Pub Date : 2018-12-01DOI: 10.1097/grh.0000000000000021
R. Bayoumi, S. Z. van der Poel, E. Koert, J. Boivin
{"title":"Fertility awareness and quality of life: assessment and impact of fertility problems and infertility","authors":"R. Bayoumi, S. Z. van der Poel, E. Koert, J. Boivin","doi":"10.1097/grh.0000000000000021","DOIUrl":"https://doi.org/10.1097/grh.0000000000000021","url":null,"abstract":"","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/grh.0000000000000021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43107157","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 : 2018-12-01DOI: 10.1097/GRH.0000000000000024
R. Kudesia, M. Muyingo, N. Tran, M. Shah, I. Merkatz, P. Klatsky
Introduction: Fertility care is an important unmet need in sub-Saharan Africa and considered low priority by donor countries and agencies. Understanding the social context of infertility may increase effectiveness of reproductive health programs. Methods: We conducted a cross-sectional study of fertile and infertile women in Kampala, Uganda, evaluating reproductive knowledge, quality of life (QOL), and infertility-related social morbidity using validated instruments and survey techniques. Results: QOL scores were lower than previously reported scores in Europe (P<0.001). A majority of respondents (53%) reported that they would rather contract HIV than live with infertility. In all, 46.7% of women listed “family planning” or a reversible contraceptive as a cause of infertility. Reproductive knowledge was low, with only 16.7% of women able to give 3 accurate causes of infertility. Infertile women reported higher rates of interpersonal violence, but these differences were not statistically significant. Conclusions: Infertility in Uganda decreases QOL comparably to other severe medical conditions and more than in prior studies. Common beliefs linking infertility to contraception may hinder implementation of family planning, though the infertility evaluation may help correct misconceptions. The connections between infertility, low reproductive knowledge, contraceptive uptake, and violence demonstrated here merit further study and may assist in designing culturally competent basic reproductive health programs in communities with limited resources.
{"title":"Infertility in Uganda: a missed opportunity to improve reproductive knowledge and health","authors":"R. Kudesia, M. Muyingo, N. Tran, M. Shah, I. Merkatz, P. Klatsky","doi":"10.1097/GRH.0000000000000024","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000024","url":null,"abstract":"Introduction: Fertility care is an important unmet need in sub-Saharan Africa and considered low priority by donor countries and agencies. Understanding the social context of infertility may increase effectiveness of reproductive health programs. Methods: We conducted a cross-sectional study of fertile and infertile women in Kampala, Uganda, evaluating reproductive knowledge, quality of life (QOL), and infertility-related social morbidity using validated instruments and survey techniques. Results: QOL scores were lower than previously reported scores in Europe (P<0.001). A majority of respondents (53%) reported that they would rather contract HIV than live with infertility. In all, 46.7% of women listed “family planning” or a reversible contraceptive as a cause of infertility. Reproductive knowledge was low, with only 16.7% of women able to give 3 accurate causes of infertility. Infertile women reported higher rates of interpersonal violence, but these differences were not statistically significant. Conclusions: Infertility in Uganda decreases QOL comparably to other severe medical conditions and more than in prior studies. Common beliefs linking infertility to contraception may hinder implementation of family planning, though the infertility evaluation may help correct misconceptions. The connections between infertility, low reproductive knowledge, contraceptive uptake, and violence demonstrated here merit further study and may assist in designing culturally competent basic reproductive health programs in communities with limited resources.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e24"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42212781","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 : 2018-12-01DOI: 10.1097/GRH.0000000000000022
C. Huyser, K. Richter
The present report describes the transition of a technique designed for the removal of infectious pathogens from animal semen to a clinical application in human immunodeficiency virus-seropositive males requesting assisted reproductive technology treatment. The relevance and application of the decontamination technique in the present-day and emerging viral epidemics is questioned. The medical history and screening of a patient will verify the type and level of viral infection, and if viruses are attached and/or potentially internalized in the sperm cell of a carrier. The procedure will only be relevant as a risk-reduction method during assisted reproductive technology treatment if the viral infection/load is known, as applied to human immunodeficiency virus positive male patients at our Unit.
