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Low cost IVF

Yanushi D Wijeyeratne, Elijah R Behr
Approximately 4% of sudden cardiac deaths are unexplained [the sudden arrhythmic death syndrome (SADS)], and up to 6-10% of survivors of cardiac arrest do not have an identifiable cardiac abnormality after comprehensive clinical evaluation [idiopathic ventricular fibrillation (IVF)]. Genetic testing may be able to play a role in diagnostics and can be targeted to an underlying phenotype present in family members following clinical evaluation. Alternatively, post-mortem genetic testing (the "molecular autopsy") may diagnose the underlying cause if a clearly pathogenic rare variant is found...
August 31, 2016: Trends in Cardiovascular Medicine
Alberto Vaiarelli, Danilo Cimadomo, Antonio Capalbo, Giovanna Orlando, Fabio Sapienza, Silvia Colamaria, Antonio Palagiano, Carlo Bulletti, Laura Rienzi, Filippo Maria Ubaldi
Pre-implantation genetic diagnosis for aneuploidy testing (PGD-A) is a tool to identify euploid embryos during IVF. The suggested populations of patients that can benefit from it are infertile women of advanced maternal age, with a history of recurrent miscarriages and/or IVF failures. However, a general consensus has not yet been reached.After the clinical failure of its first version based on cleavage stage biopsy and 9 chromosome-FISH analysis, PGD-A is currently performed by 24 chromosome screening techniques on trophectoderm (TE) biopsies...
October 2016: Journal of Assisted Reproduction and Genetics
Gautam N Allahbadia
For women of advanced age with abnormally increased FSH levels, standardized hormonal stimulation often represents a cost-intensive procedure with a low success rate. It is well established now that with mild ovarian stimulation, there is a greater percentage of good-quality eggs (although a smaller number) than with higher-dose conventional stimulation. Mild stimulation protocols reduce the mean number of days of stimulation, the total amount of gonadotropins used and the mean number of oocytes retrieved. The proportion of high-quality and euploid embryos seems to be higher compared with conventional stimulation protocols, and the pregnancy rate per embryo transfer is comparable...
October 2016: Journal of Obstetrics and Gynaecology of India
Sarah Lensen, Wellington Martins, Carolina Nastri, Lynn Sadler, Cindy Farquhar
BACKGROUND: The success rate of infertility treatments remains modest. Endometrial injury has been suggested as an intervention to increase the probability of pregnancy in women undergoing assisted reproductive technologies such as in vitro fertilisation (IVF). The majority of studies and systematic reviews have reported that endometrial injury improves the outcomes of IVF, intrauterine insemination and natural conception; however, the size and quality of the studies are poor. The low quality of the available evidence questions the presence of any real beneficial effect, and the applicability of the intervention in different populations remains unclear...
2016: Trials
Aaron K Styer, Barbara Luke, Wendy Vitek, Mindy S Christianson, Valerie L Baker, Alicia Y Christy, Alex J Polotsky
OBJECTIVE: To evaluate factors associated with elective single-embryo transfer (eSET) utilization and its effect on assisted reproductive technology outcomes in the United States. DESIGN: Historical cohort. SETTING: Not applicable. PATIENT(S): Fresh IVF cycles of women aged 18-37 years using autologous oocytes with either one (SET) or two (double-embryo transfer [DET]) embryos transferred and reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System between 2004 and 2012...
July 2016: Fertility and Sterility
Aldo Volpes, Francesca Sammartano, Simona Rizzari, Salvatore Gullo, Angelo Marino, Adolfo Allegra
PURPOSE: The aim of this study was to investigate the most suitable sperm preparation technique to apply in order to obtain a spermatozoon population with minimal DNA damage during in vitro fertilization procedures. We compared four preparation techniques: direct swim-up (DSU), pellet swim-up (PSU), density gradient (DG), and density gradient followed by swim-up (DG-SU), evaluating the effects of each technique on the DNA damage rate, evaluated by DNA fragmentation index of the spermatozoa obtained...
June 2016: Journal of Assisted Reproduction and Genetics
Olivia J Carpinello, Peter R Casson, Chia-Ling Kuo, Renju S Raj, E Scott Sills, Christopher A Jones
BACKGROUND: In states in the USA without in vitro fertilzation coverage (IVF) insurance coverage, more embryos are transferred per cycle leading to higher risks of multi-fetal pregnancies and adverse pregnancy outcomes. OBJECTIVE: To determine frequency and cost of selected adverse perinatal complications based on number of embryos transferred during IVF, and calculate incremental cost per IVF live birth. METHODS: Medical records of patients who conceived with IVF (n = 116) and delivered at >20 weeks gestational age between 2007 and 2011 were evaluated...
