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Australian intended parents' decision-making and characteristics and outcomes of surrogacy arrangements completed in Australia and overseas. 澳大利亚意向父母的决策以及在澳大利亚和海外完成的代孕安排的特点和结果。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2024-01-24 DOI: 10.1080/14647273.2023.2270157
Ezra Kneebone, Karin Hammarberg, Sam Everingham, Kiri Beilby

Markets for international surrogacy often arise in jurisdictions with limited regulations regarding assisted reproductive technologies. In some countries, like Australia, regulated domestic surrogacy services are often sidestepped for international providers. This study describes how Australian intended parents decide where to pursue surrogacy and compares the characteristics and outcomes of arrangements completed within and outside of Australia. The findings show that, although intended parents preferred undergoing surrogacy in Australia, perceiving the process as too long and complicated was a common reason to pursue an international arrangement. Multiple embryo transfer, anonymous gamete donation, and a lack of counselling were common in international surrogacy arrangements. When compared to surrogacy arrangements completed in Australia, where single embryo transfer is mandatory for surrogacy cycles, the rates of multiple birth, preterm birth and neonatal intensive care in international surrogacy were higher. These findings raise concerns about the health and welfare of international surrogacy participants, particularly the surrogates and children. In lieu of any international instrument regulating surrogacy, improving access to surrogacy at a domestic level would reduce the number of people engaging with international arrangements and in turn, reduce the potential for harm.

国际代孕市场往往出现在对辅助生殖技术监管有限的司法管辖区。在一些国家,如澳大利亚,受监管的国内代孕服务往往被国际提供者所回避。这项研究描述了澳大利亚意向父母如何决定在哪里进行代孕,并比较了澳大利亚国内外安排的特点和结果。研究结果表明,尽管意向父母更喜欢在澳大利亚进行代孕,但认为代孕过程太长、太复杂是寻求国际安排的常见原因。多胚胎移植、匿名配子捐赠和缺乏咨询在国际代孕安排中很常见。与澳大利亚完成的代孕安排相比,国际代孕中的多胞胎、早产和新生儿重症监护率更高。澳大利亚的代孕周期必须进行单胚胎移植。这些发现引发了人们对国际代孕参与者,特别是代孕者和儿童的健康和福利的担忧。与任何规范代孕的国际文书不同,改善国内代孕的机会将减少参与国际安排的人数,进而减少伤害的可能性。
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引用次数: 0
EMLA (lidocaine-prilocaine) cream for pain relief during hysterosalpingography: a systematic review and meta-analysis of randomised placebo-controlled trials. EMLA(利多卡因-丙胺卡因)乳膏用于子宫输卵管造影期间疼痛缓解:随机安慰剂对照试验的系统回顾和荟萃分析。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2022-02-27 DOI: 10.1080/14647273.2022.2040748
Ahmed Abu-Zaid, Saeed Baradwan, Mohammed Abuzaid, Rayan AlSghan, Osama Alomar, Hany Salem, Ismail A Al-Badawi

We systematically investigated the efficacy and safety of EMLA (5% lidocaine-prilocaine cream) versus placebo for pain relief among infertile patients undergoing hysterosalpingography (HSG). We screened four databases from inception until 25 November 2020. We included only randomised placebo-controlled trials (RCTs) and assessed their risk of bias. The main efficacy outcomes included safety and pain scores during the different stages of HSG. The pooled outcomes were summarised as mean difference (MD) with 95% confidence interval (CI). Three RCTs were included, comprising 258 patients (131 and 127 patients received EMLA and placebo, respectively). All RCTs revealed an overall low risk of bias. EMLA significantly reduced pain perception during cervical instrumentation of tenaculum and cannula (MD = -1.53, 95% CI [-2.59, -0.47], p = 0.005) and at 24 h after completion of HSG (MD = -1.30, 95% CI [-2.57, -0.03], p = 0.04). Despite EMLA decreased pain perception during the other procedural stages of HSG, the differences were not statistically significant compared with placebo. EMLA was safe and free of local and systemic adverse reactions. This meta-analysis advocates that topical application of 5% EMLA cream is safe and correlates with decreased pain perception during HSG, particularly during the cervical instrumentation step and at 24 h after HSG completion.

