Pub Date : 2020-06-01DOI: 10.1142/s2661318220500103
R. Warner, J. Avery, S. Neuhaus, M. Davies
Background: Anecdotally, infertility concerns among serving female Australian Defense Force (ADF) members and veterans are perceived to be prevalent, but precise data are lacking. This is the first of two papers that identify reproductive, pregnancy, and infant outcomes in an exclusively Australian military cohort. This initial paper aims to describe maternal and paternal occupation and fertility characteristics of a group of ADF members who deployed to the Middle East during the period 2001–2010. Methods: Utilizing the Middle East Area of Operations Census Study data set, a descriptive analysis was performed on the demographic and clinical variables of the cohort, where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the population. Sociodemographic data and clinical data, including maternal/paternal outcomes, were reported. Results: The self-reported infertility rate was 9%, which was significantly lower than the reported infertility rate in the comparative Australian (non-military) population. All other outcomes were comparable to the Australian population and within normal limits. Conclusions: This survey presents a generally reassuring picture of reproductive health for men and women serving in the ADF with regard to the risk of infertility, pregnancy loss, and perinatal outcomes, although the basis for fertility concerns requires further investigation.
{"title":"Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 1 — Maternal and Paternal Outcomes","authors":"R. Warner, J. Avery, S. Neuhaus, M. Davies","doi":"10.1142/s2661318220500103","DOIUrl":"https://doi.org/10.1142/s2661318220500103","url":null,"abstract":"Background: Anecdotally, infertility concerns among serving female Australian Defense Force (ADF) members and veterans are perceived to be prevalent, but precise data are lacking. This is the first of two papers that identify reproductive, pregnancy, and infant outcomes in an exclusively Australian military cohort. This initial paper aims to describe maternal and paternal occupation and fertility characteristics of a group of ADF members who deployed to the Middle East during the period 2001–2010. Methods: Utilizing the Middle East Area of Operations Census Study data set, a descriptive analysis was performed on the demographic and clinical variables of the cohort, where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the population. Sociodemographic data and clinical data, including maternal/paternal outcomes, were reported. Results: The self-reported infertility rate was 9%, which was significantly lower than the reported infertility rate in the comparative Australian (non-military) population. All other outcomes were comparable to the Australian population and within normal limits. Conclusions: This survey presents a generally reassuring picture of reproductive health for men and women serving in the ADF with regard to the risk of infertility, pregnancy loss, and perinatal outcomes, although the basis for fertility concerns requires further investigation.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75168458","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}
Pub Date : 2019-12-01DOI: 10.1142/s2661318219500208
P. Vichinsartvichai, Pawan Limvorapitux, Khanitta Traipak
Background: The delayed childbearing has doubled in prevalence during the last decade. It affects reproductive health, population distribution and economy. We use the public health approach to survey among women aged at least 35 years seeking fertility treatment. Methods: A self-administered questionnaire-based survey was conducted in women aged at least 35 years attending an infertility clinic in a university hospital. The questionnaire consisted of background information and three domains: (1) reasons for delayed childbearing, (2) required social policy incentives, and (3) acceptability toward infertility treatment. Each domain was scored from ‘5 — most important’ to ‘1 — least important’. Results: A total of 590 women (median age 38.0 years) were recruited; 86.4% of them held at least a bachelor degree and 93.2% had higher income than Thailand’s GDP per capita. They thought that the most appropriate age to have the first child was 28.7 years. The top three reasons for delayed childbearing were “I need more financial security”, “no spouse”, and “I need progress on my career”. The participants thought that “paid paternity leave”, “increase paid maternity leave”, and “good quality childcare” were essential for them to make an earlier fertility decision. The most acceptable infertility treatments were IUI, IVF/ICSI, and social oocyte banking. Conclusions: Women who delayed childbearing focus on financial and career security or finding the proper partner before fertility decision making. However, they have greater concerns over family welfare than money when it comes to domestic issues. The social policy and the related fertility treatment should adapt to serve the needs of the people and promote national fertility rate.
