Seminars in reproductive medicine最新文献

{"title":"Informing a PCOS Lifestyle Program: Mapping Behavior Change Techniques to Barriers and Enablers to Behavior Change Using the Theoretical Domains Framework.","authors":"Stephanie Pirotta,&nbsp;A E Joham,&nbsp;L J Moran,&nbsp;H Skouteris,&nbsp;S S Lim","doi":"10.1055/s-0041-1735456","DOIUrl":"https://doi.org/10.1055/s-0041-1735456","url":null,"abstract":"<p><p>This article aimed to identify the behavior change techniques (BCTs) based on facilitators and barriers to lifestyle management in women with polycystic ovary syndrome (PCOS) according to the behavior change wheel (BCW). This qualitative study design using inductive thematic analysis following semistructured interviews (<i>n</i> = 20) identified barriers and enablers to lifestyle management. These were then mapped to Capability, Opportunity, Motivation-Behavioral Model (COM-B) constructs and the corresponding Theoretical Domains Framework (TDF) domains. This study included women with PCOS residing in Australia. Main outcome measures include intervention functions, policy categories, and BCTs described in the BCW. Twenty-three BCTs were recognized to influence behavior change in women with PCOS. Factors were categorized into the subcomponents of the COM-B: psychological capability (e.g., lack of credible information), physical capability (e.g., managing multiple health conditions), physical opportunity (e.g., limited access to resources), social opportunity (e.g., adequate social support), reflective motivation (e.g., positive health expectancies following behavior change), and automatic motivation (e.g., emotional eating). Future research should use this work to guide PCOS lifestyle intervention development and then test intervention effectiveness through an experimental phase to provide empirical evidence for wider use and implementation of tailored, theory-informed PCOS lifestyle programs as part of evidence-based PCOS management.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 3-04","pages":"143-152"},"PeriodicalIF":2.7,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39343162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis on the Implementation of the Evidence-based PCOS Lifestyle Guideline: Recommendations from Women with PCOS.","authors":"Siew Lim,&nbsp;Breanna Wright,&nbsp;Melissa Savaglio,&nbsp;Denise Goodwin,&nbsp;Stephanie Pirotta,&nbsp;Lisa Moran","doi":"10.1055/s-0041-1735575","DOIUrl":"https://doi.org/10.1055/s-0041-1735575","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting women of reproductive age, affecting 8-13% in this group. Women with PCOS are more likely to have excess BMI, which in turn exacerbates the symptoms of PCOS in these women. The latest evidence-based guideline recommends lifestyle management as the first-line treatment for PCOS. However, the implementation of this recommendation through health services faces a significant challenge. As part of the mapping of the implementation plan for lifestyle management in PCOS, citizen panels and semi-structured interviews were conducted to capture the voices of consumers. Women with PCOS expressed the need for multidisciplinary, integrated care as a recurrent theme. Other important considerations included health professionals who listen and are open to learning about PCOS, the empowerment of women to self-manage PCOS and the provision of peer support. Women with PCOS also expressed the key recommendation of focusing on practical skills when providing lifestyle advice. Within that, both individual and group lifestyle sessions were valued for privacy and peer support respectively and delivery by a dietitian is preferred. These recommendations by women with PCOS should be considered when developing the implementation plan for the PCOS lifestyle guideline.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 3-04","pages":"153-160"},"PeriodicalIF":2.7,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39370478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathophysiology of Hypercoagulability and Infertility.","authors":"Ann Kinga Malinowski","doi":"10.1055/s-0041-1729763","DOIUrl":"https://doi.org/10.1055/s-0041-1729763","url":null,"abstract":"<p><p>Alongside an interplay of a multitude of factors, attainment of a favorable pregnancy outcome is predicated on successful implantation, which in itself is a complex process anchored by balanced interchange with the hemostatic system. Among other etiologies, failure of implantation can result in infertility, and lead affected couples to consider assisted reproductive technology (ART) in an effort to fulfill their desire for procreation. Given the critical role of the hemostatic system in the process of implantation, documentation of a hypercoagulable state during controlled ovarian stimulation in the context of in vitro fertilization, as well as the potential association of its derangement in the setting of thrombophilia, with infertility, ART, ovarian hyperstimulation syndrome, and failure of implantation are explored. Additionally, current evidence addressing the relationship between ART and thromboembolism is examined, as is the role of therapy with heparin and aspirin to decrease thrombotic risk and improve ART-related pregnancy outcomes. Evidence-based recommendations from relevant professional societies are summarized.