ROL DEL PERSONAL DE ENFERMERIA EN LOS TRATAMIENTOS DE REPRODUCCIÓN ASISTIDA HUMANA

Existen una gran cantidad de parejas infértiles que se someten actualmente a algún tratamiento de reproducción asistida de baja complejidad (Inseminación Artificial), o de alta complejidad (Fecundación In Vitro, Inyección Intracitoplasmática de espermatozoides (ICSI en sus siglas en inglés) y para la realización de los mismo se necesita de una correcta coordinación entre todo el personal médico, de laboratorio y de enfermería, donde este último, en sus distintos roles, será el encargado de la preparación de la paciente para que esta pueda afrontar en las mejores condiciones posibles el tratamiento, lo que a su vez facilitará un mejor entendimiento y cumplimiento de las indicaciones, una menor tasa de abandono de tratamiento y mejores resultados en la consecución de un embarazo. El objetivo principal es dar a conocer los roles que cumple actualmente el personal de enfermería como son el asistencial tanto en el consultorio como en el quirófano, brindar apoyo emocional y educativo a las pacientes y participar en proyectos de investigación institucionales. Palabras clave: enfermería, cuidados de enfermería, infertilidad, inseminación, fertilización in vitro. ABSTRACT There are a large number of infertile couples currently undergoing assisted reproduction treatment of low complexity (Artificial Insemination), or high complexity (In Vitro Fertilization, Intracytoplasmic Sperm Injection (ICSI)) and for the realization of the same requires proper coordination between all medical personnel, The latter, in their different roles, will be in charge of preparing the patient so that she can face the treatment in the best possible conditions, which in turn will facilitate a better understanding and compliance with the indications, a lower rate of abandonment of treatment and better results in achieving a pregnancy. The main objective is to raise awareness of the roles currently performed by the nursing staff, such as assistance both in the office and in the operating room, to provide emotional and educational support to patients and to participate in institutional research projects. Keywords: nursing, nursing care, infertility, insemination, in vitro fertilization

Psychosocial Aspects of Gestational Grief in Women Undergoing Infertility Treatment: A Systematic Review of Qualitative and Quantitative Evidence

Women undergoing assisted reproduction treatment without being able to become pregnant, and experiencing pregnancy loss after assisted reproduction, are triggering factors for prolonged grief and mourning. This review aims to investigate the psychosocial aspects of gestational grief among women who have undergone infertility treatment. We searched the databases of MEDLINE/PubMed, EMBASE, CINAHL, Scopus, ScienceDirect, and Lilacs for works published up to 5 March 2021. The outcomes analyzed were negative and positive psychosocial responses to gestational grief among women suffering from infertility and undergoing assisted human reproduction treatment. Eleven studies were included, which yielded 316 women experiencing infertility who were undergoing treatment. The most frequently reported negative psychosocial manifestations of grief response were depression (6/11, 54.5%), despair or loss of hope/guilt/anger (5/11, 45.5%), anxiety (4/11, 36.4%), frustration (3/11, 27.3%), and anguish/shock/suicidal thoughts/isolation (2/11, 18.2%). Positive psychosocial manifestations included the hope of becoming pregnant (4/6, 66.6%) and acceptance of infertility after attempting infertility treatment (2/6, 33.3%). We identified several negative and positive psychosocial responses to gestational grief in women experiencing infertility. Psychological support before, during, and after assisted human reproduction treatment is crucial for the management of psychosocial aspects that characterize the grief process of women experiencing infertility who become pregnant and who lose their pregnancy. Our results may help raise awareness of the area of grief among infertile women and promote policy development for the mental health of bereaved women.

O DIREITO SUCESSÓRIO DOS FILHOS HAVIDOS POR INSEMINAÇÃO ARTIFICIAL HOMÓLOGA PÓS-MORTEM

The present work aims to analyze whether the children conceived after the death of the parent by homologous fertilization have the right to inheritance, seeking to conceptualize the institutes of inheritance law and artificial insemination, analyzing the constitutional principles and the sources of law, so that find the best answer on the topic. The article will be divided into 3 parts. The first will try to explain the succession law (master of the law that regulates the transfer of assets, rights and obligations to the heir after the death of an individual) in the light of Brazilian legislation, explaining the existing Types of Succession. The second part of this article will address Assisted Human Reproduction, pointing out the different conceptions of the concept of family that has undergone significant modification over time. In addition, the second part will also deal with Artificial Insemination, which is an assisted reproduction treatment that expands the possibilities of fertilization of the egg, as well as its divisions. It also points out the principles of Brazilian law applicable to assisted human reproduction. The last part of this work will analyze post mortem artificial insemination and the effects on inheritance law based on legislation, doctrine and principles applicable to the subject, pointing out the three doctrinal currents that emerged with the aim of filling this legislative vacuum. This research is categorized as explanatory, as it aims to identify the factors that determine and contribute to the succession of the post mortem inseminated child, the procedure used in this study will be the bibliographic research.

