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Fertility Treatment (fertility + treatment)
Selected AbstractsFertility treatment in male cancer survivorsINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 4 2007Kirsten Louise Tryde Schmidt Summary The present study reviews the use of assisted reproductive technology in male cancer survivors and their partners. As antineoplastic treatment with chemotherapy or radiation therapy, has the potential of inducing impairment of spermatogenesis through damage of the germinal epithelium, many male cancer survivors experience difficulties in impregnating their partners after treatment. The impairment can be temporary or permanent. While many cancer survivors regain spermatogenesis months to years after treatment, some become infertile with a-, oligo- or azoospermia. An option to secure the fertility potential of young cancer patients is to cryopreserve semen before cancer treatment for later use. A desired pregnancy may be obtained in couples where the husband has a history of cancer, using assisted reproductive technology with either fresh or cryopreserved/thawed semen. Successful outcomes have been obtained with intrauterine insemination (IUI) as well as in vitro fertilization (IVF) with or without the use of intracytoplasmic sperm injection (ICSI). In conclusion, male cancer survivors and their partners who have failed to obtain a pregnancy naturally within a reasonable time frame after end of treatment should be referred to a fertility clinic. [source] Fertility needs and funding in couples with blood-borne viral infectionHIV MEDICINE, Issue 1 2010E Kalu Background Couples infected with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly seeking assisted conception. These couples avoid unprotected intercourse and use condoms at all times in order to minimize the risk of infecting their partner. As this practice inhibits pregnancy, assisted procreation is generally required for safe conception. For many couples, access to such services is restricted on ethical, geographical and financial grounds. Objective The aim of the study was to assess the fertility needs, geographical origin and state funding of patients with blood-borne viral infection. Methods A retrospective review of the medical records of couples referred for fertility treatment between January 1999 and December 2006, where one or both partners were infected with HIV, HBV and/or HCV, was carried out. Results Of the 205 couples included in the study, 44% lived in London, 51% came from elsewhere in the United Kingdom and 5% travelled from outside the United Kingdom to seek treatment. Genitourinary medicine clinics were the main source of referral. 85.8% of couples had HIV infection, 15.1% were infected with HBV and 13.6% had HCV infection. Fertility screening identified a high incidence of male factor infertility (33.3%) in HIV-infected men and tubal disease (40.8%) in HIV-infected women. Only 23.6% of HIV-infected couples, 20% of HBV-infected couples and 12.5% of HCV-infected couples obtained state funding for assisted conception. Conclusion Fertility screening identified a high incidence of male and tubal factor subfertility among couples living with HIV, HBV and HCV. Limited access to specialist clinics equipped to cater for these couples and restricted funding may impact negatively on couples obtaining risk-reducing assisted reproduction treatment. This may have long-term public health implications as individuals attempt to conceive through unprotected intercourse. [source] Importance of assemblage-level thinning: A field experiment in an alpine meadow on the Tibet plateauJOURNAL OF VEGETATION SCIENCE, Issue 4 2006Yanjiang Luo Anon. (1998) Abstract Question: Which fraction of the decrease in species richness under fertilization can be explained by assemblage-level thinning? Location: An alpine meadow on the eastern Tibet plateau. Methods: 60-m2 plots were randomly assigned to a control or one of four levels of ammonium phosphate fertilizer. Treatments were repeated for three years. The effect of as semblage-level thinning was decided based on similarity in quadrats within and between fertilizing levels, bootstrap simulation based on random thinning of the high density (low production, low fertility) quadrats and correlation of species' biomass in low fertility and high fertility. Results: Fertilization increased production, reduced species richness and reduced density of individuals. Heavily fertilized quadrats are more similar in species composition in 2000 but less similar in 2001 and 2002. Rarefaction showed that a decrease in density can account for 32.3-42.9% decrease of species richness, but the simulated species richness is always significantly