Fertility research and practice最新文献

{"title":"Measuring serum estradiol and progesterone one day prior to frozen embryo transfer improves live birth rates.","authors":"Snigdha Alur-Gupta, Margaret Hopeman, Dara S Berger, Kurt T Barnhart, Suneeta Senapati, Clarisa Gracia","doi":"10.1186/s40738-020-00075-2","DOIUrl":"10.1186/s40738-020-00075-2","url":null,"abstract":"<p><strong>Background: </strong>Given no consensus in the literature, this study sought to determine if a protocol of measuring serum estradiol and progesterone the day prior to frozen embryo transfer (FET) improves likelihood of pregnancy and livebirth.</p><p><strong>Methods: </strong>This was a retrospective time-series study of women undergoing autologous vitrified-warmed blastocyst programmed FETs at an academic institution. Live birth rates were compared between a surveillance protocol, where serum estrogen and progesterone surveillance are performed the day prior to a programmed FET, and a standard protocol, whereby no hormonal lab evaluation is performed the day prior.</p><p><strong>Results: </strong>Three hundred seventy-nine standard FET and 524 surveillance FET cycles were performed. Patients in the surveillance protocol were significantly more likely to achieve live birth (51% vs. 39%; aOR 1.6, 95%CI [1.2, 2.2]). Obese women were noted to be more likely to have lower progesterone hormone levels on surveillance labs (OR 3.2, 95%CI [2.0, 5.3]). However those whose hormonal medication dose was modified because of pre-transfer labs were as likely to achieve live birth as those whose dose was not modified (47% vs. 53%; aOR 0.8, 95%CI [0.6, 1.2]).</p><p><strong>Conclusions: </strong>Cycles with the surveillance protocol were more likely to result in live birth. Patients with low levels of pre-transfer hormones, such as obese patients, likely have lower pregnancy rates. It is possible that when these levels were corrected after measurement, pregnancy rates improved to match those whose levels were not low enough to warrant intervention.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37853533","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":"Staging of the estrous cycle and induction of estrus in experimental rodents: an update.","authors":"Ayodeji Folorunsho Ajayi,&nbsp;Roland Eghoghosoa Akhigbe","doi":"10.1186/s40738-020-00074-3","DOIUrl":"https://doi.org/10.1186/s40738-020-00074-3","url":null,"abstract":"<p><strong>Background: </strong>Determination of the phases of the estrous cycle and induction of estrus (heat) in experimental animals remains useful, especially in reproductive function research.</p><p><strong>Main body of the abstract: </strong>This review provides a detailed description and discusses extensively the variations observed in different phases of the estrous cycle in laboratory animals using rats and mice as examples. It also illustrates how these phases can be determined and how to induce estrus 'heat' when required. The phases of the estrous cycle can be determined using various methods such as visual assessment, vaginal smear/cytology, histology of female reproductive organs (vagina, uterus and ovaries), vaginal wall impedance assessment and determination of urine biochemical parameters. Female animals can be artificially brought to estrus phase 'heat' to make them receptive to male counterparts.</p><p><strong>Conclusion: </strong>Determination of the length and phases of the estrous cycle and induction of estrus are useful in teaching and research and evaluating the effects of drugs/chemicals on the reproductive functions.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2020-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00074-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37753144","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":"Indicators of male fertility potential in adult patients with beta-thalassemia major: a comparative study between patients undergone allogeneic stem cell transplantation and transfusion-dependent patients.","authors":"Tahereh Rostami, Mohammad Amir Mohammadifard, Shahla Ansari, Azadeh Kiumarsi, Nasrollah Maleki, Amir Kasaeian, Fatemeh Aghamahdi, Soroush Rad, Ardeshir Ghavamzadeh","doi":"10.1186/s40738-020-00071-6","DOIUrl":"10.1186/s40738-020-00071-6","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative treatment for thalassemia major (TM). Infertility and its indicators have been assessed in transfusion dependent TM men, but in this study, we sought to compare the fertility indicators of TM patients after HSCT with those in patients treated conventionally. The possible influential factors on reproductive capacity in TM patients undergone allogeneic HSCT were also evaluated.