Motherhood Plan: Has it Changed in Face of the COVID-19 Pandemics?

Background: The goal for the present study was to investigate whether women seeking fertility care have different perception concerning the impact of Covid-19 on the motherhood plan than a target population. Material and Methods: For this prospective study, a survey through onlineplatforms was conducted. Participants were randomized by age, in a 1:4 ratio, into: ART-GROUP (n=368), including patients seeking for Assisted Reproduction Treatment (ART), but still didn’t start their cycles or INTERESTED-GROUP (n=92), including participants interested in the subject, who accessed the website of a university-affiliated IVF-center. Information on their perceptions in face of the COVID-19 pandemics and the motherhood plan was collected. Results: When asked about the possibility of becoming pregnant, after the beginning of the pandemic, 47.8% of the ART-GROUP stated to believe the pandemic could affect their plans, while only 28.2% of the INTERESTEDGROUP stated the same. The plan to become pregnant was postponed by 41.3% of the ART-GROUP and by 60.8% of the INTERESTED-GROUP. The main reasons that led people to this decision were fear of getting sick, economic reasons and a pessimist view of the future. Conclusion: In conclusion, besides the fear of becoming sick, the economic burdens are the main reason for the delay in the motherhood plain.

The value of serum progesterone level on day of human chorionic gonadotrophin administration / metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

Background The clinical implication of the increased serum progesterone level on the day of HCG administration in assisted reproduction treatment (ART) is still controversial. The current study aimed to compare the predictive value of serum progesterone on day of HCG administration / metaphase II oocyte (P/MII) ratio on IVF/ ICSI outcome to serum progesterone (P) level alone and the ratio of serum progesterone/estradiol level (P/E2) ratio in prediction of pregnancy rates after ART. Material & methods Two hundred patients admitted to the IVF/ICSI program at Minia IVF center in Egypt in the period from October 2016 to May 2018 were included in this study. Serum Progesterone (P) and Estradiol (E2) levels were estimated on the day of HCG administration. The ratio between serum P and the number of MII oocytes (P/MII ratio) was calculated and the predictive values of the three parameters (P, P/E2 ratio and P/MII ratio) in prediction of cycle outcomes were measured. Results P/ MII oocyte ratio was significantly lower in patients who attained clinical pregnancy (n = 97) as compared with those who couldn’t whilst there was no significant difference in P and P/E2 ratio between the two groups. Using a cut off value of 0.125, the sensitivity and specificity of progesterone/ MII ratio in prediction of no pregnancy in IVF/ICSI were 75.7 and 77.1% respectively with the area under The Receiver operating curve (ROC-AUC) = 0.808. The respective values of the ROC-AUC for the P and P/E2 ratio were 0.651 and 0.712 with sensitivity and specificity of 71.2 and 73.5%for P level and of 72.5 and 75.3% for P/E2 ratio. Implantation or clinical pregnancy rates were significantly different between patients with high and low P/MII ratio irrespective of day of embryo transfer (day 3 or 5). Conclusions In patients with normal ovarian response, serum progesterone on day of HCG / MII oocyte ratio can be a useful predictor of pregnancy outcomes and in deciding on freezing of all embryos for later transfer instead of high progesterone level alone.

Role of Antioxidants Supplementation in the Treatment of Male Infertility

Nutritional utilization of antioxidants, such as vitamins C, E, ß-Carotene and micronutrients, such as folate and zinc, have been shown to be critically essential for normal semen quality and reproductive function. However, it is still, a large knowledge gap exists concerning the role of antioxidants on semen parameters and the role in treatment of male subfertility. Therefore, the current review article designed to find out the positive effect of antioxidants on semen quality, alterations in physiological functions of spermatozoa and infertility treatment It is advisable that patients with oxidative DNA disruption should be asked to take a simple course of antioxidants prior to undertaking assisted reproduction treatment (ART). In conclusion, antioxidant may be employed as a potent antioxidant and may improve infertility treatment outcomes with ART.