Trends in safe infertility treatment with assisted reproductive technologies

2020 ◽  
Vol 69 (4) ◽  
pp. 83-88
Author(s):  
Svetlana S. Paskar ◽  
Alla S. Kalugina ◽  
Anna G. Tkachuk

The expansion of indications for assisted reproductive technology has led to significant implications for assisted reproductive technology (ART) programs worldwide. More than 7 million children in the world were born using ART. Modern clinical practice in the field of reproductive sciences is aimed not only at increasing the effectiveness, but also at the safety of treatment. ART, like any other type of therapy, may be combined with negative side effects. Both the correct prediction of the risks associated with treatment and a personalized approach ensure the absolute safety of infertility treatment using in vitro fertilization. In this regard, over the past decade, a number of new research approaches have been noted that use ART methods integrated into clinical practice: cycle segmentation with subsequent embryo transfer and the elective transfer of one embryo. New approaches provide a control in relation to ovarian stimulation and a reduction in the number of transferred embryos, which helps to minimize primarily adverse perinatal outcomes. Predicting the risks and outcomes of treatment using mathematical modeling is the application of good clinical practice.

Author(s):  
Amber Mathiesen ◽  
Kali Roy

For those with an increased risk of having a child with a genetic condition, reproductive options include avoiding pregnancy altogether, undertaking prenatal diagnosis in a current pregnancy, and preventing the transmission of the genetic changes responsible for the condition to a child. This chapter on assisted reproductive technology and reproductive options for the at-risk couple describes the basic techniques of assisted reproductive technologies as well as reproductive testing options prior to in vitro fertilization, including preimplantation genetic screening (PGS) and preimplantation genetic diagnosis (PGD). It includes a brief overview of ovarian stimulation, intrauterine insemination (IUI), and in vitro fertilization. This chapter discusses the details of PGS including the process and its limitations. It also includes a discussion of PGD, including the process, such as linkage analysis, and limitations, such as allele dropout.


GYNECOLOGY ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 36-40
Author(s):  
Anna G. Burduli ◽  
Natalia A. Kitsilovskaya ◽  
Yuliya V. Sukhova ◽  
Irina A. Vedikhina ◽  
Tatiana Y. Ivanets ◽  
...  

The review presents data on metabolites in the follicular fluid (FF) from the perspective of reproductive medicine and their use in order to predict outcomes of assisted reproductive technology (ART) programs. It considers various components of this biological medium (hormones, lipids, melatonin, etc.) with an assessment of their predictive value in prognosis of the effectiveness of in vitro fertilization (IVF) programs. The data on experimental directions in this field and the prospects for their use in clinical practice are presented. The article emphasizes that the growing clinical need and the unsolved problem of increasing the effectiveness of ART programs determine the need for further studies of the FF composition. Materials and methods. The review includes data related to this topic from foreign and Russian articles found in PubMed which were published in recent years. Results. Given the established fact of a direct effect of FF composition on growth and maturation of oocytes, and further, on the fertilization process, various FF metabolites are actively investigated as non-invasive markers of quality of oocytes/embryos. The article provides data on the experimental directions in this field and the prospects for their use in clinical practice. However, clinical studies of a relation between various FF metabolites levels and outcomes of IVF programs are contradictory. Conclusion. Owing large economic cost for treatment of infertility with IVF, there is need for expansion and intensification of studies to identify and use reliable predictors in prognosis of ART programs outcomes.


2021 ◽  
pp. 539-543
Author(s):  
Daria A. Kinsht ◽  
◽  
Mariia K. Soboleva ◽  

Aim. To assess the main indicators of the initial reproductive health of parents, somatic health of the mother and their impact on the health of children born with singleton pregnancy ART. Materials and methods. The study included all newborn infants from singleton ART who were born at the Avicenna Medical Center (Novosibirsk) over the period 2006–2017 (n=409) and their parents (n=818). All stages of overcoming infertility (from the moment the parents go to the clinic to the birth of children) are considered in the context of one center, in a relatively homogeneous social group, with ensuring continuity at all stages. The average experience of infertility in couples was 7.2±0.2 years. The groups were formed depending on the type of infertility and the method of assisted reproductive technologies (ART) used: 205 children were born using in vitro fertilization (IVF), 204 children were born using the method of Intracytoplasm Sperm Injection (ICSI). The method of IVF and transfer of embryos into the uterine cavity is more often used in women with tuboperitoneal, endocrine types of infertility (premature ovarian failure syndrome), as well as in infertility associated with endometriosis. More serious reproductive problems (severe forms of male infertility, a combination of several types of infertility) in most cases lead to the use of more serious technological methods of ART, in particular, the addition of IVF and embryo transfer by the ICSI method. The reasons underlying infertility in most cases lead not only to the choice of the ART method, but also determine the characteristics of the course of pregnancy and the development of the intrauterine fetus. Pregnancy in the IVF group is significantly more often complicated by the threat of termination and premature birth, while ICSI pregnancy more often leads to impaired development of the intrauterine fetus. Conclusion. Features of medical support of women during the preparation for ART and, of course, during pregnancy, with a comprehensive, interdisciplinary correction of expected complications in each of the groups, will improve the perinatal outcomes of induced pregnancy and will contribute to the birth of healthy offspring.


