Talk:Assisted Reproductive Technology

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Cite this page: Hill, M.A. (2024, March 28) Embryology Assisted Reproductive Technology. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Assisted_Reproductive_Technology

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Note - This sub-heading shows an automated computer PubMed search using the listed sub-heading term. References appear in this list based upon the date of the actual page viewing. Therefore the list of references do not reflect any editorial selection of material based on content or relevance. In comparison, references listed on the content page and discussion page (under the publication year sub-headings) do include editorial selection based upon relevance and availability. (More? Pubmed Most Recent)

Assisted Reproductive Technology

<pubmed limit=5>Assisted+Reproductive+Technology</pubmed>

In Vitro Fertilization

<pubmed limit=5>In+Vitro+Fertilization</pubmed>

In Vitro Maturation

<pubmed limit=5>In+Vitro+Maturation</pubmed>

2014

Birthweight percentiles by gestational age for births following assisted reproductive technology in Australia and New Zealand, 2002-2010

Hum Reprod. 2014 Jun 7. pii: deu120. [Epub ahead of print]

Li Z1, Wang YA1, Ledger W2, Sullivan EA3.

Abstract

STUDY QUESTION: What is the standard of birthweight for gestational age for babies following assisted reproductive technology (ART) treatment? SUMMARY ANSWER: Birthweight for gestational age percentile charts were developed for singleton births following ART treatment using population-based data. WHAT IS KNOWN ALREADY: Small for gestational age (SGA) and large for gestational age (LGA) births are at increased risks of perinatal morbidity and mortality. A birthweight percentile chart allows the detection of neonates at high risk, and can help inform the need for special care if required. STUDY DESIGN, SIZE, DURATION: This population study used data from the Australian and New Zealand Assisted Reproduction Database (ANZARD) for 72 694 live born singletons following ART treatment between January 2002 and December 2010 in Australia and New Zealand. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 69 315 births (35 580 males and 33 735 females) following ART treatment were analysed for the birthweight percentile. Exact percentiles of birthweight in grams were calculated for each gestational week between Week 25 and 42 for fresh and thaw cycles by infant sex. Univariate analysis was used to determine the exact birthweight percentile values. Student t-test was used to examine the mean birthweight difference between male and female infants, between single embryo transfer (SET) and double embryo transfer (DET) and between fresh and thaw cycles. MAIN RESULTS AND THE ROLE OF CHANCE: Preterm births (birth before 37 completed weeks of gestation) and low birthweight (<2500 g) were reported for 9.7 and 7.0% of live born singletons following ART treatment. The mean birthweight was 3280 g for live born singletons following fresh cycles (3338 g for male infants and 3217 for female infants) and 3413 g for live born singletons following thaw cycles (3475 g for male infants and 3349 for female infants). The proportion of SGA for male ART births following thaw cycles at 35-41 weeks gestation was significantly lower than for the Australian general population, ranging from 3.8% (95% confidence interval (CI): 1.3%, 6.2%) at 35 weeks gestation to 7.9% (95% CI: 6.3%, 9.5%) at 41 weeks gestation. The proportion of LGA for male ART births following thaw cycles was significantly higher than for the Australian general population between 33 weeks (17.1%, 95% CI: 8.9%, 25.2%) and 41 weeks (14.4%, 95% CI: 12.3%, 16.5%). A similar trend was shown for female infants following thaw cycles. The live born singletons following SET were, on average, 45 g heavier than live born singletons following DET (P< 0.001). Overall, SGA was reported for 8.9% (95% CI: 8.6%, 9.1%) of live born singletons following SET and for 9.9% (95% CI: 9.5%, 10.3%) of live born singletons following DET. LIMITATIONS, REASONS FOR CAUTION: Birthweight percentile charts do not represent fetal growth standards but only the weight of live born infants at birth. WIDER IMPLICATIONS OF THE FINDINGS: The comparison of birthweight percentile charts for ART births and general population births provide evidence that the proportion of SGA births following ART treatment was comparable to the general population for SET fresh cycles and significantly lower for thaw cycles. Both fresh and thaw cycles showed better outcomes for singleton births following SET compared with DET. Policies to promote single embryo transfer should be considered in order to minimize the adverse perinatal outcomes associated with ART treatment. STUDY FUNDING/COMPETING INTERESTS: No specific funding was obtained. The authors have no conflicts of interest to declare. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com. KEYWORDS: assisted reproductive technology; birthweight; gestational age; single embryo transfer; small for gestational age

PMID 24908671

Congenital anomalies identified at birth among infants born following assisted reproductive technology in Colorado

Birth Defects Res A Clin Mol Teratol. 2014 Feb 14. doi: 10.1002/bdra.23222. [Epub ahead of print]

