Pub Date : 2024-07-03DOI: 10.1097/GRH.0000000000000084
Konstantinos Dafopoulos
The global trend of reproductive delay combined with age-related fertility loss may result in involuntary childlessness. The method of oocyte vitrification for fertility preservation as a prevention of age-related fertility loss is both safe and highly efficient. Among the many advantages of this strategy for women, the enhancement of reproductive autonomy, sex equality, the increased likelihood of future delivery of their genetically own offspring, and the cost-effectiveness are included.
{"title":"Advantages of cryopreservation for fertility preservation due to age-related fertility loss","authors":"Konstantinos Dafopoulos","doi":"10.1097/GRH.0000000000000084","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000084","url":null,"abstract":"The global trend of reproductive delay combined with age-related fertility loss may result in involuntary childlessness. The method of oocyte vitrification for fertility preservation as a prevention of age-related fertility loss is both safe and highly efficient. Among the many advantages of this strategy for women, the enhancement of reproductive autonomy, sex equality, the increased likelihood of future delivery of their genetically own offspring, and the cost-effectiveness are included.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"130 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681975","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 : 2024-07-01DOI: 10.1097/GRH.0000000000000088
Matthew Anyanwu, Alhaji Touray, Tuti Kujabi, Karamba Suwareh, Adama Sumbunu, Ramatoulie Drammeh, Thompson Odeku, Ifeoma Nwanganga
Introduction: The prevalence of infertility has increased worldwide. The etiological factors are also changing in trend and prominence. Male infertility is driving the epidemic in many regions of the world. Therefore, the aim of this study was to explore male factor infertility in the Gambia. Methodology: The design was a longitudinal descriptive study of subfertile couples at a specialist tertiary hospital in Banjul, the Gambia, from August 2022 to May 2023. Data were extracted from patients folders and entered into a computer database. Descriptive statistics were used to analyze the data and results expressed in tables, graphs, and percentages. Results: Total number of subfertile couples analyzed was 152: male factor 69 (45.4%), ovulation disorder 34 (22.4%), tubal factor 20 (13.2%), uterine factor 8 (5.3%), and unexplained 21 (13.8%). The median age of male folk was 50 years, with an age range of 31 to 64 years. The rates of asthenoteratozospermia, oligospermia, and azospermia were 37.8%, 36.2%, and 26%, respectively. In azoospermic males, over 75% had elevated FSH (12–44 miu/mL). Conclusions: The prevalence of male infertility is at 45.4%, which is 3-fold and 2-fold higher than tubal and ovarian factors, respectively. Male infertility is a problem with obvious implications. The predominant types of male infertility we observed in this study will almost always require multidisciplinary care and ICSI.
{"title":"Male factor infertility and implication of fertility treatment in low resource settings","authors":"Matthew Anyanwu, Alhaji Touray, Tuti Kujabi, Karamba Suwareh, Adama Sumbunu, Ramatoulie Drammeh, Thompson Odeku, Ifeoma Nwanganga","doi":"10.1097/GRH.0000000000000088","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000088","url":null,"abstract":"Introduction: The prevalence of infertility has increased worldwide. The etiological factors are also changing in trend and prominence. Male infertility is driving the epidemic in many regions of the world. Therefore, the aim of this study was to explore male factor infertility in the Gambia. Methodology: The design was a longitudinal descriptive study of subfertile couples at a specialist tertiary hospital in Banjul, the Gambia, from August 2022 to May 2023. Data were extracted from patients folders and entered into a computer database. Descriptive statistics were used to analyze the data and results expressed in tables, graphs, and percentages. Results: Total number of subfertile couples analyzed was 152: male factor 69 (45.4%), ovulation disorder 34 (22.4%), tubal factor 20 (13.2%), uterine factor 8 (5.3%), and unexplained 21 (13.8%). The median age of male folk was 50 years, with an age range of 31 to 64 years. The rates of asthenoteratozospermia, oligospermia, and azospermia were 37.8%, 36.2%, and 26%, respectively. In azoospermic males, over 75% had elevated FSH (12–44 miu/mL). Conclusions: The prevalence of male infertility is at 45.4%, which is 3-fold and 2-fold higher than tubal and ovarian factors, respectively. Male infertility is a problem with obvious implications. The predominant types of male infertility we observed in this study will almost always require multidisciplinary care and ICSI.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708903","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 : 2023-12-15DOI: 10.1097/GRH.0000000000000079
Yi Yu, Xi Zhang, Xin-xin Xu, Lei Yan, Ya-nan Zhang