</p><p><strong>Patients and methods: </strong>In this cross-sectional study, we compared the gonadal hormones level, testicular volume, Tanner stage and sperm analysis in transfusion-dependent thalassemia major (TDTM) patients who survived matched sibling HSCT (<i>n</i> = 43) with patients conventionally treated by transfusion and iron chelation (<i>n</i> = 52).</p><p><strong>Results: </strong>The patients' age range was between 16 to 41 years. Tanner stage 4-5 was seen in 39 patients (41%). The prevalence of hypogonadism in our patients was 32.63% but its frequency was not significantly different between the two groups (<i>p</i> = 0.35). Azospermia, oligospermia, astenospermia, teratospermia and even having dry and low volume ejaculate were all significantly more frequent in the post-transplant patients compared to TDTM group. In the post-HSCT group, neither patients' age at transplantation nor the conditioning regimen used in their transplant process did significantly affect their hormonal status and sperm parameters. Chronic graft versus host disease (GVHD) occurred in 14 (40%) patients. No significant difference was observed between the grade of chronic GVHD and hypogonadism (<i>P</i> = 0.853).</p><p><strong>Conclusions: </strong>Thalassemia patients undergone allogeneic HSCT have lower fertility potential, mainly in sperm parameters compared with patients treated with blood transfusion and chelation. This information is important for thalassemic patients considering HSCT.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2020-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37728371","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 factors of tubal infertility in a tertiary hospital in a low-resource setting: a case-control study.","authors":"Thomas Obinchemti Egbe, Theophile Nana-Njamen, Felix Elong, Robert Tchounzou, Andre Gaetan Simo, Gaelle Padjip Nzeuga, Cedric Njamen Nana, Emmanuella Manka'a, Charlotte Tchente Nguefack, Gregory Edie Halle-Ekane","doi":"10.1186/s40738-020-00073-4","DOIUrl":"10.1186/s40738-020-00073-4","url":null,"abstract":"<p><strong>Background: </strong>Infertility is the inability to sustain a pregnancy in a woman with regular (2-3 times per week) unprotected sexual intercourse for a period of 1 year. This is a major public health problem that remains under-recognised in Cameroon and most countries in sub-Saharan Africa. This study aimed at identifying the risk factors associated with tubal infertility in a tertiary hospital in Douala, Cameroon.</p><p><strong>Methods: </strong>We conducted a case-control study at the Obstetrics, Gynaecology and Radiology Departments of the Douala Referral Hospital from October 1, 2016, to July 30, 2017. We recruited 77 women with tubal infertility diagnosed using hysterosalpingography and 154 unmatched pregnant women served as controls. Data on socio-demographic, reproductive and sexual health, and radiologic assessments were collected using a pretested questionnaire. The data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 24.0. Logistic regression models were fitted to identify demographic, reproductive health factors, surgical, medical and toxicological factors associated with tubal infertility. The adjusted odds ratios (AOR) and their 95% confidence interval were interpreted. Statistical significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Sixty-one per cent of respondents had secondary infertility. Following multivariate logistic regression analysis, respondents who were housewives (AOR 10.7; 95% CI: 1.68-8.41, <i>p</i> = 0.012), self-employed (AOR 17.1; 95% CI: 2.52-115.8, <i>p</i> = 0.004), with a history of <i>Chlamydia trachomatis</i> infection (AOR 17.1; 95% CI: 3.4-85.5, <i>p</i> = 0.001), with <i>Mycoplasma</i> infection (AOR 5.1; 95% CI: 1.19-22.02, <i>p</i> = 0.03), with ovarian cyst (AOR 20.5; 95% CI: 2.5-168.7, <i>p</i> = 0.005), with uterine fibroid (AOR 62.4; 95% CI: 4.8-803.2, <i>p</i> = 0.002), have undergone pelvic surgery (AOR 2.3; 95% CI: 1.0-5.5, <i>p</i> = 0.05), have undergone other surgeries (AOR 49.8; 95% CI: 6.2-400, <i>p</i> = 0.000), diabetic patients (AOR 10.5; 95% CI 1.0-113.4, <i>p</i> = 0.05) and those with chronic pelvic pain (AOR 7.3; 95% CI: 3.2-17.1, <i>p</i> = 0.000) were significantly associated with tubal infertility while the young aged from 15 to 25 (AOR 0.07; 95% CI: 0.01-0.67, 0.021), those in monogamous marriages (AOR 0.05; 95% CI: 0.003-1.02, <i>p</i> = 0.05), as well as those with a history of barrier contraceptive methods (condom) (AOR 0.17; 95% CI: 0.03-1.1, <i>p</i> = 0.06) were less likely to have tubal infertility.