scholarly journals A bespoke data linkage of an IVF clinical quality registry to population health datasets; methods and performance

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Georgina M Chambers ◽  
Stephanie K.Y. Choi ◽  
Katie Irvine ◽  
Christos Venetis ◽  
Katie Harris ◽  
...  
Keyword(s):  
Data Linkage ◽  
Birth Outcome ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Clinical Quality ◽  
Quality Registry ◽  
And Performance ◽  
Administrative Datasets

IntroductionAssisted reproductive technologies (ART), such as in-vitro fertilisation (IVF), have revolutionised the treatment of infertility, with an estimated 8 million babies born worldwide. However, the long-term health outcomes for women and their offspring remain an area of concern. Linking IVF treatment data to long-term health data is the most efficient method for assessing such outcomes. ObjectivesTo describe the creation and performance of a bespoke population-based data linkage of an ART clinical quality registry to state-based and national administrative datasets. MethodsThe linked dataset was created by deterministically and probabilistically linking the Australia and New Zealand Assisted Reproduction Database (ANZARD) to New South Wales (NSW) and Australian Capital Territory (ACT) administrative datasets (performed by NSW Centre for Health Record Linkage (CHeReL)) and to national claims datasets (performed by Australian Institute of Health and Welfare (AIHW)). The CHeReL's Master Linkage Key (MLK) was used as a bridge between ANZARD's partially identifiable patient data (statistical linkage key) and NSW and ACT administrative datasets. CHeReL then provided personal identifiers to the AIHW to obtain national content data. The results of the linkage were reported, and concordance between births recorded in ANZARD and perinatal data collections (PDCs) was evaluated. ResultsOf the 62,833 women who had ART treatment in NSW or ACT, 60,419 could be linked to the CHeReL MLK (linkage rate: 96.2%). A reconciliation of ANZARD-recorded births among NSW residents found that 94.2% (95% CI: 93.9--94.4%) of births were also recorded in state/territory-based PDCs. A high concordance was found in plurality status and birth outcome (≥99% agreement rate, Cohen's kappa ranged: 0.78--0.98) between ANZARD and PDCs. ConclusionThe data linkage resource demonstrates that high linkage rates can be achieved with partially identifiable data and that a population spine, such as the CHeReL's MLK, can be successfully used as a bridge between clinical registries and administrative datasets.

scholarly journals May I have your uterus? The contribution of considering complexities preceding live uterus transplantation

2021 ◽  
pp. medhum-2020-011864
Author(s):  
Lisa Guntram
Keyword(s):  
Medical Humanities ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Medical Innovation ◽  
Uterus Transplantation ◽  
Ethical Debate ◽  
Care And Support ◽  
Different Dimensions

Uterus transplantation combined with in vitro fertilisation (IVF) (henceforth called UTx-IVF) as a treatment for infertility caused by an absence or malfunction of the uterus is advancing. About 50 transplantations have been conducted worldwide and at least 14 children have been born—9 of them by women taking part in a Swedish research project on UTx-IVF. The Swedish research protocol initially stated that the potential recipient must ‘have her own donor’ who is preferably related to the recipient. But what does it mean to ask someone for a uterus? What challenges does this question instigate? And what norms may it enact? In this article, I explore how 10 women—who have considered, and sometimes pursued, UTx-IVF—describe their experiences of searching for a donor. I aim to show how an analysis of such accounts can help us unpack some of the specific relational and gendered dimensions of UTx-IVF and by doing so enrich discussions of risks, benefits, care and support in UTx-IVF. Drawing on research in social sciences and medical humanities that has demonstrated how assisted reproductive technologies and organ donation can provoke social and familial conundrums, with respect to such topics as embodiment and identity, I present three patterns that describe different dimensions of the interviewees’ quest for a uterus donor. I discuss the negotiations that took place, how expectations unfolded and how entanglements were managed as the interviewees considered asking someone for a donation. Such an examination, I suggest, contributes to make care and support more attuned to the experiences and entanglements that UTx-IVF entails for those pursuing it. This will become increasingly important if (or when) UTx-IVF becomes part of general healthcare. To conclude, I problematise responsibilities and relational challenges in medical innovation, and in this way provide insights into how the ethical debate over UTx-IVF can broaden its scope.