Introduction: This study aimed to compare the pregnancy outcomes of different endometrial preparation protocols in patients with adenomyosis and thin endometrium during frozen embryo transfer. Methods: The study, which was conducted at the Reproductive Hospital Affiliated to Shandong University, included 236 patients with adenomyosis and thin endometrium who underwent frozen embryo transfer between January 1, 2011, and December 12, 2022. The pregnancy outcomes and maternal and infant complications among the 4 groups were further compared. Results: These patients with adenomyosis and thin endometrium were divided into 4 groups based on the endometrial preparation protocols used: natural cycle treatment (n=53), hormone replacement therapy group (n=73), gonadotropin-releasing hormone agonists + hormone replacement therapy group (n=49), and ovarian induction group (n=61). The demographic, cycle, and embryologic characteristics were similar between groups. The livebirth rates (P=0.29), full-term pregnancy rates (P=0.55), preterm pregnancy rates (P=0.33), clinical pregnancy rates (P=0.77), biochemical pregnancy miscarriage rates (P=0.28), early miscarriage rates (P=0.16), and late miscarriage rates (P=0.69) were comparable among 4 groups. In addition, there were no significant differences in maternal and infant complications. Conclusion: The pregnancy outcomes of frozen-embryo transfer among 4 endometrial preparation protocols in patients with adenomyosis and thin endometrium were comparable, indicating no significant disparities. In addition, no noteworthy variations were observed in terms of maternal and infant complications in these patients.
{"title":"Pregnancy outcomes of 4 endometrial preparation protocols in adenomyosis patients with thin endometrium during frozen embryo transfer: a retrospective cohort study","authors":"Yi Yu, Xi Zhang, Xin-xin Xu, Lei Yan, Ya-nan Zhang","doi":"10.1097/GRH.0000000000000079","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000079","url":null,"abstract":"Introduction: This study aimed to compare the pregnancy outcomes of different endometrial preparation protocols in patients with adenomyosis and thin endometrium during frozen embryo transfer. Methods: The study, which was conducted at the Reproductive Hospital Affiliated to Shandong University, included 236 patients with adenomyosis and thin endometrium who underwent frozen embryo transfer between January 1, 2011, and December 12, 2022. The pregnancy outcomes and maternal and infant complications among the 4 groups were further compared. Results: These patients with adenomyosis and thin endometrium were divided into 4 groups based on the endometrial preparation protocols used: natural cycle treatment (n=53), hormone replacement therapy group (n=73), gonadotropin-releasing hormone agonists + hormone replacement therapy group (n=49), and ovarian induction group (n=61). The demographic, cycle, and embryologic characteristics were similar between groups. The livebirth rates (P=0.29), full-term pregnancy rates (P=0.55), preterm pregnancy rates (P=0.33), clinical pregnancy rates (P=0.77), biochemical pregnancy miscarriage rates (P=0.28), early miscarriage rates (P=0.16), and late miscarriage rates (P=0.69) were comparable among 4 groups. In addition, there were no significant differences in maternal and infant complications. Conclusion: The pregnancy outcomes of frozen-embryo transfer among 4 endometrial preparation protocols in patients with adenomyosis and thin endometrium were comparable, indicating no significant disparities. In addition, no noteworthy variations were observed in terms of maternal and infant complications in these patients.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"297 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996776","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 : 2023-11-21DOI: 10.1097/GRH.0000000000000077
D. Zaake, Michael Weber Lwetabe, Anthony Kayiira
Objective: This study aimed to evaluate the prognostic value of a serum β-hCG level cutoff, 12 days after embryo transfer, on predicting live births among Ugandan women. Methods: This is a retrospective cross-sectional study. Three hundred thirty-seven fresh IVF cycles with serum β-hCG ≥5 mIU/mL, at 12 days after embryo transfer, were eligible. We abstracted participant characteristics, IVF cycle characteristics, live birth, clinical pregnancy, and ongoing pregnancy data from each eligible cycle. We utilized the Youden Index metric and the maximize_boot_metric method to link serum β-hCG levels to outcome data and determine the optimal cutoff values. Results: The optimal serum β-hCG cutoff value for predicting live birth was 437.42 mIU/mL with a corresponding sensitivity and false positive rate of 72% and 31%, respectively. The cutoffs for clinical and ongoing pregnancy were 239.58 mIU/mL and 353.66 mIU/mL, respectively. These corresponded with a sensitivity of 83% and 77%, respectively, and a false positive rate of 27% and 33%, respectively. The serum β-hCG cutoff had poor discriminatory performance for predicting live births but moderate performance for predicting clinical and ongoing pregnancies. Conclusion: A single serum β-hCG 12 days after cleavage embryo transfer has poor discriminatory performance in predicting live birth, albeit performing modestly in predicting clinical pregnancy and ongoing pregnancy among Ugandan women.