{"title":"What Took You So Long? A Public Health Approach to Mitigate the Delayed Childbearing","authors":"P. Vichinsartvichai, Pawan Limvorapitux, Khanitta Traipak","doi":"10.1142/s2661318219500208","DOIUrl":"https://doi.org/10.1142/s2661318219500208","url":null,"abstract":"Background: The delayed childbearing has doubled in prevalence during the last decade. It affects reproductive health, population distribution and economy. We use the public health approach to survey among women aged at least 35 years seeking fertility treatment. Methods: A self-administered questionnaire-based survey was conducted in women aged at least 35 years attending an infertility clinic in a university hospital. The questionnaire consisted of background information and three domains: (1) reasons for delayed childbearing, (2) required social policy incentives, and (3) acceptability toward infertility treatment. Each domain was scored from ‘5 — most important’ to ‘1 — least important’. Results: A total of 590 women (median age 38.0 years) were recruited; 86.4% of them held at least a bachelor degree and 93.2% had higher income than Thailand’s GDP per capita. They thought that the most appropriate age to have the first child was 28.7 years. The top three reasons for delayed childbearing were “I need more financial security”, “no spouse”, and “I need progress on my career”. The participants thought that “paid paternity leave”, “increase paid maternity leave”, and “good quality childcare” were essential for them to make an earlier fertility decision. The most acceptable infertility treatments were IUI, IVF/ICSI, and social oocyte banking. Conclusions: Women who delayed childbearing focus on financial and career security or finding the proper partner before fertility decision making. However, they have greater concerns over family welfare than money when it comes to domestic issues. The social policy and the related fertility treatment should adapt to serve the needs of the people and promote national fertility rate.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88555044","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}
Pub Date : 2019-09-16DOI: 10.1142/S2661318219300095
C. Allen
Long-term health outcomes after ART have largely focused on offspring health and perinatal parameters. Longer-term health outcomes in female patients remain difficult to fully assess. Hypothetical concerns about the effects of endocrine manipulation on hormone-sensitive conditions, e.g. breast disease, are confounded by variable factors in patients and treatments. Obstetric and perinatal factors endow an additional layer of complexity to the overall analysis and more research is required to appreciate all aspects of ART. Notwithstanding the knowledge gap, clinicians must endeavour to individualise management plans, taking into account the pros and cons of ART in the context of immediate, maternity-related and long-term health risks for their patients. This review of recent literature examines current ART practice in terms of female health and disease as we strive for best practice in an ever-changing clinical and demographic fertility landscape.
{"title":"Health and Disease After Assisted Reproductive Technology","authors":"C. Allen","doi":"10.1142/S2661318219300095","DOIUrl":"https://doi.org/10.1142/S2661318219300095","url":null,"abstract":"Long-term health outcomes after ART have largely focused on offspring health and perinatal parameters. Longer-term health outcomes in female patients remain difficult to fully assess. Hypothetical concerns about the effects of endocrine manipulation on hormone-sensitive conditions, e.g. breast disease, are confounded by variable factors in patients and treatments. Obstetric and perinatal factors endow an additional layer of complexity to the overall analysis and more research is required to appreciate all aspects of ART. Notwithstanding the knowledge gap, clinicians must endeavour to individualise management plans, taking into account the pros and cons of ART in the context of immediate, maternity-related and long-term health risks for their patients. This review of recent literature examines current ART practice in terms of female health and disease as we strive for best practice in an ever-changing clinical and demographic fertility landscape.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72736588","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}
Pub Date : 2019-09-16DOI: 10.1142/S2661318219500129
Thanh Tam Thi Ho, M. Le, Quang Vinh Truong, V. Nguyen, N. Cao
Objectives: The frequency of, and relationship between, the various manifestations of male sexual dysfunction in infertile couples have been poorly investigated, especially in Vietnam. Our study aims to assess the prevalence of premature ejaculation and erectile dysfunction in infertile couples using validated instruments, and the relationship between these disorders. Method: Cross-sectional descriptive study, using validated questionnaires including the Premature Ejaculation Diagnostic Tool (PEDT) and the International Index of Erectile Function-15 (IIEF-15), to measure the incidence of these problems in 255 male partners of infertile couples who were examined from January through December 2017, at the Center for Reproductive Endocrinology & Infertility, Hue University Hospital. Results: The prevalence of overt premature ejaculation was 4.7%, probable premature ejaculation was 7.1%, and erectile dysfunction was 26.3% (mild: 19.3%, mild-to-moderate: 3.9%, moderate: 2.7%, and severe: 0.4%). The PEDT total score was negatively correlated to IIEF-15-EFD and IIEF-15 total scores (r [Formula: see text]0.322 and r [Formula: see text]0.348, respectively). Conclusions:In light of the identified prevalence of premature ejaculation and erectile dysfunction in the studied population, screening for these conditions should be included in the evaluation of infertile couples. These two disorders could negatively reciprocal effect on each other.