Moses XJ, Torres T, Rasmussen A, George C. Author information

Abstract

BACKGROUND: Assisted reproductive technology (ART) has assisted many infertile couples in conceiving. Despite increasing use in the United States, the association between ART and congenital anomalies remains a highly contested subject. We conducted a study to examine the risk of congenital anomalies among infants conceived using ART. METHODS: A retrospective cohort study of 344,567 infants born in Colorado from 2007 to 2011 was conducted using data obtained from the Colorado Birth Certificate Database. The incidence of congenital anomalies identified at birth following conception with ART was assessed and compared with all naturally conceived infants born during the same time period. The odds ratio was calculated using multiple logistic regression after adjusting for multiple confounders. RESULTS: Of 2071 infants, 23 (1.11%) conceived using ART had a congenital anomaly identified at birth compared with 3826 (1.12%) of 342,496 infants conceived naturally. The adjusted odds ratio of a congenital anomaly among infants born following conception with ART was 1.01 (95% confidence interval, 0.67-1.52). The proportion of infants born following usage of ART in Colorado has not changed significantly (p = 0.20) from 2007 to 2011 with an overall proportion of 0.60% (range 0.52-0.64%), while the incidence of congenital anomalies has decreased significantly (p = 0.002) during the study years with an average of 1.12% (range, 0.92-1.25%). CONCLUSION: This study suggests that conception by means of ART is not associated with an increased risk of congenital abnormalities identified by birth certificate data in Colorado when compared with births following natural conception. Birth Defects Research (Part A), 2014. © 2014 Wiley Periodicals, Inc. Copyright © 2014 Wiley Periodicals, Inc. KEYWORDS: Colorado, assisted reproductive technology, birth defects, congenital anomalies, in vitro fertilization, incidence, malformations, prevalence

PMID 24532453

2013

Ongoing Pregnancy Rates in Women with Low and Extremely Low AMH Levels. A Multivariate Analysis of 769 Cycles

Kedem A, Haas J, Geva LL, Yerushalmi G, Gilboa Y, et al. (2013) Ongoing Pregnancy Rates in Women with Low and Extremely Low AMH Levels. A Multivariate Analysis of 769 Cycles. PLoS ONE 8(12): e81629. doi:10.1371/journal.pone.0081629

Patients with extremely low AMH measurements have reasonable and similar pregnancy rates as patients with low AMH. Therefore, AMH should not be used as the criterion to exclude couples from performing additional IVF treatments.


http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0081629

Comparison of the clinical outcomes of day 4 and 5 embryo transfer cycles

Clin Exp Reprod Med. 2013 Sep;40(3):122-5. doi: 10.5653/cerm.2013.40.3.122. Epub 2013 Sep 30.

Lee SH, Lee HS, Lim CK, Park YS, Yang KM, Park DW. Source Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.

Abstract

OBJECTIVE: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. METHODS: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. RESULTS: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). CONCLUSION: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration. KEYWORDS: Blastocyst, Embryo culture, Embryo selection, Embryo transfer, Embryo-uterine synchrony, Embryonic grading, Pregnancy outcome

PMID 24179869

Biomarkers of ovarian response: current and future applications

Fertil Steril. 2013 Mar 15;99(4):963-9. doi: 10.1016/j.fertnstert.2012.11.051. Epub 2013 Jan 8.

Nelson SM. Author information

Abstract With our increasing appreciation that simply maximizing oocyte yield for all patients is no longer an appropriate stimulation strategy and that age alone cannot accurately predict ovarian response, there has been an explosion in the literature regarding the utility of biomarkers to predict and individualize treatment strategies. Antral follicle count (AFC) and antimüllerian hormone (AMH) have begun to dominate the clinical scene, and although frequently pitted against each other as alternatives, both may contribute and indeed be synergistic. Their underlying technologies are continuing to develop rapidly and overcome the standardization issues that have limited their development to date. In the context of in vitro fertilization (IVF), their linear relationship with oocyte yield and thereby extremes of ovarian response has led to improved pretreatment patient counseling, individualization of stimulation strategies, increased cost effectiveness, and enhanced safety. This review highlights that although biomarkers of ovarian response started in the IVF clinic, their future extends well beyond the boundaries of assisted reproduction. The automation of AMH and its introduction into the routine repertoire of clinical biochemistry has tremendous potential. A future where primary care physicians, endocrinologists, and oncologists can rapidly assess ovarian dysfunction and the ovarian reserve more accurately than with the current standard of follicle-stimulating hormone (FSH) is an exciting possibility. For women, the ability to know the duration of their own reproductive life span will be empowering and allow them to redefine the meaning of family planning. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

PMID 23312225

Cumulus and granulosa cell markers of oocyte and embryo quality

Fertil Steril. 2013 Mar 15;99(4):979-97. doi: 10.1016/j.fertnstert.2013.01.129.

Uyar A, Torrealday S, Seli E. Source Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut. Abstract Lack of an objective, accurate, and noninvasive embryo assessment strategy remains one of the major challenges encountered in in vitro fertilization. Cumulus and mural granulosa cells reflect the characteristics of the oocyte, providing a noninvasive means to assess oocyte quality. Specifically, transcriptomic profiling of follicular cells may help identify biomarkers of oocyte and embryo competence. Current transcriptomics technologies include quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) for analysis of individual genes and microarrays and high-throughput deep sequencing for whole genome expression profiling. Recently, using qRT-PCR and microarray technologies, a multitude of studies correlated changes in cumulus or granulosa cell gene expression with clinically relevant outcome parameters, including in vitro embryo development and pregnancy. While the initial findings are promising, a clinical benefit from the use of identified biomarker genes remains to be demonstrated in randomized controlled trials. Copyright © 2013 American Society for Reproductive Medicine. All rights reserved.

