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https://www.readbyqxmd.com/read/28965551/modified-natural-cycle-in-in%C3%A2-vitro-fertilization
#1
REVIEW
Jacqueline R Ho, Richard J Paulson
The first live birth after IVF was achieved in a purely natural cycle. Because early attempts at IVF were associated with low efficiency, ovarian stimulation was added to achieve a greater margin for error in oocyte retrieval, fertilization, and thus, overall pregnancy success. As technology improved, the intuitive appeal of the natural cycle led investigators to once again attempt IVF without antecedent gonadotropin stimulation. Triggering of ovulation with hCG was added to allow for accurate scheduling of oocyte retrieval and thus increased oocyte yield...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28942518/projecting-the-potential-impact-of-the-cap-score%C3%A2-on-clinical-pregnancy-live-births-and-medical-costs-in-couples-with-unexplained-infertility
#2
Joseph B Babigumira, Fady I Sharara, Louis P Garrison
PURPOSE: The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles...
September 23, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28938728/modeling-of-live-birth-rates-and-cost-effectiveness-of-oocyte-cryopreservation-for-cancer-patients-prior-to-high-and-low-risk-gonadotoxic-chemotherapy
#3
B Lyttle Schumacher, N Grover, T Mesen, A Steiner, J Mersereau
STUDY QUESTION: What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? SUMMARY ANSWER: Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC)...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28874259/outcomes-from-a-university-based-low-cost-in%C3%A2-vitro-fertilization-program-providing-access-to-care-for-a-low-resource-socioculturally-diverse-urban-community
#4
Christopher N Herndon, Yanett Anaya, Martha Noel, Hakan Cakmak, Marcelle I Cedars
OBJECTIVE: To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. DESIGN: Retrospective cohort study. SETTING: Academic infertility center. PATIENT(S): Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28721178/global-reproductive-health-why-do-we-persist-in-neglecting-the-undeniable-problem-of-childlessness-in-resource-poor-countries
#5
EDITORIAL
W Ombelet, J Goossens
The consequences of involuntary childlessness in developing countries create more wide-ranging societal problems compared to Western societies, particularly for women. Negative psychosocial and economical consequences for childless couples are often severe and underestimated by the local and international society. Infertility treatment is often limited to certain procedures and certain costumers. Most common arguments against supporting infertility care in resource-poor countries are the "overpopulation" and the "limited resources" argument, but they totally neglect the reproductive rights and systematic exclusion of millions of women from the right to reproduce...
March 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28711302/potential-selection-of-genetically-balanced-spermatozoa-based-on-the-hypo-osmotic-swelling-test-in-chromosomal-rearrangement-carriers
#6
Alexandre Rouen, Léa Carlier, Solveig Heide, Matthieu Egloff, Pauline Marzin, Flavie Ader, Mathias Schwartz, Eli Rogers, Nicole Joyé, Richard Balet, Nathalie Lédée, Laura Prat-Ellenberg, Nino Guy Cassuto, Jean-Pierre Siffroi
Chromosomal translocations and other balanced rearrangements, although usually associated with a normal phenotype, can lead to the transmission of an abnormal unbalanced genome to the offspring. Balanced and unbalanced spermatozoa, being indistinguishable, cannot be selected or deselected for prior to IVF and pre-implantation genetic diagnosis. Spermatozoa from 16 chromosomal rearrangement carriers were studied. After incubation in a hypo-osmotic solution (hypo-osmotic swelling test, or HOST), spermatozoa were fixed on microscope slides...
June 27, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28675921/cycle-regimens-for-frozen-thawed-embryo-transfer
#7
REVIEW
Tarek Ghobara, Tarek A Gelbaya, Reuben Olugbenga Ayeleke
BACKGROUND: Among subfertile couples undergoing assisted reproductive technology (ART), pregnancy rates following frozen-thawed embryo transfer (FET) treatment cycles have historically been found to be lower than following embryo transfer undertaken two to five days following oocyte retrieval. Nevertheless, FET increases the cumulative pregnancy rate, reduces cost, is relatively simple to undertake and can be accomplished in a shorter time period than repeated in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles with fresh embryo transfer...
