assisted reproductive treatment
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2022 ◽  
Vol 12 ◽  
Author(s):  
Jiaxiong Wang ◽  
Ce Zhang ◽  
Hui Tang ◽  
Aiyan Zheng ◽  
Hong Li ◽  
...  

Asthenospermia is one of the most important causes of male infertility. Among asthenospermia, multiple morphological abnormalities of sperm flagella (MMAF) are relatively rare idiopathic conditions characterized by multiple defects in sperm flagella. Although many studies focusing on the genetic factors of MMAF have been conducted, its pathogenesis and treatment effect remain largely unknown. Here, we report a male patient from a nonconsanguineous Chinese family who exhibited a typical MMAF phenotype revealed by morphological analysis. We identified splicing mutations in CFAP251 (c.1192-3C>G), and the mutation was proven to cause exon skipping. In addition, western blotting and immunofluorescence analysis of the spermatozoa from the proband and a control subject revealed a significantly lower expression of CFAP251 protein due to pathogenic mutation. Interestingly, the patient’s mother was a heterozygous carrier for the mutation, but his father was not, and finally, the inheritance pattern was proven to be maternal uniparental disomy. We applied an intracytoplasmic sperm injection and achieved a successful pregnancy. Above all, our findings expand the spectrum of CFAP251 pathogenic mutations and provide more indications for clinical genetic counseling and assisted reproductive treatment for such patients.


Author(s):  
Vaishalee Saravanan ◽  
Geetha Desai ◽  
Veena A. Satyanarayana

Background: The uptake of assisted reproductive treatments has increased radically in urban India. We aimed to understand women’s lived experiences of assisted conception, and ART providers’ perception of their patients’ experiences.Methods: This study was cross-sectional and we used a qualitative approach and key informant interviews to understand the experiences of women and the treatment providers. Participants were ten women who had conceived through assisted reproductive treatment and ten ART providers. The data was analyzed using Braun and Clarke’s thematic analysis method.Results: During the treatment process, women felt consumed by their need to conceive. They reported that it was difficult for them to focus on other equally important aspects of their life. Stress, depression and anxiety associated with the uncertainty of their treatment outcome were prevalent. Women were also worried about miscarriage, safety and health of their baby, and forming an attachment with their fetus during the pregnancy. Providers’ concurred that women experience significant mood fluctuations in the form of stress, anxiety and depression which impacts treatment adherence and outcome. Women who have adequate spousal and family support are able to navigate the ART process better than women who lack social support.Conclusions: Findings imply the need for screening and brief psychological interventions at different stages of fertility treatment and during the antenatal and postnatal period to enhance women’s emotional well-being. 


Author(s):  
Gulnaz Sahin ◽  
Ferruh Acet ◽  
Alper Biler ◽  
Reci Meseri ◽  
Ege Nazan Tavmergen Goker ◽  
...  

2021 ◽  
Vol 10 (20) ◽  
pp. 4680
Author(s):  
Chloë De Roo ◽  
Kelly Tilleman

In vitro maturation (IVM) of transvaginally aspirated immature oocytes is an effective and safe assisted reproductive treatment for predicted or high responder patients. Currently, immature oocytes are also being collected from the contralateral ovary during laparoscopy/laparotomy and even ex vivo from the excised ovary or the spent media during ovarian tissue preparation prior to ovarian cortex cryopreservation. The first live births from in vitro-matured ovarian tissue oocytes (OTO-IVM) were reported after monophasic OTO-IVM, showing the ability to achieve mature OTO-IVM oocytes. However, fertilisations rates and further embryological developmental capacity appeared impaired. The introduction of a biphasic IVM, also called capacitation (CAPA)-IVM, has been a significant improvement of the oocytes maturation protocol. However, evidence on OTO-IVM is still scarce and validation of the first results is of utmost importance to confirm reproducibility, including the follow-up of OTO-IVM children. Differences between IVM and OTO-IVM should be well understood to provide realistic expectations to patients.


Author(s):  
C. C Repelaer van Driel- Delprat ◽  
E.w.c.m. van Dam ◽  
P.m. van de Ven ◽  
K. Aissa ◽  
M.k. ter Haar ◽  
...  

