Medical-biological and social significance of female infertility

2020 ◽  
pp. 29-38
Author(s):  
Essedulla M. OSMANOV ◽  
Aleksey Yu. PROKOPOV
Keyword(s):  
Birth Rate ◽  
Family Income ◽  
Assisted Reproductive Technologies ◽  
Pension System ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
High Rate ◽  
Sexual Life ◽  
Social Significance ◽  
Demographic Situation

As a result of the decline in the population, Russia has faced a number of economic and social problems related to the reduction of the working-age population, as well as the need to reform the existing pension system, one of the measures aimed at improving the demographic situation is the increase in the birth rate. The aim of the study is to study the medical, biological and social significance of female infertility on the basis of a literary review. The results of the review showed a high level of infertility both in Russia and around the world. Among the main medical and biological risk factors for female infertility are the high prevalence of harmful habits, the earlier age of entry into sexual life of the high rate of sexually transmitted infections, gynaecological incidence, the high rate of abortion, the postponement of the birth of children to an older age. Social factors include low family income, poor quality of life, poor relationships with spouses and dissatisfaction with sexual intimacy. The increase in the number of families with infertility indicates an increasing need for assisted reproductive technologies. In developed countries, assisted reproductive technologies produce between 0.4 and 4.0 % children. In Russia, 160836 children were born with assisted reproductive technologies from 2007 to 2013, and the contribution of assisted reproductive technologies to annual fertility increased almost 40 times (from 0.04 to 1.55 %). The conclusion: the restoration of women's reproductive health is one of the promising directions in raising the birth rate and restoring the demographic situation.

scholarly journals The Dynamics of the Vaginal Micro-Ecology During in Vitro Fertilization and Embryo Transfer (IVF-ET) Cycles and its Impact on Pregnancy Outcomes

2021 ◽  
Author(s):  
Quan Tian ◽  
Yujie Liu ◽  
Jiane Liu ◽  
Jianru Wu ◽  
Jianxin Liu ◽  
...  
Keyword(s):  
Live Birth ◽  
Pregnancy Outcomes ◽  
Evaluation System ◽  
Birth Rate ◽  
Assisted Reproductive Technologies ◽  
Live Birth Rate ◽  
Reproductive Technologies ◽  
Multivariable Logistic Regression Model ◽  
Hormonal Milieu ◽  
Ivf Et

Abstract BackgroundAbnormal reproductive tract flora may cause infertility, and it may play a key role in the success of assisted reproductive technologies (ART). The obvious short-term changes in estrogen caused by clinical protocols with IVF-ET provide a unique perspective for us to assess the vaginal flora, shifting hormonal condition and investigate the potential associations of the vaginal micro-ecology with cycle outcome of pregnancy. The Vaginal Micro-ecology Evaluation System (VMES) as a tool to analyze the vaginal microbiomes in most areas of China. This study aims to apply the VMES to evaluate the dynamics of vaginal micro-ecology during IVF-ET, and investigate the correlations between vaginal micro-ecology with pregnancy outcome.Methods　150 patients were enrolled who underwent early follicular phase prolonged protocol IVF-ET due to tubal factors. The VMES is used to evaluate vaginal microbiology indicators of vaginal swabs obtained in different hormonal milieu during the IVF-ET cycle. The pregnancy outcomes were observed, if pregnant.Results　In our data, the prevalence of bacterial vaginitis (BV) accounts for 3.3%. During IVF procedure, the vaginal microbiome varied across hormonal milieu in some but not all patients. The proportion of BV, and unidentified dysbiosis were increased significantly on the day of human chorionic gonadotropin (HCG) administration. The vaginal micro-ecology on the day of HCG administration correlated with outcome (live birth / no live birth). The multivariable logistic regression model showed that the average age, the duration of infertility, and the vaginal micro-ecology after controlled ovarian hyperstimulation (COH) were associated with the live birth rate.ConclusionOur retrospective cohort study suggests that the VEMS has enabled discovery of unidentified dysbiosis shift in the vaginal micro-ecology during IVF-ET therapy. More importantly, the vaginal micro-ecology on the day of HCG administration was significantly associated with the live birth rate.

scholarly journals Reproductive technologies, female infertility, and the risk of imprinting-related disorders