PMID 23498999

The predictive value of anti-mullerian hormone on embryo quality, blastocyst development, and pregnancy rate following in vitro fertilization-embryo transfer (IVF-ET)

J Assist Reprod Genet. 2013 Mar 17. [Epub ahead of print]

Lin WQ, Yao LN, Zhang DX, Zhang W, Yang XJ, Yu R. Source Reproductive Medcine Center, the First Affiliated Hospital of Zhejiang University, School of Medicine, Qingchun Road 79, Hangzhou, 310003, China, wzlwq70@126.com. Abstract PURPOSE: The objective of this study was to investigate the predictive value of anti-Mullerian hormone (AMH) on fertilization rate (FR), blastocyst development, embryo quality, the outcome of the pregnancy and the live birth rate (LBR) following in vitro fertilization-embryo transfer (IVF-ET)/intracytoplasmic sperm injection (ICSI). METHOD: In this prospective study outcomes were followed in 83 women undergoing cycles of IVF/ICSI within a university hospital. Basal serum AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH) and antral follicle count (AFC) were measured on Day 3. Serum AMH (Gn6 AMH ) level was measured on Day 6 after the administration of gonadotrophin (Gn). AMH was measured in follicle fluid (FF AMH) on the day of ovum pick-up (dOPU). The numbers of retrieved and fertilized oocytes, good quality embryos and blastocysts were counted. Secondary outcome variables included clinical pregnancy rate (CPR) and LBR. RESULTS: Spearman correlation analysis indicated that the numbers of oocytes, good quality embryos and blastocysts were associated with AMH (P < 0.05) and that LBR was correlated with FF AMH (r = 0.495, P < 0.05). No associations were found between FR and AMH (P > 0.05). Receiver operating characteristic analysis showed that the sensitivity of FF AMH at predicting CPR was 91.2 %; the specificity was 86.5 % and ROCAUC was 0.893 (P < 0.0001). CONCLUSION: AMH parameters were correlated with good quality embryos and blastocysts, but only FF AMH showed a significant correlation with LBR and CPR.

PMID 23504440

2012

Singleton preterm birth: risk factors and association with assisted reproductive technology

Matern Child Health J. 2012 May;16(4):807-13. doi: 10.1007/s10995-011-0787-8.

Tepper NK, Farr SL, Cohen BB, Nannini A, Zhang Z, Anderson JE, Jamieson DJ, Macaluso M. Source National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ntepper@cdc.gov

Abstract

The objectives of this study were to determine risk factors for early (less than 34 weeks gestation) and late (34-36 weeks gestation) preterm singleton birth, by assisted reproductive technology (ART) status. We linked data from Massachusetts birth records and ART records representing singleton live births from 1997 through 2004. Using multinomial regression models, we assessed risk factors for early and late preterm birth by ART status. From 1997 to 2004 in Massachusetts, among non-ART births, risk factors for early and late preterm birth were similar and included women <15 and ≥ 35 years of age, those of non-white race or Hispanic ethnicity, those with ≤ 12 years of education, those with chronic diabetes, those with gestational diabetes, those with gestational hypertension, those who smoked during pregnancy, those who used fertility medications, and those who had not had a previous live birth. Among ART births, risk factors for early and late preterm birth differed and odds of early preterm birth were increased among women with ≤ 12 years of education while odds of late preterm birth were increased among women with gestational diabetes. Odds of both early and late preterm birth were increased among women of non-white race or Hispanic ethnicity and among women with gestational hypertension. Among non-ART births, increased risk for preterm birth was more strongly related to socioeconomic factors than among ART births. Medical conditions were associated with an increased risk for preterm birth regardless of women's ART status. Efforts to prevent preterm births should focus on reducing modifiable risk factors.

PMID 21516300


Preliminary results of the first human uterus transplantation from a multiorgan donor

Fertil Steril. 2012 Oct 18. pii: S0015-0282(12)02254-6. doi: 10.1016/j.fertnstert.2012.09.035.

Ozkan O, Erman Akar M, Ozkan O, Erdogan O, Hadimioglu N, Yilmaz M, Gunseren F, Cincik M, Pestereli E, Kocak H, Mutlu D, Dinckan A, Gecici O, Bektas G, Suleymanlar G. Source Department of Plastic Surgery, Akdeniz University, Antalya, Turkey.

Abstract

OBJECTIVE: To describe the first-year results of the first human uterus transplantation case from a multiorgan donor. DESIGN: Case study. SETTING: University hospital. PATIENT(S): A 21-year-old woman with complete müllerian agenesis who had been previously operated on for vaginal reconstruction. INTERVENTION(S): Uterus transplantation procedure consisting of orthotopic replacement and fixation of the retrieved uterus, revascularization, end to site anastomoses of bilateral hypogastric arteries and veins to bilateral external iliac arteries and veins was performed. MAIN OUTCOME MEASURE(S): Resumption of menstrual cycles. RESULT(S): The patient had menarche 20 days after transplant surgery. She has had 12 menstrual cycles since the operation. CONCLUSION(S): We have described the longest-lived transplanted human uterus to date with acquirement of menstrual cycles. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

PMID 23084266

DONATION OF 'SPARE' FRESH OR FROZEN EMBRYOS TO RESEARCH: WHO DECIDES THAT AN EMBRYO IS 'SPARE' AND HOW CAN WE ENHANCE THE QUALITY AND PROTECT THE VALIDITY OF CONSENT?

Med Law Rev. 2012 May 30. [Epub ahead of print]

Scott R, Williams C, Ehrich K, Farsides B. Source 1 Centre of Medical Law and Ethics and School of Law, King's College London.