</p><p><strong>Conclusion: </strong>The following factors were independently associated with tubal infertility: being a housewife, self-employed, history of <i>Chlamydia trachomatis</i>, <i>Mycoplasma</i> infection, and uterine fibroid. Furthermore, a history of pelvic surgery and other surgeries, diabetes mellitus, and chronic pelvic pain were also associated with tubal infertility. Young age, persons in mo","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2020-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00073-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37728965","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":"Should we transfer poor quality embryos?","authors":"Anastasia Kirillova,&nbsp;Sergey Lysenkov,&nbsp;Maria Farmakovskaya,&nbsp;Yulia Kiseleva,&nbsp;Bella Martazanova,&nbsp;Nona Mishieva,&nbsp;Aydar Abubakirov,&nbsp;Gennady Sukhikh","doi":"10.1186/s40738-020-00072-5","DOIUrl":"https://doi.org/10.1186/s40738-020-00072-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate if it is safe and effective to transfer poor quality embryos.</p><p><strong>Methods: </strong>It was a retrospective analysis using individual patient data with positive controls. All patients undergoing embryo transfers of poor quality embryos on day 3 or on day 5 as part of fresh In Vitro Fertilization (IVF) cycles performed between 2012 and 2016. This study assessed a total of 738 poor quality embryos from 488 IVF programs. 261 embryo transfers were performed on day 3 (402 embryos were transferred) and 227 on day 5 (336 embryos were transferred). Control group consisted of 9893 fair and good quality embryos from 5994 IVF programs. Outcome rates were compared with two-tailed Fisher exact test using fisher.test function in R software. 95% confidence intervals for proportions were calculated using the Clopper-Pearson method with binom.test function in R. The groups of patients with poor vs. good and fair quality embryos were compared by age, body mass index(BMI), number of oocytes, female and male main diagnosis, cycle type, controlled ovarian stimulation (COS) protocol, the starting day of gonadotropin administration, the starting dose of gonadotropins, the total dose of gonadotropins, the total number of days of gonadotropins administration, the starting day of gonadotropin-releasing hormone (GnRH) agonist administration, the total number of ampoules of GnRH-agonist used, day of the trigger of ovulation administration and the type of the trigger of ovulation using the Student's t-test for interval variables and with the chi-square test for nominal variables.</p><p><strong>Results: </strong>No significant differences in the implantation rate, clinical pregnancy rate, miscarriage rate, live births, and the number of children born were found between the groups of poor quality embryos transferred on day 3 and day 5. Though the implantation rate was lower for the group of poor quality embryos, than for the control (13.9% vs 37.2%), statistically significant differences between the proportion of implanted embryos which resulted in clinical pregnancies and live births in both groups were not observed (72% vs 78.2 and 55.8% vs 62.0% respectively).</p><p><strong>Conclusion: </strong>Transfer of poor quality embryos at either day 3 or day 5 have a low potential for implantation, though those embryos which successfully implanted have the same potential for live birth as the embryos of fair and good quality. This study supports that it is safe to transfer poor quality embryos when they are the only option for fresh embryo transfer (ET).</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2020-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00072-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37677936","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":"Public reporting of IVF outcomes influences medical decision-making and physician training.","authors":"Stephanie Gunderson,&nbsp;Emily S Jungheim,&nbsp;Caleb B Kallen,&nbsp;Kenan Omurtag","doi":"10.1186/s40738-020-00070-7","DOIUrl":"https://doi.org/10.1186/s40738-020-00070-7","url":null,"abstract":"<p><strong>Background: </strong>Since 1992 ART clinics have been required to report outcome data. Our objective was to assess practitioners' opinions of the impact of public reporting of assisted reproductive technology (ART) outcomes on treatment strategies, medical decision-making, and fellow training.