scholarly journals Secular changes in human reproduction and assisted reproductive technologies

2021 ◽  
Vol 84 (3) ◽  
pp. 359-368
Author(s):  
Arthur Saniotis ◽  
Maciej Henneberg
Keyword(s):  
Natural Selection ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Medical Intervention ◽  
Reproductive Age ◽  
Human Reproduction ◽  
Secular Changes ◽  
Infertile Couples ◽  
Long Term Consequences

Abstract Since the middle to late 20th century the majority of children born in the developing world have been likely to enter into post-reproductive age. Currently, child mortality is at its lowest level in human history. While more children are living to post reproductive age, approximately 15% of couples are experiencing infecundity. This is either a result of one or both members of the couple being infecund, or, despite both being fecund, the interaction between them prevents fertility for some reason. Assisted reproductive technologies have provided many infertile couples an opportunity to have children. Assisted reproductive technologies operate by intervening and manipulating gametic and intrauterine natural selection. This paper discusses the possible influence of assisted reproductive technologies on child development. This paper outlines some of the reported changes in children resulting from assisted reproductive technologies. Although, few people are either aware or care about possible long term consequences of relaxed natural selection contributed by medical intervention (i.e. assisted reproductive technologies) we have little understanding to what extent such medical interference may affect long term fitness in humans.

scholarly journals From egg to embryo: a peripatetic journey

Reproduction ◽  
2005 ◽  
Vol 130 (6) ◽  
pp. 825-828 ◽  
Author(s):  
Richard M Schultz
Keyword(s):  
Gene Expression ◽  
Assisted Reproductive Technologies ◽  
Egg Quality ◽  
Reproductive Technologies ◽  
Molecular Signature ◽  
High Quality ◽  
Long Term Consequences ◽  
The Uk ◽  
Effect Gene

The recent surge of interest in oocyte development has been spurred in large part by the increasing implementation of assisted reproductive technologies (ART) to treat human infertility. What is becoming apparent is that ‘egg quality’ is a primary factor in the success of ART (Sauer 1998), and yet we know virtually nothing about the molecular signature of a ‘high quality’ oocyte, i.e., an oocyte that is capable of maturing, being fertilized and supporting development to term. We are gaining marked insights, however, into how sperm activate eggs and the changes in gene expression that accompany preimplantation development. Nevertheless, embryo culture is known to effect gene expression (Rinaudo & Schultz 2004), the long-term consequences of which are only recently being unmasked. This review will briefly highlight these topics that were presented during the Biennial Joint Meeting of the UK Fertility Societies at Warwick University in April 2005.

scholarly journals Depressive morbidity among female partner of infertile couple in a tertiary care setup in Bangladesh

2019 ◽  
Vol 45 (2) ◽  
pp. 93-98
Author(s):  
Tanzeem S Chowdury ◽  
T A Chowdhury ◽  
Shirin Akter Begum ◽  
Yasmin Begum ◽  
Mehriban Amatullah
Keyword(s):  
Assisted Reproductive Technologies ◽  
Tertiary Care ◽  
Severe Depression ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Unprotected Sexual Intercourse ◽  
Female Partners ◽  
Primary Infertility ◽  
Infertile Couples ◽  
Anxiety Depression

Background: There are 80 million infertile couples in the world which correspond to approximately 15% of all couples in their reproductive age. Negative attitude and behavior of family and acquaintances causes severe psychological stress resulting in social discrimination and stigmatization which may lead to anxiety, depression and even suicide. The study was aimed to estimate the prevalence and predictors of depressive morbidity among Bangladeshi infertile women. Methods: This prospective, observational study was done on a total of 215 female partners of infertile couples who attended ‘Infertility Management Center’; a Dhaka based tertiary care setup for infertility management and assisted reproductive technologies from August - December 2016. Only those who were unable to conceive after one year of unprotected sexual intercourse and agreed to take part in the study were included in the study. Patients with history of mental illness prior to infertility diagnosis and on any anti-psychotic drugs were excluded from the study. Data collection was done using the validated Beck Depression Inventory (BDI) questionnaire. Results: Among the study population 72.6% were suffering from primary infertility and 27.4% from secondary infertility. Of them, 52.6% had 5 to 10 years and 47.4% had various duration of infertility. Female cause of infertility was in 30.7% couples, male cause was in 16.3%, both were in 4.7% and finally unknown was 48.4%. Female partners of infertile couples showed different types of mode disorders such as 29.3% (n=63) having severe depression, 39.5% moderate, 20.5% mild and 10.7% having no depression. Association between educational status and depression score showed 53.02% graduate having severe depression, though statistically it was not significant. Depression was most common among patients suffering from primary infertility and among housewives as they probably had more time to think and feel the situation. Conclusion: The high level of depression among female partners of infertile couples revealed in this study is quiet alarming and requires attention of the medical fraternity. This study proposes that clinicians should be more aware about anxiety-depression disorders among infertile groups and the necessity of identifying patients who require psychological assistance. Bangladesh Med Res Counc Bull 2019; 45: 93-96