我们系统地研究了EMLA(5%利多卡因-丙胺卡因乳膏)与安慰剂在接受子宫输卵管造影术(HSG)的不孕患者中缓解疼痛的有效性和安全性。从成立到2020年11月25日,我们筛选了四个数据库。我们只纳入了随机安慰剂对照试验(RCT),并评估了其偏倚风险。主要疗效结果包括HSG不同阶段的安全性和疼痛评分。合并结果总结为平均差(MD)和95%置信区间(CI)。纳入了三项随机对照试验,包括258名患者(分别有131名和127名患者接受了EMLA和安慰剂治疗)。所有随机对照试验显示总体偏倚风险较低。EMLA显著降低了颈托和套管固定期间的疼痛感(MD=-1.53,95%CI[2.59,-0.47],p = 0.005)和24 HSG完成后h(MD=-1.30,95%CI【-2.57,-0.03】,p = 0.04)。尽管EMLA在HSG的其他程序阶段降低了疼痛感知,但与安慰剂相比,差异在统计学上并不显著。EMLA是安全的,没有局部和全身不良反应。这项荟萃分析表明,局部应用5%EMLA乳膏是安全的,并与HSG期间疼痛感知的降低相关,尤其是在宫颈内固定步骤和24岁时 HSG完成后h。
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引用次数: 1
Investigation of the risk of paternal cell contamination in PGT and the necessity of intracytoplasmic sperm injection. PGT中父系细胞污染风险的调查及卵浆内单精子注射的必要性。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2022-05-10 DOI: 10.1080/14647273.2022.2026498
Colleen Lynch, Ellen Armstrong, Marina Charitou, Tony Gordon, Darren Griffin

ICSI is widely recommended for patients undergoing preimplantation genetic testing (PGT), but are sperm a potential source of paternal cell contamination in PGT? Semen samples were obtained from five normozoospermic men consenting to research. From each sample 1, 2, 4, 8 and 10 sperm were collected in PCR tubes and whole genome amplification according to PGT-A and PGT-SR processing protocols was undertaken. None of the 25 samples submitted (a total of 125 sperm) showed evidence of DNA amplification. Thus, paternal cell contamination resulting from using conventional in vitro fertilization (IVF) as the insemination method, carries a low risk of an adverse event or misdiagnosis in PGT-A. Due to the higher risk incurred with PGT-SR, clinics may wish to exercise increased caution and continue using ICSI, while PGT-M involves different processing protocols, presenting a different risk profile.

ICSI被广泛推荐给接受胚胎植入前基因检测(PGT)的患者,但是精子是PGT中父亲细胞污染的潜在来源吗?精液样本取自5名同意参与研究的无精子男性。从每个样本中收集1、2、4、8和10个精子,并根据PGT-A和PGT-SR处理方案进行全基因组扩增。提交的25个样本(总共125个精子)中没有一个显示出DNA扩增的证据。因此,使用传统的体外受精(IVF)作为授精方法导致的父系细胞污染在PGT-A中具有较低的不良事件或误诊风险。由于PGT-SR的风险较高,诊所可能希望更加谨慎并继续使用ICSI,而PGT-M涉及不同的处理方案,呈现不同的风险特征。
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引用次数: 0
Should women with high body mass index be denied fertility treatments? 体重指数高的女性是否应该被拒绝接受生育治疗?
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-08-01 DOI: 10.1080/14647273.2022.2152741
Sadaf Shaikh, Garima Srivastava, Roy Homburg

Obesity is an emerging global epidemic with a negative impact on fertility. Almost all guidelines and policies have a stringent limit of body mass index (BMI) to access fertility services which has promoted a debate amongst fertility practitioners globally. Proponents of placing such a limit point to the negative impact of elevated BMI on the outcome of fertility treatment, its cost effectiveness and the risk it poses to the intending mother and unborn child. Opponents of placing a restriction base their arguments on the lack of conclusive, robust evidence regarding the variables along with the ethical dilemmas of promoting discrimination and stigmatization by denying a couple their basic right of parenthood. In this review, we analyse these medical and ethical dilemmas in the light of current evidence. The focus is on female infertility.