{"title":"Premature Ejaculation and Erectile Dysfunction in Male Partners of Infertile Couples: Prevalence and Correlation","authors":"Thanh Tam Thi Ho, M. Le, Quang Vinh Truong, V. Nguyen, N. Cao","doi":"10.1142/S2661318219500129","DOIUrl":"https://doi.org/10.1142/S2661318219500129","url":null,"abstract":"Objectives: The frequency of, and relationship between, the various manifestations of male sexual dysfunction in infertile couples have been poorly investigated, especially in Vietnam. Our study aims to assess the prevalence of premature ejaculation and erectile dysfunction in infertile couples using validated instruments, and the relationship between these disorders. Method: Cross-sectional descriptive study, using validated questionnaires including the Premature Ejaculation Diagnostic Tool (PEDT) and the International Index of Erectile Function-15 (IIEF-15), to measure the incidence of these problems in 255 male partners of infertile couples who were examined from January through December 2017, at the Center for Reproductive Endocrinology & Infertility, Hue University Hospital. Results: The prevalence of overt premature ejaculation was 4.7%, probable premature ejaculation was 7.1%, and erectile dysfunction was 26.3% (mild: 19.3%, mild-to-moderate: 3.9%, moderate: 2.7%, and severe: 0.4%). The PEDT total score was negatively correlated to IIEF-15-EFD and IIEF-15 total scores (r [Formula: see text]0.322 and r [Formula: see text]0.348, respectively). Conclusions:In light of the identified prevalence of premature ejaculation and erectile dysfunction in the studied population, screening for these conditions should be included in the evaluation of infertile couples. These two disorders could negatively reciprocal effect on each other.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88874135","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}
Pub Date : 2019-09-16DOI: 10.1142/s2661318219500142
Fiona Eidenberger, K. Huber, P. Fuchs, Nikola Simkovicova, M. Imhof
Background: An elevated DNA Fragmentation Index (DFI) has been associated with male infertility; therefore measuring the sperm nuclear DNA integrity appears to be useful in predicting the ability of spermatozoa to fertilize oocytes. Aim: To evaluate the effect of micronutrient supplementation over DFI values in subfertile men. Methods: This was a retrospective/comparative study that included a total of 306 subfertile males consulting the clinic from March 2011 to November 2017, who had performed the Sperm Chromatin Dispersion test (SCD) — a method used to detect DNA fragmentation — along with the initial semen analysis. Of the included population, [Formula: see text] 146 had received two daily oral capsules of a standardized combined micronutrient compound ([Formula: see text], Lenus Pharma, Vienna, Austria) for three months plus lifestyle change (study group). Each capsule contains L-carnitine, L-arginine, coenzyme Q10, zinc, vitamin E, folic acid, glutathione and selenium. Those who did not receive the active treatment ([Formula: see text] 160) but only engaged with lifestyle changes were considered controls. The SCD test was performed in both groups at baseline and after 3 months. Results: For the first statistical analysis, patients with an initial mean DFI of >15% were considered ([Formula: see text] 66 [37 were study and 29 were controls]). After 3 months, both groups displayed a significant decrease of mean DFI values. However, this decrease was more evident in the study group as compared to controls (10.54% vs. 14.48%, [Formula: see text] 0.05; [Formula: see text] 0.013). For the second statistical approach the entire population was considered ([Formula: see text] 306). After 3 months, only the study group displayed a significant decrease of the mean initial DFI value (10.16% to 6.49%, [Formula: see text] < 0.0001); decrease that was more evident as compared to controls (6.49% vs. 8.82%, [Formula: see text] 0.05; [Formula: see text] 0.000020). Conclusions: Among subfertile men with a DFI >15%, both regimes significantly decreased sperm DNA fragmentation; however, when any baseline DFI value was considered, only treatment with the active standardized micronutrient compound achieved a significant better result.