June 2016: Applied Health Economics and Health Policy
La-mu Cidan, Li Chen, Dan Zhang
OBJECTIVE: To explore the therapeutic effects and advantages of dual channel and dual cycle regimen in the treatment of severe ovarian hyperstimulation syndrome (OHSS) with pregnancy. METHODS: This study enrolled 60 severe OHSS patients who were successfully pregnant with vitro fertilization-embryo transfer (IVF-ET). The patients were divided into conventional single cycle treatment group (Group A) and dual cycle and dual channel treatment group (Group B). Before the treatment and at the 3rd d and 9th d of treatment, all the patients received the measurements of body mass (BM), abdominal circumference (AC), maximum depth of ascites in ultrasonic (D), serum albumin (ALB), Na+ concentration, white blood cell count (WBC), hematocrit (HCT), drink intake (Intake) and urine volume...
November 2015: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
Theodoros Kalampokas, Abha Maheswari
This is a report of a case of an egg recovery procedure completed with manual suction instead of the automated negative pressure suction. A 35-year-old woman who was undergoing in vitro fertilization (IVF) treatment had to undergo oocyte recovery using manual suction through a syringe instead of the automated negative pressure suction systems because of the failure of both the initial and replacement systems. The treatment cycle ended in a positive pregnancy test and a clinical pregnancy with acceptable oocyte fertilization rates and no complications during procedure...
2015: Journal of the Turkish German Gynecological Association
Maryam Zafer, Hacsi Horvath, Okeoma Mmeje, Sheryl van der Poel, Augusto E Semprini, George Rutherford, Joelle Brown
OBJECTIVE: To evaluate the effectiveness of semen washing in human immunodeficiency virus (HIV)-discordant couples in which the male partner is infected. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Forty single-arm open-label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen...
March 2016: Fertility and Sterility
Georgia Kakourou, Christina Vrettou, Antonis Kattamis, Aspasia Destouni, Myrto Poulou, Maria Moutafi, Georgia Kokkali, Konstantinos Pantos, Stephen Davies, Sophia Kitsiou-Tzeli, Emmanuel Kanavakis, Joanne Traeger-Synodinos
Preimplantation genetic diagnosis (PGD) to select histocompatible siblings to facilitate curative haematopoeitic stem-cell transplantation (HSCT) is now an acceptable option in the absence of an available human leukocyte antigen (HLA) compatible donor. We describe a case where the couple who requested HLA-PGD, were both carriers of two serious haematological diseases, beta-thalassaemia and sideroblastic anaemia. Their daughter, affected with sideroblastic anaemia, was programmed to have HSCT. A multiplex-fluorescent-touchdown-PCR protocol was optimized for the simultaneous amplification of: the two HBB-gene mutated regions (c...
2016: Systems Biology in Reproductive Medicine
Charalampos S Siristatidis, Ahmed Gibreel, George Basios, Abha Maheshwari, Siladitya Bhattacharya
BACKGROUND: Gonadotrophin-releasing hormone agonists (GnRHa) are commonly used in assisted reproduction technology (ART) cycles to prevent a luteinising hormone surge during controlled ovarian hyperstimulation (COH) prior to planned oocyte retrieval, thus optimising the chances of live birth. OBJECTIVES: To evaluate the effectiveness of the different GnRHa protocols as adjuncts to COH in women undergoing ART cycles. SEARCH METHODS: We searched the following databases from inception to April 2015: the Cochrane Menstrual Disorders and Subfertility Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (2015, Issue 3), MEDLINE, EMBASE, CINAHL, PsycINFO, and registries of ongoing trials...
2015: Cochrane Database of Systematic Reviews
R Kumar Pramod, Rakesh Kumar, Abhijit Mitra
Current methods of transgenic animal production are afflicted by low efficiency and high cost. Recently, the electroporation aided sperm-mediated gene transfer (SMGT) emerges as a promising alternative with variable success rate. Among the domestic animal species, the electroporation-aided SMGT is less investigated in goats, except a few reports in which attempts have been made using the auto-uptake method of SMGT. In this study, we report an optimized electroporation condition for SMGT of caprine sperm cells...