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Patricia Fauque ◽  
Jacques De Mouzon ◽  
Aviva Devaux ◽  
Sylvie Epelboin ◽  
Marie-José Gervoise-Boyer ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
Global Risk ◽  
Vitro Fertilization ◽  
Increased Risk ◽  
Genomic Imprints

Abstract Background Epidemiological studies suggest that singletons born from assisted reproductive technologies (ART) have a high risk of adverse perinatal outcomes, specifically for imprinting disorders. Because ART processes take place at times when epigenetic reprogramming/imprinting are occurring, there is concern that ART can affect genomic imprints. However, little is currently known about the risk of imprinting defects according to the type of ART or the type of underlying female infertility. From the French national health database, a cohort of 3,501,495 singletons born over a 5-year period (2013–2017) following fresh embryo or frozen embryo transfers (fresh-ET or FET from in vitro fertilization), intrauterine insemination, or natural conception was followed up to early childhood. Based on clinical features, several syndromes/diseases involving imprinted genes were monitored. The effects of ART conception and the underlying cause of female infertility were assessed. Results Compared with infants conceived naturally, children born after fresh-ET had a higher prevalence of imprinting-related diseases, with an aOR of 1.43 [95% CI 1.13–1.81, p = 0.003]. Namely, we observed an increased risk of neonatal diabetes mellitus (1.96 aOR [95% CI 1.43–2.70], p < 0.001). There was an overall independent increase in risk of imprinting diseases for children with mothers diagnosed with endometriosis (1.38 aOR [95% CI 1.06–1.80], p = 0.02). Young and advanced maternal age, primiparity, obesity, smoking, and history of high blood pressure or diabetes were also associated with high global risk. Conclusions This prospective epidemiological study showed that the risk of clinically diagnosed imprinting-related diseases is increased in children conceived after fresh embryo transfers or from mothers with endometriosis. The increased perturbations in genomic imprinting could be caused by controlled ovarian hyperstimulation and potentially endometriosis through the impairment of endometrial receptivity and placentation, leading to epigenetic feto-placental changes. Further studies are now needed to improve understanding of the underlying molecular mechanisms (i.e. genetic or epigenetic causes).

Not Yet a Woman: The Influence of Socio-Political Constructions of Motherhood on Experiences of Female Infertility

2019 ◽  
Vol 50 (3) ◽  
pp. 890-907
Author(s):  
Hannah Wells ◽  
Milena Heinsch
Keyword(s):  
Social Work ◽  
Scoping Review ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Female Infertility ◽  
Support Needs ◽  
Infertile Women ◽  
Interdisciplinary Knowledge ◽  
Systemic Factors ◽  
Feminine Ideals

AbstractIn contemporary pronatalist societies, motherhood and childbearing are constructed as inevitable fulfilments of the female identity, resulting in the stigmatisation of women who do not conform to these feminine ‘ideals’. This article reports on the findings of a scoping review, which explored constructions of women and motherhood in Western societies, and how they influence women’s experiences of infertility. Three key themes were identified: (i) the ‘women as mothers’ discourse; (ii) medicalisation and the ‘female biological fault’; and (iii) ‘deviant’ mothers and infertility. While these themes facilitate a deeper understanding of the ways social ideologies can influence the identity and life-course of infertile women, the current literature was found to be overwhelmingly medical in focus, centred on the concept of Assisted Reproductive Technologies. This article aims to expand narrow discourses on female infertility by exploring women’s support needs and the socio-political impacts on their experience. It extends the interdisciplinary knowledge base in this area by considering the contributions social work can make in addressing these systemic factors.

Features of seminal plasma cytokine profile and an occurrence of pregnancy when carrying out a program of assisted reproductive technologies

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 9-13
Author(s):  
Tatiana V Dontsova ◽  
Alina A Babayan ◽  
Marina A Nikolaeva ◽  
Alla S Arefieva ◽  
Elena A Kalinina ◽  
...  
Keyword(s):  
Sexual Intercourse ◽  
Seminal Plasma ◽  
Transforming Growth Factor ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Female Reproductive Tract ◽  
Cytokine Profile ◽  
Sexual Life ◽  
Operating Characteristics ◽  
Diagnostic Significance