higher than the observed one. When production and species richness are similar at two levels of fertilization, species biomass in the higher fertility treatment is positively correlated with biomass at lower fertility. When the two fertilizer levels differed in production and species richness, there was no evidence of correlation in species biomass, suggesting that assemblage level thinning cannot explain all the loss of species. Conclusion: Although a decrease in density could explain much of the decrease (up to 42.9%) in species richness when this alpine meadow was fertilized, other important mechanisms such as interspecific competition cannot be ignored. Future studies should investigate the effect of assemblage level thinning on species diversity, and search for mechanisms responsible for a decrease in diversity. [source] Possible predictive factors for ICSI?ANDROLOGIA, Issue 4 2003Molecular biology techniques in combination with therapeutic testicular biopsies Summary. Applying intracytoplasmic sperm injection (ICSI), the selection of an unsuccessful spermatozoon results in great emotional consequences for the couple. Therefore, there is a need for a prognostic parameter to estimate their chances for successful fertility treatment. This review summarizes both the main reasons for spermatogenic impairment, and possible predictive factors for successful sperm retrieval applying testicular sperm extraction and outcome of ICSI. While basic sperm parameters, aetiology and type of spermatozoa, and serum follicle-stimulating hormone and inhibin levels have been shown to be unrelated to the outcome of ICSI, Y-chromosome microdeletions are known to have a negative influence on the fertilizing capacity of spermatozoa. Recently, a significant correlation has been reported between the protamine-1 to protamine-2 mRNA ratio in haploid spermatids of testicular biopsies and the ability of spermatozoa for successful fertilization of an oocyte. In future, both the outstanding role of the haploid spermatids and the involvement of molecular biological techniques will improve the role of therapeutic testicular biopsies. [source] Infertility in Australia circa 1980: an historical population perspective on the uptake of fertility treatment by Australian women born in 1946-51AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2009Danielle L. Herbert Abstract Objective: To estimate the prevalence of lifetime infertility in Australian women born in 1946-51 and examine their uptake of treatment. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1946-51 (n=13,715) completed up to four mailed surveys from 1996 to 2004. The odds of infertility were estimated using logistic regression with adjustment for socio-demographic and reproductive factors. Results: Among participants, 92.1% had been pregnant. For women who had been pregnant (n=12738): 56.5% had at least one birth but no pregnancy loss (miscarriage and/or termination); 39.9% experienced both birth and loss; and 3.6% had a loss only. The lifetime prevalence of infertility was 11.0%. Among women who reported infertility (n=1511), 41.7% used treatment. Women had higher odds of infertility when they had reproductive histories of losses only (OR range 9.0-43.5) or had never been pregnant (OR=15.7, 95%CI 11.8-20.8); and higher odds for treatment: losses only (OR range 2.5-9.8); or never pregnant (1.96, 1.28-3.00). Women who delayed their first birth until aged 30+ years had higher odds of treatment (OR range 3.2-4.3). Conclusions: About one in ten women experienced infertility and almost half used some form of treatment, especially those attempting pregnancy after 1980. Older first time mothers had an increased uptake of treatment as assisted reproductive technologies (ART) developed. Implications: This study provided evidence of the early uptake of treatment prior to 1979 when the national register of invasive ART was developed and later uptake prior to 1998 when data on non-invasive ART were first collected. [source] Pregnancy Complication and Outcome in Women with History of Allergy to Medicinal AgentsAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2010Iris Ohel Citation Ohel I, Levy A, Zweig A, Holcberg G, Sheiner E. Pregnancy complication and outcome in women with history of allergy to medicinal agents. Am J Reprod Immunol 2010; 64: 152,158 Problem, Pregnancy outcome in women with a previous history of drug allergy and the role of drug allergies in adverse pregnancy outcomes is unclear. Method of study, A retrospective cohort study comparing pregnancies of women with and without history of drug allergy was conducted. Data were collected from the computerized perinatal database. A multiple logistic regression model, with background