Fertility research and practice最新文献

{"title":"Vaginal cuff dehiscence following transvaginal oocyte retrieval: a case report.","authors":"Sarah K O'Connor,&nbsp;David A Ryley,&nbsp;Charles W Obasiolu,&nbsp;Katharine M Esselen,&nbsp;Christine C Skiadas,&nbsp;Wendy Kuohung","doi":"10.1186/s40738-020-00085-0","DOIUrl":"https://doi.org/10.1186/s40738-020-00085-0","url":null,"abstract":"<p><strong>Background: </strong>Vaginal cuff dehiscence (VCD) is a rare but potentially serious complication following hysterectomy with an estimated incidence of 0.14-1.4%. There is a wide range of risk factors thought to contribute to VCD, but due to its rare occurrence, much still remains to be learned about the true impact of risk factors leading to dehiscence. We present here the second known report of VCD to occur in a patient undergoing transvaginal oocyte retrieval during her fertility treatment. This case highlights what may become a more common clinical scenario as more premenopausal women are diagnosed with reproductive tract cancers and access assisted reproductive therapies to preserve fertility.</p><p><strong>Case presentation: </strong>Our patient is a 35-year-old G1 P0 A1 who had undergone ovary-sparing total laparoscopic hysterectomy (TLH) following diagnosis of endometrial adenocarcinoma. She underwent two in-vitro fertilization (IVF) cycles after TLH to bank frozen blastocysts, the first vaginal oocyte retrieval (VOR) taking place 12 weeks following hysterectomy. She experienced VCD during her second VOR that occurred 17 weeks after TLH, the second case of VCD to be reported in the literature during fertility preservation treatment following hysterectomy. The patient underwent an emergent and uncomplicated repair of the defect vaginally the same day.</p><p><strong>Conclusions: </strong>Currently there are no guidelines in place for women who have undergone hysterectomy with regard to when they can begin fertility treatment in the post-operative period. Based on now two case reports, it is worth considering extension of the typical 6-week timeline of avoidance of vaginal procedures to allow for full cuff healing. Infertility providers should also be mindful of limiting transvaginal ultrasounds where possible to reduce force along the cuff.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00085-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38359486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in fertility knowledge among women from low and high resource settings presenting for fertility care in two United States metropolitan centers.","authors":"Jacquelyn R Hoffman,&nbsp;Meaghan A Delaney,&nbsp;Cecilia T Valdes,&nbsp;Diana Herrera,&nbsp;Samuel L Washington,&nbsp;Lusine Aghajanova,&nbsp;James F Smith,&nbsp;Christopher N Herndon","doi":"10.1186/s40738-020-00084-1","DOIUrl":"https://doi.org/10.1186/s40738-020-00084-1","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined health literacy and fertility knowledge among women from low income, socio-culturally diverse communities presenting for fertility care in the United States. Our study sought to examine demographic predictors of fertility-related knowledge among infertile women from low and high-resource communities in two major metropolitan centers in the United States.</p><p><strong>Methods: </strong>Fertility Knowledge Assessments were administered to women presenting for fertility care at county medical centers serving low-resource, largely immigrant patients and to women from largely affluent populations presenting to comprehensive fertility centers in two cities. The influence of demographic predictors on fertility knowledge was examined through regression analysis.</p><p><strong>Results: </strong>A total of 143 women were included in our analysis. In the county hospital/low resource clinic (LR, <i>n</i> = 70), the mean age was 32.8 ± 6.1 years vs 35.0 ± 5.0 years in the fee-for-service/high resource clinic (HR, <i>n</i> = 73). Among the LR patients, 74% were immigrants, 71% had an annual income <$25,000 and 52% had completed high school. Among HR patients, 36% were immigrants, 60% had an annual income >$100,000, and 95% had some college or above. On average, women from HR settings scored 3.0 points higher on the Fertility Knowledge Assessment than their LR counterparts (<i>p</i> < 0.001). Upon multivariate analysis, education level remained the sole independent factor associated with fertility knowledge assessment score (<i>p</i> < 0.001). Stratifying by resource level revealed that income was highly associated with fertility knowledge (<i>p</i> < 0.01) among high resource individuals even when adjusting for education level.</p><p><strong>Conclusions: </strong>Women from low resource, largely immigrant communities, seeking fertility care have greater disparities in fertility knowledge and lower health literacy compared to women from high resource clinical settings. Further studies are needed to understand these barriers and to develop targeted inventions to lower disparities and improve care for these vulnerable populations.