Abstract

This paper analyses elements of the legal process of consent to the donation of 'spare' embryos to research, including stem-cell research, and makes a recommendation intended to enhance the quality of that process, including on occasion by guarding against the invalidity of such consent. This is important in its own right and also so as to maximise the reproductive treatment options of couples engaged in in vitro fertilisation (IVF) treatment and to avoid possible harms to them. In Part 1, with reference to qualitative data from three UK IVF clinics, we explore the often delicate and contingent nature of what comes to be, for legal purposes, a 'spare' embryo. The way in which an embryo becomes 'spare', with its implications for the process of consent to donation to research, is not addressed in the relevant reports relating to or codes of practice governing the donation of embryos to research, which assume an unproblematic notion of the 'spare' embryo. Significantly, our analysis demonstrates that there is an important and previously unrecognised first stage in the donation of a 'spare' embryo to research, namely: consent to an embryo being 'spare' and so, at the same time, to its disuse in treatment. This is not explicitly covered by the Human Fertilisation and Embryology (HFE) Act 1990, as amended by the HFE Act 2008. Having identified this important initial stage in the process of consent to the donation of a 'spare' embryo to research in conclusion to Part 1, in Part 2 we analyse the idea of consent to an embryo's disuse in treatment on the basis that it is 'spare' with reference to the legal elements of consent, namely information as to nature and purpose, capacity, and voluntariness. We argue that there are in fact three related consent processes in play, of which the principal one concerns consent to an embryo's disuse in treatment. If the quality of this first consent is compromised, in turn this will impact on the quality of the consent to the donation of that 'spare' embryo to research, followed by the quality of consent to future cycles of assisted reproduction treatment in the event that these are needed as a result of a donation decision. The analysis overall is of central relevance to the debate as to whether, and if so when, it should be permissible to request the donation of fresh embryos for research, as opposed to those that have been frozen and, for instance, have reached the end of their statutory storage term. This has a particular bearing on the donation of embryos to stem-cell research since there is a debate as to whether fresh embryos are most useful for this.

PMID 22647978

A novel isolator-based system promotes viability of human embryos during laboratory processing

PLoS One. 2012;7(2):e31010. Epub 2012 Feb 29.

Hyslop L, Prathalingam N, Nowak L, Fenwick J, Harbottle S, Byerley S, Rhodes J, Watson B, Henderson R, Murdoch A, Herbert M. Source Newcastle Fertility Centre, Newcastle upon Tyne, England, United Kingdom.

Abstract

In vitro fertilisation (IVF) and related technologies are arguably the most challenging of all cell culture applications. The starting material is a single cell from which one aims to produce an embryo capable of establishing a pregnancy eventually leading to a live birth. Laboratory processing during IVF treatment requires open manipulations of gametes and embryos, which typically involves exposure to ambient conditions. To reduce the risk of cellular stress, we have developed a totally enclosed system of interlinked isolator-based workstations designed to maintain oocytes and embryos in a physiological environment throughout the IVF process. Comparison of clinical and laboratory data before and after the introduction of the new system revealed that significantly more embryos developed to the blastocyst stage in the enclosed isolator-based system compared with conventional open-fronted laminar flow hoods. Moreover, blastocysts produced in the isolator-based system contained significantly more cells and their development was accelerated. Consistent with this, the introduction of the enclosed system was accompanied by a significant increase in the clinical pregnancy rate and in the proportion of embryos implanting following transfer to the uterus. The data indicate that protection from ambient conditions promotes improved development of human embryos. Importantly, we found that it was entirely feasible to conduct all IVF-related procedures in the isolator-based workstations.

PMID 22393356


Live birth after ovarian tissue autotransplantation following overnight transportation before cryopreservation

Fertil Steril. 2012 Feb;97(2):387-90. Epub 2011 Dec 16.

Dittrich R, Lotz L, Keck G, Hoffmann I, Mueller A, Beckmann MW, van der Ven H, Montag M. Source Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany. ralf.dittrich@uk-erlangen.de

Abstract

OBJECTIVE: To describe the first live birth after transplantation of ovarian tissue following overnight transportation of the tissue before freezing. DESIGN: Technical note. SETTING: University department of obstetrics and gynecology. PATIENT(S): A 25-year-old cancer survivor with previous Hodgkin disease and relapse. INTERVENTION(S): The ovarian tissue was kept cool for >20 hours in a special transport medium and a special cooling device before it was cryopreserved. After premature ovarian failure due to preconditioning chemotherapy for bone marrow transplantation, the cryopreserved ovarian tissue was transplanted orthotopically. MAIN OUTCOME MEASURE(S): Resumption of ovarian function after transplantation, recovery of fertility, and pregnancy. RESULT(S): Ovarian function returned in the patient 3 months after transplantation, as shown by follicle development and estrogen production. During the fifth menstrual cycle, mild stimulation with FSH was initiated in accordance with a low-dose protocol. When ultrasonography revealed a follicle 18-20 mm in size in the ovarian graft, hCG was added and the patient had sexual intercourse at the optimal time point. On day 14 of the luteal phase, hCG concentration and vaginal echography confirmed a viable intrauterine pregnancy, which resulted in a healthy live birth. CONCLUSION(S): Overnight transportation of ovarian tissue appears to be possible in combination with appropriate transportation logistics. However, further investigations are needed before this procedure can be offered as a chance for women to preserve fertility independently of direct access to a tissue-processing bank. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

PMID 22177311

The role of melatonin as an antioxidant in the follicle

J Ovarian Res. 2012 Jan 26;5:5.

Tamura H, Takasaki A, Taketani T, Tanabe M, Kizuka F, Lee L, Tamura I, Maekawa R, Aasada H, Yamagata Y, Sugino N. Source Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505 Japan. hitamura@yamaguchi-u.ac.jp.