Aim. To asses an effectiveness of assisted reproductive technologies (ART) program given characteristics of the cytokine profile of seminal plasma (SP) entering the female reproductive tract during sexual intercourse. Outcomes and methods. 33 married couples who applied for a treatment of infertility by means of in vitro fertilization /ICSI (Intracytoplasmic Sperm Injection) were included in the prospective study. Patients were recommended to have sexual intercourse with no restrictions during treatment and to have the last sexual intercourse 3 days before an intended transvaginal puncture (ITP). Testing of cytokines (transforming growth factor (TGF)-b1, interferon (IFN)-g, interleukin (IL)-33, IL-6, IL-8, IL-23, IL-10, tumor necrosis factor (TNF)-a, IL-18, IL- 17A, IFN-a, IL-12, monocyte chemotactic protein-1) levels in samples of partners’ SP obtained on the day having ITP were carried out using multiplex analysis with LegendPlex kits (BioLegend, USA). Results. When comparing a cytokine profile of SP in couples who did not become pregnant (n=25) and couples who become pregnant (n=8) increased IL-18 and reduced IL-10 levels (p=0,017 and p=0, 01 respectively) were revealed in the group which got pregnant. To assess a clinical relevance of cytokine content in SP ROC (Receiver Operating Characteristics) curve was used. It was established that determining of IL-18 concentration in SP has the greatest diagnostic significance (the area under a curve was 0.792±0.107, test sensitivity - 62.5%, test specificity - 95.24% at threshold concentration>210.43 pg/ml). Incidence of pregnancy at IL-18 concentration above threshold levels was 83,3% while at lower concentrations of IL-18 pregnancy occurred only in 13.0% of women. Conclusions. Elevated IL-18 levels and decreased IL-10 levels in SP of female patients’ partners who don’t have restriction of sexual life when treating infertility with ART are favorable factors for a pregnancy to occur.

scholarly journals Cryopreservation of human spermatozoa with penetrating and non-penetrating cryoprotectants

2019 ◽  
Vol 85 (4) ◽  
pp. 27-34
Author(s):  
E. Pavlovich ◽  
G. Gapon ◽  
T. Yurchuk ◽  
M. Petrushko
Keyword(s):  
Assisted Reproductive Technologies ◽  
Morphological Characteristics ◽  
Study Groups ◽  
Reproductive Technologies ◽  
High Rate ◽  
Motile Cells ◽  
Group 3 ◽  
Group 2 ◽  
Cryopreservation Method ◽  
Group 1

Сryopreserved spermatozoa are widely used in infertility treatment by assisted reproductive technologies. However, the spermatozoa survival rate remains low in patients with oligoastenoteratozoospermia. Therefore the development of effective cryopreservation methods for spermatozoa from pathospermia is relevant. The effectiveness of cryopreservation spermatozoa from oligoastenoteratozoospermia man using penetrating and non-penetrating cryoprotectants was compared. Sperm motility, viability and morphological characteristics were evaluated after cryopreservation with glycerol and polyvinylpyrrolidone. The average number of spermatozoa count in fresh ejaculate was (11.0±0.2) mln/ml. After isolation of active motile fraction the number of cells was (3.8±0.3) mln/ml and (84.3±8.4) % from them were motile (group 3). (78.8±6.6) % of spermatozoa cryopreserved with glycerol (group 1) and (41.4±8.1) % cryopreserved with polyvinylpyrrolidone (group 2) remained active motile. The spermatozoa viability after cryopreservation was (82.1±8.6) % and (89.6±8.6) % in group 1 and 2, respectively. Despite the high rate of spermatozoa survival in group 1 the number of motile cells decreased to (27.3±4.8) % after cryoprotectant removing stage. Morphological analysis revealed that the incidence of spermatozoa head abnormalities was (25.97±2.67), (19.21±2.67) and (20.57±1.19) % in group 1–3, respectively. The differences of spermatozoa midpiece and tail abnormalities in the study groups were statistically insignificant. The use of polyvinylpyrrolidone as a cryoprotectant allows preserving 90 % of survived spermatozoa from oligoastenoteratozoospermia men after freeze/thawing. The set of spermatozoa head, neck and midpiece abnormalities is significantly lower after cryopreservation with polyvinylpyrrolidone compared with routine method with glycerol. Two-stage spermatozoa cryopreservation method with polyvinylpyrrolidone is promising for assisted reproductive technologies since spermatozoa can be used immediately after warming for oocyte fertilization without cryoprotectant removing step.