{"title":"Prognostic value of a serum β-human chorionic gonadotropin cutoff, twelve days after fresh embryo transfer, on predicting live birth among Ugandan women","authors":"D. Zaake, Michael Weber Lwetabe, Anthony Kayiira","doi":"10.1097/GRH.0000000000000077","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000077","url":null,"abstract":"Objective: This study aimed to evaluate the prognostic value of a serum β-hCG level cutoff, 12 days after embryo transfer, on predicting live births among Ugandan women. Methods: This is a retrospective cross-sectional study. Three hundred thirty-seven fresh IVF cycles with serum β-hCG ≥5 mIU/mL, at 12 days after embryo transfer, were eligible. We abstracted participant characteristics, IVF cycle characteristics, live birth, clinical pregnancy, and ongoing pregnancy data from each eligible cycle. We utilized the Youden Index metric and the maximize_boot_metric method to link serum β-hCG levels to outcome data and determine the optimal cutoff values. Results: The optimal serum β-hCG cutoff value for predicting live birth was 437.42 mIU/mL with a corresponding sensitivity and false positive rate of 72% and 31%, respectively. The cutoffs for clinical and ongoing pregnancy were 239.58 mIU/mL and 353.66 mIU/mL, respectively. These corresponded with a sensitivity of 83% and 77%, respectively, and a false positive rate of 27% and 33%, respectively. The serum β-hCG cutoff had poor discriminatory performance for predicting live births but moderate performance for predicting clinical and ongoing pregnancies. Conclusion: A single serum β-hCG 12 days after cleavage embryo transfer has poor discriminatory performance in predicting live birth, albeit performing modestly in predicting clinical pregnancy and ongoing pregnancy among Ugandan women.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"32 11-12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139252911","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 : 2023-10-06DOI: 10.1097/GRH.0000000000000073
Julie Balen
Infertility is a neglected global public health issue affecting an estimated 56–72 million couples worldwide. The prevention and management of infertility was recognized as a basic component of sexual and reproductive health at the landmark 1994 International Conference on Population and Development, yet progress in this area remains limited. Interdisciplinary research has been conducted in The Gambia, West Africa, since 2016, with communities, women’s organizations, clinicians, and health policy and systems stakeholders, to identify key gaps in fertility care, and to better understand the delivery of infertility services. A partnership between the Ministry of Health, Safe Haven Foundation, and international researchers helped create The Gambia’s National Infertility Awareness Campaign and gave birth to the Fertility Care Policy Dialogue supporting the inclusion of infertility in The Gambia’s new 10-year National Health Policy. It also helped to establish the White Rose Interdisciplinary Network on Fertility Care in the Global South. To date, the network has more than 60 members globally, including researchers, health workers, policy makers, and activists who work together on infertility awareness raising, policy change, and system strengthening, with the aim of improving equitable access to fertility care for all. Here, we introduce the network and draw on key lessons from ongoing infertility-related research in The Gambia.