Abstract

ABSTRACT: Melatonin (N-acetyl-5-methoxytryptamine) is secreted during the dark hours at night by pineal gland, and it regulates a variety of important central and peripheral actions related to circadian rhythms and reproduction. It has been believed that melatonin regulates ovarian function by the regulation of gonadotropin release in the hypothalamus-pituitary gland axis via its specific receptors. In addition to the receptor mediated action, the discovery of melatonin as a direct free radical scavenger has greatly broadened the understanding of melatonin's mechanisms which benefit reproductive physiology. Higher concentrations of melatonin have been found in human preovulatory follicular fluid compared to serum, and there is growing evidence of the direct effects of melatonin on ovarian function especially oocyte maturation and embryo development. Many scientists have focused on the direct role of melatonin on oocyte maturation and embryo development as an anti-oxidant to reduce oxidative stress induced by reactive oxygen species, which are produced during ovulation process. The beneficial effects of melatonin administration on oocyte maturation and embryo development have been confirmed by in vitro and in vivo experiments in animals. This review also discusses the first application of melatonin to the clinical treatment of infertile women and confirms that melatonin administration reduces intrafollicular oxidative damage and increase fertilization rates. This review summarizes our recent works and new findings related to the reported beneficial effects of melatonin on reproductive physiology in its role as a reducer of oxidative stress, especially on oocyte maturation and embryo development.

PMID 22277103 [PubMed - in process] PMCID: PMC3296634

Retransplantation of cryopreserved ovarian tissue: the first live birth in Germany

Dtsch Arztebl Int. 2012 Jan;109(1-2):8-13. Epub 2012 Jan 9.

Müller A, Keller K, Wacker J, Dittrich R, Keck G, Montag M, Van der Ven H, Wachter D, Beckmann MW, Distler W. Source Frauenklinik, Universitätsklinikum Erlangen.

Abstract

BACKGROUND: Cryopreserved ovarian tissue can be retransplanted to restore fertility after radiation or chemotherapy. To date, 15 live births after retransplantation have been reported worldwide. We report the first pregnancy and the first live birth after retransplantation in Germany. CASE REPORT: A 25-year-old female patient received initial chemotherapy and radiation of the mediastinum for Hodgkin's lymphoma in 2003 and suffered a relapse two years later. Ovarian tissue was laparoscopically removed and cryopreserved, and she was then treated with high-dose chemotherapy and stem cell transplantation. She remained in remission for 5 years and she could not conceive during this time. The cryopreserved ovarian tissue was thawed and laparoscopically retransplanted into a peritoneal pouch in the ovarian fossa of the right pelvic wall. Three months later, her menopausal symptoms resolved, and she had her first spontaneous menstruation. Six months after retransplantation, after two normal menstrual cycles, low-dose follicle stimulating hormone (FSH) treatment induced the appearance of a dominant follicle in the tissue graft. Ovulation was then induced with human chorionic gonadotropin (HCG), whereupon the patient conceived naturally. After an uncomplicated pregnancy, she bore a healthy child by Caesarean section on 10 October 2011. Histological examination of biopsy specimens revealed that the ovarian tissue of the graft contained follicles in various stages of development, while the original ovaries contained only structures without any reproductive potential. CONCLUSION: This was the first live birth after retransplantation of cryopreserved ovarian tissue in Germany and also the first case with histological confirmation that the oocyte from which the patient conceived could only have come from the retransplanted tissue. In general, young women who will be undergoing chemotherapy and/or radiotherapy for cancer must be informed and counseled about the available options for fertility preservation.

PMID 22282711

Assisted reproductive technology in Europe, 2007: results generated from European registers by ESHRE

Hum Reprod. 2012 Apr;27(4):954-966. Epub 2012 Feb 17.

de Mouzon J, Goossens V, Bhattacharya S, Castilla JA, Ferraretti AP, Korsak V, Kupka M, Nygren KG, Andersen AN; The European IVF-Monitoring (EIM); Consortium for the European Society on Human Reproduction and Embryology (ESHRE). Source ESHRE Central Office, Meerstraat 60, B-1852 Grimbergen, Belgium.

Abstract

BACKGROUND This 11th European IVF-monitoring report presents the results of assisted reproductive technology (ART) treatments initiated in Europe during 2007. METHODS From 33 countries, 1029 clinics reported 493 184 treatment cycles: IVF (120 761), ICSI (256 642), frozen embryo replacement (91 145), egg donation (15 731), preimplantation genetic diagnosis/preimplantation genetic screening (4638), in vitro maturation (660) and frozen oocytes replacements (3607). Overall, this represents a 7.6% increase since 2006, mostly related to an increase in all registers. IUI using husband/partner's (IUI-H) and donor (IUI-D) semen was reported from 23 countries: 142 609 IUI-H (+6.2%) and 26 088 IUI-D (+7.2%). RESULTS In 18 countries where all clinics reported, 376 971 ART cycles were performed in a population of 425.6million (886 cycles per million). The clinical pregnancy rates per aspiration and per transfer were 29.1 and 32.8% for IVF, and 28.6 and 33.0% for ICSI. Delivery rate after IUI-H was 10.2% in women aged < 40 years. In IVF/ICSI cycles, 1, 2, 3 and ≥4 embryos were transferred in 21.4, 53.4, 22.7 and 2.5% of cycles, with no decline in the number of embryos per transfer since 2006. The proportion of multiple deliveries (22.3: 21.3% twin and 1.0% triplet), did not decrease compared with 2006 (20.8%) and 2005 (21.8%). In women < 40 years undergoing IUI-H, twin deliveries occurred in 11.7% and triplets in 0.5%. CONCLUSIONS In comparison with previous years, the reported number of ART cycles in Europe increased in 2007; pregnancy rates increased marginally, but the earlier decline in the number of embryos transferred and multiple births did not continue.