背景:DNA片段化指数(DFI)升高与男性不育有关;因此，测量精子核DNA的完整性似乎有助于预测精子与卵母细胞受精的能力。目的:评价微量营养素补充对低生育能力男性DFI值的影响。方法:这是一项回顾性/比较研究，包括2011年3月至2017年11月期间咨询诊所的306名低生育能力男性，他们进行了精子染色质分散测试(SCD) -一种用于检测DNA片段的方法-以及初始精液分析。在纳入的人群中，[公式:见文本]146人每天服用两粒口服胶囊的标准化复合微量营养素化合物([公式:见文本]，Lenus Pharma，奥地利维也纳)，为期三个月，并改变生活方式(研究组)。每粒胶囊含有左旋肉碱、左旋精氨酸、辅酶Q10、锌、维生素E、叶酸、谷胱甘肽和硒。那些没有接受积极治疗但只改变生活方式的人被认为是对照组。两组分别在基线和3个月后进行SCD测试。结果:在第一次统计分析中，考虑初始平均DFI >15%的患者([公式:见文]66[37为研究，29为对照])。3个月后，两组患者的平均DFI值均显著下降。然而，与对照组相比，研究组的下降更为明显(10.54% vs. 14.48%，[公式:见文]0.05;[公式:见正文]0.013)。第二种统计方法考虑了整个人口([公式:见案文]306)。3个月后，只有研究组的平均初始DFI值显著下降(10.16% ~ 6.49%，[公式:见文]< 0.0001);与对照组相比，下降更为明显(6.49% vs. 8.82%，[公式:见文]0.05;[公式:见文]0.000020)。结论:在DFI >15%的低生育能力男性中，两种方案均可显著降低精子DNA断裂;然而，当考虑任何基线DFI值时，只有使用活性标准化微量营养素化合物治疗才能取得明显更好的结果。
{"title":"Measured with Sperm Chromatin Dispersion (SCD) Technique: Will DNA Integrity in Spermatozoa Increase After Micronutrient Supplementation? Comparative Controlled Study","authors":"Fiona Eidenberger, K. Huber, P. Fuchs, Nikola Simkovicova, M. Imhof","doi":"10.1142/s2661318219500142","DOIUrl":"https://doi.org/10.1142/s2661318219500142","url":null,"abstract":"Background: An elevated DNA Fragmentation Index (DFI) has been associated with male infertility; therefore measuring the sperm nuclear DNA integrity appears to be useful in predicting the ability of spermatozoa to fertilize oocytes. Aim: To evaluate the effect of micronutrient supplementation over DFI values in subfertile men. Methods: This was a retrospective/comparative study that included a total of 306 subfertile males consulting the clinic from March 2011 to November 2017, who had performed the Sperm Chromatin Dispersion test (SCD) — a method used to detect DNA fragmentation — along with the initial semen analysis. Of the included population, [Formula: see text] 146 had received two daily oral capsules of a standardized combined micronutrient compound ([Formula: see text], Lenus Pharma, Vienna, Austria) for three months plus lifestyle change (study group). Each capsule contains L-carnitine, L-arginine, coenzyme Q10, zinc, vitamin E, folic acid, glutathione and selenium. Those who did not receive the active treatment ([Formula: see text] 160) but only engaged with lifestyle changes were considered controls. The SCD test was performed in both groups at baseline and after 3 months. Results: For the first statistical analysis, patients with an initial mean DFI of >15% were considered ([Formula: see text] 66 [37 were study and 29 were controls]). After 3 months, both groups displayed a significant decrease of mean DFI values. However, this decrease was more evident in the study group as compared to controls (10.54% vs. 14.48%, [Formula: see text] 0.05; [Formula: see text] 0.013). For the second statistical approach the entire population was considered ([Formula: see text] 306). After 3 months, only the study group displayed a significant decrease of the mean initial DFI value (10.16% to 6.49%, [Formula: see text] < 0.0001); decrease that was more evident as compared to controls (6.49% vs. 8.82%, [Formula: see text] 0.05; [Formula: see text] 0.000020). Conclusions: Among subfertile men with a DFI >15%, both regimes significantly decreased sperm DNA fragmentation; however, when any baseline DFI value was considered, only treatment with the active standardized micronutrient compound achieved a significant better result.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87445489","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}
Pub Date : 2019-09-16DOI: 10.1142/S2661318219500130
Shubiao Han, W. Han, Xiaodong Zhang, Junxia Liu, G. Huang