肥胖症是一种新出现的全球流行病,对生育有负面影响。几乎所有的指南和政策都对获得生育服务的体重指数(BMI)做出了严格限制,这在全球生育从业者中引发了一场争论。支持者指出,体重指数升高会对生育治疗的结果、成本效益产生负面影响,并给孕妇和胎儿带来风险。反对者的理由是缺乏有关变量的确凿、有力的证据,以及通过剥夺一对夫妇为人父母的基本权利而助长歧视和污名化的伦理困境。在这篇综述中,我们将根据现有证据分析这些医学和伦理困境。重点是女性不孕症。
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引用次数: 0
Psychological distress in infertile women: the role of quality of marital relationships and self-compassion. 不孕妇女的心理困扰:婚姻关系质量和自我同情的作用。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-06-24 DOI: 10.1080/14647273.2023.2222547
Mehrdad Hajihasani, Raziyeh Ekhtiari Amiri

Infertility is a common disease. At least 10-15% of women deal with infertility in some way. Infertile women suffer from a higher degree of psychological distress compared to fertile women. This study aims to identify the role of the quality of marital relationships and self-compassion in psychological distress in infertile women. The participants were 400 women who were referred to fertility clinics in Iran over a two-year period. Questionnaires containing Demographic Questionnaire, Psychological Distress Scale (DASS), Marital Quality Scale (MQS) and Self-Compassion Scale (MCS). The results showed that predictor variables explain a total of 29.9% of the variance of psychological distress in infertile women. The quality of marital relationships (p  =  0.001 and β  =  -0.49) and self-compassion (p < 0.05 and β  =  -0.08) can negatively predict the psychological distress of infertile women. Considering that the significant role of the quality of marital relationships and self-compassion in the psychological distress of infertile women has been confirmed; therefore, interventions that focus on the quality of marital relationships and self-compassion may be effective and should be used as a resource to combat psychological distress in infertile women.

不孕症是一种常见疾病。至少有 10%-15%的妇女在某种程度上患有不孕症。与已育妇女相比,不孕妇女的心理压力更大。本研究旨在确定婚姻关系质量和自我同情在不孕妇女心理困扰中的作用。研究对象为 400 名两年内转诊至伊朗不孕不育诊所的妇女。调查问卷包括人口学问卷、心理压力量表(DASS)、婚姻质量量表(MQS)和自我同情量表(MCS)。结果显示,预测变量共解释了不孕妇女心理困扰方差的 29.9%。婚姻关系质量(p = 0.001,β = -0.49)和自我同情(p
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引用次数: 0
Y-chromosome haplogroups and Azoospermia Factor (AZF) analysis in Tunisian infertile male. 突尼斯不育男性的 Y 染色体单倍群和无精子症因子(AZF)分析。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-01-02 DOI: 10.1080/14647273.2022.2163194
Myriam Ghorbel, Siwar Baklouti-Gargouri, Rim Keskes, Afifa Sellami, Ken McElreavy, Leila Ammar-Keskes

The aim of the present study was to clarify the implication of Y chromosome genetic variations and haplogroups in Tunisian infertile men. A total of 27 Y-chromosomal binary markers partial microdeletions (gr/gr, b1/b3 and b2/b3) and copy number variation of DAZ and CDY genes in the AZFc region were analysed in 131 Tunisian infertile men with spermatogenic failure and severe reduced sperm concentrations and in 85 normospermic men as controls. Eleven different haplogroups in the overall population study (E3b2; J1J*, E1, E3b*, F, G, K, P/Q, R*, R1* and R1a1) were found. Interestingly, the J1J* haplogroup was significantly more frequent in azoo/oligospermic patients than in normospermic men (35.1% and 22.3%, respectively (p value = 0.04)). Results showed also that patients without DAZ/CDY1 copies loss and without partial microdeletions belonged to the R1 haplogroup. The relative high frequencies of two haplogroups, E3b2 (35.1%) and J (30%) was confirmed in Tunisia. We reported in the present study and for the first time, that J1J* haplogroup may confer a risk factor for infertility in the Tunisian population and we suggested that R1 haplogroup may ensure certain stability to Y-chromosome in Tunisian men.

