Objective: We present late amniocentesis with the application of uniparental disomy (UPD) testing following successful in vitro fertilization (IVF) and transfer of three mosaic embryos in a pregnancy ...with a favorable outcome. Case report: A 41-year-old, gravida 2, para 0, woman underwent late amniocentesis at 28 weeks of gestation because of advanced maternal age. The pregnancy was conceived by IVF and transfer of three mosaic embryos, i.e., one embryo with mosaic trisomies 20 and 2, one embryo with mosaic partial trisomies 9 and 3 and one embryo with partial trisomies 11 and 17. First-trimester non-invasive prenatal testing (NIPT) and fetal ultrasound revealed no abnormal findings. Late amniocentesis revealed a karyotype of 46,XY. Array comparative genomic hybridization (aCGH) revealed the result of arr GRCh37 (X,Y) × 1, (1–22) × 2. Polymorphic DNA marker analysis using the DNAs extracted from the uncultured amniocytes and parental bloods excluded UPD 20. At 38 weeks of gestation, a healthy 3010-g male baby was delivered with no phenotypic abnormalities. Conclusion: Prenatal diagnosis of normal karyotype following mosaic embryo transfer should include UPD testing if necessary.
This paper analyzes the clinical significance of noninvasive prenatal testing (NIPT) for fetal chromosome aneuploidy in the screening of in vitro fertilization-embryo transfer (IVF) pregnancies.
The ...study subjects consisted of 3163 IVF-pregnant women who underwent NIPT at the Women's Hospital, School of Medicine, Zhejiang University and Taizhou Hospital, Zhejiang Province from February 2015 to June 2019. Fetal or neonatal karyotype analysis was carried out in high-risk patients, with subsequent follow-up on pregnancy outcomes.
NIPT results of 3163 pregnant women suggested 20 cases of high-risk fetal chromosome aneuploidy, of which 2185 cases were a single pregnancy. Of the 13 cases of high-risk chromosome aneuploidy in single pregnancies, seven were true positive, and six were false positive according to fetal or newborn chromosomal karyotype diagnosis. Twin pregnancies accounted for 978 cases in which NIPT indicated seven cases of high-risk chromosome aneuploidy; six of these cases were true positive, and one case was false positive according to fetal or newborn chromosomal karyotype diagnosis. The specificity, positive predictive value, and false-positive rate of trisomy 21 syndrome in IVF single embryo NIPT were 99.86%, 62.5%, and 0.14%, respectively. The specificity, positive predictive value, and false-positive rate of trisomy 18 syndrome were 99.95%, 66.67%, and 0.05%, respectively. The specificity of trisomy 13 syndrome was 99.91%, and the false-positive rate was 0.09%. The specificity of trisomy 21 syndrome in IVF twin NIPT was 99.89%, the positive predictive value was 83.33%, and the false-positive rate was 0.11%. The specificity and positive predictive value of fetal trisomy 18 syndrome were 100.00%, and the false-positive rate of it were 0.00%. Sensitivity and false-negative rates were 100% in all cases.
NIPT is an ideal prenatal test for IVF-pregnant women due to its high sensitivity and specificity in screening for fetal aneuploidy.
Oocyte secreted factors (OSFs), including growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15), play an important role in the process of follicular development and oocyte ...maturation. Since OSFs are expressed in oocytes and cumulus granulosa cells, the aim of the present study was to explore whether the expression levels of GDF9 and BMP15 mRNAs in cumulus granulosa cells can be used as molecular markers for predicting oocyte developmental potential.
Cumulus cells of 2426 cumulus-oocyte complexes were collected from 196 female patients who underwent intracytoplasmic sperm injection (ICSI) and were used for mRNA detection on the egg retrieval day. Pearson correlation analysis was used to analyze the correlation between OSF expression and general physiological parameters. Partial correlation analysis was used to analyze the correlation between OSF expression and oocyte developmental potential. Covariance analysis was used to compare OSF expression among different groups. Receiver operating characteristic curves were used to examine the diagnostic value of GDF9 and BMP15 mRNA for predicting pregnancy.
The expression levels of GDF9 and BMP15 mRNAs were significantly associated with age, body mass index (BMI), oocyte maturation, normal fertilization, and cleavage rate (P < 0.05). The expression levels of GDF9 and BMP15 mRNAs in the group with high-quality embryos were significantly higher than those in the group without high-quality embryos (P < 0.05). The expression levels of GDF9 and BMP15 mRNAs in the pregnancy group were significantly higher than those in the nonpregnancy group (P < 0.05). The cut-off value of GDF9 mRNA for predicting pregnancy was 4.82, with a sensitivity of 82% and a specificity of 64%. The cut-off value of BMP15 mRNA for predicting pregnancy was 2.60, with a sensitivity of 78% and a specificity of 52%.