Background: This study was conducted to evaluate the impact of vitrification on mitochondrial of human IVM oocytes. Methods: A total of 401 immature oocytes were obtained from ovarian stimulated cycles, which were randomly divided into fresh and vitrification groups after IVM. According to the cultured time after thawing, the vitrification groups were divided into 0 hours (0 h), 2 hours (2 h), or 4 hours (4 h) subgroups. Mitochondrial morphology and oxygen consumption were compared among the four groups. After fertilization by ICSI, normal fertilization, cleaved embryos, and blastocyst formation rate were also calculated. Results: The mean gray value of mitochondria structure was significantly decreased in 0 h and 2 h groups when compared to control group (0.48 ± 0.09, 0.50 ± 0.36 vs. 0.61 ± 0.12, respectively; P [Formula: see text] 0.05), and recovered (0.61 ± 0.24 vs. 0.61 ± 0.12, P [Formula: see text] 0.05) in 4 h group. In addition, oxygen consumption was also significantly decreased in 0 h and 2 h groups compared to fresh (2.91 ± 0.77 fmol/s, 3.26 ± 1.34 fmol/s vs. 3.96 ± 1.44 fmol/s, respectively; P [Formula: see text] 0.05), and recovered after 4 h culture (3.96 ± 1.44 fmol/s vs. 4.41 ± 1.38 fmol/s, respectively; P [Formula: see text] 0.05). The percentage of normal fertilization and cleaved embryos were no differences among the four groups, however, blastocyst development rate was significantly lower in 0 h group. Conclusion: These results indicate that during the vitrification process, the oxygen consumption and mitochondrial structure of oocytes may undergo temporary dynamic changes, but appear to recover by 4 hours.
{"title":"Vitrification of Human In-Vitro Matured Oocytes: Effects on Mitochondrial Ultrastructure and Oxygen Consumption","authors":"Shubiao Han, W. Han, Xiaodong Zhang, Junxia Liu, G. Huang","doi":"10.1142/S2661318219500130","DOIUrl":"https://doi.org/10.1142/S2661318219500130","url":null,"abstract":"Background: This study was conducted to evaluate the impact of vitrification on mitochondrial of human IVM oocytes. Methods: A total of 401 immature oocytes were obtained from ovarian stimulated cycles, which were randomly divided into fresh and vitrification groups after IVM. According to the cultured time after thawing, the vitrification groups were divided into 0 hours (0 h), 2 hours (2 h), or 4 hours (4 h) subgroups. Mitochondrial morphology and oxygen consumption were compared among the four groups. After fertilization by ICSI, normal fertilization, cleaved embryos, and blastocyst formation rate were also calculated. Results: The mean gray value of mitochondria structure was significantly decreased in 0 h and 2 h groups when compared to control group (0.48 ± 0.09, 0.50 ± 0.36 vs. 0.61 ± 0.12, respectively; P [Formula: see text] 0.05), and recovered (0.61 ± 0.24 vs. 0.61 ± 0.12, P [Formula: see text] 0.05) in 4 h group. In addition, oxygen consumption was also significantly decreased in 0 h and 2 h groups compared to fresh (2.91 ± 0.77 fmol/s, 3.26 ± 1.34 fmol/s vs. 3.96 ± 1.44 fmol/s, respectively; P [Formula: see text] 0.05), and recovered after 4 h culture (3.96 ± 1.44 fmol/s vs. 4.41 ± 1.38 fmol/s, respectively; P [Formula: see text] 0.05). The percentage of normal fertilization and cleaved embryos were no differences among the four groups, however, blastocyst development rate was significantly lower in 0 h group. Conclusion: These results indicate that during the vitrification process, the oxygen consumption and mitochondrial structure of oocytes may undergo temporary dynamic changes, but appear to recover by 4 hours.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88210408","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}
Pub Date : 2019-09-16DOI: 10.1142/S2661318219300083
S. B. Mazhar, Javeria Mumtaz, Qurratulain Saeed, F. Nawaz
Primary amenorrhea secondary to childhood pelvic trauma is very rare. We report two cases of adolescent girls with cryptomenorrhoea. Case 1 presented at 14 years of age with primary amenorrhea and cyclical lower abdominal pain for 1 year. She was run over by a tractor when she was three years old. Ultrasonography pelvis showed hematometra. Examination under anesthesia with diagnostic laparoscopy proceed laparotomy revealed uterine avulsion at level of isthmus. The second case presented at 13 years of age with urinary retention. Catheterization was not possible due to malpositioning of urethra so suprapubic catheterization was performed by urologists. Ultrasonography pelvis revealed hematocolpos. Detailed history revealed run over injury by a vehicle when she was two years old. Examination under anesthesia showed obstruction due to adhesions high up in vagina which were divided.
