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Assistive reproductive therapy

Øivind Torkildsen, Trygve Holmøy, Kjell-Morten Myhr
Several reports indicate increased disease activity in patients with multiple sclerosis (MS) undergoing assisted reproductive techniques (ART), in the form of gonadtopin releasing hormone (GnRH) agonists. Other forms of ART treatments, like gonadotropin-treatment, have therefore been considered a safer option for MS-patients. We present a patient who despite being completely clinically and radiologically stable for eight years during disease modifying therapy experienced a nearly fulminant disease course almost immediately after starting gonadotropin-treatment, indicating that this form of follicle stimulating treatment could also be a major risk factor for MS disease activity...
March 6, 2018: Multiple Sclerosis and related Disorders
Greisa Vila, Anton Luger
Growth hormone (GH) is not approved for use during conception and pregnancy. Nevertheless, data from the clinical care practice reveal that most women concieve on GH replacement therapy (GHRT), and more than half continue on GHRT also during pregnancy. GH stimulates the hypothalamic-pituitary-gonadal axis at all levels, and there is evidence that GH deficiency impacts the morphology of reproductive organs, onset of puberty, ovarian function and fertility. Patients with hypopituitarism often conceive using assisted reproductive techniques and several studies support the benefit of GH supplementation for achieving fertility in women with growth hormone deficiency...
March 8, 2018: Minerva Endocrinologica
Taniqua A Miller, Rebecca H Allen, Andrew M Kaunitz, Carrie A Cwiak
Family planning represents a key component of reproductive health care. Accordingly, the provision of contraception must span the reproductive age spectrum, including perimenopause. The risk of pregnancy is decreased, but not trivial, among women over 40 years of age. Evidence-based guidelines for contraceptive use can assist clinicians in counseling their patients in this population. Intrauterine contraception is one of the most effective methods and is safe to use in midlife women with few exceptions. Progestin-only contraception is another safe option for most midlife women because it is not associated with an increased risk of cardiovascular complications...
February 16, 2018: Menopause: the Journal of the North American Menopause Society
Shun-Jen Tan, Chi-Huang Chen, Shauh-Der Yeh, Yun-Ho Lin, Chii-Ruey Tzeng
OBJECTIVE: To report an infertility case of deep-infiltrating bladder endometriosis conceiving following robot-assisted surgery and modified gonadotropin-releasing hormone agonist (GnRHa) treatment. CASE REPORT: A 33 year-old infertile female presenting with dysmenorrhea was found to have a bladder mass by pelvic ultrasound. Cystoscopy revealed a protruding tumor from the posterior bladder wall, and endometriosis was highly suspected. Robot-assisted laparoscopic partial cystectomy was performed for the deep-infiltrating bladder endometriosis...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Jenna A LoGiudice, Jenna Massaro
AIM: This review evaluates the impact of complementary therapies on psychosocial factors in women undergoing IVF. BACKGROUND: According to the CDC, nearly 7% of married women in the United States face infertility. Approximately 1.5% of all infants born in the U.S. annually are conceived through assisted reproductive technologies (ART), such as IVF. Women undergoing ART report distress, anxiety, and depression related to their treatment. Stress has been cited as the top reason why women terminate treatment...
February 2018: Applied Nursing Research: ANR
Douglas A Gibson, Ioannis Simitsidellis, Olympia Kelepouri, Hilary O D Critchley, Philippa T K Saunders
OBJECTIVE: To investigate the impact of the androgen precursor dehydroepiandrosterone (DHEA) on the decidualization of human endometrial stromal cells isolated from women of advanced reproductive age. DESIGN: In vitro study. SETTING: University research institute. PATIENT(S): Proliferative phase primary human endometrial stromal fibroblasts (hESFs) were isolated from women of advanced reproductive age (n = 16; mean age, 44...
February 1, 2018: Fertility and Sterility
Mohamed Shehata
About 4% of male patients with cancer are under the age of 35 years. With the current increase in efficacy and safety of therapies, a growing number of young adults can achieve long-term survival. In male patients receiving systemic chemotherapy and or bone marrow transplantation, a permanent loss of fertility is a common adverse effect. The only possibility to preserve the patient's fertility is to spare the gametes or gamete-forming cells from the chemotherapeutic effect. In adults, this can be achieved by the cryopreservation of spermatozoa with the subsequent application of assisted reproductive technology...