本研究旨在阐明突尼斯不育男性的 Y 染色体基因变异和单倍群的影响。研究分析了 131 名患有生精功能障碍和精子浓度严重下降的突尼斯不育男性以及 85 名精子正常男性作为对照组的 27 个 Y 染色体二元标记部分微缺失(gr/gr、b1/b3 和 b2/b3)以及 AZFc 区 DAZ 和 CDY 基因的拷贝数变异。在整个人群研究中发现了 11 个不同的单倍群组(E3b2、J1J*、E1、E3b*、F、G、K、P/Q、R*、R1* 和 R1a1)。有趣的是,J1J*单倍群在无精子症/少精子症患者中的出现率明显高于正常精子症男性(分别为35.1%和22.3%(P值=0.04))。结果还显示,没有 DAZ/CDY1 拷贝缺失和部分微缺失的患者属于 R1 单倍群。在突尼斯,E3b2(35.1%)和 J(30%)这两个单倍群的频率相对较高。我们在本研究中首次报告了 J1J* 单倍群可能是突尼斯人群不育症的一个风险因素,并认为 R1 单倍群可确保突尼斯男性 Y 染色体的一定稳定性。
{"title":"Y-chromosome haplogroups and Azoospermia Factor (AZF) analysis in Tunisian infertile male.","authors":"Myriam Ghorbel, Siwar Baklouti-Gargouri, Rim Keskes, Afifa Sellami, Ken McElreavy, Leila Ammar-Keskes","doi":"10.1080/14647273.2022.2163194","DOIUrl":"10.1080/14647273.2022.2163194","url":null,"abstract":"<p><p>The aim of the present study was to clarify the implication of Y chromosome genetic variations and haplogroups in Tunisian infertile men. A total of 27 Y-chromosomal binary markers partial microdeletions (gr/gr, b1/b3 and b2/b3) and copy number variation of <i>DAZ</i> and <i>CDY</i> genes in the AZFc region were analysed in 131 Tunisian infertile men with spermatogenic failure and severe reduced sperm concentrations and in 85 normospermic men as controls. Eleven different haplogroups in the overall population study (E3b2; J1J*, E1, E3b*, F, G, K, P/Q, R*, R1* and R1a1) were found. Interestingly, the J1J* haplogroup was significantly more frequent in azoo/oligospermic patients than in normospermic men (35.1% and 22.3%, respectively (<i>p</i> value = 0.04)). Results showed also that patients without <i>DAZ/CDY1</i> copies loss and without partial microdeletions belonged to the R1 haplogroup. The relative high frequencies of two haplogroups, E3b2 (35.1%) and J (30%) was confirmed in Tunisia. We reported in the present study and for the first time, that J1J* haplogroup may confer a risk factor for infertility in the Tunisian population and we suggested that R1 haplogroup may ensure certain stability to Y-chromosome in Tunisian men.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":" ","pages":"1238-1247"},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10517714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimising the screening for haemoglobinopathies in pregnancy planning. 优化怀孕计划中的血红蛋白病筛查。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-03-21 DOI: 10.1080/14647273.2023.2190041
Robert S Nickel, Deepika S Darbari, Brenda Martin, Lisa Thaniel, Harvey Stern, Cyril Jacquot

Haemoglobinopathies are among the most common inherited disorders around the world. In the United States the diagnosis of haemoglobinopathy or a carrier state is made by universal newborn screening. However, many individuals of childbearing age do not know they are a haemoglobinopathy carrier. Screening for common haemoglobinopathies is generally offered as a part of pregnancy planning so that prospective parents can be counselled regarding the risk of having a child with a haemoglobinopathy. Multiple tests exist to screen patients for presence of haemoglobinopathy carrier or disease state; however, it is crucial to order and interpret the results correctly to appropriately counsel couples. In this case series, we describe clinical scenarios where prospective parents were surprised to unexpectedly have a child with sickle cell disease, a haemoglobinopathy that causes severe clinical complications. Through these cases we demonstrate that deficiencies in testing can occur at different levels which may lead to incorrect estimation of the risk of having a child affected by a haemoglobinopathy. Consultation with a haematologist, laboratory medicine specialist, or genetic counsellor should be considered to select the appropriate test and interpret its results.