July 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28583200/high%C3%A2-quality-clinical%C3%A2-grade-human-embryonic-stem-cell-lines-derived-from-fresh-discarded-embryos
#8
Jinpei Ye, Nicola Bates, Despina Soteriou, Lisa Grady, Clare Edmond, Alex Ross, Alan Kerby, Philip A Lewis, Tope Adeniyi, Ronnie Wright, Kay V Poulton, Marcus Lowe, Susan J Kimber, Daniel R Brison
BACKGROUND: Human embryonic stem cells (hESCs) hold tremendous promise for cell replacement therapies for a range of degenerative diseases. In order to provide cost-effective treatments affordable by public health systems, HLA-matched allogeneic tissue banks of the highest quality clinical-grade hESCs will be required. However only a small number of existing hESC lines are suitable for clinical use; they are limited by moral and ethical concerns and none of them apply Good Manufacturing Practice (GMP) standards to the earliest and critical stages of gamete and embryo procurement...
June 5, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28421902/the-role-of-ovarian-reserve-markers-in-prediction-of-clinical-pregnancy
#9
Ali G Zebitay, Orkun Cetin, Fatma F Verit, Seda Keskin, M Nafi Sakar, Sercin Karahuseyinoglu, Gulsah Ilhan, Sezai Sahmay
To evaluate the role of ovarian reserve markers in the prediction of clinical pregnancy and embryo transfer accomplishment among poor responder IVF applicants. 304 female poor responder IVF applicants were included in this prospective cohort study conducted at the IVF-unit. Antral follicle count, FSH, LH, E2, AMH and IVF outcomes were compared in pregnant and non-pregnant groups as well as in ET vs. non-ET groups. The number of retrieved oocytes was significantly correlated positively with AMH and AFC, and negatively with FSH and age...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28369357/general-practitioners-adherence-to-work-up-and-referral-recommendations-in-fertility-care
#10
H W van der Pluijm-Schouten, R P M G Hermens, C F van Heteren, H J Schers, M J Schleedoorn, M Arkenbout, P W Maassen, J A M Kremer, W L D M Nelen
STUDY QUESTION: What is the current guideline adherence by general practitioners (GPs) for work-up and subsequent referral from primary to secondary care for patients suffering from infertility? SUMMARY ANSWER: Guideline adherence by GPs concerning infertility was 9.2% in couples referred. WHAT IS KNOWN ALREADY: Adherence to recommendations can decrease unnecessary referral, diagnostics and treatments, and consequently result in lower expenditures...
June 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28142289/time-lapse-imaging-is-it-time-to-incorporate-this-technology-into-routine-clinical-practice
#11
Priya Bhide, Abha Maheshwari, Rachel Cutting, Susan Seenan, Anita Patel, Khalid Khan, Roy Homburg
Time-lapse imaging (TLI) systems for embryo incubation, assessment and selection are a novel technology available to in vitro fertilization (IVF) clinics. However, there is uncertainty about their clinical and cost-effectiveness and insufficient good quality evidence to warrant their routine use. Despite this, enthusiastic commercial marketing and slipping clinical equipoise have led to the widespread hasty introduction of this technology into practice, often at a considerable expense to the patient. We have reviewed the published literature and aim to summarize the strengths, weaknesses, opportunities and threats of these systems...
February 1, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28007790/the-effect-of-expressive-writing-intervention-for-infertile-couples-a-randomized-controlled-trial
#12
Yoon Frederiksen, Mia Skytte O'Toole, Mimi Y Mehlsen, Benedicte Hauge, Helle Olesen Elbaek, Robert Zachariae, Hans Jakob Ingerslev
STUDY QUESTION: Is expressive writing intervention (EWI) efficacious in reducing distress and improving pregnancy rates for couples going through ART treatment? SUMMARY ANSWER: Compared to controls, EWI statistically significantly reduced depressive symptoms but not anxiety and infertility-related distress. WHAT IS KNOWN ALREADY: ART treatment is considered stressful. So far, various psychological interventions have been tested for their potential in reducing infertility-related distress and the results are generally positive...
December 21, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27909571/affordable-art-in-kenya-the-only-hope-for-involuntary-childlessness
#13
S W Ndegwa
The reported overall subfertility rate in Kenia is 26.1% with 50% attributed to tubal factors and 15% due to male factors. This is probably an underestimation taking into consideration that due to the stigma and myths of the disease, many couples are seeking alternative care from religious sects, witchdoctors, herbalists. Because the costs associated with IVF in private centres are only affordable for the happy few, the only true hope for most Kenyans struggling with unintended childlessness lies in the introduction of affordable ART services...