January 15, 2016: Gene
Claus Yding Andersen, Helle Olesen Elbaek, Birgit Alsbjerg, Rita Jakubcionyte Laursen, Betina Boel Povlsen, Lise Thomsen, Peter Humaidan
STUDY QUESTION: Can the luteal phase support be improved in terms of efficacy, hormonal profiles and convenience as compared with today's standard care? SUMMARY ANSWER: Daily low-dose rhCG supplementation in GnRHa triggered IVF cycles can replace the traditional used luteal phase support with exogenous progesterone. WHAT IS KNOWN ALREADY: A bolus of hCG for final maturation of follicles in connection with COS may induce the risk of OHSS and the luteal phase progesterone levels rise very abruptly in the early luteal phase...
October 2015: Human Reproduction
Karinna Lattes, Mario Brassesco, Manuel Gomez, Miguel A Checa
Poor ovarian response (POR) often means low success rates after in vitro fertilisation (IVF). We aim to study the impact of a low-dose growth hormone (GH) supplementation in pregnancy rates in poor responders in a prospective, self-controlled study of 64 poor responders to previous IVF cycles, who failed to achieve pregnancy and were supplemented with low-doses of GH in a subsequent cycle using the same gonadotropin dose and protocol. Our primary endpoint was the clinical pregnancy rate (CPR), considering secondary endpoints, the number of retrieved oocytes, embryos, embryo quality and the proportion of cycles with embryo transfer...
July 2015: Gynecological Endocrinology
Anna Pia Ferraretti, Luca Gianaroli, Maria Cristina Magli, Paul Devroey
OBJECTIVE: To validate the use of clomiphene citrate in IVF when mild stimulation approaches are chosen to reduce patient discomfort, risk, and cost. DESIGN: Prospective cohort study. SETTING: Private IVF clinic. PATIENT(S): A total of 163 patients undergoing IVF and with a good prognosis (defined as ≤38 years old with normal ovarian reserve and normovulatory cycles, body mass index <29 kg/m(2), no previous assisted reproductive technology cycles, no severe endometriosis, no history of recurrent miscarriage, no endocrine/autoimmune diseases, and no surgical semen extraction)...
August 2015: Fertility and Sterility
H Altay Güvenir, Gizem Misirli, Serdar Dilbaz, Ozlem Ozdegirmenci, Berfu Demir, Berna Dilbaz
In medicine, estimating the chance of success for treatment is important in deciding whether to begin the treatment or not. This paper focuses on the domain of in vitro fertilization (IVF), where estimating the outcome of a treatment is very crucial in the decision to proceed with treatment for both the clinicians and the infertile couples. IVF treatment is a stressful and costly process. It is very stressful for couples who want to have a baby. If an initial evaluation indicates a low pregnancy rate, decision of the couple may change not to start the IVF treatment...
September 2015: Medical & Biological Engineering & Computing
Jane Gervasio
Total nutrient admixture (TNA) is a complete parenteral nutrition (PN) formulation composed of all macronutrients, including dextrose, amino acids, and intravenous fat emulsions (IVFE), in one bag. The TNA may be safely administered to the patient, with all components aseptically compounded and minimal administration manipulation required, lending itself to decreases in risks of catheter contamination and patient infections. The TNA is compatible and stable at recommended concentrations, and since the IVFE is in the TNA, it is infused at slower rates, allowing for better fat clearance...
June 2015: Nutrition in Clinical Practice
M M J van Heesch, J L H Evers, M A H B M van der Hoeven, J C M Dumoulin, C E M van Beijsterveldt, G J Bonsel, R H M Dykgraaf, J B van Goudoever, C Koopman-Esseboom, W L D M Nelen, K Steiner, P Tamminga, N Tonch, H L Torrance, C D Dirksen
STUDY QUESTION: Do in vitro fertilization (IVF) multiples generate higher hospital costs than IVF singletons, from birth up to age 5? SUMMARY ANSWER: Hospital costs from birth up to age 5 were significantly higher among IVF/ICSI multiple children compared with IVF/ICSI singletons; however, when excluding the costs incurred during the birth admission period, hospital costs of multiples and singletons were comparable. WHAT IS KNOWN ALREADY: Concern has risen over the long-term outcome of children born after IVF...
June 2015: Human Reproduction
Marcia C Inhorn, Pasquale Patrizio
BACKGROUND: Infertility is estimated to affect as many as 186 million people worldwide. Although male infertility contributes to more than half of all cases of global childlessness, infertility remains a woman's social burden. Unfortunately, areas of the world with the highest rates of infertility are often those with poor access to assisted reproductive techniques (ARTs). In such settings, women may be abandoned to their childless destinies. However, emerging data suggest that making ART accessible and affordable is an important gender intervention...
July 2015: Human Reproduction Update
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