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

2018 ◽  
pp. 122-126
Author(s):  
I.A. Zhabchenko ◽  
◽  
O.R. Sudmak ◽  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Ischemic Lesion ◽  
Vitro Fertilization ◽  
Pregnancy And Delivery

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history. Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out. Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS. Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation. Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

scholarly journals Significance of disorders of proteomic profile of follicular fluid for predicting the effectiveness of in vitro fertilisation in women with infertility

2018 ◽  
Vol 99 (3) ◽  
pp. 496-503
Author(s):  
O S Zolotykh ◽  
S V Lomteva ◽  
K Yu Sagamonova
Keyword(s):  
Assisted Reproductive Technology ◽  
Follicular Fluid ◽  
Molecular Mechanisms ◽  
Reproductive Technologies ◽  
Reproductive Technology ◽  
In Vitro Fertilisation ◽  
Proteomic Profile ◽  
Technology Programs ◽  
Group 2

Aim. To study the proteomic profile of follicular fluid in patients with infertility in assisted reproductive technology programs. Methods. The study included women with infertility included in assisted reproductive technology programs: 15 women who had in vitro fertilisation which resulted in pregnancy (group 1) and 16 women with a negative result of this program (group 2). Fractionation of the follicular fluid samples was performed using the sets of special magnetic beads. Proteomic profiling was performed by tandem MALDI-mass-spectrometry. The anti-Müllerian hormone level was measured by ELISA. Results. The study revealed differences in the detectability of follicular fluid proteins with different regulatory properties in patients of groups 1 and 2. With the negative outcome of in vitro fertilisation, expression of a number of proteins involved in the processes of folliculogenesis, ovulation, selection of the dominant follicle, as well as proteins necessary for the development of the zygote and blastula was reduced in females' follicular fluid. Increased expression in women from group 2 was registered for proteins enhancing proteolytic reactions, cell apoptosis, including oocytes, which disrupt the positive action of activin and damage structural and functional state of mitochondria. A definite relationship was found between the level of anti-Müllerian hormone and rate of detection of a number of proteins, in particular protocadherin-2α, cystatin C, betaglycan, prostatic acid phosphatase, and dermicidin. Conclusion. The revealed changes in proteomic profile of the follicular fluid obviously play an important role in the molecular mechanisms that determine the effectiveness of assisted reproductive technologies; the identified differentially expressed proteins can serve as objective markers for predicting the outcomes of in vitro fertilisation.

Rare occurrence of Tetralogy of Fallot in dizygotic twins conceived via in vitro fertilisation

2019 ◽  
Vol 29 (12) ◽  
pp. 1541-1542
Author(s):  
Jason W. Greenberg ◽  
Chetana Reddy ◽  
Charles B. Huddleston
Keyword(s):  
Tetralogy Of Fallot ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Rare Occurrence ◽  
Dizygotic Twins

AbstractAn increased incidence of CHD has been noted in twin gestations and in infants conceived using assisted reproductive technologies. However, CHD in these populations remains understudied and the mechanisms underlying these phenomena remain unclear. We present the case of twins conceived via in vitro fertilisation both with Tetralogy of Fallot and additional cardiac and extracardiac malformations.

Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

2019 ◽  
Vol 45 (5) ◽  
pp. 346-350 ◽  
Author(s):  
Mila Stefanova Zemyarska
Keyword(s):  
Assisted Reproductive Technologies ◽  
Cost Effective ◽  
Reproductive Technologies ◽  
Conclusive Evidence ◽  
Diagnostic Tools ◽  
In Vitro Fertilisation ◽  
Unborn Child ◽  
Effective Adjunct ◽  
Psychological Benefit

In vitro fertilisation (IVF) ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.

scholarly journals Foreword: A perspective on the role of emerging technologies for the propagation of companion animals, non-domestic and endangered species

2007 ◽  
Vol 19 (6) ◽  
pp. iii ◽  
Author(s):  
Monique C. J. Paris ◽  
Gabriela F. Mastromonaco ◽  
Damien B. B. P. Paris ◽  
Rebecca L. Krisher
Keyword(s):  
Endangered Species ◽  
Emerging Technologies ◽  
Assisted Reproductive Technologies ◽  
Companion Animals ◽  
Reproductive Technologies ◽  
Reproductive Physiology ◽  
In Vitro Fertilisation ◽  
Genetic Management ◽  
The Status

Assisted reproductive technologies (ART) have been used successfully in humans, domestic and laboratory species for many years. In contrast, our limited knowledge of basic reproductive physiology has restricted the application of ART in companion animal, non-domestic and endangered species (CANDES). Although there are numerous benefits, and in some cases a necessity, for applying ART for the reproductive and genetic management of CANDES, the challenges encountered with even the most basic procedures have limited the rate of progress. In this foreword we discuss the status of conventional ART, such as artificial insemination and in vitro fertilisation, as well as their benefits and inherent difficulties when applied to CANDES. It is upon these techniques, and ultimately our knowledge of basic reproductive physiology, that the success of emerging technologies, such as those described in this special issue, are dependent for success.

