Fertility research and practice最新文献

{"title":"Efficiency of metaphase II oocytes following minimal/mild ovarian stimulation in vitro fertilization.","authors":"John J Zhang,&nbsp;Mingxue Yang,&nbsp;Zaher Merhi","doi":"10.1186/s40738-016-0025-6","DOIUrl":"https://doi.org/10.1186/s40738-016-0025-6","url":null,"abstract":"<p><strong>Background: </strong>An inverse relationship between oocyte efficiency and ovarian response was reported in conventional IVF. The purpose of this study was to report metaphase II (MII) oocyte efficiency according to oocyte yield in minimal/mild stimulation IVF (mIVF) and to assess whether oocyte yield affects live birth rate (LBR).</p><p><strong>Methods: </strong>Infertile women (<i>n</i> = 264) aged < 39 years old with normal ovarian reserve who had mIVF were recruited. All participants received the same protocol for ovarian stimulation. All the embryos were cultured to the blastocyst stage and vitrified using a freeze-all approach. This was followed by a single blastocyst transferred to each participant in subsequent cycles over a 6-month period. Ovarian response was categorized according to the number of MII oocyte yield (low: 1-2, intermediate: 3-6 and high ≥ 7 MII oocytes). MII oocyte utilization rate was calculated as the number of live births divided by the number of MII oocytes produced after only one oocyte retrieval and subsequent transfers of vitrified/warmed blastocysts. The main outcome measure was cumulative LBR over a 6-month period.</p><p><strong>Results: </strong>Among all the participants, 1173 total retrieved oocytes (4.4 ± 0.2 per patient) resulted in 1019 (3.9 ± 0.2 per patient) total MII oocytes, a clinical pregnancy rate of 48.1 % and a LBR of 41.2 %. Oocyte utilization rate was inversely related to ovarian response where it was 30.3 % in the \"low\" vs. 9.3 % in the \"intermediate\" vs. 4.3 % in the \"high\" oocyte yield groups (<i>p</i> < 0.05). Implantation rate significantly dropped as the number of MII oocytes increased and was highest in the \"low\" oocyte yield group (<i>p</i> < 0.0001). Cumulative LBR was similar in \"low,\" \"intermediate,\" and \"high\" oocyte yield groups (<i>p</i> > 0.05). The number of MII oocytes had poor sensitivity and specificity for predicting a live birth.</p><p><strong>Conclusion: </strong>These data extend the hypothesis of oocyte efficiency reported in conventional IVF protocols to mIVF protocols.</p><p><strong>Trial registration: </strong>Registration clinicaltrials.gov: NCT00799929.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0025-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35094629","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":"Promoting the use of elective single embryo transfer in clinical practice.","authors":"Tamara Tobias,&nbsp;Fady I Sharara,&nbsp;Jason M Franasiak,&nbsp;Patrick W Heiser,&nbsp;Emily Pinckney-Clark","doi":"10.1186/s40738-016-0024-7","DOIUrl":"https://doi.org/10.1186/s40738-016-0024-7","url":null,"abstract":"<p><strong>Background: </strong>The transfer of multiple embryos after in vitro fertilization (IVF) increases the risk of twins and higher-order births. Multiple births are associated with significant health risks and maternal and neonatal complications, as well as physical, emotional, and financial stresses that can strain families and increase the incidence of depression and anxiety disorders in parents. Elective single embryo transfer (eSET) is among the most effective methods to reduce the risk of multiple births with IVF.</p><p><strong>Main body: </strong>Current societal guidelines recommend eSET for patients <35 years of age with a good prognosis, yet even this approach is not widely applied. Many patients and clinicians have been reluctant to adopt eSET due to studies reporting higher live birth rates with the transfer of two or more embryos rather than eSET. Additional barriers to eSET include risk of treatment dropout after embryo transfer failure, patient preference for twins, a lack of knowledge about the risks and complications associated with multiple births, and the high costs of multiple IVF cycles. This review provides a comprehensive summary of strategies to increase the rate of eSET, including personalized counseling, access to educational information regarding the risks of multiple pregnancies and births, financial incentives, and tools to help predict the chances of IVF success. The use of comprehensive chromosomal screening to improve embryo selection has been shown to improve eSET outcomes and may increase acceptance of eSET.</p><p><strong>Conclusions: </strong>eSET is an effective method for reducing multiple pregnancies resulting from IVF. Although several factors may impede the adoption of eSET, there are a number of strategies and tools that may encourage the more widespread adoption of eSET in clinical practice.