</p><p><strong>Methods: </strong>Survey study performed in an academic medical center. Members of the Society of Reproductive Endocrinology and Infertility and the Society of Reproductive Surgery were recruited to participate in an online survey in April 2012.<i>:</i> Categorical survey responses were expressed as percentages. Written responses were categorized according to common themes regarding effects of reporting on participants' medical management of patients. The study was primarily qualitative and was not powered to make statistical conclusions.</p><p><strong>Results: </strong>Of 1019 surveys sent, 323 participants (31.7%) responded from around the United States, and 275 provided complete data. Nearly all (273 of 282; 96.8%) participants responded that public reporting sometimes or always affected other providers' practices, and 264 of 281 (93.9%) responded that other practitioners were motivated to deny care to poor-prognosis patients to improve reported success rates. However, only 121 of 282 (42.9%) indicated that public reporting influenced their own medical management. The majority of respondents agreed that public reporting may hinder adoption of single embryo transfer practices (194 of 299; 64.9%) and contribute to the persistent rate of twinning in in vitro fertilization (187 of 279; 67%). A small majority (153 of 279; 54.8%) felt that public reporting did not benefit fellow training, and 58 (61.7%) of the 94 participants who trained fellows believed that having fellows perform embryo transfers reduced pregnancy rates. A small majority (163 of 277; 58.8%) of respondents reported their ART success rates on clinical websites. However, the majority (200 of 275; 72.7%) of respondents compared their success rates with those of other clinics. Finally, most respondents (211 of 277; 76%) believed that most centers that advertised their success rates did so in ways that were misleading to patients.</p><p><strong>Conclusions: </strong>Public reporting of ART clinical outcomes is intended to drive improvement, promote trust between patients and providers, and inform consumers and payers. However, providers reported that they modified their practices, felt others denied care to poor-prognosis patients, and limited participation of trainees in procedures in response to public reporting of ART outcomes.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"6 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2020-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-020-00070-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37654750","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":"Bayesian smoothed small-areas analysis of urban inequalities in fertility across 1999-2013.","authors":"Brenda Biaani León-Gómez,&nbsp;Mercè Gotsens,&nbsp;Marc Marí-Dell'Olmo,&nbsp;Ma Felicitas Domínguez-Berjón,&nbsp;Miguel Ángel Luque-Fernandez,&nbsp;Unai Martin,&nbsp;Maica Rodríguez-Sanz,&nbsp;Gloria Pérez","doi":"10.1186/s40738-019-0066-8","DOIUrl":"https://doi.org/10.1186/s40738-019-0066-8","url":null,"abstract":"<p><strong>Background: </strong>Since the 2008 economic crisis in Spain, overall fertility has continued to decrease, while urban inequalities have increased. There is a general lack of studies of fertility patterns in small-areas of Spanish cities. We explored the effects of the economic crisis on fertility during three time periods in urban settings in Spain.</p><p><strong>Methods: </strong>We studied the distribution of fertility rates among women (15-49 years) from Spain and low-middle income countries (LIC) who were living in 13 Spanish cities. We mapped fertility and the MEDEA socioeconomic deprivation index in small-areas, and analyzed age-related trends in fertility rates. We performed an ecological regression analysis of fertility and the deprivation index in two pre-crisis periods (1999-2003 and 2004-2008) and one crisis period (2009-2013). Fertility rates were calculated and smoothed using the hierarchical Bayesian model (BYM).