scholarly journals Future developments in assisted reproduction in humans

Reproduction ◽  
2002 ◽  
pp. 171-183 ◽  
Author(s):  
K Hardy ◽  
C Wright ◽  
S Rice ◽  
M Tachataki ◽  
R Roberts ◽  
...  

The advent of human in vitro fertilization (IVF) over 30 years ago has made the oocyte and preimplantation embryo uniquely accessible. This accessibility has given rise to new micromanipulation techniques, such as intracytoplasmic sperm injection for treatment of male infertility, as well as embryo biopsy for preimplantation diagnosis of both genetic disease and aneuploidy, a major cause of early embryo demise and miscarriage. In the UK, average pregnancy rates after IVF and embryo transfer are < 25%, even after transfer of several embryos. Unfortunately, a third of these pregnancies involve multiple gestations. Research is currently focusing on methods to improve IVF success rates while reducing twin and triplet pregnancies and their associated increased morbidity and mortality. One approach is to develop screening methods to identify the most viable embryos, so that transfer of fewer healthy embryos will result in a higher proportion of singleton pregnancies. Screening methods include optimizing culture conditions for prolonged culture and selection of viable blastocysts for transfer, or embryo biopsy and aneuploidy screening. Assisted reproduction is also increasingly important in other branches of medicine: survival rates for cancer sufferers are improving continually and there is now a significant need for approaches to preserve fertility after sterilizing chemo-and radiotherapy treatment. Techniques for cryopreserving male and female gametes or gonadal tissue are being developed, although systems to grow and mature these gametes are in their infancy. Finally, there are also concerns regarding the safety of these new assisted reproductive technologies.

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Bing Qu ◽  
Yunhe Xiong ◽  
Xiaofan Yu ◽  
Jinli Ding ◽  
Jing Weng ◽  
...  

As infertility became a significant public health problem, assisted reproductive technologies (ARTs) were introduced. However, the fertilization rate of in vitro fertilization (IVF) per cycle varied, and patients needed to repeat IVF or change to intracytoplasmic sperm injection (ICSI). Here, 75 couples suffering from female fallopian tubal blockage (tubal group) and 42 spouses beset by male abnormal sperm status (dysspermia group) were recruited. We comprehensively explored the relationship among couples’ clinical factors, follicular metabolites, and IVF/ICSI stepwise outcomes. IVF/ICSI outcomes were affected by follicular metabolites and physical status in both women and men, regardless of which side infertility came from. Particularly, in the tubal group, the energy supporting pathways—glycolysis and pyruvate metabolism—were most essential in follicles, and IVF/ICSI outcomes were also related to sperm parameters. However, in the dysspermia group, in addition to sperm conditions, oocyte quality acted as a compensation for poor sperm quality, for which aminoacyl-tRNA biosynthesis and the related supporting metabolism were critical in the follicular environment, and ultimately played a decisive role in IVF/ICSI outcomes. The respective logistic regression models in combination with selective male sperm parameters, estradiol (E2), follicular alanine, glutamine, glycoprotein, lipid, and acetic acid, were constructed to predict IVF or ICSI outcomes. No matter which sex infertility comes from, factors from both men and women should be considered. The current study provides a feasible option for pre-IVF evaluation, as well as guidance for follow-up clinical intervention to improve IVF/ICSI success rates.


2013 ◽  
Vol 3 (3) ◽  
pp. 219 ◽  
Author(s):  
Amanda Selk ◽  
Timea Belej-Rak ◽  
Heather Shapiro ◽  
Ellen Greenblatt

Background: We performed a retrospective chart review in 2006to review oncology patients’ use of banked semen samples infertility treatments at a tertiary care centre.Methods: From 2002 to 2005, 367 oncology patients bankedsemen. During the same period, 31 patients used banked samplesin 48 treatment cycles. Samples were used for intrauterine insemination(IUI) in 28 cycles and for in vitro fertilization (IVF) withor without intracytoplasmic sperm injection (ICSI) in 20 cycles.Results: Pregnancy rates per cycle were 21% for IUI and 50%for IVF with or without ICSI. Overall, 16 of the 31 couples achieveda pregnancy with assisted reproductive technologies (52%).Conclusion: This data indicates high pregnancy success rates withthe use of banked semen samples from men with cancer.Contexte : Une revue rétrospective de dossiers a été effectuée afind’examiner le recours à des échantillons de sperme provenantde patients cancéreux pour le traitement de l’infertilité dans uncentre de soins tertiaires.Méthodes : Entre 2002 et 2005, des échantillons de spermeprovenant d’un total de 367 patients atteints de cancer ont été misen banque. Durant la même période, 31 patientes ont utilisé ceséchantillons au cours de 48 cycles de traitement. Les échantillonsont été utilisés pour insémination intra-utérine (IIU) lors de28 cycles et pour fertilisation in vitro (FIV) avec ou sans injectionintracytoplasmique de sperme (ICSI) lors de 20 cycles.Résultats : Le taux de grossesse par cycle était de 21 % avecl’IIU et de 50 % pour la FIV avec ou sans ICSI. Au total, 16 des31 patientes sont devenues enceintes (52 %).Conclusion : Ces données montrent des taux élevés de grossesseobtenus par l’utilisation d’échantillons de sperme provenantd’hommes atteints de cancer.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Eric S. Surrey