2021 ◽  
Vol 11 (2) ◽  
pp. 315-328
Author(s):  
Maryna Petrushko ◽  
Volodymyr Piniaiev ◽  
Taisiia Yurchuk

The birth of children after infertility treatment of married couples with the help of assisted reproductive technologies has become a reality after many years of basic research on the physiology of reproductive system, development of oocyte’s in vitro fertilization methods and cultivation of embryos at pre-implantation stages. Given the widespread use of assisted reproductive technologies in modern medical practice and the great interest of society to this problem, the aim of the study was to trace the main stages and key events of assisted reproductive technologies in the world and in Ukraine, as well as to highlight the activities of outstanding scientists of domestic and world science who were at the origins of the development of this area. The paper used historical methods to study and interpret the texts of primary sources and present scientific historical events. In addition, the current trends in assisted reproductive technologies are covered based on the results of our own, more than 30 years of experience in the field of reproductive biology and medicine, and the achievements of world scientists. As a result of the work, it has been shown that despite certain ethical and social biases, the discovery of individual predecessor scientists became the basis for the efforts of Robert Edwards and Patrick Steptoe to ensure birth of the world's first child, whose conception occurred outside the mother's body. There are also historical facts and unique photos from our own archive, which confirm the fact of the first successful oocyte in vitro fertilization and the birth of a child after the use of assisted reproductive technologies in Ukraine. Over the last 20 years, assisted reproductive technologies have continued to grow, addressing many other issues of reproductive potential preservation and infertility treatment. State of the art methods of assisted reproductive technologies include the development of cryopreservation method of gametes and embryos by vitrification, genetic screening of embryos in order to prevent the hereditary diseases transmission and embryo transfer with chromosomal abnormalities, the birth of a child “from three parents” in severe cases of mutations in the mitochondrial genome, etc.


2020 ◽  
Vol 21 (15) ◽  
pp. 5175 ◽  
Author(s):  
Huixia Yang ◽  
Christina Kuhn ◽  
Thomas Kolben ◽  
Zhi Ma ◽  
Peng Lin ◽  
...  

Assisted reproductive technology (ART) has rapidly developed and is now widely practised worldwide. Both the characteristics of ART (handling gametes/embryos in vitro) and the infertility backgrounds of ART parents (such as infertility diseases and unfavourable lifestyles or diets) could cause increased oxidative stress (OS) that may exert adverse influences on gametogenesis, fertilisation, and foetation, even causing a long-lasting influence on the offspring. For these reasons, the safety of ART needs to be closely examined. In this review, from an ART safety standpoint, the origins of OS are reviewed, and the long-lasting cardiovascular effects and potential mechanisms of OS on the offspring are discussed.


2021 ◽  
pp. 63-70
Author(s):  
G.M. Karibayeva ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova

Currentliterature review presents the analysis of results of studies of morphological qualities and anomalies (dysmorphisms) of human oocytes in the field of assisted reproductive technologies. The variety of intracytoplasmic anomalies encountered in the clinical practice of in vitro fertilization, their effect on fertilization, cleavage, implantation frequency, clinical pregnancy rate were described. Moreover, the morphological characteristics of oocyte could be considered to use as biomarkers in predicting the quality of embryos and blastocysts, and further implantation potential.


2020 ◽  
Vol 4 (4) ◽  
pp. 19-42
Author(s):  
Alexandra A. Moskaleva

Assisted reproductive technologies (ART) are an infertility treatment tool. In Russia, more than 250 centers implementing infertility treatment with the help of ART have been opened in 67 regions. In 2014, in vitro fertilization (IVF) was included in the programme of state guarantees, and since 2016 the service can be obtained within the Mandatory Health Insurance (MHI) system. Author of this study analyzes how the impact of economic factors on fertility with the use of ART has changed in relation to the inclusion of IVF in the MHI system, and what social factors affect the usage of this technology. The analysis bases on the panel data for the regions of Russia covering the period from 2011 to 2017. The fixed effects method was used to assess the impact of various factors. The study shows that the population income level has a significant positive impact on the proportion of births with the use of ART even after the inclusion of IVF into the MHI programme. At the same time, the inclusion of IVF in the MHI programme has led to an increase in the proportion of births using ART. The positive effect of this inclusion is higher in wealthier regions. Among social factors, a significant impact has the accessibility of information about the procedure, which is measured by the share of population having access to the Internet.


Author(s):  
Svetlana Dragojevic-Dikic ◽  
Saveta Draganic ◽  
Srdjan Dikic ◽  
Vladimir Pilija

One of the main characteristics of the new millennium is the affirmation of human rights in all aspects of human existence, with the intention of turning declarative statements into reality. Development of up-to-date assisted reproductive technologies (ART) and their application in infertility treatment have raised numerous ethical, legal, religious, social and other questions. In vitro fertilization, donation of gametes, embryos and pre-embryos, cryopreservation of gametes, embryos, ovarian and testicular tissues, embryo transfer, genetic reproductive techniques, cloning and other sophisticated methods used in infertility treatment require cooperation between the medical and legal professions. Ethical aspects of human reproduction and assisted fertilization are based on full respect of the life of an individual even before conception, from pre-embryo stage, via embryo stage and fetus stage to a newborn infant. Regarding investigative and clinical projects, this standpoint implies the legalization of all ART procedures, unencumbered exchange of information and consensus about their application, and adherence to the basic ethical principles of autonomy benefit, justice and common welfare. Ethical postulates provide unequivocal directions in the creation of new life and resolve all possible ethical dilemmas, protecting the rights of doctors and participant in relevant procedures alike and reasserting the crucial principle - respect of human dignity.


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