Management of Endometriomas Prior to IVF

2017 ◽  
Vol 9 (3) ◽  
pp. 150-157
Author(s):  
Antonio Maiorana ◽  
Domenico Incandela ◽  
Antonella Mercurio ◽  
Walter Alio ◽  
Laura Giambanco ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Reproductive Technology ◽  
Reproductive Outcome ◽  
Negative Effects ◽  
Vitro Fertilization ◽  
Intra Cytoplasmic Sperm Injection ◽  
The Impact ◽  
Specific Impact

Endometriosis causes a decrease in fertility in affected patients. The different forms of the disease, peritoneal, ovarian, deep infiltrating and adenomyosis, are often present in varying degrees in the same patient, either together or individually, and cause infertility through a pathogenesis that is not yet clear. A significant number of women with endometriosis and endometriomas will eventually seek assisted reproductive technology (ART) for conception. The specific impact of endometriomas alone and the impact of surgical intervention for endometriomas on the reproductive outcome of women undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) are areas that need further clarification and, for this reason, the management of endometriomas before clinical IVF is a very complex topic. In order to provide useful information for the clinical management of patients with endometriomas having IVF, in this review we investigated: the impact of the presence of endometriomas, both individually and associated with other types of the disease, on IVF techniques; the possible role of surgery and its possible negative effects; the risks and difficulties related to conservative management during IVF procedures.

scholarly journals Anticoagulation and in vitro fertilization and ovarian stimulation

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 379-386 ◽  
Author(s):  
Shannon M. Bates
Keyword(s):  
Assisted Reproduction ◽  
Antithrombotic Therapy ◽  
Ovarian Hyperstimulation Syndrome ◽  
Reproductive Technology ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Vitro Fertilization ◽  
The Impact

Abstract Assisted reproductive technology is widely used to treat couples affected by infertility. Complications associated with assisted reproduction include venous thromboembolism, ovarian hyperstimulation syndrome, and recurrent implantation failure. It has also been proposed that thrombophilia may be associated with an increased likelihood of these events. Although data are limited, antithrombotic therapy is frequently used to enhance the likelihood of successful assisted reproduction. This chapter reviews the risks of venous and arterial thromboembolism associated with assisted reproduction, as well as available data regarding the impact of thrombophilia on the risks of thromboembolism and failure of implantation. The role of antithrombotic therapy in reducing the likelihood of these events, along with recommendations from various guidelines, are also discussed.

scholarly journals The Role of Acupuncture in Assisted Reproductive Technology

2012 ◽  
Vol 2012 ◽  
pp. 1-15 ◽  
Author(s):  
Cui Hong Zheng ◽  
Ming Min Zhang ◽  
Guang Ying Huang ◽  
Wei Wang
Keyword(s):  
Assisted Reproductive Technology ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Sham Acupuncture ◽  
Reproductive Technology ◽  
Laser Acupuncture ◽  
Vitro Fertilization ◽  
Positive Effects

The aim of this paper was to provide reliable evidence by performing a systematic review and meta-analysis for evaluating the role of acupuncture in assisted reproductive technology. All randomized controlled trials that evaluated the effects of acupuncture, including manual, electrical, and laser acupuncture (LA) techniques, on the clinical pregnancy rate (CPR) and live birth rate (LBR) of in vitro fertilization (IVF) or artificial insemination were included. The controlled groups consisted of no acupuncture and sham acupuncture groups. The sham acupuncture included sham acupuncture at acupoints, sham acupuncture at non- or inappropriate points, sham LA, and adhesive tapes. Twenty-three trials (a total of 5598 participants) were included in this paper. The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups, whereas the LBR was not significantly different between the two groups. However, the results were quite distinct when the type of control and/or different acupuncture times were examined in a sensitivity analysis. The results mainly indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF. More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used.

scholarly journals Sperm chromatin structure assay versus sperm chromatin dispersion kits: Technical repeatability and choice of assisted reproductive technology procedure

2020 ◽  
Vol 47 (4) ◽  
pp. 277-283
Author(s):  
Vidya Laxme B ◽  
Silviya Stephen ◽  
Ramyashree Devaraj ◽  
Sridurga Mithraprabhu ◽  
Ricardo P. Bertolla ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Chromatin Structure ◽  
Reproductive Technology ◽  
Sperm Chromatin ◽  
Sperm Dna Fragmentation ◽  
Vitro Fertilization ◽  
Sperm Chromatin Structure Assay ◽  
Sperm Dna ◽  
The Impact

Objective: The sperm DNA fragmentation index (DFI) guides the clinician’s choice of an appropriate assisted reproductive technology (ART) procedure. The DFI can be determined using commercially available methodologies, including sperm chromatin dispersion (SCD) kits and sperm chromatin structure assay (SCSA). Currently, when DFI is evaluated using SCD kits, the result is analyzed in reference to the SCSA-derived threshold for the choice of an ART procedure. In this study, we compared DFI values obtained using SCSA with those obtained using SCD and determined whether the difference affects the choice of ART procedure.Methods: We compared SCSA to two SCD kits, CANfrag (n=36) and Halosperm (n=31), to assess the DFI values obtained, the correlations between tests, the technical repeatability, and the impact of DFI on the choice of ART. Results: We obtained higher median DFI values using SCD kits than when using SCSA, and this difference was significant for the CANfrag kit (p<0.001). The SCD kits had significantly higher coefficients of variation than SCSA (p<0.0001). In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) would be chosen for a significantly higher proportion of patients if a decision were made based on DFI derived from SCD rather than DFI determined using SCSA (p=0.003). Conclusion: Our results indicate that SCD kit-specific thresholds should be established in order to avoid the unnecessary use of IVF/ICSI based on sperm DNA damage for the management of infertility. Appropriate measures should be taken to mitigate the increased variability inherent to the methods used in these tests.