Increased genetic gains in multi-trait sheep indices using female reproductive technologies combined with optimal contribution selection and genomic breeding values

2017 ◽  
Vol 57 (10) ◽  
pp. 1984 ◽  
Author(s):  
T. Granleese ◽  
S. A. Clark ◽  
A. A. Swan ◽  
J. H. J. van der Werf
Keyword(s):  
Embryo Transfer ◽  
Genetic Gain ◽  
Reproductive Technologies ◽  
In Vitro Fertilisation ◽  
Multiple Trait ◽  
Breeding Programs ◽  
Young Females ◽  
Selection Accuracy ◽  
Individual Trait

Female reproductive technologies such as multiple ovulation and embryo transfer (MOET) and juvenile in vitro fertilisation and embryo transfer (JIVET) can produce multiple offspring per mating in sheep and cattle. In breeding programs this allows for higher female selection intensity and, in the case of JIVET, a reduction in generation interval, resulting in higher rates of genetic gain. Low selection accuracy of young females entering JIVET has often dissuaded producers from using this technology. However, genomic selection (GS) could increase selection accuracy of candidates at a younger age to help increase rates of genetic gain. This increase might vary for different traits in multiple trait breeding programs depending on genetic parameters and the practicality of recording, particularly for hard to measure traits. This study used both stochastic (animals) and deterministic (GS) simulation to evaluate the effect of reproductive technologies on the genetic gain for various traits in sheep breeding programs, both with and without GS. Optimal contribution selection was used to manage inbreeding and to optimally assign reproductive technologies to individual selection candidates. Two Australian sheep industry indexes were used – a terminal sire index that focussed on growth and carcass traits (the ‘Lamb 2020’ index) and a Merino index that focuses on wool traits, bodyweight, and reproduction (MP+). We observed that breeding programs using artificial insemination or natural mating (AI/N) + MOET, compared with AI/N alone, yielded an extra 39% and 27% genetic gain for terminal and Merino indexes without GS, respectively. However, the addition of JIVET to AI/N + MOET without GS only yielded an extra 1% genetic gain for terminal index and no extra gain in the Merino index. When GS was used in breeding programs, we observed AI/N + MOET + JIVET outperformed AI/N + MOET by 21% and 33% for terminal and Merino indexes, respectively. The implementation of GS increased genetic gain where reproductive technologies were used by 9–34% in Lamb 2020 and 37–98% in MP+. Individual trait response to selection varied in each breeding program. The combination of GS and reproductive technologies allowed for greater genetic gain in both indexes especially for hard to measure traits, but had limited effect on the traits that already had a large amount of early age records.

scholarly journals Infertility and the excruciating pursuit of motherhood

2021 ◽  
pp. 01-02
Author(s):  
Urmila G
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Reproductive Technologies ◽  
Infertility Treatment ◽  
In Vitro Fertilisation ◽  
Natural Conception ◽  
Graphic Description

What’s a Lemon Squeezer Doing in My Vagina? is a memoir of Rohini S Rajagopal’s excruciating five-year long fight with infertility and her journey to motherhood. After several failed attempts at natural conception and many negative home pregnancy tests, the author and her husband Ranjith visit a fertility centre in Bangalore. Rajagopal delivers a graphic description of the physical and emotional unpleasantness of her infertility treatment and also gives a vivid account of her experiences with the assisted reproductive technologies (ARTs) such as the intrauterine insemination (IUIs), in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). Intrauterine Insemination (IUI) is facilitated by directly injecting a man’s sperm into the woman’s uterus around the time the eggs emerge from the ovaries.

scholarly journals The future of animal production: improving productivity and sustainability

2011 ◽  
Vol 149 (S1) ◽  
pp. 9-16 ◽  
Author(s):  
D. A. HUME ◽  
C. B. A. WHITELAW ◽  
A. L. ARCHIBALD
Keyword(s):  
Agricultural Research ◽  
Wide Spectrum ◽  
Genetic Selection ◽  
Reproductive Technologies ◽  
Breeding Value ◽  
Food Needs ◽  
Analytical Tools ◽  
The Impact

SUMMARYThe challenge for the next 50 years is to increase the productivity of major livestock species to address the food needs of the world, while at the same time minimizing the environmental impact. The present review presents an optimistic view of this challenge. The completion of genome sequences, and high-density analytical tools to map genetic markers, allows for whole-genome selection programmes based on linkage disequilibrium for a wide spectrum of traits, simultaneously. In turn, it will be possible to redefine genetic prediction based on allele sharing, rather than pedigree relationships and to make breeding value predictions early in the life of the peak sire. Selection will be applied to a much wider range of traits, including those that are directed towards environmental or adaptive outcomes. In parallel, reproductive technologies will continue to advance to allow acceleration of genetic selection, probably including recombination in vitro. Transgenesis and/or mutagenesis will be applied to introduce new genetic variation or desired phenotypes. Traditional livestock systems will continue to evolve towards more intensive integrated farming modes that control inputs and outputs to minimize the impact and improve efficiency. The challenges of the next 50 years can certainly be met, but only if governments reverse the long-term disinvestment in agricultural research.

Sign in / Sign up

Export Citation Format

Share Document