elimination, was constructed to control for confounders. Results, Of 186,443 deliveries, 4.6% (n = 8647) occurred in patients with a history of drug allergy. The following conditions were significantly associated with a history of drug allergy: advanced maternal age, recurrent abortions, fertility treatments, hypertensive disorders, and diabetes mellitus. Using multivariate analysis, with background elimination, history of drug allergy was significantly associated with intrauterine growth restriction (OR = 1.52, CI = 1.3,0.8, P < 0.001) and with preterm delivery (OR = 1.26, CI = 1.14,1.38, P < 0.001). Conclusion, A history of drug allergy is an independent risk factor for intrauterine growth restriction and preterm delivery. Further prospective studies are needed to investigate the nature of this association. [source] NARRATIVE ARTIFICE AND WOMEN'S AGENCYBIOETHICS, Issue 2 2005ALINE H. KALBIAN ABSTRACT The choice to pursue fertility treatments is a complex one. In this paper I explore the issues of choice, agency, and gender as they relate to assisted reproductive technologies (ARTs). I argue that narrative approaches to bioethics such as those by Arthur Frank and Hilde Lindemann Nelson clarify judgments about autonomy and fertility medicine. More specifically, I propose two broad narrative categories that help capture the experience of encounters with fertility medicine: narratives of hope and narratives of resistance. This narrative typology captures the inevitable conflict that women feel when they become subjects of fertility medicine. On the one hand, they must remain hopeful; on the other, they must not surrender themselves completely. Nelson's account of counterstories as narratives of resistance helps us see how women can reconcile the experience of a strong desire to have children with the desire to remain authentic and whole. [source] Hypospadias: risk factor patterns and different phenotypesBJU INTERNATIONAL, Issue 2 2010Marijn M. Brouwers Study Type , Aetiologic (case-referent) Level of Evidence 2a OBJECTIVE To obtain more insight into the origin of hypospadias by exploring a wide range of potential risk factors in a case-referent study in which a distinction was made between different phenotypes. PATIENTS AND METHODS Cases and referents were 305 boys with hypospadias and 629 boys with middle ear effusion whose parents completed postal questionnaires. Hypospadias phenotype was classified as distal (195 boys), middle (67), and proximal (43). Adjusted odds ratios (OR) with 95% confidence intervals (CI) were estimated using logistic regression. RESULTS Low birth weight, being a twin or triplet, mother being a diethylstilbestrol-daughter, fertility treatments, paternal subfertility, obesity, prescriptive drug use, and familial occurrence of hypospadias or testicular cancer were associated with hypospadias in general. For familial occurrence of hypospadias, there were high risk estimates for the distal and middle phenotypes with an OR (95%CI) of 10.4 (4.5,24.1) and 9.0 (3.1,26.0), but not for the proximal type at 1.8 (0.2,14.9). By contrast, the association with low birth weight (a proxy for placental dysfunction) seemed much stronger for proximal hypospadias with an OR (95%CI) of 9.1 (3.4,24.2) compared with distal and middle hypospadias at 2.6 (1.4,5.0) and 2.3 (0.8,6.5). There were similar estimates for pre-eclampsia. CONCLUSION These findings indicate aetiological heterogeneity of hypospadias and provide indications for the possible mechanisms through which specific risk factors may interfere with penile development. [source] Fertility outcomes in women with hypopituitarismCLINICAL ENDOCRINOLOGY, Issue 1 2006R. Hall Summary Background, Women with hypopituitarism are known to have a poor outcome once pregnancy has been achieved by ovulation induction. There are no data, however, recording the efficacy of ovulation induction and pregnancy rates in this group of subfertile women. Methods, The outcome of fertility treatments in all 19 women with hypopituitarism attending the fertility clinics of University College London Hospitals over the past 20 years was audited. Results, Ovulation was achieved in almost all women (95%) but occurred in only 60% of treatment cycles. Pregnancy was achieved in 47% of women or 11% of cycles resulting in a live birth rate of 6·7% per cycle. Seven of the 18 pregnancies (39%) miscarried. Only 42% of women treated achieved a live birth. Conclusion, Ovulation induction in women with hypopituitarism yields relatively low pregnancy rates in comparison to other causes of anovulation and a high miscarriage rate. Pituitary hormone deficiency beyond gonadotrophins has a major adverse effect on achieving pregnancy. [source] | ||||||||||