</p><p><strong>Results: </strong>Higher fertility was generally associated with socioeconomic deprivation, with adjustment for the mothers' age and nationality. While Spanish citizens tended to delay childbearing throughout the three study periods, fertility increased among Spanish adolescents from deprived urban areas during the economic crisis. There was a general decline in fertility among immigrants after the crisis, especially in southern cities. Overall, fertility appeared to be stable, with higher fertility in more deprived areas.</p><p><strong>Conclusion: </strong>Increased unemployment and changes to government family policies may have contributed to delayed childbearing in Spain. For immigrants, more restrictive immigration policies may have played a crucial role in decreasing fertility rates. Reforming such policies will be key for better reproductive rights and improved fertility rates across all population cohorts in Spain.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"5 ","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2019-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-019-0066-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37501811","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":"Impact of genital Chlamydia trachomatis infection on reproductive outcomes among infertile women undergoing tubal flushing: a retrospective cohort at a fertility centre in Uganda.","authors":"Anthony Kayiira, Daniel Zaake, Michael Webba Lwetabe, Peter Sekweyama","doi":"10.1186/s40738-019-0069-5","DOIUrl":"10.1186/s40738-019-0069-5","url":null,"abstract":"<p><strong>Background: </strong>The impact of current <i>C. trachomatis</i> on clinical pregnancy and live birth rates among women undergoing tubal flushing is largely unknown. This study aimed to investigate whether current female genital <i>C. trachomatis</i> infection affects the chance of achieving a clinical pregnancy and a live birth, among infertile women undergoing tubal flushing, at a fertility centre in Uganda.</p><p><strong>Methods: </strong>A retrospective Cohort study at a peri-urban fertility centre. A total of 253 eligible women with tubal factor infertility, who underwent tubal flushing, were enrolled and categorised according to their exposure to current genital <i>C. trachomatis</i> infection. These women were followed up for a period of 12 months, with the primary outcome measure being clinical pregnancy and live birth. Secondary outcome measures included pregnancy loss and procedural related adverse events.</p><p><strong>Results: </strong>Exposure to current genital <i>C. trachomatis</i> infection reduced chance of clinical pregnancy (adjusted relative risk 0.42; 95% confidence interval, 0.18-0.96) and a live birth (adjusted relative risk 0.37; 95% confidence interval, 0.14-0.95) after tubal flushing. Women with current <i>C. trachomatis</i> infection had an increased risk of adverse events (adjusted relative risk, 1.20; 95% confidence interval, 1.08-1.34). However, current <i>C. trachomatis</i> infection did not affect the risk of spontaneous abortion and ectopic pregnancy.</p><p><strong>Conclusion: </strong>Current genital <i>C. trachomatis</i> infection in women with tubal factor infertility, undergoing tubal flushing, lowers their chance of pregnancy and live birth.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"5 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2019-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37501810","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":"IVF outcomes after hysteroscopic metroplasty in patients with T- shaped uterus.","authors":"Esra Uyar,&nbsp;Deniz Usal,&nbsp;Belgin Selam,&nbsp;Mehmet Cincik,&nbsp;Tayfun Bagis","doi":"10.1186/s40738-019-0063-y","DOIUrl":"https://doi.org/10.1186/s40738-019-0063-y","url":null,"abstract":"<p><strong>Background: </strong>T- shaped uterus may be associated with infertility and adverse pregnancy outcomes. Hysteroscopic metroplasty may improve the reproductivity for these cases. To our knowledge, there is no data in literature about the clinical consequences of in vitro fertilization (IVF) in patients undergoing hysteroscopic metroplasty for T-shaped uterus. The principal objective of the current study is to assess the impact of hysteroscopic metroplasty for T-shaped uterus on the reproductive outcomes of IVF.</p><p><strong>Methods: </strong>IVF outcomes of 74 patients who underwent hysteroscopic metroplasty for T- shaped uterus and 148 patients without any uterine abnormalities and with diagnosis of unexplained infertility (control group) were retrospectively analyzed.