December 2017: Turkish Journal of Obstetrics and Gynecology
Anna Heger, Michael Sator, Katharina Walch, Detlef Pietrowski
Introduction: Smoking is a serious problem for the health care system. Many of the compounds identified in cigarette smoke have toxic effects on the fertility of both females and males. The purpose of this study was to determine whether smoking affects clinical factors during IVF/ICSI therapy in a single-center reproductive unit. Material and Methods: In a retrospective study of 200 IVF/ICSI cycles, endometrial thickness and the outcome of IVF/ICSI therapy were analyzed...
January 2018: Geburtshilfe und Frauenheilkunde
Nicola Noble
The menopause is a physiological event involving ovarian failure as a result of a loss of ovarian follicular activity, which leads to oestrogen deficiency, resulting in permanent cessation of menstruation and loss of reproductive function. Women undergoing the menopause are seen in a range of healthcare settings. It is important that all nurses, particularly those practising in primary care and women's health, have an understanding of the symptoms, treatment and long-term implications of the menopause on women's health and quality of life...
January 24, 2018: Nursing Standard
M Nickkho-Amiry, R Savant, K Majumder, E Edi-O'sagie, M Akhtar
OBJECTIVE: To assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART). DESIGN: A systematic review and meta-analysis. SETTING: Department of reproductive medicine at teaching university hospital, UK. PATIENTS: Subfertile women with endometrioma undergoing ART. INTERVENTIONS: Surgical removal of endometrioma or expectant management. MAIN OUTCOME MEASURES: Clinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins...
January 17, 2018: Archives of Gynecology and Obstetrics
Kate Devine, Kevin S Richter, Eric A Widra, Jeffrey L McKeeby
OBJECTIVE: To assess the noninferiority of vaginal P (Endometrin) compared with daily intramuscular P for replacement in programmed vitrified-warmed blastocyst transfer cycles and to assess the noninferiority of vaginal P in combination with intramuscular progesterone every third day compared with daily intramuscular P. DESIGN: Three-arm randomized controlled noninferiority study. To enable early recognition of inferiority if present, an a priori interim analysis was planned and completed once ongoing pregnancy data were available for 50% of the total enrollment goal...
January 12, 2018: Fertility and Sterility
Huixing Chen, Yong Zhu, Zijue Zhu, Erlei Zhi, Keming Lu, Xiaobo Wang, Feng Liu, Zheng Li, Weiliang Xia
BACKGROUND: The mechanism of intramanchette transport is crucial to the transformation of sperm tail and the nuclear condensation during spermiogenesis. Although few dysfunctional proteins could result in abnormal junction between the head and tail of spermatozoon, little is known about the genetic cues in this process. OBJECTIVE: Based on patients with severe decapitated and decaudated spermatozoa (DDS) syndrome, the study aimed to validate whether new mutation exists on their Hook microtubule-tethering protein 1 (HOOK1) genes and follow their results of assisted reproduction treatment (ART)...
January 12, 2018: Journal of Medical Genetics
Prerana N Bhavsar, Namita J Padwal, Madhura Bhide, Santosh P Ghagare, Anagha R Joshi, Niteen D Karnik
Ovarian hyperstimulation syndrome is usually an iatrogenic complication in women taking ovulation induction medications during assisted reproduction. We hereby report the case of a 25 years old female who presented with hypertension, polyserositis with tense ascites and large cystic ovaries. She developed sigmoid and transverse sinus thrombosis. She had undergone a clandestine ovulation induction therapy as a commercial ovum donor. She fitted in severe category of ovarian hyperstimulation syndrome.
November 2017: Journal of the Association of Physicians of India
M Enciso, J P Carrascosa, J Sarasa, P A Martínez-Ortiz, S Munné, J A Horcajadas, J Aizpurua
STUDY QUESTION: Is it possible to determine the receptivity status of an endometrium by combined quantitative reverse transcription PCR (RT-qPCR) expression analysis of genes involved in endometrial proliferation and immunity? SUMMARY ANSWER: The new ER Map®/ER Grade® test can predict endometrial receptivity status by RT-qPCR using a new panel of genes involved in endometrial proliferation and the maternal immune response associated to embryonic implantation. WHAT IS KNOWN ALREADY: The human endometrium reaches a receptive status adequate for embryonic implantation around Days 19-21 of the menstrual cycle...
