Features of pregnancy and delivery course in women after programs of assisted reproductive technologies

Objective. To study the features of the course of pregnancy and childbirth in women after ART programs. Medical care for families with infertility, in particular through assisted reproductive technologies (ART) programs, is an important area of comprehensive government policy to promote fertility. Materials and methods. The retrospective study was carried out on the basis of GBUZ TO Perinatal Center, Tyumen. We analyzed 237 birth histories of women whose pregnancies occurred with the use of ART and 237 birth histories of patients whose pregnancies occurred on their own. The material for the study was the birth histories of patients. Results. The results showed a higher incidence of pregnancy complications in women after ART programs. Thus, a higher number of premature births, placental disorders, isthmic-cervical insufficiency (ICI) were noted, as well as a significantly higher percentage of operative delivery by cesarean section. Conclusions. The presence of an initially large "baggage" of concomitant and gynecological diseases in infertile patients, whose pregnancies occurred with the use of ART programs, leads to a higher percentage of pregnancy complications and a high number of surgical deliveries.

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Elemental composition of blood of infertile patients participating in assisted reproduction programs

Bulletin of Russian State Medical University ◽

10.24075/brsmu.2021.010 ◽

2021 ◽

pp. 45-50

Author(s):

AG Syrkasheva ◽

VE Frankevich ◽

NV Dolgushina

Keyword(s):

Trace Elements ◽

Elemental Composition ◽

Negative Correlation ◽

Inductively Coupled Plasma ◽

Assisted Reproductive Technologies ◽

Significant Negative Correlation ◽

Reproductive Technologies ◽

Art Programs ◽

Inductively Coupled ◽

Infertile Patients

The association between levels of trace elements, endocrine diseases and reproductive impairments is actively investigated currently. In this connection, it seems relevant to study elemental status (elemental composition of blood and amounts of elements therein) of infertile patients enlisted in programs employing assisted reproductive technologies (ART). This study aimed to analyze trace elements in blood of infertile patients, relationship between the level of such trace elements and parameters of the ART programs they are in. The study included 30 infertile patients aged 18–39 years. Relying on inductively coupled plasma mass spectrometry, we identified concentrations of 31 chemical element in blood of the participants. Two elements out of 31 (antimony and beryllium) were not found in any blood sample; 10 elements (titanium, chromium, cobalt, nickel, arsenic, mercury, barium, gold, vanadium) were detected in some blood samples, the remaining 19 elements were found in all samples. Age of the patients correlated negatively with the level of silicon (r = –0.384; p = 0.036) and positively with the level of molybdenum (r = 0.384; p = 0.036). The level of anti-mullerian hormone was in a significant negative correlation with the level of lithium (r = –0.367; p = 0.046). The level of free thyroxine was in a significant negative correlation with the level of boron (r = –0.402; p = 0.028) and a positively correlated with the levels of iron (r = 0.410; p = 0.024) and silver (r = 0.432; p = 0.017). Considering the embryological cycle, we noted a positive correlation between the level of silicon and the number of blastocysts obtained (r = 0.387; p = 0.034). There was no statistical relationship registered between elemental composition of blood the frequency of pregnancy in ART cycles.

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SOCIODEMOGRAPHIC FEATURES OF PROCREATIVE BEHAVIOR IN THE ROUTINE USE OF ASSISTED REPRODUCTIVE TECHNOLOGIES

Вестник Пермского университета Философия Психология Социология ◽

10.17072/2078-7898/2021-3-361-369 ◽

2021 ◽

pp. 361-369

Author(s):

Nina E. Rusanova ◽

◽

Olga G. Isupova ◽

Keyword(s):