June 27, 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/27868470/perinatal-outcomes-and-cost-effectivity-of-the-assisted-reproduction-pregnancies-with-advanced-age-a-retrospective-analysis
#14
Nafiye Yilmaz, Mustafa Kara, Bugra Coskun, Metin Kaba, Selçuk Erkilinc, Okan Yenicesu, Salim Erkaya
We demonstrated the IVF-ICSI results, perinatal outcomes and cost-effectivity of the patients with advanced age at a tertiary centre. A total of 456 patients categorised into two groups according to age: group 1 (n = 158) (≥39years) and group 2 (n = 298) (<39years) were analysed retrospectively. In addition, subgroup analysis was performed according to the 40 years cut-off. Clinical pregnancy rate was significantly different between the groups (p< .001). Preterm delivery (< 37 gestational week) and low birth weight (< 2500 g) were significantly higher in advanced aged women than youngsters (p< ...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27836979/a-mild-ovarian-stimulation-strategy-in-women-with-poor-ovarian-reserve-undergoing-ivf-a-multicenter-randomized-non-inferiority-trial
#15
M A Youssef, M van Wely, H Al-Inany, T Madani, N Jahangiri, S Khodabakhshi, M Alhalabi, M Akhondi, S Ansaripour, R Tokhmechy, L Zarandi, A Rizk, M El-Mohamedy, E Shaeer, M Khattab, M H Mochtar, F van der Veen
STUDY QUESTION: In subfertile women with poor ovarian reserve undergoing IVF does a mild ovarian stimulation strategy lead to comparable ongoing pregnancy rates in comparison to a conventional ovarian stimulation strategy? SUMMARY ANSWER: A mild ovarian stimulation strategy in women with poor ovarian reserve undergoing IVF leads to similar ongoing pregnancy rates as a conventional ovarian stimulation strategy. WHAT IS KNOWN ALREADY: Women diagnosed with poor ovarian reserve are treated with a conventional ovarian stimulation strategy consisting of high-dose gonadotropins and pituitary downregulation with a long mid-luteal start GnRH-agonist protocol...
January 2017: Human Reproduction
https://www.readbyqxmd.com/read/27831635/short-gonadotropin-releasing-hormone-agonist-versus-flexible-antagonist-versus-clomiphene-citrate-regimens-in-poor-responders-undergoing-in-vitro-fertilization-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
M Schimberni, F Ciardo, M Schimberni, A Giallonardo, V De Pratti, M Sbracia
OBJECTIVE: Poor responders represent a frustrating condition for couples undergoing IVF and clinicians, and their treatment remains disputed. To assess the efficacy and the most suitable protocol, we conducted a randomized controlled trial comparing three different protocols of ovarian stimulation in poor responder women: clomiphene citrate (CC) plus a high dose of gonadotropins and GnRH antagonist, flexible GnRH antagonist protocol and a short GnRH agonist protocol. PATIENTS AND METHODS: Between July 2014 and December 2015 we enrolled 250 poor responders in a previous IVF cycle at least 3 months before...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27825533/no-need-for-luteal-phase-support-in-ivf-cycles-after-mild-stimulation-proof-of-concept-study
#17
Anna Pia Ferraretti, Paul Devroey, M Cristina Magli, Luca Gianaroli
This is a pilot study performed in a private IVF unit. The objective of the study was to investigate whether luteal support is required in IVF cycles after mild stimulation with clomiphene citrate and low FSH doses. The study included 15 patients with good prognosis (defined as ≤38 years old with normal ovarian reserve and normovulatory cycles, body mass index <29 kg/m(2), no previous cycles, no severe endometriosis, no history of recurrent miscarriage, no endocrine/autoimmune diseases and no surgical semen extraction from the partner) undergoing IVF with mild stimulation...
February 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/27692676/sudden-death-and-cardiac-arrest-without-phenotype-the-utility-of-genetic-testing
#18
REVIEW
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...
April 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27491771/pre-implantation-genetic-testing-in-art-who-will-benefit-and-what-is-the-evidence
#19
REVIEW
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
https://www.readbyqxmd.com/read/27486273/getting-older-women-pregnant-contemporary-thoughts
#20
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
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