{"title":"The fertility care gap in the Global South: lessons from The Gambia, West Africa, and ways forward to establish fertility care for all","authors":"Julie Balen","doi":"10.1097/GRH.0000000000000073","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000073","url":null,"abstract":"Infertility is a neglected global public health issue affecting an estimated 56–72 million couples worldwide. The prevention and management of infertility was recognized as a basic component of sexual and reproductive health at the landmark 1994 International Conference on Population and Development, yet progress in this area remains limited. Interdisciplinary research has been conducted in The Gambia, West Africa, since 2016, with communities, women’s organizations, clinicians, and health policy and systems stakeholders, to identify key gaps in fertility care, and to better understand the delivery of infertility services. A partnership between the Ministry of Health, Safe Haven Foundation, and international researchers helped create The Gambia’s National Infertility Awareness Campaign and gave birth to the Fertility Care Policy Dialogue supporting the inclusion of infertility in The Gambia’s new 10-year National Health Policy. It also helped to establish the White Rose Interdisciplinary Network on Fertility Care in the Global South. To date, the network has more than 60 members globally, including researchers, health workers, policy makers, and activists who work together on infertility awareness raising, policy change, and system strengthening, with the aim of improving equitable access to fertility care for all. Here, we introduce the network and draw on key lessons from ongoing infertility-related research in The Gambia.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"210 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139322266","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 : 2023-08-23DOI: 10.1097/GRH.0000000000000076
M. Aderonmu, Adebisi N. Oyero, O. B. Shote, Chinelo G. Okonkwo, O. Ashiru
Introduction: In vitro fertilization, a form of assisted reproductive technology has evolved over the last 3–5 decades in the management of infertility and now has been expanded to include third-party reproductive solutions. There are 2 types of gestational surrogacy: (1) full surrogacy (an egg from a woman is fertilized with a sperm and the resulting embryo is implanted into another woman) or (2) partial surrogacy (sperm from a man is used to fertilize an egg from the same woman in whom the embryo will be transferred to). In Nigeria, there is a paucity of publications on the outcomes of surrogate pregnancies, even though it is being practiced. At the Medical Art Center Ikeja Lagos, we practice only full surrogacy, otherwise referred to as gestational surrogacy. Study design: This was a retrospective descriptive study of 61 cycles performed over 76 months between January 1, 2015 and April 30, 2021 at a private-run single-location fertility center in South West Nigeria. Data were extracted from the electronic medical records of the commissioning parents and the gestational carrier. Results: There were a total of 58 gestational carriers in the program. Eleven (19%) had a miscarriage and there were 63 live births, out of which were 14 twin pairs (44%), 1 set of triplets (~5%) and the rest were singletons. One (1.7%) surrogate had delivery complicated by a hysterectomy on account of postpartum hemorrhage. There was no maternal mortality. The commonest reason for choosing surrogacy was multiple failed in vitro fertilization cycles, uterine factor infertility, and advanced maternal age. Conclusion: Gestational surrogacy is a valid medically assisted reproduction option for individuals who desire to have children. This option should continue to be supported by ethical, regulatory, and legal frameworks available in Nigeria.
{"title":"Our bab(y)ies, your uterus—a retrospective study on surrogacy at a private fertility center in South West Nigeria","authors":"M. Aderonmu, Adebisi N. Oyero, O. B. Shote, Chinelo G. Okonkwo, O. Ashiru","doi":"10.1097/GRH.0000000000000076","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000076","url":null,"abstract":"Introduction: In vitro fertilization, a form of assisted reproductive technology has evolved over the last 3–5 decades in the management of infertility and now has been expanded to include third-party reproductive solutions. There are 2 types of gestational surrogacy: (1) full surrogacy (an egg from a woman is fertilized with a sperm and the resulting embryo is implanted into another woman) or (2) partial surrogacy (sperm from a man is used to fertilize an egg from the same woman in whom