{"title":"Sperm viral decontamination: a juncture between prevention and risk minimization in the ART laboratory","authors":"C. Huyser, K. Richter","doi":"10.1097/GRH.0000000000000022","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000022","url":null,"abstract":"The present report describes the transition of a technique designed for the removal of infectious pathogens from animal semen to a clinical application in human immunodeficiency virus-seropositive males requesting assisted reproductive technology treatment. The relevance and application of the decontamination technique in the present-day and emerging viral epidemics is questioned. The medical history and screening of a patient will verify the type and level of viral infection, and if viruses are attached and/or potentially internalized in the sperm cell of a carrier. The procedure will only be relevant as a risk-reduction method during assisted reproductive technology treatment if the viral infection/load is known, as applied to human immunodeficiency virus positive male patients at our Unit.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44559210","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 : 2018-09-01DOI: 10.1097/GRH.0000000000000014
Meenal S. Khandeparkar, Shivsamb Jalkote, Madhavi M. Panpalia, S. Nellore, Trupti V. Mehta, K. Ganesan, F. Parikh
Introduction: Magnetic resonance imaging (MRI) is the current reference standard for noninvasive imaging of the pelvis. In patients with infertility potentially earmarked for in vitro fertilization/intracytoplasmic sperm injection procedures, the distinction between adenomyosis and its mimics is extremely vital. This article highlights the vital role of MRI in the detection of subtle nuances of adenomyosis in infertility and the key imaging features of its associated conditions and mimics. Materials and Methods: This is a retrospective Health Insurance Portability and Accountability Act compliant study. Inclusion criteria consisted of (a) clinically diagnosed cases of primary infertility; (b) suspicion of adenomyosis on transabdominal and transvaginal ultrasonography; (c) nonvisualization/obscuration of the junctional zone; (d) multiparametric MRI performed at 3 T. Exclusion criteria included (a) other causes of primary infertility including Mullerian ductal anomalies, ovulation factors, and, hormonal factors such as hypothalamic-pituitary axis abnormalities; (b) secondary infertility. We identified a cohort of 114 patients who underwent multiparametric pelvic MRI on a 3 T system between July 2011 and March 2017 at our institution to rule out adenomyosis as a cause of primary infertility. Results: A total of 38 of 114 patients were diagnosed with adenomyosis, with focal adenomyosis seen in 20 patients and diffuse adenomyosis in 18 patients. Isolated adenomyosis was seen in 10 patients, whereas 28 patients had adenomyosis in combination with other pelvic pathologies. Twelve patients had isolated junctional zone thickening without any other features of adenomyosis or deep pelvic endometriosis. Conclusions: Pelvic MRI is the reference standard for the noninvasive detection of the subtle nuances of uterine adenomyosis, and, its associations including deep pelvic endometriosis in patients with infertility.
{"title":"High-resolution magnetic resonance imaging in the detection of subtle nuances of uterine adenomyosis in infertility","authors":"Meenal S. Khandeparkar, Shivsamb Jalkote, Madhavi M. Panpalia, S. Nellore, Trupti V. Mehta, K. Ganesan, F. Parikh","doi":"10.1097/GRH.0000000000000014","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000014","url":null,"abstract":"Introduction: Magnetic resonance imaging (MRI) is the current reference standard for noninvasive imaging of the pelvis. In patients with infertility potentially earmarked for in vitro fertilization/intracytoplasmic sperm injection procedures, the distinction between adenomyosis and its mimics is extremely vital. This article highlights the vital role of MRI in the detection of subtle nuances of adenomyosis in infertility and the key imaging features of its associated conditions and mimics. Materials and Methods: This is a retrospective Health Insurance Portability and Accountability Act compliant study. Inclusion criteria consisted of (a) clinically diagnosed cases of primary infertility; (b) suspicion of adenomyosis on transabdominal and transvaginal ultrasonography; (c) nonvisualization/obscuration of the junctional zone; (d) multiparametric MRI performed at 3 T. Exclusion criteria included (a) other causes of primary infertility including Mullerian ductal anomalies, ovulation factors, and, hormonal factors such as hypothalamic-pituitary axis abnormalities; (b) secondary infertility. We identified a cohort of 114 patients who underwent multiparametric pelvic MRI on a 3 T system between July 2011 and March 2017 at our institution to rule out adenomyosis as a cause of primary infertility. Results: A total of 38 of 114 patients were diagnosed with adenomyosis, with focal adenomyosis seen in 20 patients and diffuse adenomyosis in 18 patients. Isolated adenomyosis was seen in 10 patients, whereas 28 patients had adenomyosis in combination with other pelvic pathologies. Twelve patients had isolated junctional zone thickening without any other features of adenomyosis or deep pelvic endometriosis. Conclusions: Pelvic MRI is the reference standard for the noninvasive detection of the subtle nuances of uterine adenomyosis, and, its associations including deep pelvic endometriosis in patients with infertility.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46303843","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 : 2018-09-01DOI: 10.1097/GRH.0000000000000013
K. Bamgbopa, P. Okonta, R. Ajayi, Rose O Ogbeche, C. Igbokwe, K. Onwuzurigbo
The rapid expansion of assisted reproductive technologies (ART) services in Nigeria has stimulated public interest in the need to address related ethical issues and the institutionalization of regulatory guidelines to regulate the practice of ART in Nigeria in order to protect patients’ rights and safety. This study aims to document the views of various stakeholders in ART regarding salient ethical issues relating to its practice in Nigeria. The Ethics committee of the Association for Fertility and Reproductive Health in Nigeria (AFRH) organized a focus group discussion with participants drawn from different sociocultural/religious backgrounds and professional disciplines to deliberate on 16 key ethical issues in ART practice. Given the understanding that there are no rights or wrong answers when considering the ethics, the participants reached a consensus that access to ART is a fundamental reproductive right for all members of the society regardless of marital status and that choices made are dependent individual circumstances. There was a noticeable progressive shift in opinions on some issues, compared with a previous study, and a persistent negative view of others within the legal and sociocultural dictates of the Nigerian society especially on issues concerning sex selection and orientation. This study provides updated information on the societal viewpoints and perceptions which could aid the promulgation of ethical practice guidelines for ART practitioners in Nigeria.