February 1, 2018: Human Reproduction
William D Winkelman, Mitchell P Rosen, Evelyn Mok-Lin
OBJECTIVE: To study the resources available for cancer patients once referred for fertility preservation. MATERIALS AND METHODS: Cross-sectional study clinics that are members of the Society for Assisted Reproductive Technology assess support for fertility preservation. RESULTS: Surveys were distributed to a total of 1135 members at 394 Society for Assisted Reproductive Technology clinics. Responses were received from 99 individuals representing a total of 84 unique clinics (21...
January 8, 2018: American Journal of Clinical Oncology
Kira Lynn Marshall, Rocío Melissa Rivera
A societal preference of delaying maternal age at first childbirth has increased reliance on assisted reproductive technologies/therapies (ART) to conceive a child. Oocytes that have undergone physiologic aging (≥35 years for humans) are now commonly used for ART, yet evidence is building that suboptimal reproductive environments associated with aging negatively affect oocyte competence and embryo development - although the mechanisms underlying these relationship are not yet well understood. Epigenetic programming of the oocyte occurs during its growth within a follicle, so the ovarian stimulation protocols that administer exogenous hormones, as part of the first step for all ART procedures, may prevent the gamete from establishing an appropriate epigenetic state...
December 27, 2017: Molecular Reproduction and Development
Sara Fill Malfertheiner, Dagmar Gutknecht, Monika Bals-Pratsch
Background: A hyperglycemic metabolic status with insulin resistance can have a negative effect on fertility and pregnancy outcomes. The aim of this retrospective study was to investigate disorders of glucose and insulin metabolism in women wanting to conceive who conceived spontaneously prior to planned assisted reproduction (ART). Associated risk factors of patients in terms of live births and miscarriages were also analyzed. Method: Out of total study population of 589 pregnancies, the pregnancies of 129 women wishing to have children who conceived spontaneously prior to planned ART were analyzed in more detail...
December 2017: Geburtshilfe und Frauenheilkunde
Yuta Tsuji, Junko Otsuki, Toshiroh Iwasaki, Kohyu Furuhashi, Yukiko Matsumoto, Shoji Kokeguchi, Masahide Shiotani
Aim: Several studies have indicated that the cause of the increased birthweight of frozen-thawed embryos was associated with assisted reproductive technology (ART) procedures, such as cryopreservation. In the present study, the mean birthweight of singletons was compared between the ovulatory and hormone replacement therapy (HRT) cycles in order to investigate the primary factor that leads to higher birthweights from frozen-thawed embryo transfer (FET). Methods: This retrospective study was carried out from January 2011 to December 2014 on 2738 singletons who were born at 37-41 weeks' gestation, following ART in a single facility...
July 2017: Reproductive Medicine and Biology
Masahide Shiotani, Yukiko Matsumoto, Eri Okamoto, Satoshi Yamada, Yuri Mizusawa, Kohyu Furuhashi, Hiromi Ogata, Seiji Ogata, Shoji Kokeguchi
Aim: Human chorionic gonadotropin (hCG) is used frequently for luteal support in fresh in vitro fertilization cycles as it induces progesterone secretion from the ovaries after oocyte retrieval and modulates the endometrium for implantation in fresh cycles. In contrast, hCG is not usually used for the transfer of cryopreserved-thawed embryos in estrogen/progesterone replacement cycles because ovulation is suppressed. However, several studies have shown that luteinizing hormone and hCG receptors are present in the human endometrium and that hCG can directly induce the decidualization of endometrial stromal cells in vitro...
April 2017: Reproductive Medicine and Biology
Caroline Wilson, Samantha Hinsley, Helen Marshall, David Cameron, Richard Bell, David Dodwell, Robert E Coleman
Purpose: Adjuvant bisphosphonates have been shown to improve disease outcomes in early breast cancer in women who are postmenopausal at the start of treatment. We explored the influence of pretreatment serum levels of reproductive hormones in the hypothalamic-pituitary-gonadal (HPG) axis from a subset of patients included in the AZURE trial to investigate their impact on disease recurrence and whether reproductive hormone measurements are of value in selecting patients for treatment with adjuvant zoledronic acid...
November 2017: Journal of Bone Oncology
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