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2016-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0024-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35094627","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 is below replacement in Harar Health and Demographic Surveillance System (Harar HDSS), Harar town, Eastern Ethiopia.","authors":"Nega Assefa,&nbsp;Agumasie Semahegn","doi":"10.1186/s40738-016-0023-8","DOIUrl":"https://doi.org/10.1186/s40738-016-0023-8","url":null,"abstract":"<p><strong>Background: </strong>Population growth is determined by fertility, mortality and migration rates. Fertility is the prime determinant of population growth, which is highly associated with family planning, literacy, urbanization, and expansion of health system. In many part of Africa, its level is more than twice the replacement level. In Ethiopia, a significant decline in fertility mainly in the urban setting has been reported over the past decade, yet there is a paucity of information on the level of the decline. Therefore, this analysis aims to assess the level of fertility in Harar Health and Demographic Surveillance System (Harar HDSS) Eastern Ethiopia.</p><p><strong>Methods: </strong>Harar HDSS is an urban HDSS located in the city of Harar, eastern Ethiopia. It was established in 2011. All the population under surveillance are followed regularly and updated every six month for any change in the population demographic characteristics. Data were collected on a face-to-face interview to record demographic and socio-economic characteristics. Data were entered into customized HRS-2 software used for capturing longitudinal data and exported to computational software for analysis. For this analysis fertility data of the year 2013 were used. Fertility levels were analyzed using descriptive statistics.</p><p><strong>Results: </strong>The total population of Harar HDSS in 2013 was 30,055. Of these, 15,701 (52.2 %) were females and 14, 354 (47.8 %) were males. The crude birth rate and general fertility rate for the year 2013 were 20.3 and 64 births per 1000, respectively. In 2013, the Total Fertility Rate (TFR) was 1.9 births per women of reproductive age. The 25 to 29 age group has the highest age-specific fertility rates (128.1 births per 1000 women), followed by the 20 to 24 year old women (89.3 births per 1000 women).</p><p><strong>Conclusion: </strong>Total fertility rate was relatively low. However, there were a significant number of births among adolescent women. Improving and sustaining access for reproductive health care for young women is highly recommended.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0023-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093556","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":"Heavy menstrual bleeding and dysmenorrhea are improved by Magnetic Resonance Guided Focused Ultrasound Surgery (MRgFUS) of adenomyosis.","authors":"Ramya Jayaram,&nbsp;Kalpana Subbarayan,&nbsp;Sridurga Mithraprabhu,&nbsp;Mirudhubashini Govindarajan","doi":"10.1186/s40738-016-0021-x","DOIUrl":"https://doi.org/10.1186/s40738-016-0021-x","url":null,"abstract":"<p><strong>Background: </strong>To assess reduction in heavy menstrual bleeding and dysmenorrhea following MRI guided Focused Ultrasound Surgery (MRgFUS) of focal and diffuse adenomyosis up to 12 months post-treatment a retrospective cohort study was done at a tertiary care academic medical center for obstetrics, gynecology and infertility.</p><p><strong>Methods: </strong>MRgFUS for adenomyosis uterus was done for thirty-seven patients presenting with symptoms of heavy menstrual bleeding and dysmenorrhea with MRI-suspected adenomyosis. The main outcome measure, was reduction in heavy menstrual bleeding, dysmenorrhea and Symptom Severity Scoring (SSS) over a 3, 6 and 12 month period. Secondary outcome was evidence of fertility preservation post procedure. D'Agostino & Pearson omnibus normality test, one-way Ananova, Pearson's correlation coefficient analysis was performed on the data. Statistical significances, p-value and r-value were determined.</p><p><strong>Results: </strong>Out of 37 patients who were treated by MRgFUS, 26 had sufficient follow-up to be included in the analysis. SSS calculated at 3, 6 and 12 months was significantly over the baseline. Both heavy menstrual bleeding and dysmenorrhea, which were assessed separately, were found to significantly improve over time with a positive correlation between the two. No other intervention was required.</p><p><strong>Conclusion: </strong>MRgFUS provides immediate and sustained relief for patients with focal and diffuse adenomyosis.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2016-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0021-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093554","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":"Factors associated with uterine fibroid in Ghanaian women undergoing pelvic scans with suspected uterine fibroid.","authors":"Benjamin Dabo Sarkodie,&nbsp;Benard Ohene Botwe,&nbsp;David Nana Adjei,&nbsp;Eric Ofori","doi":"10.1186/s40738-016-0022-9","DOIUrl":"https://doi.org/10.1186/s40738-016-0022-9","url":null,"abstract":"<p><strong>Background: </strong>Uterine fibroids are the most common benign tumours affecting premenopausal women and are often associated with considerable hospitalization and morbidity. Literature shows virtually no study concerning the quantification of the main factors associated with uterine fibroids in Ghanaian women. The purpose of this study was to assess the main factors associated with uterine fibroid among Ghanaian women presenting for ultrasound.