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 1-02","pages":"34-61"},"PeriodicalIF":2.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38922102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preimplantation Genetic Testing for Aneuploidy: Current Perspectives.","authors":"Ariadne L'Heveder,&nbsp;Benjamin P Jones,&nbsp;Roy Naja,&nbsp;Paul Serhal,&nbsp;Jara Ben Nagi","doi":"10.1055/s-0041-1731828","DOIUrl":"https://doi.org/10.1055/s-0041-1731828","url":null,"abstract":"<p><p>Despite improvements in assisted reproduction techniques (ARTs), live birth rates remain suboptimal, particularly in women with advanced maternal age (AMA). The leading cause of poor reproductive outcomes demonstrated in women with AMA, as well as women with recurrent miscarriage and repetitive implantation failure, is thought to be due to high rates of embryonic aneuploidy. Preimplantation genetic testing for aneuploidies (PGT-A) aims to select an euploid embryo for transfer and therefore improve ART outcomes. Early PGT-A studies using fluorescent in situ hybridization on mainly cleavage-stage biopsies failed to show improved delivery rates and, in certain cases, were even found to be harmful. However, the development of comprehensive chromosome screening, as well as improvements in culture media and vitrification techniques, has resulted in an emerging body of evidence in favor of PGT-A, demonstrating higher implantation, pregnancy, and live birth rates. While there are concerns regarding the potential harm of invasive biopsy and the cost implications of PGT-A, the introduction of noninvasive techniques and the development of new high-throughput methods which lower costs are tackling these issues. This review aims to assess the evidence for PGT-A, address possible concerns regarding PGT-A, and also explore the future direction of this technology.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 1-02","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39164922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial Receptivity Testing and Therapy in Assisted Reproductive Treatment.","authors":"Lukasz Tadeusz Polanski,&nbsp;Miriam Baumgarten","doi":"10.1055/s-0041-1730421","DOIUrl":"https://doi.org/10.1055/s-0041-1730421","url":null,"abstract":"<p><p>Assisted reproductive treatment (ART) gave numerous couples the chance to have their biological child. Improvement in laboratory and culture conditions allows for selection of embryos with the best developmental potential, although replacement of these top-quality embryos does not, however, guarantee reproductive success. Endometrial receptivity is essential for pregnancy establishment and may be the limiting factor for the observed pregnancy rates with ART. Multiple modalities have been in use to assess endometrial receptivity, with ultrasound assessment of the endometrial morphology most commonly used due to its noninvasive nature and availability. Utilization of various \"omics\" increases our understanding of endometrial receptivity and selectivity; however, significantly more work is required to develop clinically relevant and validated tests of endometrial receptivity and treatments which could improve a suboptimal endometrial milieu. Current evidence for and against use of various tests of endometrial receptivity in women undergoing ART is presented in this article.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 1-02","pages":"27-33"},"PeriodicalIF":2.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39310336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryo Glue: The Use of Hyaluronan in Embryo Transfer Media.","authors":"Beth Atkinson,&nbsp;Emma Woodland","doi":"10.1055/s-0041-1730415","DOIUrl":"https://doi.org/10.1055/s-0041-1730415","url":null,"abstract":"<p><p>EmbryoGlue is available to patients at many in vitro fertilization clinics, usually at an additional cost. The efficacy of hyaluronan-enriched transfer medium (HETM) is supported by moderate quality evidence that indicates a significant improvement in clinical outcomes such as live birth rates for patients, including poorer prognosis women (i.e., maternal age factor [>35 years] and recurrent implantation failure). An increased multiple pregnancy rate has been reported with the use of HETM; therefore, a single embryo transfer policy should be considered in conjunction with the use of EmbryoGlue. There is no evidence to suggest that HETM has any detrimental impact, and therefore the use of HETM in clinics may be justified for a specific demographic of patients. Further robust evidence, in the form of meta-analyses or large-scale randomized controlled trials, is needed to build a sufficient consensus regarding the benefit of hyaluronan supplementation in embryo transfer media.