the embryo will be transferred to). In Nigeria, there is a paucity of publications on the outcomes of surrogate pregnancies, even though it is being practiced. At the Medical Art Center Ikeja Lagos, we practice only full surrogacy, otherwise referred to as gestational surrogacy. Study design: This was a retrospective descriptive study of 61 cycles performed over 76 months between January 1, 2015 and April 30, 2021 at a private-run single-location fertility center in South West Nigeria. Data were extracted from the electronic medical records of the commissioning parents and the gestational carrier. Results: There were a total of 58 gestational carriers in the program. Eleven (19%) had a miscarriage and there were 63 live births, out of which were 14 twin pairs (44%), 1 set of triplets (~5%) and the rest were singletons. One (1.7%) surrogate had delivery complicated by a hysterectomy on account of postpartum hemorrhage. There was no maternal mortality. The commonest reason for choosing surrogacy was multiple failed in vitro fertilization cycles, uterine factor infertility, and advanced maternal age. Conclusion: Gestational surrogacy is a valid medically assisted reproduction option for individuals who desire to have children. This option should continue to be supported by ethical, regulatory, and legal frameworks available in Nigeria.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49145846","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 : 2023-08-17DOI: 10.1097/GRH.0000000000000075
Meng Wang, Zhe Wang, Yizheng Tian, Dan Qi, Xin-xin Xu, Jianan Lv, Lei Yan, Wen Liu, Hong Lv
Introduction: During the process of assisted reproductive technology, clinicians are always faced with the problem of endometrial cavity fluid (ECF) interfering with pregnancy outcomes, especially those patients with ECF. The aim of this study was to identify which characteristics of those patients with ECF during the preparation of fresh embryo transfer would predict their recurrent ECF when they were to undergo this cycle of frozen embryo transfer due to cancellation of fresh embryo transfer or failure to obtain a live birth after fresh embryo transfer. Methods: We collected relevant clinical information of those patients receiving assisted reproduction therapy at Reproductive Hospital affiliated with Shandong University between January 2014 and December 2020, including those patients who developed ECF before fresh embryo transfer and canceled fresh embryo transfer for different reasons or did not obtain pregnancy after transfer. Patients were divided into persistent and transient ECF groups according to whether they still had ECF before the current cycle of frozen embryo transfer. We compared relevant data that may influence the persistence of ECF and performed logistic regression analysis to examine whether these variables were associated with the persistence of ECF. Results: The proportion of continued existence of ECF was 14.13% (276/1953). The variables related to the persistence of ECF were as follows: polycystic ovarian syndrome status, previous hysteroscopic adhesiolysis history, history of cesarean section, controlled ovarian hyperstimulation protocol, and endometrial thickness on human chorionic gonadotropin trigger day. Conclusions: It is recommended to inform those patients who present with a thin endometrium on human chorionic gonadotropin trigger day, the diagnosis of polycystic ovarian syndrome, a history of hysteroscopic adhesiolysis, cesarean section history, or were treated with gonadotropin-releasing hormone antagonist protocol that the ECF is less likely to resolve spontaneously, and early intervention based on the corresponding high-risk factors should be recommended.
{"title":"Predictors for persistent endometrial cavity fluid from fresh to subsequent frozen embryo transfer","authors":"Meng Wang, Zhe Wang, Yizheng Tian, Dan Qi, Xin-xin Xu, Jianan Lv, Lei Yan, Wen Liu, Hong Lv","doi":"10.1097/GRH.0000000000000075","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000075","url":null,"abstract":"Introduction: During the process of assisted reproductive technology, clinicians are always faced with the problem of endometrial cavity fluid (ECF) interfering with pregnancy outcomes, especially those patients with ECF. The aim of this study was to identify which characteristics of those patients with ECF during the preparation of fresh embryo transfer would predict their recurrent ECF when they were to undergo this cycle of frozen embryo transfer due to cancellation of fresh embryo transfer or failure to obtain a live birth after fresh embryo transfer. Methods: We collected relevant clinical information of those patients receiving