血红蛋白病是全世界最常见的遗传性疾病之一。在美国,血红蛋白病或血红蛋白病携带者的诊断是通过普及新生儿筛查来实现的。然而,许多育龄人士并不知道自己是血红蛋白病携带者。常见血红蛋白病的筛查通常是作为怀孕计划的一部分提供的,这样就可以就生育血红蛋白病患儿的风险向未来的父母提供咨询。有多种检测方法可以筛查患者是否存在血红蛋白病携带者或疾病状态;然而,正确订购和解释检测结果对于为夫妇提供适当的咨询服务至关重要。在本系列病例中,我们描述了一些临床案例,在这些案例中,准父母们意外地发现孩子患有镰状细胞病,这种血红蛋白病会导致严重的临床并发症。通过这些病例,我们证明了不同程度的检测缺陷可能导致对孩子患血红蛋白病风险的错误估计。应考虑咨询血液科医生、实验室医学专家或遗传咨询师,以选择适当的检测方法并解释检测结果。
{"title":"Optimising the screening for haemoglobinopathies in pregnancy planning.","authors":"Robert S Nickel, Deepika S Darbari, Brenda Martin, Lisa Thaniel, Harvey Stern, Cyril Jacquot","doi":"10.1080/14647273.2023.2190041","DOIUrl":"10.1080/14647273.2023.2190041","url":null,"abstract":"<p><p>Haemoglobinopathies are among the most common inherited disorders around the world. In the United States the diagnosis of haemoglobinopathy or a carrier state is made by universal newborn screening. However, many individuals of childbearing age do not know they are a haemoglobinopathy carrier. Screening for common haemoglobinopathies is generally offered as a part of pregnancy planning so that prospective parents can be counselled regarding the risk of having a child with a haemoglobinopathy. Multiple tests exist to screen patients for presence of haemoglobinopathy carrier or disease state; however, it is crucial to order and interpret the results correctly to appropriately counsel couples. In this case series, we describe clinical scenarios where prospective parents were surprised to unexpectedly have a child with sickle cell disease, a haemoglobinopathy that causes severe clinical complications. Through these cases we demonstrate that deficiencies in testing can occur at different levels which may lead to incorrect estimation of the risk of having a child affected by a haemoglobinopathy. Consultation with a haematologist, laboratory medicine specialist, or genetic counsellor should be considered to select the appropriate test and interpret its results.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":" ","pages":"1334-1339"},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9516069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of delayed blastulation and expansion grade on clinical outcomes of high-quality blastocyst transfer: an analysis of 1751 frozen-thawed cycles. 囊胚移植延迟和扩增等级对优质囊胚移植临床结果的影响:对 1751 个冷冻解冻周期的分析。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-03-21 DOI: 10.1080/14647273.2023.2188491
Yingchun Guo, Yuting Xiang, Yanfang Wang, Tingting Li, Cong Fang

The aim of the study was to compare retrospectively the extent of blastulation timing (Day 5 or later) and expansion grade to predict the ability of blastocysts to give rise to a pregnancy. Blastocysts frozen on day 5 with a lower expansion grade (group D5) or day 6 with a higher expansion grade (group D6) were included. A single embryo was thawed and transferred on day 5 after ovulation or progesterone supplementation. Differences in patient baseline characteristics, endometrial preparation and pregnancy outcomes between groups were stratified by patient age and anti-Müllerian hormone (AMH) levels. Logistic regression was used to analyse the results. A total of 617 blastocysts in group D5 and 1134 blastocysts in group D6 were assessed. Stratified analyses showed higher biochemical pregnancy, clinical pregnancy and live birth rates for patients aged less than 30 years old, and higher ongoing pregnancy rate for patients with AMH ≥ 1.1 ng/ml. For patients aged less than 30 years old, the biochemical pregnancy, clinical pregnancy and live birth rates in group D5 were higher than those in group D6.