The assisted reproductive technologies, particularly in vitro fertilization (IVF), represent the most efficient and successful means of overcoming infertility associated with endometriosis. Although older studies suggest that IVF outcomes are compromised in endometriosis patients, more contemporary reports show no differences compared to controls. The exception may be evidence of poorer outcomes and diminished ovarian response in women with advanced disease, particularly those with significant ovarian involvement or prior ovarian surgery. Prolonged pre-IVF cycle suppressive medical therapy, particularly gonadotropin releasing hormone agonists, appears to improve success rates in a subset of endometriosis patients. However, as of yet, there is no diagnostic marker to specifically identify those who would most benefit from this approach. Pre-IVF cycle surgical resection of nonovarian disease has not been consistently shown to improve outcomes with the possible exception of resection of deeply invasive disease, although the data is limited. Precycle resection of ovarian endometriomas does not have benefit and should only be performed for gynecologic indications. Indeed, there is a large body of evidence to suggest that this procedure may have a deleterious impact on ovarian reserve and response. A dearth of appropriately designed trials makes development of definitive treatment paradigms challenging.


2021 ◽  
Vol 22 (16) ◽  
pp. 8574
Author(s):  
Huixia Yang ◽  
Zhi Ma ◽  
Lin Peng ◽  
Christina Kuhn ◽  
Martina Rahmeh ◽  
...  

Epigenetics play a vital role in early embryo development. Offspring conceived via assisted reproductive technologies (ARTs) have a three times higher risk of epigenetic diseases than naturally conceived children. However, investigations into ART-associated placental histone modifications or sex-stratified analyses of ART-associated histone modifications remain limited. In the current study, we carried out immunohistochemistry, chip-sequence analysis, and a series of in vitro experiments. Our results demonstrated that placentas from intra-cytoplasmic sperm injection (ICSI), but not in vitro fertilization (IVF), showed global tri-methylated-histone-H3-lysine-4 (H3K4me3) alteration compared to those from natural conception. However, for acetylated-histone-H3-lysine-9 (H3K9ac) and acetylated-histone-H3-lysine-27 (H3K27ac), no significant differences between groups could be found. Further, sex -stratified analysis found that, compared with the same-gender newborn cord blood mononuclear cell (CBMC) from natural conceptions, CBMC from ICSI-boys presented more genes with differentially enriched H3K4me3 (n = 198) than those from ICSI-girls (n = 79), IVF-girls (n = 5), and IVF-boys (n = 2). We also found that varying oxygen conditions, RNA polymerase II subunit A (Polr2A), and lysine demethylase 5A (KDM5A) regulated H3K4me3. These findings revealed a difference between IVF and ICSI and a difference between boys and girls in H3K4me3 modification, providing greater insight into ART-associated epigenetic alteration.


Temida ◽  
2014 ◽  
Vol 17 (3) ◽  
pp. 49-68
Author(s):  
Ksenija Krickovic-Pele ◽  
Kosana Beker

This paper analyses gender and social controversies of assisted reproductive technologies and the discrimination of childless women in Serbia. Primary goals of this paper are critical analysis of new reproductive technologies phenomenon, discrimination against women without children and critical analysis of the legal framework regulating biomedical assisted reproduction in Serbia from gender studies and feminist methodology perspectives, as well as presentation of the research results on discrimination of childless women. For the purpose of this research the survey and the content analysis have been used. A survey was conducted of 50 female participants in the in vitro fertilization program at the Department for Gynecology and Obstetrics in Novi Sad. The results indicate that the regulations on biomedical assisted reproduction and the criteria for inclusion in the in vitro fertilization program are discriminatory and that women involved in the program feel discriminated against, usually at work and in their own surroundings. The conclusion is that it is necessary to change the regulations governing this area, further work on the elimination of discrimination against childless women and destigmatisation of women and couples that cannot or do not want to have children.


