{"title":"The use of adjuvants in assisted reproduction treatment","authors":"R. Kennedy","doi":"10.1097/GRH.0000000000000033","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000033","url":null,"abstract":"The basic process of in vitro fertilization and related techniques has been overtime expanded by a group of interventions known collectively as “add-ons” or adjuvants. These additional processes vary from simple medications through complex laboratory procedures through to surgical procedures. Almost without exception they have been applied without thorough evaluation by adequately powered clinical trials and universally they add cost to the process. We examine the most commonly used adjuvants under the headings periconceptual medication, laboratory procedures and interventions to enhance implantation.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e33 - e33"},"PeriodicalIF":0.0,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43439406","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}
T. Takeshima, H. Ueno, M. Yamamoto, Kimitsugu Usui, Kohei Mori, Takuo Asai, Kengo Yasuda, Shinnosuke Kuroda, T. Kawahara, Y. Miyoshi, H. Uemura, Y. Yumura
{"title":"Sperm cryopreservation for fertility preservation in male patients with cancer at a single-center in Japan","authors":"T. Takeshima, H. Ueno, M. Yamamoto, Kimitsugu Usui, Kohei Mori, Takuo Asai, Kengo Yasuda, Shinnosuke Kuroda, T. Kawahara, Y. Miyoshi, H. Uemura, Y. Yumura","doi":"10.1097/GRH.0000000000000034","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000034","url":null,"abstract":"Advanced treatment modalities for cancer have led to improved prognosis in patients with cancer. However, these treatments may adversely affect the fertility of these patients. Therefore, peritreatment preservation of fertility in adolescent and young adult populations is very important. For male patients, sperm cryopreservation before the initiation of treatment for cancer is currently the most effective method for the preservation of fertility. We performed a retrospective cohort analysis of a sperm cryopreservation protocol at the Yokohama City University Medical Center between 2012 and 2017. A total of 235 men were referred and attempted sperm cryopreservation during this period. The most prevalent diseases were hematological malignancies (38.7%; leukemia, malignant lymphoma, and multiple myeloma), testicular cancer (32.3%, including extragonadal germ cell tumor), bone and soft tissue sarcoma (8.5%), lung cancer (4.7%), prostate cancer (4.3%), and brain tumor (2.6%) in descending order. The median age of patients was 31 (range: 13–65) years, mean sperm density and motility were 28.54±30.25 106/mL, and 20.38±20.62%, respectively. Sperm cryopreservation was successfully performed in 195 patients (83.0%). In those with cryopreservation failure (36 patients; 15.3%), the primary causes were azoospermia or poor semen quality. In the remaining 4 patients (1.7%), testicular spermatozoa were successfully cryopreserved through surgical extraction. In the cryopreservation failure group (n=36), 23 patients (63.9%) were referred after initiation of treatment. Of those, 17 patients were referred from the departments of hematology and oncology. Moreover, sperm density was significantly lower in patients who under gone treatment than in those of the pretreatment group (P=0.003). Cryopreserved sperm from 18 patients was used in 23 in vitro fertilization cycles, resulting in a clinical pregnancy rate of 56.5% per cycle. It is important to inform other departments regarding the option for sperm cryopreservation before initiating treatment in patients with cancer.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e34 - e34"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42487568","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}
O. Ashiru, Tinuke O. Adeyi, Ebele C. Iloabachie, B. Bello, Chizara C Okeke, Ajibola V. Soyoye
{"title":"Managing environmental exposure in clinical practice","authors":"O. Ashiru, Tinuke O. Adeyi, Ebele C. Iloabachie, B. Bello, Chizara C Okeke, Ajibola V. Soyoye","doi":"10.1097/GRH.0000000000000025","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000025","url":null,"abstract":"Introduction: Environmental toxins from various occupational industries like oil and gas, petrochemical, agriculture, and bad eating habits cause serious health hazards. This study describes the clinical success of Modern Mayr therapy type of detoxification in a fertility practice that uses detoxification as a complementary treatment. Materials and Methods: A total of 218 infertile patients undergoing in vitro fertilization treatment from January 2014 to December 2017 at the Medical Art Center (MART) Lagos, Nigeria were referred to MART-Life Detox clinic for a supervised Modern Mayr-type of detoxification before further assisted reproductive technology treatment. Patients were placed in 2 groups. Group A consisted of 131 patients with a history of one or more failed IVF cycles at MART before commencing Mayr therapy. Group B consisted of 87 patients with no previous IVF treatment at MART. Mayr therapy using special dietary nutrition and equipment such as hypoxicator and sea oxygenator was performed. Improvement in their fertility outcomes with regards to oocyte yield, pregnancy and live birth rate were assessed in subsequent cycles following detoxification. Results: The mean patient age was 41.53 years for group A and 40.6 years for group B. A total of 89% of all patients achieved significant weight reduction and improvement in body mass index. Uniform increase in oocyte yield was observed but this was particularly noticeable in previous poor responders in group A. Records showed positive hCG rates of 41.2% and 30%, clinical pregnancy rates of 27.5% and 21.8%, and live birth rates of 23.7% and 15%, in group A and B, respectively. There are currently 5 ongoing pregnancies in group A and 6 in group B. Conclusions: The data suggests that supervised modern Mayr type of detoxification may positively affect fertility indices in infertile couples who undergo assisted reproductive technology. However, there is a need for randomized controlled trials in larger populations to establish pattern of response.