Assisted Reproductive Technologies ◽

New Technology ◽

Reproductive Technologies ◽

Art Programs ◽

Vitro Fertilization ◽

Pregnancy And Childbirth ◽

Abstract Knowledge ◽

First Results ◽

The Stability

The article describes the first results of an electronic survey of Moscow and Novosibirsk university students and postgraduates in April-May 2021. The analysis of 106 questionnaires showed that 74.7 % of the respondents (among whom 67.9 % are aged from 18 to 20 years, ⅔ are female, ¾ live in cities, 92.9 % are not married) want to have children, and every fifth of them — three ones. 91.8 % of the respondents believe that their individual health will not prevent them from implementing these plans, and they consider assisted reproductive technologies to be «a chance for people who are not able to have a child naturally to become parents». Awareness of specific ART programs varies: 81.2 % know about surrogacy, 75.3 % — about sperm donation, but only 55.3 % — about egg donation, 51.8 % — about cryopreservation of reproductive material, 49.4 % — about ICSI, while only 31.8 % — about long-used artificial insemination and 28.2 % — about the relatively new technology of embryo donation. For the majority of the respondents this is «abstract» knowledge since ¾ of them have not heard of real cases of applying assisted reproduction among their relatives and acquaintances. 56.5 % of the respondents are ready to use in vitro fertilization themselves if natural pregnancy and childbirth turn out to be contraindicated or physically impossible. However, ⅔ of the respondents deny the possibility of using more «morally complex» programs related to reproductive donation and surrogacy. These results allow us to speak of new sociocultural procreative norms due to the fundamental possibility of medicalization of reproductive processes. However, this makes the conception and gestation procedures dependent on organizational resources and the stability of the public health system.

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Genetic polymorphisms of reproductive hormones and their receptors in assisted reproduction technology for patients with polycystic ovary syndrome

Drug Metabolism and Personalized Therapy ◽

10.1515/dmpt-2021-0123 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Yulia A. Koloda ◽

Yulia V. Denisova ◽

Natalia M. Podzolkova

Keyword(s):

Polycystic Ovary Syndrome ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Ovarian Response ◽

Reproductive Technologies ◽

Reproductive Hormones ◽

Current Data ◽

Nucleotide Polymorphisms ◽

Ovary Syndrome ◽

Art Programs

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.

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The birth of a healthy child in the assisted reproductive technologies program after autologous co-culture of embryo with cumulus cells and a new CAT transfer technology. Case report

GYNECOLOGY ◽

10.26442/20795696.2021.3.200876 ◽

2021 ◽

Vol 23 (3) ◽

pp. 270-274

Author(s):

Gunai R. Asfarova ◽

Veronika I. Smol'nikova ◽

Natalia P. Makarova ◽

Iuliia S. Drapkina ◽

Anastasiia P. Sysoeva ◽

...

Keyword(s):

Embryo Transfer ◽

Healthy Child ◽

Assisted Reproductive Technologies ◽

Cumulus Cells ◽

Reproductive Technologies ◽

Biologically Active ◽

Human Embryos ◽

Implantation Failure ◽

Recurrent Implantation Failure ◽

Art Programs

Cumulus cells are essential during oocytes growth and development, as well as during their maturation and fertilization. Research results have shown that embryo co-cultivation with autologous cumulus cells increases the frequency of blastocyst formation, and also improves the effectiveness of ART programs. Embryo transfer in such programs is recommended to be carried out using the CAT technology (Cumulus-Aided embryo Transfer), which includes embryo cultivation on a layer of cumulus cells and embryo transfer with a certain amount of diluted cumulus cells. Patient G., 38 years old, came to the department with infertility for 15 years and recurrent implantation failure in history. The patient had ART program with autologous co-cultivation of embryos with cumulus cells and a new CAT transfer technology. The patient fell pregnant and gave birth to a healthy child. Autologous cumulus cells can be a source of biologically active substances and improve embryological parameters and implantation rate in ART programs. Embryo co-cultivation with cumulus cells is especially important for patients with recurrent implantation failure. This technique can become an alternative for optimizing human embryos culturing.

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INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

Reproductive Medicine ◽

10.37800/rm2021-2-7 ◽

2021 ◽

pp. 68-75

Author(s):

A.O. Polumiskova ◽

S.I. Tevkin ◽

T.M. Jussubaliyeva ◽

M.S. Shishimorova

Keyword(s):

Pregnancy Rate ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Miscarriage Rate ◽

Art Programs ◽

Group A ◽

The Difference ◽

Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

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Transitioning from Infertility-Based (ART 1.0) to Elective (ART 2.0) Use of Assisted Reproductive Technologies and the DOHaD Hypothesis: Do We Need to Change Consenting?

Seminars in Reproductive Medicine ◽

10.1055/s-0038-1677526 ◽

2018 ◽

Vol 36 (03/04) ◽

pp. 204-210 ◽

Cited By ~ 1

Author(s):

Amanda Adeleye ◽

Paolo Rinaudo

Keyword(s):

Family Planning ◽

Glucose Intolerance ◽

Animal Studies ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Parents And Children ◽

Health And Disease ◽

Infertile Patients ◽

Art Techniques

AbstractThe use of assisted reproductive technologies (ARTs) has increased significantly in recent years. While this is partially due to improved access for infertile patients, another contribution to the growth of ART utilization is represented by individuals without infertility, who electively chose to freeze their gametes and embryos for future use, before ever attempting conception spontaneously. Overall, the safety of ART for parents and children is well described and the risks are modest. However, while long-term health consequences for offspring as postulated by the Developmental Origin of Health and Disease (DOHaD) hypothesis are unknown, numerous animal studies suggest a predisposition for chronic diseases like hypertension and glucose intolerance. In this article, we argue that a key difference exists between infertile patients, who need to use ART as the only means to achieve pregnancy, and (likely) fertile patients who elect to use ART techniques as a family planning option. We believe that these two sets of patients are different and their risks–benefit ratios are different. We propose that while all patients should be aware of the risks, patients planning to utilize ART techniques without a diagnosis of infertility should be encouraged to think critically about the additional risks, particularly the “potential” long-term risks that may be imposed from these elective procedures.