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 1-02","pages":"24-26"},"PeriodicalIF":2.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombophilia, Inflammation, and Recurrent Pregnancy Loss: A Case-Based Review.","authors":"Elvira Grandone,&nbsp;Gregory Piazza","doi":"10.1055/s-0041-1731827","DOIUrl":"https://doi.org/10.1055/s-0041-1731827","url":null,"abstract":"<p><p>Recurrent pregnancy loss (RPL) is defined as the loss of two or more pregnancies and is often multifactorial with the majority of miscarriages being due to aneuploidy and anatomic or physiological abnormalities. However, inherited or acquired thrombophilias have also been associated with RPL, albeit inconsistently. While inherited thrombophilias, such as factor V Leiden and prothrombin gene mutation, are relatively prevalent in women with RPL compared with the general population, a causal link has yet to be definitively established. Recently, systemic inflammation, as measured by high-sensitivity C-reactive protein, has also been hypothesized to play a role in infertility. Based on limited prospective trial data, antithrombotic therapy and antiplatelet agents have been proposed as possible tools for the prevention of RPL. Because of the multifactorial nature of RPL and infertility, various clinicians, as obstetricians and gynecologists, endocrinologists, hematologists, or vascular medicine specialists, may be requested to counsel these women. This, together with evidence gaps, frequently leads to distinctly different diagnostic and therapeutic recommendations, especially regarding thrombophilia testing and treatment. Using four case vignettes in this review, we critically appraise the literature and highlight how two clinicians from different subspecialties approach the relationship between RPL, inflammation, and thrombophilia.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 1-02","pages":"62-68"},"PeriodicalIF":2.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39063797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological Testing in Assisted Reproductive Technology.","authors":"Joshua Odendaal,&nbsp;Siobhan Quenby","doi":"10.1055/s-0041-1730908","DOIUrl":"https://doi.org/10.1055/s-0041-1730908","url":null,"abstract":"<p><p>Fetal implantation requires carefully orchestrated involvement of the maternal immune system. Aberrant function within implantation has been suggested as a cause of implantation failure. The emergence of immunological theories of miscarriage has led to immunological testing as an adjuvant treatment in assisted reproductive technology; however, it remains controversial, with mixed evidence both for immunological cause and the benefits of immunological testing. Literature on common methods of immunological testing within assisted reproductive technology is reviewed including those of peripheral and uterine natural killer cells, chronic endometritis, and T-helper cells cytokine ratio. There is little consensus in the evidence on immunological testing in the context of recurrent implantation failure. The field is limited by a lack of uniformity in approach to testing and heterogeneity of the pathophysiological cause. Nevertheless, the maternal immune system is heavily involved in implantation and the new era of personalized medicine ensures that a more defined approach to immunological testing will be achieved.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"39 1-02","pages":"13-23"},"PeriodicalIF":2.7,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39098128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity, Diabetes and Reproductive Health.","authors":"Eleanor P Thong,&nbsp;Siew S Lim","doi":"10.1055/s-0041-1727221","DOIUrl":"https://doi.org/10.1055/s-0041-1727221","url":null,"abstract":"As the global prevalence of obesity continues to climb exponentially, a concurrent increase in diabetes is now evident in both developed and developing countries. Obesity and diabetes have deleterious effects on reproductive health and affect fertility in a myriad of ways, including but not limited to perturbations of the hypothalamic-pituitary-ovarian axis, oocyte quality and implantation. The relationship between obesity, diabetes and reproductive disorders is multidirectional, where obesity increases the risk