Stanovnistvo ◽  
2004 ◽  
Vol 42 (1-4) ◽  
pp. 45-65
Author(s):  
Mirjana Devedzic

The development of reprogenetics during the last two decades of the XX century has brought a new age of reproduction. The paper surveys different types of reprogenetics in a wider sense, i.e. different assisted reproductive technologies (ART) that include manipulation of female reproductive cell out of a woman's womb. Development of reprogenetics is documented by available quantitative indicators of the number and success of ART procedures in developed countries at the beginning of the XXI century. Since 1978, when the first baby was born from in vitro fertilization, the number of children born that way has reached 1% of all children, and in some countries even over 3%. Moreover, existing documentation is incomplete and does not include all forms of assisted reproduction - in reality, the importance of assisted reproduction is even higher and becomes demographically significant. Hence the paper indicates existing and potential effects of the ART development on the demographic development i.e. on specific demographic aspects of this phenomenon. It also points out the effects on the level of fertility, on the changes of direct fertility determinants, and on the levels of mortality and infant mortality, as well as a new understanding of birth control, the possibility of affecting biological structures, and the changes of the fundaments of marriage and family. Development perspectives of reprogenetics are also being raised in the context of bioethical discussions and indicate ethical dilemmas related to assisted reproduction. Solutions to the dilemmas define the scope of applying new reproductive technologies in the future.


2021 ◽  
Vol 99 (Supplement_1) ◽  
pp. 114-114
Author(s):  
Sebastian Canovas ◽  
Raquel Romar ◽  
Pilar Coy

Abstract Physiological fertilization, and early embryo development, involves dramatic transcriptomic, epigenetic and morphological changes in a short temporal window. During this period gametes and early embryos are surrounded by reproductive fluids (oviductal and uterine), which contain nutrients, growth factors, hormones and extracellular vesicles acting as carriers of DNA, RNA, proteins and other factors with putative roles in intercellular communication. Under in vitro conditions, and in the absence of these fluids, embryos derived from Assisted Reproductive Technologies (ART) reveal transcriptional and epigenetic differences compared with in vivo embryos, which could result in long-term phenotypic consequences in adult life. Therefore, reproductive fluids supplementation in the culture medium offers an alternative to imitate physiological conditions and decrease these consequences. In vitro, oviductal fluid (OF) can modulate capacitation-associated events and sperm-zona pellucida interactions and contribute to the control of polyspermy in pigs. The use of in vitro fertilization media supplemented with reproductive fluids (Natur-IVF) improves embryo quality and blastocysts hatching ability. Moreover, Natur-IVF embryos show expression and methylation patterns closer to in vivo blastocysts. In cows, supplementation of culture media with reproductive fluids, or some isolated factors, improves blastocyst rate and survival after embryo transfer, and reverses the expression of some altered genes. However, considering the complexity of the oviductal and uterine fluids, it seems difficult that the use of just a few factors in isolation can reverse all undesired consequences of the IVP. On the other hand, sex-specific embryonic plasticity, as a consequence of the oviductal regulatory signals, have been proposed. Thus, we have analysed the sex-specific effect of supplementation with reproductive fluids in bovine embryos and data reveal sex-dependent impact in DNA methylation. All these results confirm that developmental programme can be modulated by reproductive fluids and it shows sex-specific effects. This strategy allows the possibility of minimizing undesired in vitro derived consequences.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 113-116
Author(s):  
L A Bagdasaryan ◽  
I E Korneyeva

The aim of the study is to systematically analyze the data available in the modern literature on the relationship between endometrial thickness and the frequency of pregnancy in the program of assisted reproductive technologies (ART). Materials and methods. The review includes data from foreign and domestic articles found in PubMed on this topic. Results. The article presents data on the relationship between the thickness of the endometrium and the frequency of pregnancy in ART programs. The greatest number of studies is devoted to the evaluation of the relationship between the thickness of the endometrium and the frequency of pregnancy on the day of the ovulation trigger. Data are presented on the existence of a correlation between the thickness of the endometrium measured on the day of the ovulation trigger and the frequency of clinical pregnancy, as well as data on the need to evaluate the structure of the endometrium and the state of subendometric blood flow. The importance of multilayered (three-layered) endometrium as a prognostic marker of success in in vitro fertilization/intracytoplasmic sperm injection programs in the ovum is emphasized. The conclusion. The thickness of the endometrium can not be used as an argument for canceling the cycle or abolishing embryo transfer to the uterine cavity. Further studies in this direction are needed with a study of the morphological and molecular genetic characteristics of the endometrium, which in the future will allow us to evaluate the relationship between the thickness of the endometrium and the probability of pregnancy.


Author(s):  
N.A. Altinnik , S.S. Zenin , V.V. Komarova et all

The article discusses the factors that determine the content of the legal limitations of pre-implantation genetic diagnosis in the framework of the in vitro fertilization procedure, taking into account international experience and modern domestic regulatory legal regulation of the field of assisted reproductive technologies. The authors substantiates the conclusion that it is necessary to legislate a list of medical indications for preimplantation genetic diagnosis, as well as the categories of hereditary or other genetic diseases diagnosed in the framework of this procedure.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Monfort ◽  
Carmen Orellana ◽  
Silvestre Oltra ◽  
Mónica Rosello ◽  
Alfonso Caro-Llopis ◽  
...  

AbstractDevelopment of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.


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