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Effectiveness and outcomes of embryo cryopreservation programs in assisted reproductive technologies

Journal of obstetrics and women s diseases ◽

10.17816/jowd63439-46 ◽

2014 ◽

Vol 63 (4) ◽

pp. 39-46 ◽

Cited By ~ 1

Author(s):

Yana Nikolayevna Kravchuk ◽

Alla Stanislavovna Kalugina ◽

Olga Vladimirovna Bystrova ◽

Svetlana Aleksandrovna Shlykova

Keyword(s):

Embryo Transfer ◽

Assisted Reproductive Technologies ◽

Negative Impact ◽

Perinatal Outcomes ◽

Reproductive Technologies ◽

Embryo Cryopreservation ◽

Control Group ◽

Fresh Embryo Transfer ◽

Art Programs ◽

Thawed Embryo Transfer

Background. Embryo cryopreservation is an essential part of ART programs today. In recent years vitrification method is used increasingly widely. Purposes and tasks. To compare the effectiveness of ART programs using vitrified and fresh embryos, as well as different endometrial preparation regimes for frozen\thawed embryo transfer (modified natural cycle (MNC) and the preparatory hormone therapy(PHT)). To analyze the course of pregnancy and perinatal outcomes after vitrified embryo transfer. Materials and methods. We prospectively assessed the ART programs effectiveness and perinatal outcomes in 153 patients (I group), who underwent vitrified embryo transfer in 2011-2013 year. To prepare the endometrium for thawed embryo transfer in 83 patients PHT (Ia subgroup) and MNC in 70 patients (Ib subgroup) were used. Control group consisted of 70 patients, who underwent fresh embryo transfer. Results. The clinical pregnancy rate, birth rate and “take home baby” rate were not significantly different between the I (47,5 %; 30,9 %; 30,9 %) and II (53,0 %; 34,9 %; 32,5 %) groups, and between Ia (48,3 %; 28,4 %; 28,4 %) and IIb (46,6 %; 34,1 %; 34,1 %) subgroups. Complications during pregnancy and delivery, birthweight, length, Apgar score, congenital malformation rate did not differ significantly after vitrified and fresh embryo transfer. Conclusion. Vitrification is an effective method to achieve clinical results, comparable to native cycles. Application of PHT and MNC results in similar clinical outcomes. Transfer Vitrified embryo transfer does not have a negative impact on obstetric and perinatal outcomes when compared with native cycles.

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Inositol and folates in the restoration of reproductive function in women and prevention of congenital malformations

Reproductive Endocrinology ◽

10.18370/2309-4117.2021.61.95-100 ◽

2021 ◽

pp. 95-100

Author(s):

H.I. Reznichenko ◽

Y.H. Reznichenko

Keyword(s):

Folic Acid ◽

Reproductive Health ◽

Congenital Malformations ◽

Ovarian Function ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Reproductive Technologies ◽

Late Gestation ◽

Trophoblast Invasion ◽

Pregnancy And Childbirth

In recent years, Ukraine has seen a significant deterioration in the reproductive health of women in the face of declining birth rates. One of the main causes of comorbidity of infertility and background pathologies is the insufficient supply of a woman's body in the pre-pregnancy period with micronutrients – folate, vitamins, myo-inositol and others. This increases the risk of complications during pregnancy and childbirth and congenital malformations.Literature analysis showed that myo-inositol in combination with folate are an extremely important way to prevent fertility disorders, complications of pregnancy and childbirth, congenital malformations and support the reproductive health of the next generation. Myo-inositol in combination with folic acid promotes the effects of luteinizing and follicle-stimulating hormones, normalization of ovarian function, oocyte quality, trophoblast invasion during blastocyst attachment, prevention of congenital malformations by neutralizing the action of homocysteine with metafolin in the pregravid period and during pregnancy and assisted reproductive technologies, reducing the incidence of miscarriage, preeclampsia and other complications. The neuroprotective effect of myo-inositol indicates the importance of its use for fetal neuroprotection in late gestation, especially in hypoxia.Fertifolin, which contains an improved combination of natural nutrients as myo-inositol 1000 mg and folic acid 100 µg in the form of metafolin (calcium L-methylfolate), successfully copes with this goal. Metafolin has greater bioavailability and more actively helps to increase the level of folate in blood plasma, in contrast to folic acid. Metafolin is characterized by fewer drug interactions and less often masks the symptoms of B12-deficient anemia, reduces the risk of anemia, placental dysfunction, malformations of the neural tube. Fertifolin is also effectively used as an adjunct in polycystic ovary syndrome and in assisted reproductive technology protocols.