{"title":"Cryptomenorrhea Secondary to Past Childhood Pelvic Trauma in Young Adolescent Girls: Case Series","authors":"S. B. Mazhar, Javeria Mumtaz, Qurratulain Saeed, F. Nawaz","doi":"10.1142/S2661318219300083","DOIUrl":"https://doi.org/10.1142/S2661318219300083","url":null,"abstract":"Primary amenorrhea secondary to childhood pelvic trauma is very rare. We report two cases of adolescent girls with cryptomenorrhoea. Case 1 presented at 14 years of age with primary amenorrhea and cyclical lower abdominal pain for 1 year. She was run over by a tractor when she was three years old. Ultrasonography pelvis showed hematometra. Examination under anesthesia with diagnostic laparoscopy proceed laparotomy revealed uterine avulsion at level of isthmus. The second case presented at 13 years of age with urinary retention. Catheterization was not possible due to malpositioning of urethra so suprapubic catheterization was performed by urologists. Ultrasonography pelvis revealed hematocolpos. Detailed history revealed run over injury by a vehicle when she was two years old. Examination under anesthesia showed obstruction due to adhesions high up in vagina which were divided.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72647979","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}
Pub Date : 2019-09-01DOI: 10.1142/s2661318219500154
J. Avery, L. Moran, V. Moore, R. Fernandez, M. Whitrow, N. Stocks, T. Gill, M. Musker, M. Davies, A. Rumbold
Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged <45 years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers; these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31; adjOR 3.18, 95% CI 1.31–7.68). Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.
目的:虽然多囊卵巢综合征(PCOS)被认为是一种终身疾病，但对于这种疾病在生育高峰期以外的女性中的诊断和影响知之甚少。我们检查了女性一生中诊断为多囊卵巢综合征的频率和并发健康状况。方法:对2015年南澳大利亚州参加横断面面对面人口调查的1509名15-95岁女性的数据进行分析。我们评估了PCOS在10岁年龄组的患病率，以及按年龄分组(< 45岁，[公式:见文本]45岁)有和没有PCOS的女性合并症的发生率。主要观察指标为诊断为PCOS及其他慢性疾病;生活方式因素。经年龄和BMI调整后，Logistic回归分析确定了多囊卵巢综合征女性合并症的风险。结果:PCOS总体患病率为5.6%(95%可信区间(CI) 4.6-6.9%)， 35-44岁年龄组患病率最高(9.1%)，15-24岁(4.1%)或65岁(3.7%)最低。患有多囊卵巢综合征且年龄<45岁的女性报告糖尿病(16.7%对3.8%)、心血管疾病(15.5%对7.2%)和关节炎(15.5%对7.2%)的可能性高于同龄女性;这些差异在45岁年龄组中有所减少。多囊卵巢综合征女性患糖尿病和心血管疾病的几率增加了一倍多(adjOR 2.23, 95% CI 1.49-4.31;adjOR 3.18, 95% CI 1.31-7.68)。结论:PCOS在年轻和绝经后妇女中诊断不足。糖尿病和心血管疾病是年轻女性多囊卵巢综合征患者需要更多关注的主要合并症。
{"title":"Prevalence of Self-reported Polycystic Ovary Syndrome and Profiles of Health Among Women of Different Generations: A Cross Sectional Study","authors":"J. Avery, L. Moran, V. Moore, R. Fernandez, M. Whitrow, N. Stocks, T. Gill, M. Musker, M. Davies, A. Rumbold","doi":"10.1142/s2661318219500154","DOIUrl":"https://doi.org/10.1142/s2661318219500154","url":null,"abstract":"Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged <45 years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers; these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31; adjOR 3.18, 95% CI 1.31–7.68). Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76246573","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}
Pub Date : 2019-07-15DOI: 10.1142/S2661318219500099
E. C. Tan, P. Chincholkar, S. Yu, S. Lim, R. Renuka, T. Yong, C. Yeo, H. Rajesh
Objective: Various parameters had been used to predict ovarian response. Among them, Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) demonstrate the most favourable analytical and performance characteristics. In this pilot study, we aim to determine the cut-off levels of AMH using automated AMH assays and AFC in the prediction of poor and high responders. Study Design: Prospective study of 43 women between 21 to 45 years old scheduled for assisted reproduction. AMH levels on day 3 of menstruation were analysed using two immunoassay kits, namely the Beckman Coulter Access AMH and the Roche Elecsys AMH on the two automated analysers Beckman Coulter DxI 800 and Roche Cobas e602 respectively. AFC was also assessed on day 3 of menstruation prior to in vitro fertilization (IVF). These were compared with the number of oocytes retrieved after controlled ovarian stimulation. Results: AMH (Beckman Coulter Access AMH and Roche