PMID 22343707

Results after ART in 2007

Country Cycles IVF + ICSI IVF ICSI FER ART infantsa ART infants per national births (%)
Aspirations Pregnancies per aspiration (%) Deliveries per aspiration (%) Aspirations Pregnancies per aspiration (%) Deliveries per aspiration (%) Thawings FER Pregnancies per thawing (%) Deliveries per thawing (%)
Albania 145 65 40.0 33.8 78 37.2 29.5 64
Austria 5222 306 30.7
Belgium 3852 29.8 22.4 12 357 28.4 20.6 7499 15.3 11.3 4925 4.1
Bosnia 162 28 32.1 14.3 114 19.3 12.3 19
Bulgaria 1282 532 33.8 25.6 675 31.6 25.8 79 15.2 8.9 378
Cyprus 1305 457 39.2 792 40.2 0.0 155 23.9
Czech Republic 4169 23.5 15.9
Denmark 11 035 5819 26.1 21.3 4952 26.0 21.3 2668 16.5 13.5 3156 4.9
Finland 4724 2830 27.3 20.6 1759 27.9 22.4 3475 21.2 16.0 1875 3.2
France 20 211 24.6 19.2 31 635 25.9 20.5 14 710 1.8
Germany 45 182 10 995 29.4 16.0 32 124 28.2 16.1 17 140 18.3 9.9 10 483 1.5
Greece 2189 780 36.8 26.5 1295 32.8 24.2 193 22.8 14.0 764
Hungary 2437 544 27.4 21.5 1787 28.2 22.8 620 23.1 13.2 776
Iceland 215 25.1 21.9 174 28.2 23.0 168 3.7
Ireland 2864 1466 33.9 27.4 974 29.0 26.3 692 22.4 15.5 958
Italy 40 005 7570 22.0 15.2 28 075 22.0 14.3 709 14.7 8.3 6575 1.2
Latvia 179 104 42.3 75 29.3 113 7.1 20
Lithuania
Macedonia 979 491 30.3 24.2 461 29.1 21.0 29 31.0 20.7 287 1.2
Montenegro 278 24 20.8 20.8 246 22.8 20.3 66 0.8
Norway 5599 2685 30.2 26.1 2703 27.3 23.2 2250 19.7 16.0 1509
Poland 4876 220 33.2 28.2 4547 35.4 29.0 2238 20.9 16.0 2164
Portugal 4496 1329 30.6 23.7 2692 27.9 20.4 524 16.4 11.8 1186 1.2
Russia 21 837 12 171 35.2 24.1 9002 33.1 20.4 3084 23.9 14.9 7197
Serbia 1120 648 24.5 17.3 426 34.5 29.8 277
Slovenia 2882 844 33.9 25.7 1932 28.5 23.7 521 18.8 14.2 913 4.6
Spain 34 499 3041 34.6 27 905 33.6 9089 23.1 12 647
Sweden 10 191 5011 32.0 24.7 4500 28.4 22.4 4500 23.2 17.2 3260 3.1
Switzerland 4503 886 28.1 20.9 3235 27.4 20.1 3312 18.7 12.6 1467
The Netherlands 16 163 8399 27.6 20.5 6659 31.8 25.1 4616 2.5
Turkey 785 34 601 5262 0.5
Ukraine 3946 1790 40.3 29.8 2028 37.4 30.9 579 29.2 22.8 1812
United Kingdom 35 922 15944 30.1 26.4 17 615 31.1 27.5 8549 20.9 18.1 13 838 1.8
Allb 264 022 108 390 29.1 21.1 199 950 28.6 20.2 72493 20.1 13.5 96 690 1.5


Number of embryos transferred and deliveries after ART in 2007

Country In vitro Fertilisation + Intracytoplasmic Sperm Injection Frozen Embryo Replacement
Transfers 1 embryo (%) 2 embryos (%) 3 embryos (% ) 4 + embryos (%) Deliveries Twin (%) Triplet (%) Deliveries Twin (%) Triplet (%)
Albania 131 25.2 29.0 44.3 1.5 45 17.8 2.2
Austria 4912 20.3 68.7 9.8 1.2
Belgium 14 876 50.2 39.6 8.4 1.7 3386 11.8 0.3 845 13.1 0.1
Bosnia 123 49.6 13.8 25.2 11.4 18 5.6 0.0
Bulgaria 1126 8.3 35.6 44.2 11.9 310 14.8 1.6 7 14.3 0.0
Cyprus
Czech Republic 2711 662
Denmark 9226 39.6 55.7 4.5 0.1 2298 16.6 0.1 361 14.1 0.0
Finland 4131 57.8 41.9 0.3 0.0 977 11.3 0.2 560 9.6 0.2
France 44 453 23.2 62.3 13.2 1.3 10 359 18.9 0.4 1913 11.3 0.2
Germany 41 615 12.5 66.9 20.6 0.0 6950 21.2 0.6 1702 15.1 0.6
Greece 1852 11.9 19.3 58.6 10.3 521 25.7 0.8 27 3.7 0.0
Hungary 2146 10.1 45.3 35.7 8.9 524 22.5 2.1 82 18.3 0.0
Iceland 322 46.6 46.0 7.5 0.0 87 17.2 0.0 50 12.0 0.0
Ireland 2221 13.6 77.4 9.0 0.0 658 24.3 0.9 107 17.8 0.0
Italy 30 780 20.4 30.5 49.1 0.0 5158 20.6 2.8 59 6.8 1.7
Latvia 173 15.0 53.8 31.2 0.0
Lithuania
Macedonia 750 23.9 26.9 30.9 18.3 216 26.4 1.4 6 33.3 0.0
Montenegro 258 14.3 32.2 41.1 12.4 55 16.4 1.8
Norway 4821 1324 13.4 0.3 361
Poland 4338 16.6 67.9 15.1 0.4 1382 20.3 0.6 359 12.8 0.0
Portugal 3585 17.4 69.2 13.3 0.2 863 21.6 0.9 62 17.7 0.0
Russia 19 510 16.2 59.6 19.8 4.4 4526 26.0 1.5 460 17.2 1.7
Serbia 911 13.3 77.1 6.9 2.7 239 8.8 3.3
Slovenia 2462 27.6 69.7 2.6 0.0 674 23.0 0.0 74 6.8 0.0
Spain 27 155 5990 27.1 0.7 1092 17.3 0.4
Sweden 8529 69.9 30.1 0.0 0.0 2246 4.6 0.1 776 6.7 0.1
Switzerland 3731 12.8 65.3 21.9 0.0 830 18.9 0.5 417 12.0 0.7
The Netherlands 13 375 3396 15.1 0.1 629 11.0 0.0
Turkey 31 808 11.5 24.1 52.8 11.7 3727 32.9 4.1
Ukraine 3510 11.3 44.2 33.1 11.4 1160 25.0 1.6 132 22.7 0.0
United Kingdom 31 114 12.8 82.3 4.9 0.0 9094 24.1 0.3 1548 17.6 0.3
All* 263 681 21.4 53.4 22.7 2.5 63617 21.3 1.0 11212 13.1 0.3