CLINICAL CASE OF SUCCESSFUL TREATMENT OF INFERTILITY IN A PATIENT WITH FAILURE IVF RESULTS IN ANAMNESIS

2020 ◽  
pp. 61-67
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Assisted Reproductive Technologies ◽  
Transvaginal Ultrasound ◽  
Clinical Manifestations ◽  
Reproductive Function ◽  
Abnormal Uterine Bleeding ◽  
Clinical Situation ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Number Of Publications

Genital endometriosis is a disease of women of reproductive age, accompanied by infertility in 50% [1]. Adenomyosis can be considered as an endometriosis of the uterus. Histologically, this process is represented by ectopic, non-tumor endometrial glands, and stroma surrounded by hypertrophic and hyperplastic myometrium [2]. Adenomyosis is accompanied by pelvic pain of varying intensity as well as menstrual disorders [1]. The disease is accompanied by significant violations of reproductive function (infertility, unsuccessful attempts at pregnancy and miscarriage, abnormal uterine bleeding). Adenomyosis can be accompanied by a violation of the function of adjacent organs (such as the bladder, rectum). Often, one of the clinical manifestations of adenomyosis is the development of sideropenic syndrome, which is also caused by the development of chronic post-hemorrhagic iron deficiency anemia. This is accompanied by a deterioration in the general condition of patients, a decrease in their ability to work. Despite a large number of publications in Russian and foreign scientific sources devoted to this problem, reproductive doctors and obstetricians-gynecologists often underestimate the role of adenomyosis in pregnancy planning using assisted reproductive technologies. Without interpreting the anamnesis data obtained through an active survey, doctors do not prescribe additional methods for diagnosing this pathology, which is not complex and expensive. To confirm the diagnosis, a transvaginal ultrasound examination of the pelvic organs during the premenstrual period is sufficient. In cases that are difficult to diagnose, the MRI method of the corresponding anatomical area can be used. Underestimation of the clinical picture and under-examination of the patient did not allow prescribing timely correction of the pathology and led to unsuccessful attempts to implement the generative function using assisted reproductive technologies. The conducted examination with clarification of the cause of IVF failures and the prescribed reasonable treatment made it possible to achieve regression of endometriosis foci in this clinical situation, followed by the patient's ability to realize generative function.

scholarly journals Alteration of Genomic Imprinting after Assisted Reproductive Technologies and Long-Term Health

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 728
Author(s):  
Eguzkine Ochoa
Keyword(s):  
Embryonic Development ◽  
Experimental Evidence ◽  
Genomic Imprinting ◽  
Animal Studies ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Early Embryonic Development ◽  
Global Methylation ◽  
The Impact

Assisted reproductive technologies (ART) are the treatment of choice for some infertile couples and even though these procedures are generally considered safe, children conceived by ART have shown higher reported risks of some perinatal and postnatal complications such as low birth weight, preterm birth, and childhood cancer. In addition, the frequency of some congenital imprinting disorders, like Beckwith–Wiedemann Syndrome and Silver–Russell Syndrome, is higher than expected in the general population after ART. Experimental evidence from animal studies suggests that ART can induce stress in the embryo and influence gene expression and DNA methylation. Human epigenome studies have generally revealed an enrichment of alterations in imprinted regions in children conceived by ART, but no global methylation alterations. ART procedures occur simultaneously with the establishment and maintenance of imprinting during embryonic development, so this may underlie the apparent sensitivity of imprinted regions to ART. The impact in adulthood of imprinting alterations that occurred during early embryonic development is still unclear, but some experimental evidence in mice showed higher risk to obesity and cardiovascular disease after the restriction of some imprinted genes in early embryonic development. This supports the hypothesis that imprinting alterations in early development might induce epigenetic programming of metabolism and affect long-term health. Given the growing use of ART, it is important to determine the impact of ART in genomic imprinting and long-term health.

scholarly journals Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting

2020 ◽  
pp. 1-10
Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
B. O. Altraide ◽  
D. H. John
Keyword(s):  
Health Facility ◽  
Uterine Fibroid ◽  
Assisted Reproductive Technologies ◽  
Descriptive Analysis ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
University Teaching ◽  
Common Cause ◽  
Healthcare Planning ◽  
Pelvic Malignancies

Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery. Objective: This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting. Methodology: This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017. Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis. Results: The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses. Conclusion: This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome.

scholarly journals IMPACT OF MULTIPLE BIRTHS ON THE OUTCOME IN EXTREMELY LOW BIRTH WEIGHT NEWBORNS

2021 ◽  
Vol 27 (3) ◽  
pp. 3985-3991
Author(s):  
Victoria Atanasova ◽  
◽  
Petar Ivanov ◽  
Elitsa Gyokova ◽  
Desislava Georgieva ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Assisted Reproductive Technologies ◽  
Ductus Arteriosus ◽  
Intraventricular Haemorrhage ◽  
Reproductive Technologies ◽  
University Hospital ◽  
Extremely Low Birth Weight ◽  
Gastrointestinal Problems