Elecsys AMH) highly correlated with AFC and the number of oocytes retrieved after ovarian stimulation. Beckman Coulter Access AMH was the better predictor for poor ovarian response with ROC [Formula: see text] of 0.83. For the prediction of a high response, AFC had a higher ROC [Formula: see text] of 0.95. Through ROC, the AMH cut-off level for poor ovarian response was 2.23 ng/ml with Beckman Coulter Access AMH and 2.02 ng/ml with Roche Elecsys AMH, while the AMH cut-off for a high ovarian response was 5.19 ng/ml with Beckman Coulter Access AMH and 4.60 ng/ml with Roche Elecsys AMH. For AFC, the cut-off for poor ovarian response was 18 and for high response was 34. Conclusion: AMH and AFC are reliable predictors of ovarian response. Establishment of specific levels may improve individualised controlled ovarian stimulation and optimise the oocyte yield. Larger studies are required to establish these findings.
{"title":"Comparison of Automated Anti-Müllerian Hormone Assays and Antral Follicle Count in Predicting Ovarian Response During Ovarian Stimulation","authors":"E. C. Tan, P. Chincholkar, S. Yu, S. Lim, R. Renuka, T. Yong, C. Yeo, H. Rajesh","doi":"10.1142/S2661318219500099","DOIUrl":"https://doi.org/10.1142/S2661318219500099","url":null,"abstract":"Objective: Various parameters had been used to predict ovarian response. Among them, Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) demonstrate the most favourable analytical and performance characteristics. In this pilot study, we aim to determine the cut-off levels of AMH using automated AMH assays and AFC in the prediction of poor and high responders. Study Design: Prospective study of 43 women between 21 to 45 years old scheduled for assisted reproduction. AMH levels on day 3 of menstruation were analysed using two immunoassay kits, namely the Beckman Coulter Access AMH and the Roche Elecsys AMH on the two automated analysers Beckman Coulter DxI 800 and Roche Cobas e602 respectively. AFC was also assessed on day 3 of menstruation prior to in vitro fertilization (IVF). These were compared with the number of oocytes retrieved after controlled ovarian stimulation. Results: AMH (Beckman Coulter Access AMH and Roche Elecsys AMH) highly correlated with AFC and the number of oocytes retrieved after ovarian stimulation. Beckman Coulter Access AMH was the better predictor for poor ovarian response with ROC [Formula: see text] of 0.83. For the prediction of a high response, AFC had a higher ROC [Formula: see text] of 0.95. Through ROC, the AMH cut-off level for poor ovarian response was 2.23 ng/ml with Beckman Coulter Access AMH and 2.02 ng/ml with Roche Elecsys AMH, while the AMH cut-off for a high ovarian response was 5.19 ng/ml with Beckman Coulter Access AMH and 4.60 ng/ml with Roche Elecsys AMH. For AFC, the cut-off for poor ovarian response was 18 and for high response was 34. Conclusion: AMH and AFC are reliable predictors of ovarian response. Establishment of specific levels may improve individualised controlled ovarian stimulation and optimise the oocyte yield. Larger studies are required to establish these findings.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87098397","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}
Pub Date : 2019-07-15DOI: 10.1142/S2661318219300071
B. Wiweko
Background: Louise Brown’s delivery in 1978 was the mark of a successful IVF program that has now been in practice for more than 40 years. The technology has delivered more than 8 million babies. Many breakthrough innovations were established to answer the problem in ART services. Optimizing ART biomarkers and cross border reproductive care have become a rising issue in ART services. Disruptive innovation disrupts the existing condition and takes the lead in the new market, including to change our patient behavior in health services. National health services addressed new issues about the impact of 4.0 industrial revolution on health workforce and our daily practices. Every disruptive innovation today is enhanced by a combination of physical, digital, and biological domain. The advancement in the