assisted reproduction therapy at Reproductive Hospital affiliated with Shandong University between January 2014 and December 2020, including those patients who developed ECF before fresh embryo transfer and canceled fresh embryo transfer for different reasons or did not obtain pregnancy after transfer. Patients were divided into persistent and transient ECF groups according to whether they still had ECF before the current cycle of frozen embryo transfer. We compared relevant data that may influence the persistence of ECF and performed logistic regression analysis to examine whether these variables were associated with the persistence of ECF. Results: The proportion of continued existence of ECF was 14.13% (276/1953). The variables related to the persistence of ECF were as follows: polycystic ovarian syndrome status, previous hysteroscopic adhesiolysis history, history of cesarean section, controlled ovarian hyperstimulation protocol, and endometrial thickness on human chorionic gonadotropin trigger day. Conclusions: It is recommended to inform those patients who present with a thin endometrium on human chorionic gonadotropin trigger day, the diagnosis of polycystic ovarian syndrome, a history of hysteroscopic adhesiolysis, cesarean section history, or were treated with gonadotropin-releasing hormone antagonist protocol that the ECF is less likely to resolve spontaneously, and early intervention based on the corresponding high-risk factors should be recommended.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45226159","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 : 2023-08-11DOI: 10.1097/GRH.0000000000000071
Amina Oumeziane, Amira Aggad, Yasmina Melbani, Fatima Nanouche, Samira Barbara, Karima Djerroudib, Rachida Bourihane, Nedjma Tazairt, S. Mouhoub, Ahlem Lacheheb, Samia Chemoul, N. Chabane, N. Boucekkine
Introduction: Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder often associated with infertility. There are several factors that could impair the pregnancy outcomes of PCOS patients. The latter endocrine profile along with high baseline luteinizing hormone (LH), high LH/follicle-stimulating hormone ratio, as well as high anti-Müllerian hormone (AMH) levels appear detrimental for patients undergoing In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). The objective of this study is to evaluate the impact of baseline LH and AMH levels on pregnancy outcomes in PCOS patients performing IVF/ICSI cycles in an antagonist protocol. Materials and methods: The current investigation is a retrospective cohort study conducted at IVF Tiziri Center in Algiers on PCOS patients undergoing IVF/ICSI from January 2017 to March 2021. According to the Rotterdam criteria, patients aged between 23 and 42 years were divided into 2 groups: group 1 (G1) =91 patients; group 2 (G2) =100 all patients had an LH level >10 IU/L. Both groups had AMH levels >5 ng/mL. Controlled ovarian stimulation was done with a fixed antagonist protocol, as for the ovulation it was triggered with human chorionic gonadotropin or gonadotropin-releasing hormone agonist. Fresh and frozen embryo transfers were, thereafter, evaluated. Concerning the statistical analysis, it was done with SPSS software. Results: The mean LH level was 15.16±7.08 for G1 versus 5.7±1.86 for G2 (P=10−6), mean LH/follicle-stimulating hormone ratio 2.71±1.36 in G1 versus 1.05±0.44 (P=10−6) and mean AMH level was 9.27±3.90 for G1 versus 7.53±2.76 for G2 with (P<10−3). The mean follicles over 11 mm in diameter, estradiol (E2) level, and progesterone level on the trigger day did not differ significantly between G1 and G2. Also, the mean of oocytes and metaphase II oocytes retrieved fertilization, and blastulation rate were similar for both groups. The pregnancy rate for G1 was 40.6% versus 54% (P>0.05); the ongoing pregnancy rate (OPR) was 28.6% in G1 versus 47% in G2 (P=0.078); and the miscarriage rate was 32.4% for G1 versus 12.9 for G2 (P=0.072). A univariate analysis was performed with all confounder factors supposed to impact pregnancy outcomes: AMH level did not impact pregnancy outcomes, whereas LH level <11 IU/L has been determined as a threshold impacting positively on OPR with odds ratio=2.01 (95% CI: 1.05–3.87). After a multivariate logistic regression including con-founders, 3 factors significantly influence OPR: LH, E2, and infertility with known etiology. Conclusion: The high baseline LH level impairs pregnancy outcomes in PCOs patients undergoing an antagonist protocol IVF/ICSI cycle. The identification of PCOS patients by their endocrine profile enables the establishment of a prognosis for council patients and a plan for an individualized therapeutic strategy.