Religious Diversity and Women’s Attitudes Toward Using Assisted Reproductive Technologies—Insights from a Pilot Study in Germany

2020 ◽  
Vol 7 (1) ◽  
pp. 150-168
Author(s):  
Nadja Milewski ◽  
Sonja Haug
Keyword(s):  
Pilot Study ◽  
Assisted Reproductive Technologies ◽  
Religious Affiliation ◽  
Religious Diversity ◽  
Muslim Women ◽  
Reproductive Technologies ◽  
High Rate ◽  
Social Relevance ◽  
Christian Women ◽  
The Social

Abstract This study examines women’s attitudes toward the own use of assisted reproductive technologies (ART) by their religious affiliation in Germany. The social relevance of ART is increasing in Western countries due to overall low birth rates, a high rate of childlessness, and a gap between the desired and the actual numbers of children. Previous literature has been scarce, however, on attitudes toward ART, and religious diversity has not been included in studies on ART. Our analysis is based on data collected in a pilot study in 2014 and 2015. The sample includes 944 women aged 18 to 50 living in Germany. The results show that Muslim women were significantly more likely than Christian women to say they would consider using ART; having no religious affiliation was associated with the least open attitude toward ART usage.

scholarly journals ANALYSIS OF THE MARKET OF MEDICAL SERVICES IN THE FIELD OF VRT AND MARKETING STRATEGY OF MEDICAL INSTITUTIONS IN KAZAKHSTAN ON THE EXAMPLE OF THE WORK OF MCC PERSONA

2020 ◽  
pp. 38-47
Author(s):  
A.V. Lokshina
Keyword(s):  
Marketing Strategy ◽  
Birth Rate ◽  
Statistical Data ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Real Situation ◽  
Medical Institutions ◽  
The Republic

The article discusses the formation of the market for assisted reproductive technologies in the Republic of Kazakhstan, in particular, studies the reasons for its emergence and formation, provides statistical data on the birth rate, registered, infertile marriages in the country as a whole and in the context of regions. Analysis of the existing statistics of patients with infertility shows the need for In Vitro Fertilisation (IVF). The author of the article aims to show the real situation in Kazakhstan in the field of assisted reproductive technologies: he draws attention to the specificity of this market, the working conditions of clinics specializing in this area and the need for a marketing strategy for these clinics. This, according to the author, is a very important area of activity, through which specialists help to find the happiness of motherhood and fatherhood.

scholarly journals Analysis of costs and results of assisted reproductive technologies in the world and Ukraine

2018 ◽  
pp. 32-40
Author(s):  
Kh.-O. J. Stasiv ◽  
O. M. Zaliska
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
State Funding ◽  
Art Programs ◽  
Demographic Situation ◽  
Urgent Task ◽  
The World ◽  
The Usa ◽  
Number Of Cycles ◽  
The Cost

Taking into account the demographic situation in Ukraine, the use of assisted reproductive technologies (ART) is an urgent task for increasing access to modern, expensive methods of infertility treatment. The aim of this study was to summarize the legislative requirements for the implementation of ART, the number of cycles, depending on the type, and the costs for ART in the leading countries of the world and in Ukraine. We showed, that most countries in Europe have budgetary financing for a certain number of cycles, while the medical restrictions and age requirements for parents are included. It was revealed that the highest costs for ART are in the USA, the lowest in Japan and Scandinavian countries. We calculated the rate of provision for IVF and ICSI cycles per 1 million population (Kart) and the countries were ranked into 3 groups. It was shown that Ukraine belongs to countries with a low indicator ‒ less than 500 cycles. Leading countries of Europe, which have government funding for ART (France, Germany, Sweden), are characterized by a high Kart. The need to increase budgetary financing for ART in Ukraine is shown. The cost analysis for ART according to official websites of private clinics was conducted in Ukraine. We established that the average cost per 1 cycle of IVF was 52 584 UAH, for 1 cycle of ICSI was 6 694 UAH. The calculated solvency adequacy ratio for IVF was 703, it indicates a low availability for the population, and for ICSI is 89, which in 7.9 more affordable for families. It was found that in 7 clinics there are no Internet pages, and on the websites of 12 clinics information on the cost of services is shown, without taking into account the use of drugs in the protocols of ART. According to the different approaches to informing on websites of the ART clinics, it is advisable to unify the information providing on the sites about the availability of cycles and the total costs for them to improve provision and access for patients. Therefore, it is important to increase the state funding for ART programs.

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