该研究的目的是回顾性比较囊胚着床时间(第 5 天或更晚)和膨胀等级的程度,以预测囊胚的妊娠能力。研究对象包括第 5 天冷冻的囊胚,其膨胀等级较低(D5 组)或第 6 天冷冻的囊胚,其膨胀等级较高(D6 组)。在排卵或补充黄体酮后的第 5 天解冻并移植单个胚胎。根据患者年龄和抗缪勒氏管激素(AMH)水平对各组患者基线特征、子宫内膜准备和妊娠结果的差异进行分层。结果采用逻辑回归法进行分析。D5 组共评估了 617 个囊胚,D6 组共评估了 1134 个囊胚。分层分析显示,年龄小于 30 岁的患者生化妊娠率、临床妊娠率和活产率较高,AMH ≥ 1.1 ng/ml 的患者持续妊娠率较高。对于年龄小于 30 岁的患者,D5 组的生化妊娠率、临床妊娠率和活产率均高于 D6 组。
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引用次数: 0
Longitudinal trends in fertility in women of advanced maternal age in the United States and Sweden from 1935-2018 and comparison to maternal mortality ratios. 1935-2018 年美国和瑞典高龄产妇生育率的纵向趋势以及与孕产妇死亡率的比较。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-02-20 DOI: 10.1080/14647273.2022.2161075
Jessica Grubman, Marcelle Cedars, Nadia Diamond-Smith

Advanced maternal age (AMA, >35 years at delivery) confers maternal and foetal risks, particularly with age >45 years and nulliparity, but longitudinal comparative data on age- and parity-specific AMA fertility is lacking. We used the Human Fertility Database (HFD), a publicly available, international database, to analyse fertility in US and Swedish women aged 35-54 from 1935 to 2018. Age-specific fertility rates (ASFR), total birth counts, and proportion of AMA births were evaluated across maternal age, parity, and time, and compared to maternal mortality rates during the same time. In the US, total AMA births nadired in the 1970s, and have risen since. Until 1980, most AMA births were to women completing parity 5 or higher; since then, most have been to low parity women. While ASFR in 35 to 39 year olds was highest in 2015, ASFR in women 40-44 and 45-49 were highest in 1935, though they have been rising recently, especially in low-parity women. While the same AMA fertility trends were seen in the US and Sweden from 1970-2018, maternal mortality rates have risen in the US despite remaining low in Sweden. Although AMA is known to contribute to maternal mortality, this discrepancy merits further consideration.

高龄产妇(AMA,分娩时年龄大于 35 岁)会带来孕产和胎儿风险,尤其是年龄大于 45 岁和非孕期的高龄产妇,但目前还缺乏有关年龄和特定奇数期 AMA 生育率的纵向比较数据。我们利用人类生育率数据库(HFD)这一公开的国际数据库,分析了美国和瑞典 35-54 岁女性从 1935 年到 2018 年的生育率。我们评估了不同年龄段的生育率(ASFR)、总出生人数和AMA生育比例,并将其与同期的孕产妇死亡率进行了比较。在美国,AMA 婴儿的总出生人数始于 20 世纪 70 年代,此后一直呈上升趋势。在 1980 年之前,大多数产妇都是在 5 个或 5 个以上足月分娩的;从那时起,大多数产妇都是在低足月分娩的。2015年,35至39岁女性的ASFR最高,而40至44岁和45至49岁女性的ASFR则在1935年最高,不过最近一直在上升,尤其是低奇偶性女性。1970-2018年期间,美国和瑞典的AMA生育趋势相同,但美国的孕产妇死亡率有所上升,尽管瑞典的孕产妇死亡率仍然很低。虽然已知AMA会导致孕产妇死亡,但这种差异值得进一步考虑。
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引用次数: 0
Impacts of the COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer: a retrospective cohort study. COVID-19 大流行对接受冷冻解冻胚胎移植的妇女早孕结果的影响:一项回顾性队列研究。
IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 Epub Date: 2023-09-05 DOI: 10.1080/14647273.2023.2251680
Xin Li, Xiaodie Yao, Lijing Bai, Renjie Lu, Shijie Geng, Xiufeng Ling, Juan Wen, Lingmin Hu