</p><p><strong>Method: </strong>A prospective cross-sectional study design was employed in this study. A total of two hundred and forty-four (244) women were consecutively evaluated from November 2011 to February 2012 using a 2-5 MHz curvilinear probe of Philips HD3 ultrasound machines at three centres in Accra using a trans-abdominal pelvic approach. Data was analysed with (SPSS) version 20.0 for windows, 2010; Chicago. The Pearson's Chi-square test was used to determine associations between selected demographic and gynaecological characteristics and uterine fibroid appearance. All tests were two-tailed and p-value of less than 0.05 was interpreted as significant.</p><p><strong>Results: </strong>The range, mean and standard deviation (SD) of the patients' age were 14-54 years, 31.89 years and ± 7.92 respectively. Factors that associated significantly with uterine fibroid in Ghanaian women included obesity (<i>X</i>² = 17.3, <i>p</i>-value = 0.001), participant's age range (<i>X</i>² = 47.4, <i>p</i>-value = 0.001), parity (<i>X</i>² = -10.169, <i>p</i>-value = 0.001), and age at last delivery (<i>X</i>² = 34.579, <i>p</i>-value = 0.001).</p><p><strong>Conclusion: </strong>Uterine fibroid was mainly associated with women of older age group of the reproductive age than the younger age categories and also associated more with women with without children compared to those with more children. Moreover, it associated more with obese patients and patient with late age at last delivery.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0022-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093555","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":"Selective use of percutaneous testis biopsy to optimize IVF-ICSI outcomes: a case series.","authors":"Russell P Hayden,&nbsp;Diane L Wright,&nbsp;Thomas L Toth,&nbsp;Cigdem Tanrikut","doi":"10.1186/s40738-016-0020-y","DOIUrl":"https://doi.org/10.1186/s40738-016-0020-y","url":null,"abstract":"<p><strong>Background: </strong>Sperm quality may degrade during transit through the male reproductive tract in some individuals. In this setting surgically retrieved testicular sperm may outperform ejaculated samples for use with in vitro fertilization (IVF) and intracytoplasmic sperm injection (IVF-ICSI). We sought to describe one center's experience with the use of fresh testicular sperm after prior failed IVF-ICSI with ejaculated samples.</p><p><strong>Results: </strong>A retrospective review was conducted evaluating IVF-ICSI cycles performed at a tertiary IVF unit between 2009 and 2014. Couples who were managed with percutaneous testis biopsy to obtain sperm, despite availability of ejaculated sperm, were included. Four couples who underwent a total of 6 percutaneous testis biopsy/IVF-ICSI cycles were identified. Collectively, the couples had undergone 9 prior IVF-ICSI cycles using fresh ejaculated sperm without successful pregnancy. From the six cycles that used fresh testicular sperm four live births resulted (1 twin gestation, 3 singletons). Only 1 of the 4 couples remained childless.</p><p><strong>Conclusions: </strong>For patients who have had prior failed IVF-ICSI attempts, this small case series demonstrates a possible therapeutic benefit when freshly procured testicular sperm are used in lieu of ejaculated samples.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2016-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0020-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093553","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":"Satisfaction with in vitro fertilization treatment: patients' experiences and professionals' perceptions.","authors":"Limor Dina Gonen","doi":"10.1186/s40738-016-0019-4","DOIUrl":"10.1186/s40738-016-0019-4","url":null,"abstract":"<p><strong>Background: </strong>This paper investigates patients' satisfaction with various aspects of fertility care and seeks to determine to what extent fertility specialists are able to assess patient satisfaction. Patients' experiences with in-vitro fertilization (IVF) services and facilities have been compiled and examined in order to discover whether patients' satisfaction is correlated to psychological factors and demographic, socio-economic, and health characteristics, and whether patients' satisfaction has an influence on the willingness to pay (WTP) for IVF treatment.</p><p><strong>Methods: </strong>The study was carried out on 204 patients and 19 fertility professionals from 8 public IVF units in Israel.