Studies evaluating pregnancy outcomes after assisted reproductive treatment (ART) in women with high-normal (2.5-4.5 mIU/L) TSH levels are conflicting, possibly due to different patient charactistics and subfertility indications. The aim of this study was to examine the hypothesis that high-normal compared to low-normal TSH levels are associated with adverse implications for pregnancy outcomes in conventional in vitro fertilization (IVF)-treated women. Therefore we analysed retrospectively the characteristics and pregnancy outcomes of 949 subfertile women with TSH 0.3-4.5 mIU/L, treated with conventional IVF between January 2008 and March 2012. Demographic and baseline characteristics were compared between groups of patients based on TSH quartiles, using one-way Anova, Kruskall-Wallis ANOVA and chi-square test. Women with high-normal quartile TSH were significantly more likely to be primary subfertile (p = 0.01), with a higher prevalence of unexplained subfertility and with 15% fewer live births after IVF compared to lower TSH quartiles (p = 0.02). In secondary subfertile women with high-normal TSH male factor subfertility prevailed (p=0.01), with more live births (p=0.01). When analysing primary and secondary subfertile women as one group, these differences failed to be observed, showing no differences in cumulative pregnancy outcomes of IVF between TSH quartiles (I: 0.3-1.21 mIU/L; II: 1.22-1.68 mIU/L; III: 1.69-2.31 mIU/L; IV: 2.32-4.5 mIU/L). In conclusion, primary subfertile women predominate in the high-normal TSH quartile, associated with significantly fewer live births in a subgroup of primary unexplained subfertile women (9%; n=87/949), while in secondary subfertile women, dominated by male factor subfertility, high-normal TSH is associated with more live births.


2021 ◽  
Author(s):  
Mahrukh Hameed Zargar ◽  
Faisel Ahmad ◽  
Mohammad Lateef ◽  
Tahir Mohiuddin Malla

Infertility is a serious problem of not being able to conceive despite regular intercourse for more than a year. Natural conception is seen to be achieved in 80%–85% of couples. About 15% of couples suffer infertility with male factor contributing to almost 50% of cases. Paradoxically, on traditional assessment, the underlying etiology of male contribution towards infertility remains unrecognized in 30% of the patients and thereby grouped as idiopathic. Diagnostics of male infertility cannot therefore be limited to usual semen analysis only. The spectrum of the recent research encourages the experts in the field to approach the Clinical, Molecular and cytogenetic shades associated with the problem besides secondary factors like life style and environment. Clinical assessment sums the medical history and physical examination of the affected individual. Molecular and cytogenetic analysis help gain new insights in understanding the problem and thereby an advantage for a successful assisted reproductive treatment (ART). Given the cost and burden ART puts in and prior to application of any invasive techniques, understanding precisely the etiology associated with male infertility is essential for the fertility specialist to circumvent inefficient or any unproductive steps in the fertilization process besides helping in counseling patients on their chance of success with the use of reproductive technology.


2021 ◽  
Vol 5 (4) ◽  
pp. 73-76
Author(s):  
Tingjuan Ren ◽  
Hongli Zhu ◽  
Rui Wang

The main cause of infertility in elderly women is poor ovarian function, decreased quality and number of oocytes, which ultimately leads to poor fertility. Low ovarian function is the most difficult point in the research of reproductive medicine and reproductive health. At present, the treatment of integrated traditional Chinese and Western medicine has gradually achieved results. Western medicine mainly regulates endocrine and assisted reproductive treatment by supplementing estrogen and progesterone, while traditional Chinese medicine (TCM) mainly focuses on invigorating the kidney, adding and subtracting according to the syndrome. The treatment effect of TCM or western medicine alone is not significant. Many clinical observations show that integrated TCM and western medicine focuses on the specialties of western medicine, which not only makes up for the insufficiency of the slow action of TCM, but also improves its clinical efficacy when combined with western medicine. Based on domestic and foreign research, this article summarizes the treatment of infertility in elderly women with integrated TCM and western medicine.


2021 ◽  
Vol 12 (4) ◽  
pp. 240-247
Author(s):  
Mădălin-Marius Margan ◽  
Roxana Margan ◽  
Fira-Mladinescu Corneluta ◽  
Putnoky Salomeia ◽  
Tuta-Sas Ioana ◽  
...  