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00084-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38294911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inability to obtain sperm for fresh IVF cycles: analysis and incidence of outcomes using a database from the United States.","authors":"Alexandra Joice Berger,&nbsp;Valary Raup,&nbsp;Ramy Abou Ghayda,&nbsp;Andrea Lanes,&nbsp;Martin Kathrins","doi":"10.1186/s40738-020-00082-3","DOIUrl":"https://doi.org/10.1186/s40738-020-00082-3","url":null,"abstract":"<p><strong>Background: </strong>Azoospermia is present in 10% of men presenting with infertility and surgical sperm retrieval rates for men with azoospermia due to spermatogenic dysfunction remain low. We investigated the incidence of failed fresh IVF cycles due to inability to obtain sperm and describe predictors for subsequent IVF.</p><p><strong>Methods: </strong>A national IVF database was used to identify fresh IVF cycles in which there was failure to obtain sperm. Patient linkage was utilized to determine outcomes of subsequent IVF.</p><p><strong>Results: </strong>243,291 fresh IVF cycles were identified; 719 (0.3%) listed \"inability to obtain sperm\" as reason for embryo non-transfer. Male infertility was a factor in 537 (75%) and ejaculation was the most common anticipated sperm source (414, 57%). 713 (99.2%) cycles resulted in retrieved oocytes, but only 627 (87.2%) cryopreserved oocytes. 265 (37%) of couples underwent subsequent IVF. On multivariable analysis, lack of initial oocyte cryopreservation (OR 0.34, <i>p</i> = 0.01) and male infertility (OR 0.14, p = 0.01) were associated with having no subsequent cycles. Partner sperm was used in 213 (80%) second cycles and sperm retrieval method was largely conserved (181/213, 85%). Embryos were transferred in 186 (70%) second cycles. Failed embryo transfers were due to repeat inability to obtain sperm in 5 (6%) cycles.</p><p><strong>Conclusions: </strong>Failure to obtain sperm during fresh IVF is rare, but most affected couples will not pursue further cycles of IVF after their initial failed attempt.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2020-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00082-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38271593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The continuum of ovarian response leading to BIRTH, a real world study of ART in Spain.","authors":"Marcos Ferrando,&nbsp;Buenaventura Coroleu,&nbsp;Luis Rodríguez-Tabernero,&nbsp;Gorka Barrenetxea,&nbsp;Cristina Guix,&nbsp;Fernando Sánchez,&nbsp;Julian Jenkins","doi":"10.1186/s40738-020-00081-4","DOIUrl":"https://doi.org/10.1186/s40738-020-00081-4","url":null,"abstract":"<p><strong>Background: </strong>The first biosimilar of recombinant follicle stimulating hormone (rFSH) launched in Europe was Bemfola® in 2014 following a clinical development programme demonstrating efficacy and safety to the satisfaction of the European Medicines Agency. Since then the increasing use of biosimilar rFSH has provided the opportunity to study both effectiveness across the whole population and the variation of rFSH use during routine clinical care in a real-world setting in Spain.</p><p><strong>Methods: </strong>This is a real-world study of 1222 women treated in 26 assisted reproduction treatment centres throughout Spain providing experience of the use of a biosimilar recombinant follicle stimulating hormone in four distinct populations. The four populations studied were poor responders, suboptimal responders, normal responders and oocyte donors. The primary endpoint was the total number of oocytes retrieved. Secondary endpoints included number of days of rFSH stimulation, total dose of rFSH administered, number of MII oocytes, number of fertilized oocytes, quality of embryos, number of embryos transferred, implantation rates, clinical pregnancy rates following embryo transfer, number of multiple pregnancies and number of serious adverse reactions, including moderate-to-severe OHSS.</p><p><strong>Results: </strong>Differences were seen across the populations both in the characteristics of the women and ART outcomes suggestive of a continuum of fertility prognosis. In the poor responders, suboptimal responders, normal responders and oocyte donor populations the mean age in years was 39.9 (±SD 3.4), 38.4 (±SD 2.9), 34.4 (±SD 3.3) and 26 (±SD 4.6) respectively and number of oocytes retrieved was 4.1 (±SD 2.7), 8.6 (±SD 6.0), 12.2 (±SD 7.2) and 19.5 (±SD 9.5) respectively. The proportion of embryos graded as best quality was 18.5%, 33.0% and 43.8%, and graded as worst quality was 20.4%, 5.8% and 5.8% for poor responders, suboptimal responders and normal responders respectively. In a similar pattern, for poor responders, suboptimal responders and normal responders the implantation rates were 16.0%, (8/50), 22.4% (49/219), 30.6% (97/317) respectively and clinical pregnancy rates were 23.2% (10/43), 30.4% (59/194) and 37.0% (114/308) respectively. Adverse events were reported in only 7 of 1222 women (0.6%).</p><p><strong>Conclusions: </strong>Overall the results were consistent with the national ART results reported for Spain, hence this study provides reassurance of the clinical effectiveness of a biosimilar rFSH used in a real world setting.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier - NCT02941341.