</p><p><strong>Results: </strong>The study found that, overall, infertile patients are satisfied with the care they received. Several demographic variables (age; education; income; number of fertility treatments) and psychological factors ('Pessimism' and 'Activeness'), were found to be significantly correlated with patient satisfaction with IVF. The results yielded a negative correlation between the WTP for IVF treatment and the satisfaction with access to care and physical conditions.</p><p><strong>Conclusions: </strong>Patient satisfaction is an important component in the evaluation of fertility treatments as well as other medical interventions. Insights into the quality of care as seen from the patients' perspective may help healthcare staff better meet patients' needs, wishes, and priorities.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2016-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0019-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093552","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 Research and Practice reviewer acknowledgement 2015","authors":"E. Ginsburg, D. Schust","doi":"10.1186/s40738-016-0018-5","DOIUrl":"https://doi.org/10.1186/s40738-016-0018-5","url":null,"abstract":"","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0018-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65749294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical vignettes and global health considerations of infertility care in under-resourced patients.","authors":"Erika Tiffanie Chow,&nbsp;Shruthi Mahalingaiah","doi":"10.1186/s40738-016-0017-6","DOIUrl":"https://doi.org/10.1186/s40738-016-0017-6","url":null,"abstract":"<p><p>The ability to receive standard of care for a diagnosis of infertility is a factor of one's financial state and educational level, which are often correlated. Providing infertility care in an under-resourced tertiary care environment provides challenges but also opportunities for unique successes in creating a family. Among the under-represented populations are recent immigrants and refugees. Challenges arise when the infertility treatment is futile or when the standard of care is inaccessible due to cost and scheduling. Unique accomplishments are noted when families are built and hope is restored for couples fleeing from genocide and war-inflicted countries. This article will highlight two clinical vignettes from the Division of Reproductive Endocrinology and Infertility clinic at Boston University School of Medicine/Boston Medical Center. Thereafter, the article will summarize the barriers to care in the United States among those with low socioeconomic status, with non-dominant racial status (non-Caucasian), and with refugee status. All identifiers have been removed and names altered in the patient vignettes.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2016-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0017-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093551","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":"Candidate gene analysis in a case of congenital absence of the endometrium.","authors":"Serap Simavli,&nbsp;Ana Paula Abreu,&nbsp;Mary R Kwaan,&nbsp;Robert G Dluhy,&nbsp;Elena H Yanushpolsky,&nbsp;Colleen Feltmate,&nbsp;Sandra R Cerda,&nbsp;Rona S Carroll,&nbsp;Ursula B Kaiser,&nbsp;Wendy Kuohung","doi":"10.1186/s40738-016-0015-8","DOIUrl":"https://doi.org/10.1186/s40738-016-0015-8","url":null,"abstract":"<p><strong>Background: </strong>Primary amenorrhea usually result from a genetic or anatomic abnormality. We present the first reported patient with the absence of endometrium and lumen in a small bicornuate uterus in a patient with primary amenorrhea.</p><p><strong>Case presentation: </strong>A 41-year-old woman presented for evaluation of primary amenorrhea and infertility. She did develop normal secondary sexual characteristics but never had menses. Physical examination, hormone analyses, and karyotype analysis were normal. Transvaginal ultrasonography revealed a small uterus with absent endometrial stripe. Ovaries were normal in size. Pathology from hysterectomy for abnormal Pap smears revealed a hypoplastic bicornuate uterus with absence of lumen and absent endometrium. DNA analyses for mutations in the coding sequences of three members of HOXA gene family was performed, but no variants in the coding sequence of these genes were found. These findings support the hypothesis that mutations in the coding sequence of HOXA10, HOXA11, and HOXA13 are not responsible for congenital endometrial absence with bicornuate hypoplastic uterus.</p><p><strong>Conclusions: </strong>Congenital absence of the endometrium is an uncommon etiology for primary amenorrhea, and nonvisualization of the endometrial stripe on ultrasound imaging in association with primary amenorrhea should raise suspicion of this rare disorder in this case.</p>","PeriodicalId":87254,"journal":{"name":"Fertility research and practice","volume":"2 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2016-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40738-016-0015-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35093550","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}