Objective: The aim of this paper is to illustrate the main points of interest regarding the way treatment of infertility impacts the life of couples who struggle with this condition in Romania. The unique aspects and specific challenges regarding social, financial and psychological implications that affect Romanian couples who access specialized treatment for infertility will be thoroughly discussed. Methods: This study is a descriptive cross-sectional research. The sample population included patients who attended specialized infertility treatment (Assisted Reproductive Techniques - ART) in Fertility Clinics from Romania. The study was conducted between 2017 and 2019 and data was gathered through two infertility questionnaires. Results: The questionnaire for women was filled in by 829 female participants who struggled with infertility and resorted to ART and the questionnaire for men was completed by 227 male participants, as partners of the women, some of them as well with fertility issues. We analysed the results regarding all aspects surrounding infertility and ART, such as: psychological implications, impact of stress, access to specialized treatment, costs for treatment. Conclusion: The results showed that couples who struggle with infertility have to deal with high costs for specialized infertility treatments, in addition to stress related to treatment, creating a combination which negatively impacts their future chances of getting a pregnancy.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Gudleviciute ◽  
P Maldunas ◽  
G Gersvaltaityte ◽  
Z Gudlevicien ◽  
V Paliulyt

Abstract Study question Does seasonal variation impact zona pellucida (ZP) thickness, other assisted reproductive treatment (ART) factors and ART outcome? Summary answer Seasonality and lunar phase impact ZP thickness while specific weather conditions alone do not, however, seasonality does not impact other ART factors or ART outcome. What is known already: Several epidemiological studies have demonstrated seasonal variation in natural pregnancy and birth rate, which varies across geographic regions. It has been suggested that temperature and light may affect the ability to conception via hormonal changes. However, data regarding the seasonal variation during ART is controversial and several studies with conflicting results have been published. One retrospective observational cohort study reported the significant influence of seasonality on fertilization rates with highest ones during the spring and the lowest ones in the autumn. However, another retrospective study did not demonstrate any significant influence of the seasons on ART outcome. Study design, size, duration This retrospective study was performed in the Fertility Center, VUH Santaros Clinics, Lithuania. 959 IVF/ICSI cycles conducted in IVF laboratory between 2017 and 2019 were analysed. The thickness of ZP was measured of 5002 oocytes retrieved between 2017 and 2018. Degenerated oocytes were excluded from the study. Average temperature (AT), precipitation (AP) and sunshine hours (ASH) of every month were taken from Lithuanian Hydrometeorological Service database. Lunar phase (LP) data was collected using Google Calendar. Participants/materials, setting, methods IVF/ICSI cycles were divided into four seasonal groups according to the day of oocyte pick-up. The number of retrieved and fertilized oocytes, transferred embryos, fertilization and pregnancy rates were compared among groups. Then, to avoid bias in fertilization rate, ICSI cycles were excluded and only IVF cycles were analysed. Measurements of ZP thickness were taken using NIS-Elements F software. It was evaluated if AT, AP, ASH, LP and seasonality had an effect on ZP thickness. Main results and the role of chance The mean number of retrieved oocytes and fertilized oocytes as well as the percentage of women who conceived was highest in the spring and lowest in the summer without statistical significance among all seasonal groups (p > 0.05). The fertilization rate was lowest in the spring (66.60%) and highest in the autumn (68.76%) without statistical significance among all four groups. The odds were 1.49 times higher to conceive in spring compared to summer and this result was statistically significant (95% CI 1.01–2.21; p = 0.046), however, when comparing all four seasons together, the difference was not significant. The calculations with only IVF cycles followed the same pattern except that the odds ratio results were not significant and the fertilization rate was highest in the winter. None of the weather conditions (average temperature, average precipitation and average sunshine hours) had an impact on ZP thickness. However, the mean ZP thickness was lowest in the summer (18.86 ± 3.08 µm) and highest in the autumn (19.43 ± 2.98 µm) and the difference among all four seasons was statistically significant (p < 0.05). The mean ZP thickness was lowest during the first quarter lunar phase and highest during the new moon phase with statistical significance among groups (p < 0.05). Limitations, reasons for caution A limitation of our study is unequal number of the IVF/ICSI procedures between months/seasons (e.g., the sample size of autumn was 340 while the sample size of summer was only 161). Also, the measurements of ZP were taken manually therefore there could be some errors. Wider implications of the findings: Understanding possible effects of external factors on ART outcome is important for the best treatment results. Even though seasonality and lunar phase significantly impact ZP thickness, we could not demonstrate any significant seasonal influence on other ART factors or ART outcome. Further studies with higher number of patients are required. Trial registration number Not applicable


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