of diabetes and diabetes in turn exacerbates weight gain via insulin resistance and exogenous insulin administration. The interplay between obesity and insulin resistance underlies the pathophysiology of polycystic ovary syndrome (PCOS), the most common endocrinopathy in reproductive agedwomen. Diabetes and obesity both lead to a pro-inflammatorymilieu, impairing ovarian follicle and steroid hormone production,1 leading tomenstrual disturbance. On the other hand, PCOS is associated with an increased risk of obesity and dysglycaemia, cementing the link between reproductive andmetabolic health. The relationship between obesity, diabetes and reproductive health is highlighted at specific reproductive stages. During the preconception phase, women with obesity are at higher risk of PCOS or infertility. After conception, pre-existing obesity and excess gestational weight gain increase the risk of developing gestational diabetes, hypertension and pre-eclampsia.2 There are also further considerations in managing pre-existing diabetes during pregnancy where blood glucose control can be challenging due to changes in insulin sensitivity with each trimester.3 Higher body mass index and poorer glycaemic control are associated with increased risks of adverse effects to the fetus, such as macrosomia or intrauterine growth restriction. In the postpartum period and beyond, a history of pregnancy with complications such as gestational diabetes increases the risk of type 2 diabetes later in life,4 especially in those with excess weight gain.5 Therefore, early recognition and management of these risk factors are vital to optimize pregnancy and long-term maternal health outcomes. In this issue, we cover the epidemiology and mechanisms of obesity in women with diabetes and describe the relationships between obesity, diabetes and reproductive disorders.We discuss the prevention of these conditions in the preconception, intrapartum and postpartum phases. The shortand longterm management and prognosis of these conditions are also discussed in more detail. Finally, perspectives on the whole-person impact these conditions have on individuals, in terms of stigma and mental health consequences, are explored. We hope that the articles in this issue will be a valuable resource to clinicians and scientists alike, for improving the care of reproductive-aged women at increased risk of metabolic disease. In addition, we aim to promote a greater awareness and interest on th","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"38 6","pages":"331-332"},"PeriodicalIF":2.7,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1727221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25537206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Stigma across the Preconception, Pregnancy, and Postpartum Periods: A Narrative Review and Conceptual Model.","authors":"Briony Hill,&nbsp;Angela C Incollingo Rodriguez","doi":"10.1055/s-0041-1723775","DOIUrl":"https://doi.org/10.1055/s-0041-1723775","url":null,"abstract":"<p><p>Weight stigma is a pervasive issue promoting significant adverse health and psychosocial consequences. Preconception, pregnant, and postpartum women are particularly vulnerable to weight stigma, which can directly impact their health and that of the next generation. Of note, weight stigma affects women living with obesity who are already at risk for developing gestational diabetes and experiencing associated stigmas. This narrative review aimed to examine the literature on weight stigma across the preconception, pregnancy, and postpartum periods, specifically to (1) synthesize the evidence using a socioecological lens; (2) develop a conceptual model of weight stigma tailored to women across this life phase; and (3) provide recommendations for future research. To date, weight stigma research across the preconception, pregnancy, and postpartum periods has focused predominately on pregnancy and antenatal care. The drivers and facilitators of this stigma are pervasive, occurring across various contexts and settings. Manifestations of weight stigma include decreased reproductive healthcare quality, mental health symptoms, poorer health behaviors, and adverse pregnancy outcomes. Future research should further investigate the experiences of women preconception and postpartum, and health/social impacts beyond healthcare. The model herein will guide such research to ultimately identify opportunities for stigma reduction and improve multigenerational health and well-being outcomes.</p>","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":"38 6","pages":"414-422"},"PeriodicalIF":2.7,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1723775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25485875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}