The effect of COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer (FET) remains unclear. We aimed to evaluate whether early pregnancy outcomes were altered in patients undergoing FET during the pandemic. In this retrospective cohort study, women conceived through FET in 2016-2021 from two hospitals in China were included. The early pregnancy outcomes were compared using Logistic regression model, including biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), and early pregnancy loss rate (EPLR). A total of 16,669 (67.2%) and 6,113 (26.8%) FET cycles enrolled before and during the pandemic, respectively. Univariate analyses showed that women undergoing FET during the pandemic had significantly increased BPR (72.9% vs. 69.7%) and CPR (59.5% vs. 55.0%), and significantly decreased EPLR (13.7% vs. 16.7%) compared to pre-pandemic (all P < 0.001). Moreover, after adjustment, the results were in accordance with univariate analysis for CPR [adjusted OR (95%CI) = 1.08 (1.01-1.14)] and EPLR [adjusted OR (95%CI) = 0.82 (0.73-0.91)], while the statistical significance between BPR and the pandemic disappeared. In summary, women conceived by FET did not have a reduced possibility of clinical pregnancy and a higher risk of early pregnancy loss during the pandemic compared with the pre-pandemic.

COVID-19 大流行对接受冷冻-解冻胚胎移植(FET)的妇女早孕结果的影响仍不清楚。我们的目的是评估大流行期间接受冷冻胚胎移植的患者的早孕结局是否会发生改变。在这项回顾性队列研究中,纳入了中国两家医院在2016-2021年间通过冷冻冻融胚胎移植受孕的女性。采用 Logistic 回归模型比较了早孕结果,包括生化妊娠率(BPR)、临床妊娠率(CPR)和早孕丢失率(EPLR)。大流行前和大流行期间分别共有 16,669 例(67.2%)和 6,113 例(26.8%)人工流产周期。单变量分析表明,与大流行前相比,在大流行期间接受 FET 的妇女的 BPR(72.9% vs. 69.7%)和 CPR(59.5% vs. 55.0%)显著增加,EPLR(13.7% vs. 16.7%)显著减少(均为 P<0.05)。
{"title":"Impacts of the COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer: a retrospective cohort study.","authors":"Xin Li, Xiaodie Yao, Lijing Bai, Renjie Lu, Shijie Geng, Xiufeng Ling, Juan Wen, Lingmin Hu","doi":"10.1080/14647273.2023.2251680","DOIUrl":"10.1080/14647273.2023.2251680","url":null,"abstract":"<p><p>The effect of COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer (FET) remains unclear. We aimed to evaluate whether early pregnancy outcomes were altered in patients undergoing FET during the pandemic. In this retrospective cohort study, women conceived through FET in 2016-2021 from two hospitals in China were included. The early pregnancy outcomes were compared using Logistic regression model, including biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), and early pregnancy loss rate (EPLR). A total of 16,669 (67.2%) and 6,113 (26.8%) FET cycles enrolled before and during the pandemic, respectively. Univariate analyses showed that women undergoing FET during the pandemic had significantly increased BPR (72.9% vs. 69.7%) and CPR (59.5% vs. 55.0%), and significantly decreased EPLR (13.7% vs. 16.7%) compared to pre-pandemic (all <i>P</i> < 0.001). Moreover, after adjustment, the results were in accordance with univariate analysis for CPR [adjusted OR (95%CI) = 1.08 (1.01-1.14)] and EPLR [adjusted OR (95%CI) = 0.82 (0.73-0.91)], while the statistical significance between BPR and the pandemic disappeared. In summary, women conceived by FET did not have a reduced possibility of clinical pregnancy and a higher risk of early pregnancy loss during the pandemic compared with the pre-pandemic.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":" ","pages":"1477-1484"},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10153969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Human Fertility
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