{"title":"Public perceptions on ethics in the practice of assisted reproductive technologies in Nigeria","authors":"K. Bamgbopa, P. Okonta, R. Ajayi, Rose O Ogbeche, C. Igbokwe, K. Onwuzurigbo","doi":"10.1097/GRH.0000000000000013","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000013","url":null,"abstract":"The rapid expansion of assisted reproductive technologies (ART) services in Nigeria has stimulated public interest in the need to address related ethical issues and the institutionalization of regulatory guidelines to regulate the practice of ART in Nigeria in order to protect patients’ rights and safety. This study aims to document the views of various stakeholders in ART regarding salient ethical issues relating to its practice in Nigeria. The Ethics committee of the Association for Fertility and Reproductive Health in Nigeria (AFRH) organized a focus group discussion with participants drawn from different sociocultural/religious backgrounds and professional disciplines to deliberate on 16 key ethical issues in ART practice. Given the understanding that there are no rights or wrong answers when considering the ethics, the participants reached a consensus that access to ART is a fundamental reproductive right for all members of the society regardless of marital status and that choices made are dependent individual circumstances. There was a noticeable progressive shift in opinions on some issues, compared with a previous study, and a persistent negative view of others within the legal and sociocultural dictates of the Nigerian society especially on issues concerning sex selection and orientation. This study provides updated information on the societal viewpoints and perceptions which could aid the promulgation of ethical practice guidelines for ART practitioners in Nigeria.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47710397","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 : 2018-09-01Epub Date: 2018-08-16DOI: 10.1097/GRH.0000000000000018
Allison M Power, Tracey J Woodruff, Jeanne A Conry, Linda C Giudice
Advocacy, training, and research for the prevention of adverse health effects from environmental exposure are the major foci of the International Federation of Gynecology and Obstetrics (FIGO) Reproductive and Developmental Environmental Health (RDEH) Working Group. A critical need for a consistent global effort to address these threats to human reproductive and developmental health was identified after the publication of influential committee opinions (ACOG, Obstet Gynecol, 2013; FIGO, Int J Gynaecol Obstet, 2015) and the assembling of the FIGO 2015 Pre-Congress Workshop, "Summit on Shaping Our Planetary Legacy: Setting an Agenda for Environmental Reproductive Health." RDEH's goals are to convene experts of diverse backgrounds to generate evidence-based knowledge and propose solutions to the increasing threats of harmful environmental chemicals to global human reproduction and development by prevention of harm through education, research, and advocacy. This practicum is a guide for establishing a global task force, such as FIGO RDEH, for developing collaboration among experts across disciplines and time zones, and for building accessible and vital databases.