area of the internet of things, artificial intelligence, virtual reality, nanotechnology, cloud computing, big data, deep learning, machine learning, robotics, and gene editing could potentially support us to innovate. And to improve the quality and outcome of ART, the introduction of the latest technology, such as robotics and artificial intelligence, has become an essential approach. A recent study discovered that the use of artificial intelligence would remove the embryologist’s subjectivity and improve the way we choose the best embryo for implantation. The next challenging issue in ART is improving the success rate through optimizing noninvasive biomarkers development. Many biological products such as blood, tissue, organ fluid can be assessed and considered to be used as IVF biomarkers. Proteomic tools were used and are needed to analyze a sample from subjects before it was created as a biomarker for improving the IVF services quality. Conclusion: The development of IVF over 40 years has brought about many distinct achievements in the laboratory and in clinic. Industrial revolution 4.0 has generated many innovations that have helped improve the quality of ART services, including AUGMENT social egg freezing, artificial intelligence, and genome editing. In this era, precision medicine looks very promising for bridging the gap and increasing the accuracy and efficacy of promotive, preventive, diagnostic, and treatment approaches in reproductive medicine.
{"title":"Cutting Edge of Reproductive Medicine","authors":"B. Wiweko","doi":"10.1142/S2661318219300071","DOIUrl":"https://doi.org/10.1142/S2661318219300071","url":null,"abstract":"Background: Louise Brown’s delivery in 1978 was the mark of a successful IVF program that has now been in practice for more than 40 years. The technology has delivered more than 8 million babies. Many breakthrough innovations were established to answer the problem in ART services. Optimizing ART biomarkers and cross border reproductive care have become a rising issue in ART services. Disruptive innovation disrupts the existing condition and takes the lead in the new market, including to change our patient behavior in health services. National health services addressed new issues about the impact of 4.0 industrial revolution on health workforce and our daily practices. Every disruptive innovation today is enhanced by a combination of physical, digital, and biological domain. The advancement in the area of the internet of things, artificial intelligence, virtual reality, nanotechnology, cloud computing, big data, deep learning, machine learning, robotics, and gene editing could potentially support us to innovate. And to improve the quality and outcome of ART, the introduction of the latest technology, such as robotics and artificial intelligence, has become an essential approach. A recent study discovered that the use of artificial intelligence would remove the embryologist’s subjectivity and improve the way we choose the best embryo for implantation. The next challenging issue in ART is improving the success rate through optimizing noninvasive biomarkers development. Many biological products such as blood, tissue, organ fluid can be assessed and considered to be used as IVF biomarkers. Proteomic tools were used and are needed to analyze a sample from subjects before it was created as a biomarker for improving the IVF services quality. Conclusion: The development of IVF over 40 years has brought about many distinct achievements in the laboratory and in clinic. Industrial revolution 4.0 has generated many innovations that have helped improve the quality of ART services, including AUGMENT social egg freezing, artificial intelligence, and genome editing. In this era, precision medicine looks very promising for bridging the gap and increasing the accuracy and efficacy of promotive, preventive, diagnostic, and treatment approaches in reproductive medicine.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81769511","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}
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