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46078594","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":"“Nobody left behind”: the role of data registries in assisted reproductive technology","authors":"S. Dyer, F. Zegers‐Hochschild","doi":"10.1097/GRH.0000000000000026","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000026","url":null,"abstract":"“The freedom for all to live a flourishing life” is the big vision that underpins world-wide action and advocacy for human development. High-level global strategies, including the Sustainable Development Goals and United Nations Human Development Report, present plans of action that “nobody is left behind”. Central to living a flourishing life is the freedom and human right to found a family and have children. In the case of infertility, nobody is left behind if thosewhowish to access care have the freedom to do so; and, beyond access, find evidence-based treatment with a transparent track-record pertaining to outcomes. One of the international markers used to reflect access to infertility care is the number of assisted reproductive technology (ART) cycles per million inhabitants. Although numbers mean different things in different communities, it has been accepted that access is met if 3000 couples per million population undergoART per annum. This estimate is derived from an algorithm which considers infertility prevalence, non-ART pregnancies as well as treatment-independent pregnancies. However, it must be stated that the demand for treatment can be reduced to half of this theoretical need. Many factors are responsible, such as the influence of religion, as well as cultural and educational factors. Qualitatively, the freedom to access infertility care is met if interventions are available, affordable and acceptable. Affordability pertains to the ability of the individual or the society to pay for the intervention without incurring undue financial risks or harm. Availability comprises physical presence of facilities and interventions within reach of consumers. Acceptability implies that an intervention is acceptable to the patient and vice versa. In all of these domains, visible and invisible biases exist. In many health systems, poverty creates prominent and visible barriers in the affordability domain—and often similarly prominent but less visible barriers in the acceptability domain.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43132860","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":"International Federation of Fertility Societies’ Surveillance (IFFS) 2019: Global Trends in Reproductive Policy and Practice, 8th Edition","authors":"S. Ory","doi":"10.1097/GRH.0000000000000029","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000029","url":null,"abstract":"The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the IFFS concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The editorial board members and survey respondents are responsible for the views and comments, respectively, expressed in this publication and they do not necessarily represent the decisions, policy, or views of the IFFS.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e29"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47970722","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}
D. Keating, S. Cheung, A. Parrella, P. Xie, Z. Rosenwaks, G. Palermo
{"title":"ICSI from the beginning to where we are today: are we abusing ICSI?","authors":"D. Keating, S. Cheung, A. Parrella, P. Xie, Z. Rosenwaks, G. Palermo","doi":"10.1097/grh.0000000000000035","DOIUrl":"https://doi.org/10.1097/grh.0000000000000035","url":null,"abstract":"","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/grh.0000000000000035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61697330","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":"Meeting Abstracts from the 2019 IFFS Shanghai World Congress","authors":"","doi":"10.1097/GRH.0000000000000030","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000030","url":null,"abstract":"","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"18 1","pages":"e30"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61697718","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":"The scientific basis of the reproductive revolution in Sub-Saharan Africa: challenges and opportunities","authors":"J. H. Olobo-Lalobo","doi":"10.1097/grh.0000000000000031","DOIUrl":"https://doi.org/10.1097/grh.0000000000000031","url":null,"abstract":"","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/grh.0000000000000031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61697270","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":"The place of ART in Africa","authors":"G. Serour, A. Serour, Yehia El Faysal, Y. Islam","doi":"10.1097/GRH.0000000000000027","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000027","url":null,"abstract":"Since the birth of Louis Brown on July 25th, 1978 through in vetro fertilization, assisted reproductive technology (ART) now is widely used for the treatment of both male and female infertility. Today globally almost 2 million ART cycles are performed every year. Although Africa constitutes 16% of the world population, yet its share of ART is much less than its fair share of 320,000 cycles per year. There are several barriers to the wide application of ART in Africa. These include epidemiological, geographic, financial, and socio-cultured barriers in addition to the health education barrier, restrictive health policy barrier and health systems barrier. In Africa there is an increasing demand for ART. Africa, like many parts in the world, is witnessing a changing life style which affects fertility. In Africa infertility is a medico-socio cultural problem with sex-based sufferings. Furthermore there is a higher prevalence of STIs and postpartum and postabortion infections which contributes to both male and female infertility. This coupled with the fact that treatment of infertility is a human right issue which should not be discriminated on economic, geographic, or racial basis, necessitates finding ways to overcome such disparity in the provision of ART for infertile patients in Africa. The paper discusses the various possible ways to improve availability and access to ART in Africa. The infertile couples in Africa should not suffer the health, psychological, and societal burden of infertility simply because others in the African continent reproduce too many. The 2030 SDGs agenda has envisaged a better future. One where we collectively tear down the barriers and correct disparities, focusing first on those left further behind.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e27 - e27"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61697698","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":"Male infertility and environmental factors","authors":"A. Perheentupa","doi":"10.1097/GRH.0000000000000028","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000028","url":null,"abstract":"Semen quality in men is decreasing. Numerous chemicals act as endocrine-disrupting agents and their detrimental effect on fertility and spermatogenesis has been shown in rodent studies. Consequences in humans are challenging to study and effects of fetal exposure on fertility are apparent only 2 decades later. Appropriate animal models are needed to study the reproductive effects of the thousands of chemicals that humans come in contact with. The burden of proof of chemical safety must shift from the individual and health care provider to the manufacturers similar to the licensing of medical drugs.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"4 1","pages":"e28 - e28"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61697710","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}