{"title":"Establishing the global working group on Reproductive and Developmental Environmental Health (RDEH): practicum of a global resource.","authors":"Allison M Power, Tracey J Woodruff, Jeanne A Conry, Linda C Giudice","doi":"10.1097/GRH.0000000000000018","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000018","url":null,"abstract":"<p><p>Advocacy, training, and research for the prevention of adverse health effects from environmental exposure are the major foci of the International Federation of Gynecology and Obstetrics (FIGO) Reproductive and Developmental Environmental Health (RDEH) Working Group. A critical need for a consistent global effort to address these threats to human reproductive and developmental health was identified after the publication of influential committee opinions (<i>ACOG, Obstet Gynecol</i>, 2013; FIGO, <i>Int J Gynaecol Obstet</i>, 2015) and the assembling of the FIGO 2015 Pre-Congress Workshop, \"Summit on Shaping Our Planetary Legacy: Setting an Agenda for Environmental Reproductive Health.\" RDEH's goals are to convene experts of diverse backgrounds to generate evidence-based knowledge and propose solutions to the increasing threats of harmful environmental chemicals to global human reproduction and development by prevention of harm through education, research, and advocacy. This practicum is a guide for establishing a global task force, such as FIGO RDEH, for developing collaboration among experts across disciplines and time zones, and for building accessible and vital databases.</p>","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37370416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1097/GRH.0000000000000016
Ernestine Gwet-Bell, Bea B. Gwet, Nicole Akoung, M. Fiadjoe
Cameroon is a country located in Central Africa is facing a high infertility rate and numerous big challenges in taking care of the infertile couples. The main infertility causes are tubal stenosis in women and oligoasthenospermia in men. This is the consequences of sexual infections mainly due to sexually transmitted diseases. These cases require the use of techniques such as laparoscopy and assisted reproductive technology which are costly for the population. Fertility care is facing numerous challenges. We have chosen to describe the top 5 of these challenges. They are: the high rate of infertility, the stigmatization of infertile women, poor medical staff, the virtual absence of fertility centers and the high health care cost in poor countries. We urge the country’s authorities to invest more in prevention, training, and implementing universal health insurance.
{"title":"The 5 main challenges faced in infertility care in Cameroon","authors":"Ernestine Gwet-Bell, Bea B. Gwet, Nicole Akoung, M. Fiadjoe","doi":"10.1097/GRH.0000000000000016","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000016","url":null,"abstract":"Cameroon is a country located in Central Africa is facing a high infertility rate and numerous big challenges in taking care of the infertile couples. The main infertility causes are tubal stenosis in women and oligoasthenospermia in men. This is the consequences of sexual infections mainly due to sexually transmitted diseases. These cases require the use of techniques such as laparoscopy and assisted reproductive technology which are costly for the population. Fertility care is facing numerous challenges. We have chosen to describe the top 5 of these challenges. They are: the high rate of infertility, the stigmatization of infertile women, poor medical staff, the virtual absence of fertility centers and the high health care cost in poor countries. We urge the country’s authorities to invest more in prevention, training, and implementing universal health insurance.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e16"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44896492","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 : 2018-09-01DOI: 10.1097/GRH.0000000000000017
O. Ashiru, Rose O Ogbeche, M. Oladimeji, Ebele C. Iloabachie, Akemini E. Umana, Jumoke G. Osumah
Introduction: Embryo biopsy is a prerequisite for preimplantation genetic testing (PGT). Although cleavage stage biopsy is very common, trophectoderm biopsy at blastocyst stage has become increasingly popular in recent times. This study describes the clinical success of PGT cycles for sickle cell anemia using both cleavage and trophectoderm biopsy in a developing country. Materials and Methods: All patients undergoing in vitro fertilization and PGT for sickle cell anemia from April 2011 to February 2017. Embryos were biopsied either on day 3 (blastomere) or day 5/6 (trophectoderm). Laser pulses (ZILOS-tk Laser) perforating the zona pellucida were followed by either blastomere aspiration from a day 3 cleavage stage embryo or trophectoderm biospy from a day 5/6 blastocyst. Embryos were vitrified awaiting subsequent thaw and transfer. After excluding homozygous hemoglobin SS embryos, frequencies of positive human chorionic gonadotrophin, clinical pregnancy, implantation rate and live birth rate were recorded for day 3 cleavage stage embryos (group A) and day 5/6 blastocysts (group B). Results: Of the 34 patients undergoing in vitro fertilization PGT for sickle cell anemia, embryos from 18 underwent day 3 blastomere aspiration (group A) whereas embryos from 16 underwent day 5/6 trophectoderm biopsies (group B). The mean patient age was 34.4 years for group A and 34.1 years for group B. A total of 131 embryos were biopsied in group A and 106 in group B. Percentages of unaffected embryos (ie, HB AA and AS) in groups A and B were 40.4% and 68.0%, respectively. Positive human chorionic gonadotrophin rates were 7.7% and 60%, clinical pregnancy rates 7.7% and 20%, implantation rates 3.7% and 32.1%, and live birth rates 3.7% and 20%, respectively. Conclusions: In this developing country, the use of trophectoderm biopsy for interrogating embryos at risk for sickle cell anemia appeared superior to blastomere aspiration at the cleavage stage for the purpose of PGT.