2011

Sperm storage for cancer patients in the UK: a review of current practice

Hum Reprod. 2011 Nov;26(11):2935-43. Epub 2011 Aug 26.

Sharma V. Source The Leeds Centre for Reproductive Medicine, Seacroft Hospital, Leeds LS146UH, UK. vinay.sharma@leedsth.nhs.uk Abstract An increasing number of cancer patients can now hope to have a full and normal life due to significant improvements in treatment outcomes and survival rates. The application of cryobiology to store fertile gametes before sterilizing treatments has been a natural progression. Greater awareness has markedly increased the worldwide demand for long-term storage of sperm, and has prompted the UK Human Fertilization and Embryology Authority to extend the period of storage permitted by their regulations to 55 years. Other patients undergoing sterilizing chemotherapy and/or radiotherapy such as haemoglobinopathies requiring bone marrow transplantation and autoimmune disorders such as rheumatoid arthritis may further increase the indications for sperm storage. Most adult and adolescent patients and their relatives/spouses/parents/guardians value this service even though very few eventually use the sperm. There is an urgent need to develop national and international guidelines for the provision, organization, maintenance and management of the cryopreservation services.

PMID 21873609

Bivariate analysis of basal serum anti-Müllerian hormone measurements and human blastocyst development after IVF

Reprod Biol Endocrinol. 2011 Dec 2;9:153.

Sills ES, Collins GS, Brady AC, Walsh DJ, Marron KD, Peck AC, Walsh AP, Salem RD. Source Division of Reproductive Endocrinology, Pacific Reproductive Center, Irvine, California, USA. dr.sills@prc-ivf.com

Abstract

BACKGROUND: To report on relationships among baseline serum anti-Müllerian hormone (AMH) measurements, blastocyst development and other selected embryology parameters observed in non-donor oocyte IVF cycles. METHODS: Pre-treatment AMH was measured in patients undergoing IVF (n = 79) and retrospectively correlated to in vitro embryo development noted during culture. RESULTS: Mean (+/- SD) age for study patients in this study group was 36.3 ± 4.0 (range = 28-45) yrs, and mean (+/- SD) terminal serum estradiol during IVF was 5929 +/- 4056 pmol/l. A moderate positive correlation (0.49; 95% CI 0.31 to 0.65) was noted between basal serum AMH and number of MII oocytes retrieved. Similarly, a moderate positive correlation (0.44) was observed between serum AMH and number of early cleavage-stage embryos (95% CI 0.24 to 0.61), suggesting a relationship between serum AMH and embryo development in IVF. Of note, serum AMH levels at baseline were significantly different for patients who did and did not undergo blastocyst transfer (15.6 vs. 10.9 pmol/l; p = 0.029). CONCLUSIONS: While serum AMH has found increasing application as a predictor of ovarian reserve for patients prior to IVF, its roles to estimate in vitro embryo morphology and potential to advance to blastocyst stage have not been extensively investigated. These data suggest that baseline serum AMH determinations can help forecast blastocyst developmental during IVF. Serum AMH measured before treatment may assist patients, clinicians and embryologists as scheduling of embryo transfer is outlined. Additional studies are needed to confirm these correlations and to better define the role of baseline serum AMH level in the prediction of blastocyst formation. PMID 22136508

Historic

In vitro fertilization and cleavage of human ovarian eggs

Am J Obstet Gynecol. 1948 Mar;55(3):440-52.

MENKIN MF, ROCK J.

  • Miriam Menken and John Rock retrieved more than 800 oocytes from women during operations for various conditions.
  • One hundred and thirty-eight of these oocytes were exposed to spermatozoa in vitro.

PMID 18903892


IN VITRO FERTILIZATION AND CLEAVAGE OF HUMAN OVARIAN EGGS

Science. 1944 Aug 4;100(2588):105-7.

Rock J, Menkin MF.