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00081-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38228312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk profile of Qatari women treated for infertility in a tertiary hospital: a case-control study.","authors":"Sarah Musa, Sherif Osman","doi":"10.1186/s40738-020-00080-5","DOIUrl":"10.1186/s40738-020-00080-5","url":null,"abstract":"<p><strong>Background: </strong>Female infertility is a multifactorial condition constituting a worldwide public health problem. The ability to reproduce is an important product of any marriage, hence infertility may exert a negative impact on physical, financial, social and emotional wellbeing of affected couples. The cornerstone to the management of any disease, including infertility, is prevention. Identifying the modifiable risk factors of female infertility will aid at prevention, early detection, and treatment of medical conditions that can threaten fertility as well as promoting healthy behaviours that can preserve it.</p><p><strong>Aim: </strong>To explore the risk profile of infertility among Qatari women and compare risk factors distribution among primary vs. secondary infertility.</p><p><strong>Methodology: </strong>A hospital-based case control study was conducted from September 17th, 2017- February 10th, 2018. Cases (<i>n</i> = 136) were enrolled from infertility clinic and controls (pregnant women, <i>n</i> = 272), were enrolled from antenatal clinic, Women Hospital, Hamad Medical Corporation (HMC). Interview questionnaire was utilized to collect data about sociodemographic, risk factors related to infertility and patient health Questionnaire (PHQ)-2. Body Mass Index (BMI) was calculated. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05.</p><p><strong>Results: </strong>Forty three primary and ninety three secondary infertility cases were included. Risk factors were age >  35 years (OR = 3.7, 95% CI: 1.41-9.83), second-hand smoking (OR = 2.44, 95% CI:1.26-4.73), steady weight gain (OR = 4.65,, 95% CI: 2.43-8.91), recent weight gain (OR = 4.87, 95% CI: 2.54-9.32), menstrual cycle irregularities (OR = 4.20, 95% CI:1.14-15.49), fallopian tube blockage (OR = 5.45, 95% CI: 1.75-16.95), and symptoms suggestive of sexually transmitted infections (STIs) including chronic lower abdominal/pelvic pain (OR = 3.46, 95% CI: 1.57-7.63), abnormal vaginal discharge (OR = 3.32, 95% CI:1.22-9.03) and dyspareunia (OR = 7.04, 95% CI: 2.76-17.95). Predictive factors for secondary infertility were; longer time from previous conception (OR = 5.8, 95% CI: 3.28-10.21), history of stillbirth (OR = 2.63, 95% CI: 1.04-6.67) or miscarriage (OR = 2.11, 95% CI: 1.21-3.68) and postpartum infection (OR = 3.75, 95% CI: 1.27-11.06). Protective factors were higher education level (OR = 0.44, 95% CI: 0.25-0.78), higher income (OR = 0.17, 95% CI: 0.06-0.49), and awareness/loyalty to fertility window (OR = 0.33, 95% CI: 0.21-0.52 and OR = 0.29, 95% CI: 0.19-0.44, consequently).</p><p><strong>Conclusion: </strong>This study highlighted the opportunities to strengthen public health as well as hospital-based health promotion programs importantly toward behavioural-related risk factors (e.g. smoking, obesity, STIs etc.). Moreover, detecting, preventing, and managing modifiable risk factors through awarenes","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38228311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility patients' use and perceptions of online fertility educational material.","authors":"Claire Ann Jones,&nbsp;Chaula Mehta,&nbsp;Rhonda Zwingerman,&nbsp;Kimberly E Liu","doi":"10.1186/s40738-020-00083-2","DOIUrl":"https://doi.org/10.1186/s40738-020-00083-2","url":null,"abstract":"<p><strong>Background: </strong>Online educational information is highly sought out by patients with infertility. This study aims to assess patient-reported usage and helpfulness of fertility educational material on a clinic website and social media accounts.</p><p><strong>Methods: </strong>Educational material was created on common fertility topics in text and video format and posted on the clinic website and social media accounts. At the first consultation for infertility, patients were provided with a postcard directing them to material online. At the first follow-up appointment, patients were invited to fill out a survey assessing whether patients viewed the online educational material and if they found the information helpful.</p><p><strong>Results: </strong>98.4% (251/255) of patients completed the survey, of which 42.6% (106/249) looked at the online material. Of those who viewed the online information, 99.1% (115/116) found the information helpful or somewhat helpful and 67.6% (73/108) found reading the material online better prepared them for making fertility decisions at their doctor's appointment.</p><p><strong>Conclusion: </strong>Patients found online fertility information on the clinic website and social media accounts useful for making fertility treatment decisions. Providing online educational material has the potential to improve patient care by empowering patients with the knowledge to make more informed treatment decisions, and improving the quality of the time spent with the physician.