative interviews and a survey showed that well informed women expect unrealistically high pregnancy rates as they think that their (family’s) fertility and their clinic is better than average. Several prognostic models have recently been published. The adapted van Loendersloot model including clinical and laboratory characteristics proved performant for our clinic (AUC=0.74) and was validated internally (Devroe et al, BMJ Open, 2020). The impact of providing couples with their IVF-prognosis on expectations and wellbeing of female and male patients has yet to be studied. Study design, size, duration A prospective survey, questioning a final sample of 148 partnered individuals, completing their 2nd-6th IVF-cycle (2019-2020) in a University clinic, on the days of oocyte aspiration (OA) and fresh embryo transfer (ET). Thirty other partnered individuals declined participation (participation rate=85%) and 26 were excluded due to ET-cancellation. The IVF-prognosis (live birth rate, LBR, per completed IVF-cycle including fresh and frozen ETs from the same ovarian stimulation) was calculated with the adapted van Loendersloot model. Participants/materials, setting, methods Each partner reported their perception of their expected IVF-LBR on a visual analogue scale on the day OA. After being informed on their IVF-prognosis by gynaecologists, they re-rated their expected IVF-LBR and filled out the reliable ‘STAI-State-Anxiety Inventory’ on the day of fresh ET. Linear mixed models, taking account of partnering and assessing the association with gender, explored whether individuals updated their expected IVF-LBR after receiving their IVF-prognosis and whether IVF-prognosis and anxiety were associated. Main results and the role of chance The mean IVF-prognosis was 30.9% (±16.8). The 148 partnered individuals had a mean expected IVF-LBR of 59.1% (±20.0) on the day of OA (no gender effect; p = 0.079). After being informed on their IVF-prognosis (day of ET), women’s and men’s mean expected IVF-LBR was 50.9% (±24.5) and 58.1% (±22.1), respectively (gender effect; p = 0.002). Linear mixed models, including couple and time as random factors, did not show an effect of time on expected IVF-LBRs (p = 0.15). Although women were more likely than men to update their expected IVF-LBR (p = 0.002), the updates were not significantly different from the IVF-LBR expected on the day of OA (p = 0.10). Women were more anxious than men (41.5±10.6 and 21.9±7.2, respectively, p &lt; 0.001) after being given their IVF-prognosis. Linear mixed models, including couple as a random factor, showed an association between IVF-prognosis and anxiety (p = 0.016), especially in women (gender effect; p = 0.004). Subgroup analysis showed that partnered individuals with lower than average prognoses (n = 78) did update their expected IVF-LBR (p = 0.036) while others (n = 70) did not update their expected IVF-LBR (p = 0.761). Among the subgroup with lower prognoses women were more likely to update their expected IVF-LBR than men (p = 0.013), while no gender effect was observed among the subgroup with higher IVF-prognoses (p = 0.078). Limitations, reasons for caution This is an explorative study in preparation of an adequately powered randomized controlled trial, testing whether couples who are informed on their IVF-prognosis update their expected IVF-LBR and whether this causes anxiety, as compared to care as usual in which couples are not informed on their IVF-prognosis. Wider implications of the findings Men and especially women with a less than average prognosis update their IVF-expectations after having received this prognosis which may trigger anxious reactions. These findings should be re-examined in an RCT. Following up the effect of sharing IVF-prognoses on longer-term distress and IVF-discontinuation would be interesting. Trial registration number not applicable

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