PMID 17788930 http://www.sciencemag.org/content/100/2588/105.long

USA

Assisted Reproductive Technology Surveillance - United States, 2006

Assisted Reproductive Technology Surveillance - United States, 2006

Assisted reproductive technology surveillance--United States, 2006. Sunderam S, Chang J, Flowers L, Kulkarni A, Sentelle G, Jeng G, Macaluso M; Centers for Disease Control and Prevention (CDC). MMWR Surveill Summ. 2009 Jun 12;58(5):1-25. PMID: 19521336 [PubMed - indexed for MEDLINE]Free Article Related citations


Assisted reproductive technology surveillance--United States, 2005. Wright VC, Chang J, Jeng G, Macaluso M; Centers for Disease Control and Prevention (CDC). MMWR Surveill Summ. 2008 Jun 20;57(5):1-23. Erratum in: MMWR Surveill Summ. 2009 Mar 6;58(8):203-4. MMWR Surveill Summ. 2008 Oct 10;57(40):1105. PMID: 18566567 [PubMed - indexed for MEDLINE]Free Article Related citations


Assisted reproductive technology surveillance - United States, 2004. Wright VC, Chang J, Jeng G, Chen M, Macaluso M; Centers for Disease Control and Prevention. MMWR Surveill Summ. 2007 Jun 8;56(6):1-22. Erratum in: MMWR Morb Mortal Wkly Rep. 2007 Jul 6;56(26):658. PMID: 17557073 [PubMed - indexed for MEDLINE]Free Article Related citations


Assisted reproductive technology surveillance--United States, 2000. Wright VC, Schieve LA, Reynolds MA, Jeng G. MMWR Surveill Summ. 2003 Aug 29;52(9):1-16. Erratum in: MMWR 2003 Oct 3; 52(39):942. PMID: 14532867 [PubMed - indexed for MEDLINE]Free Article Related citations


Assisted reproductive technology surveillance--United States, 2003. Wright VC, Chang J, Jeng G, Macaluso M. MMWR Surveill Summ. 2006 May 26;55(4):1-22. PMID: 16723970 [PubMed - indexed for MEDLINE]Free Article Related citations


Assisted reproductive technology surveillance--United States, 2001. Wright VC, Schieve LA, Reynolds MA, Jeng G, Kissin D. MMWR Surveill Summ. 2004 Apr 30;53(1):1-20. PMID: 15123982 [PubMed - indexed for MEDLINE]Free Article Related citations


Assisted reproductive technology surveillance--United States, 2002. Wright VC, Schieve LA, Reynolds MA, Jeng G; Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). MMWR Surveill Summ. 2005 Jun 3;54(2):1-24. PMID: 15931153 [PubMed - indexed for MEDLINE]Free Article Related citations


Pregnancy outcomes after assisted reproductive technology. Allen VM, Wilson RD, Cheung A; Genetics Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC); Reproductive Endocrinology Infertility Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC). J Obstet Gynaecol Can. 2006 Mar;28(3):220-50. English, French. PMID: 16650361 [PubMed - indexed for MEDLINE] Related citations


Preconception and interconception health status of women who recently gave birth to a live-born infant--Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. D'Angelo D, Williams L, Morrow B, Cox S, Harris N, Harrison L, Posner SF, Hood JR, Zapata L; Centers for Disease Control and Prevention (CDC). MMWR Surveill Summ. 2007 Dec 14;56(10):1-35. Erratum in: MMWR Morb Mortal Wkly Rep. 2008 Apr 25;57(16):436. PMID: 18075488 [PubMed - indexed for MEDLINE]Free Article Related citations


From the Centers of Disease Control and Prevention. Use of assisted reproductive technology--United States, 1996 and 1998. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep. 2002 Feb 8;51(5):97-101. PMID: 11892956 [PubMed - indexed for MEDLINE]Free Article Related citations


Single-embryo transfer reduces clinical pregnancy rates and live births in fresh IVF and Intracytoplasmic Sperm Injection (ICSI) cycles: a meta-analysis. Baruffi RL, Mauri AL, Petersen CG, Nicoletti A, Pontes A, Oliveira JB, Franco JG Jr. Reprod Biol Endocrinol. 2009 Apr 23;7:36. PMID: 19389258


  • Use of zona pellucida-bound sperm for intracytoplasmic sperm injection produces higher embryo quality and implantation than conventional intracytoplasmic sperm injection[1] "The proportion of high-quality embryos (grades 1 and 2) and implantation rate were significantly higher in the test group than in the control group, but the difference in fetal heart pregnancy rate was not significant despite seven more pregnancies being obtained in the test group (26 pregnancies) versus the control group (19 pregnancies) following fresh embryo transfers."
  • Global variations in the uptake of single embryo transfer.[2]"Single embryo transfer (SET) is the most effective way of reducing multiple pregnancy rates associated with assisted reproductive technology (ART). Despite published evidence suggesting that the judicious use of elective SET can lead to near-elimination of multiples without compromising cumulative live birth rates, the uptake of this strategy has been variable. ...Data from 31 countries suggest that there has been a gradual increase in SET rates over a 3 year period (2003-2005) but major geographical differences were noted. SET rates are highest in Sweden (69.4%) but are as low as 2.8% in the USA."
  • Assisted Reproductive Technologies (ART) With Baboons[3] A Nonhuman Primate Model for ART and Reproductive Sciences "The first ART baboons produced by ICSI, a pair of male twins, were delivered naturally at 165 days postgestation. Genetic testing of these twins confirmed their ART parental origins and demonstrated that they are unrelated fraternal twins not identicals."
  • Trends in delivery and neonatal outcome after in vitro fertilization in Sweden: data for 25 years.[4] "The decrease in unwanted outcomes can, to a large extent, be explained by the reduced rate of multiple births but was seen also among singletons. Other explanations can be sought in changes in the characteristics of patients undergoing IVF."
  1. <pubmed>20971463</pubmed>
  2. <pubmed>20634207</pubmed>
  3. <pubmed>20631291</pubmed>
  4. <pubmed>20139431</pubmed>