{"title":"Blastocyst and cleavage stage embryo biopsy for preimplantation genetic testing of the sickle cell gene in carrier couples: the experience of an IVF clinic in a developing country a retrospective study","authors":"O. Ashiru, Rose O Ogbeche, M. Oladimeji, Ebele C. Iloabachie, Akemini E. Umana, Jumoke G. Osumah","doi":"10.1097/GRH.0000000000000017","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000017","url":null,"abstract":"Introduction: Embryo biopsy is a prerequisite for preimplantation genetic testing (PGT). Although cleavage stage biopsy is very common, trophectoderm biopsy at blastocyst stage has become increasingly popular in recent times. This study describes the clinical success of PGT cycles for sickle cell anemia using both cleavage and trophectoderm biopsy in a developing country. Materials and Methods: All patients undergoing in vitro fertilization and PGT for sickle cell anemia from April 2011 to February 2017. Embryos were biopsied either on day 3 (blastomere) or day 5/6 (trophectoderm). Laser pulses (ZILOS-tk Laser) perforating the zona pellucida were followed by either blastomere aspiration from a day 3 cleavage stage embryo or trophectoderm biospy from a day 5/6 blastocyst. Embryos were vitrified awaiting subsequent thaw and transfer. After excluding homozygous hemoglobin SS embryos, frequencies of positive human chorionic gonadotrophin, clinical pregnancy, implantation rate and live birth rate were recorded for day 3 cleavage stage embryos (group A) and day 5/6 blastocysts (group B). Results: Of the 34 patients undergoing in vitro fertilization PGT for sickle cell anemia, embryos from 18 underwent day 3 blastomere aspiration (group A) whereas embryos from 16 underwent day 5/6 trophectoderm biopsies (group B). The mean patient age was 34.4 years for group A and 34.1 years for group B. A total of 131 embryos were biopsied in group A and 106 in group B. Percentages of unaffected embryos (ie, HB AA and AS) in groups A and B were 40.4% and 68.0%, respectively. Positive human chorionic gonadotrophin rates were 7.7% and 60%, clinical pregnancy rates 7.7% and 20%, implantation rates 3.7% and 32.1%, and live birth rates 3.7% and 20%, respectively. Conclusions: In this developing country, the use of trophectoderm biopsy for interrogating embryos at risk for sickle cell anemia appeared superior to blastomere aspiration at the cleavage stage for the purpose of PGT.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e17"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/GRH.0000000000000017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46383180","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 : 2018-09-01DOI: 10.1097/GRH.0000000000000010
Q. Katler, N. Tricarico, L. Bishop
Numerous medications are available to assist with follicular stimulation and ovulation induction in women with ovulatory dysfunction, including clomiphene citrate, aromatase inhibitors, and injectable gonadotropins. In patients that are at a higher risk for the development of ovarian hyperstimulation syndrome in an ovulation induction cycle, a gonadotropin-releasing hormone agonist trigger may be substituted for traditional hCG trigger at the expense of an increased potential for suboptimal response. When compared with serum luteinizing hormone (LH) evaluation, using a home urinary LH immunoassay for ovulation detection in gonadotropin-releasing hormone agonist agonist trigger cycles may serve multiple advantages. Accordingly, a home LH immunoassay may play a novel role as a safe, inexpensive and effective alternative to conventional phlebotomy, particularly in lower-resource settings.
{"title":"Brief report on the advantages of ovulation monitoring using home urinary LH immunoassays in ovulation induction cycles with a gonadotropin-releasing hormone agonist trigger","authors":"Q. Katler, N. Tricarico, L. Bishop","doi":"10.1097/GRH.0000000000000010","DOIUrl":"https://doi.org/10.1097/GRH.0000000000000010","url":null,"abstract":"Numerous medications are available to assist with follicular stimulation and ovulation induction in women with ovulatory dysfunction, including clomiphene citrate, aromatase inhibitors, and injectable gonadotropins. In patients that are at a higher risk for the development of ovarian hyperstimulation syndrome in an ovulation induction cycle, a gonadotropin-releasing hormone agonist trigger may be substituted for traditional hCG trigger at the expense of an increased potential for suboptimal response. When compared with serum luteinizing hormone (LH) evaluation, using a home urinary LH immunoassay for ovulation detection in gonadotropin-releasing hormone agonist agonist trigger cycles may serve multiple advantages. Accordingly, a home LH immunoassay may play a novel role as a safe, inexpensive and effective alternative to conventional phlebotomy, particularly in lower-resource settings.","PeriodicalId":92638,"journal":{"name":"Global reproductive health","volume":"3 1","pages":"e10"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43995647","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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