{"title":"Impact of baseline luteinizing hormone (LH) level and anti-Müllerian hormone (AMH) on pregnancy outcomes in polycystic ovary syndrome (PCOS) patients undergoing IVF/ICSI cycle in antagonist protocol","authors":"Amina Oumeziane, Amira Aggad, Yasmina Melbani, Fatima Nanouche, Samira Barbara, Karima Djerroudib, Rachida Bourihane, Nedjma Tazairt, S. Mouhoub, Ahlem Lacheheb, Samia Chemoul, N. Chabane, N. Boucekkine","doi":"10.1097/GRH.0000000000000071","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000071","url":null,"abstract":"Introduction: Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder often associated with infertility. There are several factors that could impair the pregnancy outcomes of PCOS patients. The latter endocrine profile along with high baseline luteinizing hormone (LH), high LH/follicle-stimulating hormone ratio, as well as high anti-Müllerian hormone (AMH) levels appear detrimental for patients undergoing In vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). The objective of this study is to evaluate the impact of baseline LH and AMH levels on pregnancy outcomes in PCOS patients performing IVF/ICSI cycles in an antagonist protocol. Materials and methods: The current investigation is a retrospective cohort study conducted at IVF Tiziri Center in Algiers on PCOS patients undergoing IVF/ICSI from January 2017 to March 2021. According to the Rotterdam criteria, patients aged between 23 and 42 years were divided into 2 groups: group 1 (G1) =91 patients; group 2 (G2) =100 all patients had an LH level >10 IU/L. Both groups had AMH levels >5 ng/mL. Controlled ovarian stimulation was done with a fixed antagonist protocol, as for the ovulation it was triggered with human chorionic gonadotropin or gonadotropin-releasing hormone agonist. Fresh and frozen embryo transfers were, thereafter, evaluated. Concerning the statistical analysis, it was done with SPSS software. Results: The mean LH level was 15.16±7.08 for G1 versus 5.7±1.86 for G2 (P=10−6), mean LH/follicle-stimulating hormone ratio 2.71±1.36 in G1 versus 1.05±0.44 (P=10−6) and mean AMH level was 9.27±3.90 for G1 versus 7.53±2.76 for G2 with (P<10−3). The mean follicles over 11 mm in diameter, estradiol (E2) level, and progesterone level on the trigger day did not differ significantly between G1 and G2. Also, the mean of oocytes and metaphase II oocytes retrieved fertilization, and blastulation rate were similar for both groups. The pregnancy rate for G1 was 40.6% versus 54% (P>0.05); the ongoing pregnancy rate (OPR) was 28.6% in G1 versus 47% in G2 (P=0.078); and the miscarriage rate was 32.4% for G1 versus 12.9 for G2 (P=0.072). A univariate analysis was performed with all confounder factors supposed to impact pregnancy outcomes: AMH level did not impact pregnancy outcomes, whereas LH level <11 IU/L has been determined as a threshold impacting positively on OPR with odds ratio=2.01 (95% CI: 1.05–3.87). After a multivariate logistic regression including con-founders, 3 factors significantly influence OPR: LH, E2, and infertility with known etiology. Conclusion: The high baseline LH level impairs pregnancy outcomes in PCOs patients undergoing an antagonist protocol IVF/ICSI cycle. The identification of PCOS patients by their endocrine profile enables the establishment of a prognosis for council patients and a plan for an individualized therapeutic strategy.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43665198","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 : 2023-06-13DOI: 10.1097/GRH.0000000000000072
A. Sharma, A. Sharma, R. Bakshi, Sarthak Bakshi
Background: There is a correlation between infertility and serious mental, emotional, and social difficulties reported in the literature. Sexual dysfunction (SD) is quite common in both males and females and often are linked with infertility among couples. Aim and objective: The purpose of this study is to investigate whether or not there is a correlation between infertility and SD in couples who are having treatment for infertility at an infertility clinic. Materials and methods: Total of 100 couples were included in this study and were given the Changes in Sexual Functioning Questionnaire (CSFQ) questionnaire. The data thus obtained were recorded and analyzed using SPSS software. Result: The present study finding indicated that the mean CSFQ score was significantly lower in infertile females compared with the males, indicating that females suffered from SD more. The mean of CSFQ among males was 48.37, and for CSFQ among females; the average was 40.32, which was below the cut-off rate indicating SD is more common in females compared with males. However, our study showed no positive correlation between the lower CSFQ score between both genders with the place of living. As maximum of the study participants were Hindu we have not performed any correlation analysis with religion. Further, this study showed no such differences in duration of the infertility with the CSFQ score. Conclusion: This study thus concluded that SD is more common in infertile couples. The prevalence of SD is more in females compared with males.