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2020-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00083-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38186629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramuscular progesterone versus 8% Crinone vaginal gel for luteal phase support following blastocyst cryopreserved single embryo transfer: a retrospective cohort study.","authors":"Jennifer B Bakkensen,&nbsp;Catherine Racowsky,&nbsp;Ann M Thomas,&nbsp;Andrea Lanes,&nbsp;Mark D Hornstein","doi":"10.1186/s40738-020-00079-y","DOIUrl":"https://doi.org/10.1186/s40738-020-00079-y","url":null,"abstract":"<p><strong>Background: </strong>The optimal route of progesterone administration for luteal support in cryopreserved embryo transfer (CET) has been the subject of much debate. While most published research has pertained to day 3 transfers, recent data on blastocyst CET has suggested that intramuscular progesterone (IMP) is superior to twice daily vaginal Endometrin suppositories for luteal phase support, resulting in significantly higher ongoing pregnancy rates. This study aimed to determine whether IMP is similarly superior to 8% Crinone vaginal gel for luteal phase support following blastocyst CET.</p><p><strong>Methods: </strong>Autologous and donor oocyte blastocyst cryopreserved single embryo transfer (SET) cycles from January 2014-January 2019 utilizing either 50 mg IMP daily or 90 mg 8% Crinone gel twice daily for luteal support were included. The primary outcome was live birth. Secondary outcomes included biochemical pregnancy, spontaneous abortion, and clinical pregnancy. All analyses were adjusted a priori for oocyte age. Log-binomial regression analysis was performed with differences in outcomes reported as relative risk (RR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 1710 cycles were included, of which 1594 utilized IMP and 116 utilized 8% Crinone gel. Demographic and cycles characteristics were similar between the two groups. Compared to cycles utilizing IMP, cycles utilizing Crinone gel resulted in similar rates of live birth (RR 0.91; 95% CI 0.73-1.13), biochemical pregnancy (RR 1.12, 95% CI 0.65-1.92), spontaneous abortion (RR 1.41, 95% CI 0.90-2.20), and clinical pregnancy (RR 1.00, 95% CI 0.86-1.17).</p><p><strong>Conclusions: </strong>Compared to cryopreserved blastocyst SET cycles utilizing IMP for luteal support, cycles utilizing 8% Crinone gel resulted in similar likelihood of live birth.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00079-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38120807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes among paediatric healthcare professionals in Sweden towards sperm donation to single women: a survey study.","authors":"Gabriela Armuand,&nbsp;Agneta Skoog Svanberg,&nbsp;Claudia Lampic,&nbsp;Evangelia Elenis,&nbsp;Gunilla Sydsjö","doi":"10.1186/s40738-020-00078-z","DOIUrl":"https://doi.org/10.1186/s40738-020-00078-z","url":null,"abstract":"<p><strong>Background: </strong>The number of families conceived through sperm donation to single women is increasing. However, there is limited knowledge about health care professionals' attitudes towards solo-mothers by choice, and there is some indication that professionals' personal opinions influence their care of individuals who use alternate ways to build a family. The primary aim of the study was to investigate attitudes towards, and experiences of, families following sperm donation to single women among healthcare professionals working in primary child healthcare.</p><p><strong>Methods: </strong>Between April and November 2016 a total of 712 physicians, registered nurses and psychologists working within primary healthcare in Sweden were invited to participate in a cross-sectional online survey study. The study-specific questionnaire contained the following four domains: Attitudes towards legalization and financing, Attitudes towards the family and the child's health, Clinical experience and Knowledge about sperm donation to single women.</p><p><strong>Results: </strong>The majority of the participants were positive or neutral towards sperm donation being allowed to single women in Sweden. However, one third believed that children risk worse mental health and social stigma. Half of healthcare professionals had own clinical experience of caring for solo-mothers by choice and their children, and of these one third perceived that these families had more need of support than other parents. One out of four indicated that they did not have sufficient knowledge to be able to provide adequate care to these families.</p><p><strong>Conclusions: </strong>The present results indicate that while there was a relatively large support for sperm donation being allowed to single women in Sweden among health care professionals, many expressed concerns about the child's health, as well as low confidence in their knowledge about the specific needs in this patient group. There is a need for educational interventions targeted to healthcare professionals in primary child healthcare in order to provide adequate care to solo-mothers by choice and their children.