scholarly journals Monozygotic twinning associated with assisted reproductive technologies: a review

Reproduction ◽  
2008 ◽  
Vol 136 (4) ◽  
pp. 377-386 ◽  
Author(s):  
K I Aston ◽  
C M Peterson ◽  
D T Carrell
Keyword(s):  
Assisted Reproductive Technologies ◽  
Monozygotic Twin ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Monochorionic Twins ◽  
Fertility Treatments ◽  
Increased Risk ◽  
Mz Twins ◽  
Twin Pregnancies ◽  
Natural Incidence

Twin birth rates have increased markedly in developed countries since the 1970s for two primary reasons: increasing maternal age and the advent and increasing use of fertility treatments. In addition, monozygotic (MZ) twin pregnancies have been reported to occur at a significantly higher rate following assisted reproductive technologies (ART) procedures compared with the natural incidence. Twin pregnancies are of concern due to a dramatically increased risk of associated complications. Monozygotic twin pregnancies carry a 10–20% risk of twin–twin transfusion syndrome, and monoamniotic monochorionic twins are additionally at risk for cord entanglement. While the mechanisms and contributory factors for dizygotic twinning are well established, very little is known about the mechanisms involved in MZ twinning or the factors that contribute to its occurrence. In this review, we will discuss a number of potential mechanisms involved in MZ twinning and explore factors that may be contributing to the increased incidence of ART-associated MZ twins. An improved understanding of the factors that contribute to increased MZ twinning associated with ART will help to elucidate the poorly understood mechanisms involved in the process and will further aid in reducing the overall incidence of multiple pregnancies with their associated risks following ART procedures.

scholarly journals Epigenetics and Neurological Disorders in ART

2019 ◽  
Vol 20 (17) ◽  
pp. 4169
Author(s):  
Marina La Rovere ◽  
Marica Franzago ◽  
Liborio Stuppia
Keyword(s):  
Neurological Disorders ◽  
Assisted Reproductive Technologies ◽  
Current Knowledge ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Epigenetic Modifications ◽  
Epigenetic Alterations ◽  
Long Term Effects ◽  
Increased Risk

About 1–4% of children are currently generated by Assisted Reproductive Technologies (ART) in developed countries. These babies show only a slightly increased risk of neonatal malformations. However, follow-up studies have suggested a higher susceptibility to multifactorial, adult onset disorders like obesity, diabetes and cardiovascular diseases in ART offspring. It has been suggested that these conditions could be the consequence of epigenetic, alterations, due to artificial manipulations of gametes and embryos potentially able to alter epigenetic stability during zygote reprogramming. In the last years, epigenetic alterations have been invoked as a possible cause of increased risk of neurological disorders, but at present the link between epigenetic modifications and long-term effects in terms of neurological diseases in ART children remains unclear, due to the short follow up limiting retrospective studies. In this review, we summarize the current knowledge about neurological disorders promoted by epigenetics alterations in ART. Based on data currently available, it is possible to conclude that little, if any, evidence of an increased risk of neurological disorders in ART conceived children is provided. Most important, the large majority of reports appears to be limited to epidemiological studies, not providing any experimental evidence about epigenetic modifications responsible for an increased risk.

scholarly journals Assessing an impact on perinatal outcome in monochorionic and dichorionic twin pregnancy complicated with discordant fetal growth

2021 ◽  
Vol 15 (1) ◽  
pp. 51-60
Author(s):  
K. V. Kostyukov ◽  
K. A. Gladkova ◽  
O. V. Ionov
Keyword(s):  
Body Weight ◽  
Fetal Growth ◽  
Twin Pregnancy ◽  
Reproductive Technologies ◽  
Morbidity And Mortality ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Antenatal Period ◽  
Increased Risk ◽  
Twin Pregnancies

Introduction. Multifetal pregnancy is associated with an increased risk of perinatal morbidity and mortality. Type of placentation and discordant fetal growth may be risk factors of adverse pregnancy outcomes.Aim: to compare an impact of dichorionic and monochorionic twin pregnancies with symmetric and discordant fetal growth on perinatal outcomes, as well as morbidity and mortality.Materials and Methods. There was conducted a retrospective study of 485 pregnant women and paired 959 newborns. Depending on the type of chorionicity, subjects were stratified into two study groups being further subdivided into based on describing fetal weight discordance. The antenatal period and the neonatal outcome of newborns in groups and subgroups were compared.Results. We analyzed 308 dichorionic and 177 monochorionic twin pregnancies. It was found that neonate discordant growth was observed in 5.4 % and 13.4 % (p < 0.001), respectively. The incidence of assisted reproductive technologies was higher in dichorionic than in monochorionic twins comprising 66.5 and 40.7 % (р < 0.001). Antenatal mortality in monochorionic vs. dichorionic twins was by 8-fold higher. The preterm birth rate in monochorionic vs. dichorionic twins was 74.6 and 62.7% (p = 0.009), respectively. Neonate body weight in monochorionic vs. dichorionic twins was lowered comprising 1991 and 2430 gr. (р < 0.001), respectively. Low Apgar scores were more common for monochorionic twins with discordant body weight. The rate of early neonatal mortality in monochorionic vs. dichorionic twins was 4.4 % vs. 1.5 % (p = 0.009), whereas in dichorionic vs. monochorionic twins with weight discordance it was up to 5.8 and 10.5% (р < 0.001), respectively.Conclusion. Monochorionic twin pregnancy complicated with growth discordance is associated with a higher risk of adverse antenatal period as well as neonatal morbidity and mortality compared to symmetric DCDA twins. Chorionicity and growth discordancy represent important predictors for outcome of twin pregnancy.