</p><p><strong>Results: </strong>Patients in metroplasty and control groups were comparable with respect to age, BMI, partner's age and duration of infertility. Number of patients with a history of pregnancy beyond 20 weeks of gestation was significantly lower in the metroplasty group (4.1% vs 18.2%; <i>p</i> < 0.05). Number of previous unsuccessful cycles and percentage of patients with ≥3 unsuccessful IVF cycles (35.1% vs 17.6%; <i>p</i> < 0.05) were significantly higher in the metroplasty group. There were no significant differences in the reproductive outcomes such as the pregnancy rate, clinical pregnancy or live birth rate between the metroplasty and control groups. There were non-significant trends for higher rates of miscarriage (18.8% vs 8%, <i>p</i> > 0.05) and biochemical pregnancy (20.0% vs 10.7%, <i>p</i> > 0.05) in the metroplasty group compared to the control group.</p><p><strong>Conclusions: </strong>Reproductive results of the IVF cycles after hysteroscopic correction of T-shaped uterus were comparable to those of the patients without any uterine abnormalities and with diagnosis of unexplained infertility. Hysteroscopic metroplasty may contribute to improved IVF outcomes in patients with T-shaped uterus.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"5 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2019-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-019-0063-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37463915","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":"Use and pattern of previous care received by infertile Nigerian women.","authors":"Amina Mohammed-Durosinlorun,&nbsp;Joel Adze,&nbsp;Stephen Bature,&nbsp;Amina Abubakar,&nbsp;Caleb Mohammed,&nbsp;Matthew Taingson,&nbsp;Lydia Airede","doi":"10.1186/s40738-019-0068-6","DOIUrl":"https://doi.org/10.1186/s40738-019-0068-6","url":null,"abstract":"<p><strong>Background: </strong>Prevalence of infertility in sub-Saharan Africa is high yet fertility care, its development and access is limited in resource-poor countries like Nigeria so infertile women resort to different forms of treatment. This study aimed to determine the use and pattern of previous treatments.</p><p><strong>Methodology: </strong>This was a descriptive Cross Sectional study conducted at a tertiary hospital in North-Western Nigeria. Interviewer administered pretested questionnaires were administered to 236 consenting clients seen at their first visit to the gynaecology clinic with complaints of inability to conceive, between January 2016 to March 2018. We collected information on demographic and reproductive characteristics, previous fertility treatment and other data relevant to infertility. Descriptive analysis was done using SPSS software version 22.</p><p><strong>Results: </strong>Two hundred and thirty six clients participated in the study and majority were 20-29 years (44.5%), with a mean age of 31.5 ± 7.4, while the mean age of their husbands was 41 ± 8.0. More clients were educated up to secondary level or above (80.9%), with more Muslims (65%) than Christians. All clients were married except one, most clients had been married for 5 years or more, 18.2% were in their second order of marriage and 28% were in polygamous marriages. Many of the clients were homemakers (46.6%) and earned an average monthly income of less than fifty thousand naira. About 59.3% of clients presented with primary infertility, with 15.7% being infertile for duration of more than 10 years. One hundred and forty six respondents (61.9%) had received previous hospital treatments before presentation to our facility, 37% had visited more than three hospitals, 70% did not have adequate investigations done, treatment was successful in 15% while 40.7% received traditional treatments. Husbands of women receiving previous treatment were slightly older (<i>p</i> value < 0.05).</p><p><strong>Conclusion: </strong>Majority of woman have multiple and unnecessary visits to several hospitals for infertility care with little positive results despite time and resources spent. Quality of infertility care needs to be improved.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"5 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-019-0068-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37449287","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}