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2020-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00078-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37919950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating pregnancies near the uterotubal junction (angular, cornual, and interstitial): a review and recommendations.","authors":"Alex R Finlinson,&nbsp;Kassie J Bollig,&nbsp;Danny J Schust","doi":"10.1186/s40738-020-00077-0","DOIUrl":"https://doi.org/10.1186/s40738-020-00077-0","url":null,"abstract":"<p><p>Eccentrically located intracavitary pregnancies, which include pregnancies traditionally termed as cornual and/or angular, have long presented complex diagnostic and management challenges given their inherent relationship to interstitial ectopic pregnancies. This review uses the existing literature to discriminate among interstitial, cornual, and angular pregnancies. Current arguments propose the outright abandonment of the terms cornual and angular may be justified in favor of the singular term, eccentric pregnancy. Disparate definitions and diagnostic approaches have compromised the literature's ability to precisely describe prognosis and ideal management practices for each of these types of pregnancies. Standardizing the classification of these pregnancies near the uterotubal junction is important to unify conservative, yet safe and effective management strategies. We advocate the use of early first trimester ultrasound to correctly differentiate between eccentric pregnancy and interstitial ectopic pregnancy as current research suggests substantially better outcomes with correctly diagnosed and expectantly managed eccentric pregnancies than past investigations may have shown. The expectant management of eccentric pregnancies will often result in a healthy term pregnancy, while interstitial ectopic pregnancies inherently have a poor likelihood of progressing to viability. When the terms and diagnosis of cornual, angular, and interstitial pregnancy are indistinct, there is substantial risk of intrauterine pregnancies to be inappropriately managed as ectopic pregnancies. Until we standardize terms and criteria, it will remain difficult, if not impossible, to determine true risk for pregnancy loss, preterm labor, abnormal placentation, and uterine or uterotubal rupture. The development of best practice guidelines will require standardized terminology and diagnostic techniques.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2020-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00077-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37919949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis.","authors":"Zahra Kiani, Masoumeh Simbar, Sepideh Hajian, Farid Zayeri, Maryam Shahidi, Marzieh Saei Ghare Naz, Vida Ghasemi","doi":"10.1186/s40738-020-00076-1","DOIUrl":"10.1186/s40738-020-00076-1","url":null,"abstract":"<p><strong>Background: </strong>Infertile women are exposed more frequently to anxiety risk than are infertile men, thereby adversely affecting the procedures with which they are treated and the quality of their lives. Yet, this problem is often disregarded. This study accordingly determined the prevalence of anxiety symptoms among infertile women.</p><p><strong>Methods: </strong>All Persian and English studies published from the early 2000s to May 2019 were searched in international (i.e., PubMed, the Cochrane Library, Web of Science, Scopus, Embase, and PsycINFO) and national (i.e., SID, Magiran) databases as well as through Google Scholar. After the titles and abstracts of the articles were reviewed, their quality was evaluated, and relevant works for examination were selected in consideration of established inclusion and exclusion criteria. The risk of biases of individual studies according to Newcastle - Ottawa Scale was assessed. The heterogeneity of the studies was assessed using the I² statistic, and indicators of publication bias were ascertained using Egger's test. Stata (version 14) was employed in analyzing the findings.</p><p><strong>Results: </strong>Thirteen studies having a collective sample size of 5055 infertile women were subjected to meta-analysis, with study heterogeneity incorporated into a random effects model. The findings indicated that 36% of the infertile women involved in the evaluated studies self-reported their experience with anxiety. The pooled prevalence of the condition among the subjects was 36.17% [95% confidence interval (CI): 22.47-49.87]. The pooled prevalence levels in low- and middle-income countries and high-income countries were 54.24% (95% CI: 31.86-78.62) and 25.05% (95% CI: 15.76-34.34), respectively. The results revealed no evidence of publication bias (P _{Egger's test} = 0.406).</p><p><strong>Conclusion: </strong>Considering the prevalence of anxiety in infertile women and its effects on health processes and quality of life, this problem requires serious consideration and planning for effective intervention, especially in low- and middle-income nations.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7157980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37853517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}