scholarly journals Prevalence of pathogenic copy number variants among children conceived by donor oocyte

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Monfort ◽  
Carmen Orellana ◽  
Silvestre Oltra ◽  
Mónica Rosello ◽  
Alfonso Caro-Llopis ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Copy Number ◽  
Assisted Reproductive Technologies ◽  
Copy Number Variants ◽  
Reproductive Technologies ◽  
Significant Excess ◽  
Vitro Fertilization ◽  
Donor Oocyte ◽  
Increased Risk

AbstractDevelopment of assisted reproductive technologies to address infertility has favored the birth of many children in the last years. The majority of children born with these treatments are healthy, but some concerns remain on the safety of these medical procedures. We have retrospectively analyzed both the fertilization method and the microarray results in all those children born between 2010 and 2019 with multiple congenital anomalies, developmental delay and/or autistic spectrum disorder (n = 486) referred for array study in our center. This analysis showed a significant excess of pathogenic copy number variants among those patients conceived after in vitro fertilization with donor oocyte with respect to those patients conceived by natural fertilization (p = 0.0001). On the other hand, no significant excess of pathogenic copy number variants was observed among patients born by autologous oocyte in vitro fertilization. Further studies are necessary to confirm these results and in order to identify the factors that may contribute to an increased risk of genomic rearrangements, as well as consider the screening for genomic alterations after oocyte donation in prenatal diagnosis.

Infecundity and Infertility

2019 ◽  
Author(s):  
Marie Thoma ◽  
Carie Cox ◽  
Jasmine Fledderjohann ◽  
Rudolph Kantum Adageba
Keyword(s):  
Public Health ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Assisted Reproductive Technologies ◽  
Significant Proportion ◽  
Well Being ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Increased Risk ◽  
Global Epidemiology

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Global Public Health. Please check back later for the full article. Infertility remains a neglected area in sexual and reproductive health, yet its consequences are staggering. Infertility is estimated to impact about 15% (estimates range from 48 million to 180 million) of couples of reproductive age worldwide. It is associated with adverse physical and mental health outcomes, financial distress, severe social stigma, increased risk of domestic abuse, and marital instability. While men and women are equally likely to be infertile, women often bear the societal burden of infertility, particularly in societies where a woman’s identity and social value is closely tied to her ability to bear children. Despite these consequences, disparities in access to infertility treatment between low- and high-income populations persist, given the high cost and limited geographic availability of diagnostic services and assisted reproductive technologies. In addition, a significant proportion of infertility arises from preventable factors, such as smoking, sexually transmitted infections, pregnancy-related infection or unsafe abortion, and environmental contaminants. Accordingly, programs that address the equitable prevention and treatment of infertility are not only in keeping with a reproductive rights perspective, but can also improve public health. However, progress on infertility as a global concern in the field of sexual and reproductive health and rights is stymied by challenges in understanding the global epidemiology of infertility, including its causes and determinants, barriers to accessing quality infertility care, and a lack of political will and attention to this issue. Tracking and measurement of infertility is highly complex, resulting in considerable ambiguity about its prevalence and stratification of reproduction globally. A renewed global focus on infertility epidemiology, risk factors, and access to and receipt of quality of care will support individuals in trying to reach their desired number and spacing of children and improve overall health and well-being.

Embryo Culture Conditions and the Epigenome

2018 ◽  
Vol 36 (03/04) ◽  
pp. 211-220 ◽  
Author(s):  
Sneha Mani ◽  
Monica Mainigi
Keyword(s):  
Embryo Culture ◽  
Assisted Reproductive Technologies ◽  
Culture Media ◽  
Reproductive Technologies ◽  
Common Mechanism ◽  
Success Rates ◽  
Blastocyst Development ◽  
Increased Risk ◽  
Modifiable Factors

AbstractAssisted reproductive technologies (ARTs) lead to an increased risk for pregnancy complications, congenital abnormalities, and specific imprinting disorders. Epigenetic dysfunction is thought to be one common mechanism which may be affecting these outcomes. The timing of multiple ART interventions overlaps with developmental time periods that are particularly vulnerable to epigenetic change. In vitro embryo culture is known to impact blastocyst development, in vitro fertilization (IVF) success rates, as well as neonatal outcomes. Embryo culture, in contrast to other procedures involved in ART, is obligatory, and has the highest potential for causing alterations in epigenetic reprograming. In this review, we summarize progress that has been made in exploring the effects of embryo culture, culture media, and oxygen tension on epigenetic regulation in the developing embryo. In humans, it is difficult to isolate the role of embryo culture on epigenetic perturbations. Therefore, additional well-controlled animal studies isolating individual exposures are necessary to minimize the epigenetic effects of modifiable factors utilized during ART. Findings from these studies will likely not only improve IVF success rates but also reduce the risk of adverse perinatal outcomes.