scholarly journals The Impact of Autoantibodies on IVF Treatment and Outcome: A Systematic Review

2019 ◽  
Vol 20 (4) ◽  
pp. 892 ◽  
Author(s):  
Mara Simopoulou ◽  
Konstantinos Sfakianoudis ◽  
Evangelos Maziotis ◽  
Sokratis Grigoriadis ◽  
Polina Giannelou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inclusion Criteria ◽  
Vitro Fertilization ◽  
Different Types ◽  
Significant Research ◽  
Central Database ◽  
The Impact

The role of autoantibodies in in vitro fertilization (IVF) has been discussed for almost three decades. Nonetheless, studies are still scarce and widely controversial. The aim of this study is to provide a comprehensive systematic review on the possible complications associated to autoantibodies (AA) impeding the chances of a successful IVF cycle. An Embase, PubMed/Medline and Cochrane Central Database search was performed on 1 December 2018, from 2006 until that date. From the 598 articles yielded in the search only 44 relevant articles ultimately fulfilled the inclusion criteria and were qualitatively analyzed. Five subsets of results were identified, namely, thyroid related AA, anti-phospholipid antibodies, anti-nuclear antibodies, AA affecting the reproductive system and AA related to celiac disease. It may be implied that the majority of auto-antibodies exert a statistically significant effect on miscarriage rates, whereas the effects on clinical pregnancy and live birth rates differ according to the type of auto-antibodies. While significant research is performed in the field, the quality of evidence provided is still low. The conduction of well-designed prospective cohort studies is an absolute necessity in order to define the impact of the different types of autoantibodies on IVF outcome.

scholarly journals Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility?

2020 ◽  
Vol 38 (01) ◽  
pp. 029-035
Author(s):  
Mohan S. Kamath ◽  
Judith F.W. Rikken ◽  
Jan Bosteels
Keyword(s):  
Intrauterine Insemination ◽  
Semen Analysis ◽  
Unexplained Infertility ◽  
Fertility Treatment ◽  
Future Research ◽  
Vitro Fertilization ◽  
Tubal Patency ◽  
The Impact

AbstractThe standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevalence of pelvic infection, setting, and availability of expertise. Moreover, whenever a laparoscopy is planned as a part of the fertility workup, the preparation should include ability to carry out simultaneous therapeutic intervention to maximize the benefit. Similarly, the routine use of hysteroscopy in women with unexplained infertility cannot be recommended. There is a need to investigate the impact of choice of tubal test on chances of spontaneous conception and treatment outcomes in women with unexplained infertility. Our future research agenda should also include high-quality multicenter randomized trials assessing the cost-effectiveness of screening and operative hysteroscopy prior to intrauterine insemination or in vitro fertilization.

scholarly journals Follicular fluid metabolome and cytokinome profiles in poor ovarian responders and the impact of dehydroepiandrosterone supplementation

2020 ◽  
Author(s):  
Veronique Viardot-Foucault ◽  
Jieliang Zhou ◽  
Dexi Bi ◽  
Yoshihiko Takinami ◽  
Heng Hao Tan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Amino Acids ◽  
Follicular Fluid ◽  
Lower Number ◽  
Vitro Fertilization ◽  
Future Studies ◽  
Poor Ovarian Responders ◽  
The Impact

AbstractPoor ovarian responders (POR) are women undergoing in-vitro fertilization who respond poorly to ovarian stimulation, resulting in the retrieval of lower number of oocytes, and subsequently lower pregnancy rates. The follicular fluid (FF) provides a crucial microenvironment for the proper development of follicles and oocytes. Conversely, dysregulated FF metabolome and cytokinome could have detrimental effects on oocytes in POR. Androgens such as dehydroepiandrosterone (DHEA) have been proposed to alter the POR follicular microenvironment but its effects on the FF metabolome and cytokine profiles is unknown. In this study, untargeted LC-MS/MS metabolomics was performed on FF of POR patients with DHEA supplementation (DHEA+) and without (DHEA-) in a randomized clinical trial (N=52). Untargeted metabolomics identified 118 FF metabolites of diverse chemistries, which included lipids, steroids, amino acids, hormones, among others. FF metabolomes were different between DHEA+ and DHEA- groups. Specifically, glycerophosphocholine, linoleic acid, progesterone, and valine were significantly lower in DHEA+ relative to DHEA-. Among cytokines, MCP1, IFNγ, LIF and VEGF-D were significantly lower in DHEA+ relative to DHEA. Collectively, our data suggest a role of DHEA on these metabolic and cytokines pathways, and these FF metabolites could be used to guide future studies in DHEA supplementation regimen.

The Path to Gestational Surrogacy

2016 ◽  
Author(s):  
Laura Harrison
Keyword(s):  
Historical Perspective ◽  
The United States ◽  
Reproductive Technologies ◽  
Reproductive Technology ◽  
Vitro Fertilization ◽  
Technology Industry ◽  
First Child ◽  
Gestational Surrogacy

This chapter places reproductive technologies in historical perspective, beginning with the birth of the first child born through in vitro fertilization in 1978, the accompanied explosion of infertility services in the United States, and the development of gestational surrogacy. This chapter also considers how the advent of gestational surrogacy complicated the selection of a surrogate, the surrogate population, and the role of race in the reproductive technology industry. This chapter also introduces the feminist framework within which this book is situated by contextualizing the varied feminist responses to ARTs in the last several decades.

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