{"title":"Prospective study of 100 infertile couples: does infertility lead to sexual dysfunction","authors":"A. Sharma, A. Sharma, R. Bakshi, Sarthak Bakshi","doi":"10.1097/GRH.0000000000000072","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000072","url":null,"abstract":"Background: There is a correlation between infertility and serious mental, emotional, and social difficulties reported in the literature. Sexual dysfunction (SD) is quite common in both males and females and often are linked with infertility among couples. Aim and objective: The purpose of this study is to investigate whether or not there is a correlation between infertility and SD in couples who are having treatment for infertility at an infertility clinic. Materials and methods: Total of 100 couples were included in this study and were given the Changes in Sexual Functioning Questionnaire (CSFQ) questionnaire. The data thus obtained were recorded and analyzed using SPSS software. Result: The present study finding indicated that the mean CSFQ score was significantly lower in infertile females compared with the males, indicating that females suffered from SD more. The mean of CSFQ among males was 48.37, and for CSFQ among females; the average was 40.32, which was below the cut-off rate indicating SD is more common in females compared with males. However, our study showed no positive correlation between the lower CSFQ score between both genders with the place of living. As maximum of the study participants were Hindu we have not performed any correlation analysis with religion. Further, this study showed no such differences in duration of the infertility with the CSFQ score. Conclusion: This study thus concluded that SD is more common in infertile couples. The prevalence of SD is more in females compared with males.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49390182","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 : 2023-05-18DOI: 10.1097/GRH.0000000000000069
Maria Louise Fufezan, E. Mocanu
Obesity [body mass index (BMI) ≥30 kg/m2] has been shown to be a risk factor in reducing the rate of successful in vitro fertilization (IVF) outcomes. In this systematized literature review, we investigate whether embryo quality specifically is affected by single-parent obesity (maternal or paternal) and obesity in both parents at the time of conception. We systematically searched for studies published over the last 10 years that graded embryo quality in conventional IVF and intracytoplasmic sperm injection procedures. Studies that did not use measured weight and height for BMI calculation were excluded. Ten eligible articles were found across 13 public databases. Comparing the results of 1845 couples, both female and male obesity independently caused faster preimplantation embryo development (P <0.05). The fertilization rate was not affected by either female, male, or combined parental obesity (P>0.05). Day 3 embryo quality does not seem to be affected by either female or male obesity alone. The 2 studies that investigated the effect of combined parental obesity on embryo quality reached contradictory findings. Male, but not female, >7% BMI reduction following bariatric surgery significantly increased the number of top-quality embryos compared with their results before surgery (P<0.05). We conclude that embryos of couples with single-parent obesity are not of lower quality compared with those of normal-weight parents. Combined parental obesity may affect embryo quality. BMI reduction could lead toward a successful outcome in obese infertile couples, regardless of whether they are undergoing IVF or not.
{"title":"Obesity and fertility: a literature review of the association between parental obesity at the time of conception and embryo quality","authors":"Maria Louise Fufezan, E. Mocanu","doi":"10.1097/GRH.0000000000000069","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000069","url":null,"abstract":"Obesity [body mass index (BMI) ≥30 kg/m2] has been shown to be a risk factor in reducing the rate of successful in vitro fertilization (IVF) outcomes. In this systematized literature review, we investigate whether embryo quality specifically is affected by single-parent obesity (maternal or paternal) and obesity in both parents at the time of conception. We systematically searched for studies published over the last 10 years that graded embryo quality in conventional IVF and intracytoplasmic sperm injection procedures. Studies that did not use measured weight and height for BMI calculation were excluded. Ten eligible articles were found across 13 public databases. Comparing the results of 1845 couples, both female and male obesity independently caused faster preimplantation embryo development (P <0.05). The fertilization rate was not affected by either female, male, or combined parental obesity (P>0.05). Day 3 embryo quality does not seem to be affected by either female or male obesity alone. The 2 studies that investigated the effect of combined parental obesity on embryo quality reached contradictory findings. Male, but not female, >7% BMI reduction following bariatric surgery significantly increased the number of top-quality embryos compared with their results before surgery (P<0.05). We conclude that embryos of couples with single-parent obesity are not of lower quality compared with those of normal-weight parents. Combined parental obesity may affect embryo quality. BMI reduction could lead toward a successful outcome in obese infertile couples, regardless of whether they are undergoing IVF or not.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44904170","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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