The influence of disordered fat metabolism on male fertility at the reproductive age and the effectiveness of the ECF programs

2014 ◽  
Vol 60 (5) ◽  
pp. 34-42 ◽  
Author(s):  
Irina I Vityazeva ◽  
Mariya V Altashina ◽  
Ekaterina A Troshina
Keyword(s):  
Male Fertility ◽  
Assisted Reproductive Technologies ◽  
Fat Metabolism ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Negative Influence ◽  
Reproductive Age ◽  
Excessive Body Weight ◽  
Prevalence Of Obesity ◽  
The Developed Countries

The excessive body weight and obesity in the men of the reproductive age exert the negative influence on their reproductive system and can promote the development of infertility. The high prevalence of obesity and the reduction of the birth rate in the developed countries stimulate the extensive investigations into the mechanisms by which the excess adipose tissue affects male fertility. The authors overview the literature publications concerning the hormonal profile and the adipokine level, as well as disturbance of spermatogenesis in the men with disordered fat metabolism with special reference to the peculiarities of the management of infertility with the application of the assisted reproductive technologies.

No paternal effect on monozygotic twinning in the Swedish Twin Registry

Twin Research ◽  
1998 ◽  
Vol 1 (4) ◽  
pp. 212-215 ◽  
Author(s):  
Paul Lichtenstein ◽  
Bengt Källén ◽  
Max Köster
Keyword(s):  
Genetic Effect ◽  
Monozygotic Twin ◽  
Biological Mechanism ◽  
Paternal Effect ◽  
Monozygotic Twinning ◽  
Twin Registry ◽  
Increased Risk ◽  
Twin Pregnancies ◽  
Population Controls ◽  
Swedish Twin Registry

AbstractPrevious research has provided evidence for a genetic effect in monozygotic twinning, indicated by an increased risk for monozygotic women to have monozygotic offspring. However, since the biological mechanism for this trait is unknown, it is not clear if there exists a paternal inheritance. In this study we investigated twin pregnancies in offspring born in 1941–1996 to male twins in the Swedish Twin Registry and population controls born in 1926–1980. In total 4 225 331 offspring, of which 89 286 were twins, were studied. There was neither an increase in the probability for monozygotic men to have like-sexed twin offspring risk ratio (RR = 0.95; 95% CI = 0.77–1.13) nor an increase in the estimated number of monozygotic twin births. Thus, there is no evidence for a paternal effect on monozygotic twinning, suggesting that the gene(s) increasing the liability for division of the embryo are expressed in the mother and not in the fertilised egg.

scholarly journals Corpus luteal contribution to maternal pregnancy physiology and outcomes in assisted reproductive technologies

2013 ◽  
Vol 304 (2) ◽  
pp. R69-R72 ◽  
Author(s):  
Kirk P. Conrad ◽  
Valerie L. Baker
Keyword(s):  
Embryo Transfer ◽  
Assisted Reproductive Technologies ◽  
Plasma Osmolality ◽  
Reproductive Technologies ◽  
Fresh Embryo Transfer ◽  
Pregnant Rats ◽  
Infertile Women ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Donor Eggs

Investigations in the rat model of pregnancy indicate an important role for the corpus luteal (CL) hormone relaxin in the maternal circulatory and osmoregulatory changes in pregnancy, which are epitomized by profound vasodilation and modest hypoosmolality, respectively. In a pilot study of infertile women who became pregnant through donor eggs, in vitro fertilization, and embryo transfer, the gestational rise in glomerular filtration and fall in plasma osmolality were markedly subdued. Because these women were infertile, they lacked a CL and circulating relaxin (and possibly other vasoactive CL hormones). Based on these findings in pregnant rats and women, we hypothesize that infertile women conceiving through donor eggs will have overall subdued circulatory changes (e.g., attenuated reduction in systemic vascular resistance and subdued increase in cardiac output) particularly during early pregnancy when CL hormones predominate before the full development and maturation of the placenta. In contrast, infertile women conceiving by autologous eggs retrieved after ovarian stimulation and fresh embryo transfer may have a relatively hyperdynamic circulation due to the presence of many CL (up to 20 or more) and higher circulating levels of vasodilatory ovarian hormones such as relaxin. Emerging evidence suggests that women undergoing Assisted Reproductive Technologies (ART) have increased risk for adverse pregnancy outcomes such as preeclampsia and small for gestational-age babies. This increased risk may be partly caused by the maternal milieu, which is not physiological in ART pregnancies due to the abnormal status of the CL.

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