Objective: To evaluate the outcome of the extremely low birth weight newborns (ELBWNs) from single and twin pregnancies. Material and methods: The study lasts from 2005 to 2017 and includes all life born ELBWNs treated in University Hospital, Pleven, Bulgaria. Patients' groups: singletons (1) and twins (2); twins conceived naturally(2.1) and after assisted reproductive technologies – ART(2.2). Results: One hundred and eighty two (182) ELBWNs are examined, 65 (35.7%) of them are twins. The twins, compared to singletons, are significantly more often conceived by ART (47.7 vs 4.3%, p<0.001) and significantly more rarely infected prenatally (18 vs 41%, p 0.002). The survival rate is 51.3% for singletons and 56.6% for twins, NS. Survived twins (n 37) achieve later their optimal nutritive tolerance (30±11 vs 25±10 days, p 0.046), require more blood transfusions (3.6±1.9 vs 2.6±1.8 per patient, p 0.009) and longer mechanical ventilation (16±15 vs 9±12 days, p 0.03) than survival singletons (n 60). The twins suffer more often from intraventricular haemorrhage (46 vs 18%, p 0.004), patent ductus arteriosus (35 vs 15%, p 0.02) and long-term complications (51 vs 30%, p 0.04) than singletons. ART-twins (n 31)compared to the subgroup 2.1 (n 34) are more frequently intubated in the delivery room (81 vs. 50%, p 0.01)but suffer less frequently from nosocomial infections (53 vs. 85%, p 0.03). Conclusions: According to our data, ELBW-twins frequently suffer from respiratory, haemorrhagic, and gastrointestinal problems than ELBW-singletons, resulting in more long-term complications. Our study proves that ART does not influence the outcome in multiples.

scholarly journals Inositol and vitamin D may naturally protect human reproduction and women undergoing assisted reproduction from COVID-19 risk

2021 ◽  
pp. 113-117
Author(s):  
M.S. Bezerra Espinola ◽  
M. Bertelli ◽  
M. Bizzarri
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Respiratory Infections ◽  
Phosphatidyl Inositol ◽  
Reproductive Technologies ◽  
Human Reproduction ◽  
Risk Category ◽  
Virus Species

In late 2019, the new Coronavirus has been identified in the city of Wuhan (China) then COVID-19 spreads like wildfire in the rest of the world. Pregnant women represent a risk category for increased abortion rates and vertical transmission with adverse events on the newborns has been recently confirmed. The scientific world is struggling for finding an effective cure for counteracting symptomatology. Today, there are many therapeutic proposes but none of them can effectively counteract the infection. Moreover, many of these compounds show important side effects not justifying their use. Scientific literature reports an immune system over-reaction through interleukins- 6 activation. In this regard, the possibility to control the immune system represents a possible strategy for counteracting the onset of COVID-19 symptomatology. Vitamin D deficiency shows increased susceptibility to acute viral respiratory infections. Moreover, Vitamin D seems involved in host protection from different virus species by modulating activation and release of cytokines. Myo-inositol down-regulates the expression of IL-6 by phosphatidyl-inositol-3-kinase pathway. Furthermore, myo-inositol is the precursor of phospholipids in the surfactant and it is applied for inducing surfactant synthesis in infants for treating respiratory distress syndrome. This review aims to summarize the evidence about COVID-19 infection in pregnant women and to encourage the scientific community to investigate the use of Vitamin D and Myo-inositol which could represent a possible preventive treatment for pregnant women or women undergoing assisted reproductive technologies.

scholarly journals Experience of performing radical trachelectomy with uterine transposition in organ-preserving treatment of stage IB-II invasive cervical cancer

2021 ◽  
Vol 67 (1) ◽  
pp. 85-90
Author(s):  
Alyena Chernyshova ◽  
Vitaly Аntipov ◽  
Larisa Коlomiets ◽  
Vladimir Chernov ◽  
Victor Gyunter ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Assisted Reproductive Technologies ◽  
Invasive Cervical Cancer ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Combined Modality Treatment ◽  
Radical Trachelectomy ◽  
Stage Ib

The development and implementation of organ-preserving treatment modalities is the priority trend in the current cancer treatment of patients of the reproductive age. Methods of expanding indications for organ-preserving treatment in cancer patients are becoming relevant. We present our experience in performing radical trachelectomy with uterine transposition in patients with stage IB-II cervical cancer. Our surgical technique allows the preservation of the uterus and adnexa in patients with invasive cervical cancer, who need to receive combined modality treatment including extended surgery followed by chemotherapy or radiation therapy to the pelvis. Transposition of the uterus and adnexa after radical abdominal or laparoscopic trachelectomy allows the movement of the uterus and ovaries out of the radiation field. After completion of radiation therapy, the uterus with adnexa is repositioned into the pelvis and uterine-vaginal anastomosis is formed using an implant made of titanium nickelide. Independent pregnancy and the use of assisted reproductive technologies are permitted after passing the time when distant metastases are most likely to develop.  

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