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A comparison of NGS and FISH technologies: comprehensive 24-chromosome screening of embryo

Faktori eksperimental'noi evolucii organizmiv ◽

10.7124/feeo.v21.858 ◽

1970 ◽

Vol 21 ◽

pp. 311-315

Author(s):

Yu. V. Gontar ◽

O. Yu. Verlynskyi ◽

A. Kyrpyi ◽

I. E. Ylyn ◽

A. M. Fedota

Keyword(s):

Preimplantation Genetic Diagnosis ◽

Assisted Reproductive Technologies ◽

Genetic Diagnosis ◽

Reproductive Technologies ◽

The Other ◽

Preimplantation Embryos ◽

Art Programs ◽

Chromosomal Aneuploidy ◽

Investigation Methods

Aim. Optimization of the algorithm of complex 24 chromosomes screening in programs of assisted reproductive technologies. Methods. Research of non-disjunction chromosomes in preimplantation embryos based on the results of trophectoderm nucleus diagnostics using FISH and NGS-based CCS. During the preimplantation genetic diagnosis (PGD) on the nucleus by FISH were used probes for chromosomes 13, 16, 18, 21, 22, X, Y. Results. Among the demonstrated cases of embryo diagnosis there was only one embryo that showed a coincidence in the results obtained by different investigation methods. In the other sample, where was diagnosed non-mosaic 18 and 22 monosomy by FISH, the NGS-based CCS showed only monosomy 18. The other embryo had ploidy mosaicism indicated by FISH, but according to NGS results it was evaluated as euploid. Conclusions. Embryos obtained in ART programs must be screened for chromosomal aneuploidy in the preimplantation period to increase the effectiveness in the programs of assisted reproductive technologies, using combination of FISH and NGS methods. Keywords: preimplantation genetic diagnosis, assisted reproductive technologies, aneuploid embryos, NGS, FISH.

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Hyaluronidase-based swim-up for semen selection in patients with human papillomavirus semen infection

Biology of Reproduction ◽

10.1093/biolre/ioaa173 ◽

2020 ◽

Author(s):

Luca De Toni ◽

Ilaria Cosci ◽

Andrea Carosso ◽

Luisa Barzon ◽

Bruno Engl ◽

...

Keyword(s):

Human Papillomavirus ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Complete Loss ◽

Sperm Parameters ◽

Slight Reduction ◽

Sexually Active ◽

Hpv Dna ◽

Sexually Transmitted ◽

Infertile Patients

Abstract Infection by human papillomavirus (HPV) represents one of the most common sexually transmitted diseases in both men and women worldwide. Recently, the detection of HPV virions in the semen of a large percentage of sexually active men has been associated with detrimental effects on both sperm parameters and on assisted reproductive technologies (ART) treatment outcomes. Conventional semen washing procedure used in ART have proved to be ineffective in removing HPV bound to sperm, requiring the identification of more effective and specific methods. In the present study, we assessed the possible use of hyaluronidase for the detachment of HPV from sperm cell surface. Semen samples from five normozoospermic control subjects (CTRL) were incubated with HPV virus-like particles (HPV-VLP) and treated with hyaluronidase by both a modified swim-up procedure (M-SU) and single-cell approach (SCA). The treatment with hyaluronidase was associated with the complete loss of HPV-VLP signal on sperms by both M-SU and SCA. In addition, semen samples from 12 HPV-positive infertile patients were treated with hyaluronidase 80 IU/mL by M-SU, resulting in the complete loss of HPV-DNA signal from sperm surface. Finally, the possible impact of hyaluronidase treatment on sperm parameters was assessed on both sperms from the five CTRL subjects and on further five oligo-astheno-terato-zoospermic (OAT) patients, both HPV negative. The treatment with hyaluronidase was equally associated with a slight reduction of sperm viability and progressive motility in both CTRL and OAT. In conclusion, the treatment with hyaluronidase removed efficiently and safely HPV virions bound to spermatozoa.

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