The expression levels of GDF9 and BMP15 mRNAs were closely associated with oocyte maturation, fertilization, embryo quality, and pregnancy outcome; therefore, GDF9 and BMP15 mRNAs in cumulus granulosa cells may be considered as new molecular markers for predicting oocyte developmental potential.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Do maternal and perinatal outcomes differ between natural and programmed frozen embryo transfer (FET) cycles?
Retrospective cohort study at a university-affiliated fertility centre including 775 ...patients who underwent programmed or natural FET cycles resulting in a singleton live birth using blastocysts vitrified between 2013 and 2018.
A total of 384 natural and 391 programmed FET singleton pregnancies were analysed. Programmed FET resulted in higher overall maternal complications (32.2% 126/391 versus 18.8% 72/384; P < 0.01), including higher probability of hypertensive disorders of pregnancy (HDP) (15.3% 60/391 versus 6.3% 24/384; P < 0.01), preterm premature rupture of membranes (2.6% 10/391 versus 0.3% 1/384; P = 0.02) and caesarean delivery (53.2% 206/387 versus 42.8% 163/381; P = 0.03) compared with natural FET. After controlling for potential confounders, including age, body mass index, parity, smoking status, history of diabetes or chronic hypertension, infertility diagnosis, number of embryos transferred and use of preimplantation genetic testing, the adjusted odds ratio for HDP was 2.39 (95% CI 1.37 to 4.17) and for overall maternal complications was 2.21 (95% CI 1.51 to 3.22) comparing programmed with natural FET groups. The groups did not significantly differ for any perinatal outcomes analysed, including birth weight (3357.9 ± 671.6 g versus 3318.4 ± 616.2 g; P = 0.40) or rate of birth defects (1.5% 6/391 versus 2.1% 8/384; P = 0.57), respectively.
Vitrified–warmed blastocyst transfer in a programmed cycle resulted in a twofold higher probability of HDP compared with transfer in a natural cycle. Natural FET cycle should, therefore, be recommended as first line for all eligible patients undergoing FET to reduce the risk of HDP.
Infertility in patients with bowel endometriosis Barra, Fabio; Mikhail, Emad; Villegas-Echeverri, Juan Diego ...
Best practice & research. Clinical obstetrics & gynaecology,
March 2021, 2021-Mar, 2021-03-00, 20210301, Letnik:
71
Journal Article
Recenzirano
The impact of bowel endometriosis on fertility is unclear, and the optimal management of patients who wish to conceive is not well-defined. Infertile patients with bowel endometriosis may either ...undergo surgery to enhance fertility or assisted reproductive technology (ART). It is necessary to consider that some complications may occur in patients undergoing ART because of the ovarian stimulation needed during these procedures. Interpretation of the available data on fertility outcomes after colorectal surgery for deep endometriosis is difficult as several studies do not distinguish patients with real infertility from those wishing to conceive without proven infertility and outcomes of complex surgery are operator-dependent. The effect of bowel surgery to increase the likelihood of spontaneous conception is yet to be established. Limited data are available on fertility outcomes after the removal of endometriotic nodules without the excision of bowel endometriotic implants.
•The impact of colorectal endometriosis per se on fertility is still controversial.•There is not a consensus about specific indication, type of approach, and timing for colorectal surgery for improving fertility outcomes.•Limited data are present about fertility outcomes after removal of DE nodules without excision of bowel endometriotic implants.
Graphene oxide (GO) and Fe3O4 super paramagnetic material are good candidate for some applications such as drug delivery. It has been shown that combining Fe3O4 with graphene oxide increases the ...biological efficiency of GO. The use of novel assisted reproductive technologies such as gonadotropins injection has been able to help the fertility of infertile people, but the side effects of these methods and high costs are still problems. The aim of the present study was to investigate the effect of magnetic graphene oxide (MGO) on the in vivo maturation of mouse oocytes. Thirty 6–8-week old female Naval Medical Research Institute (NMRI) mice were treated with intra peritoneal (I.P) injection of MGO mixed with hormones. 12 h after I.P. injection of MGO mixed with PMSG and HCG, the number of metaphase II (MII) oocytes obtained from the left fallopian tubes was counted in each group. Also, immuno-cytochemical staining of glutathione and morphometric analysis of ovaries were studied. The results of this study showed that the simultaneous use of MGO, pregnant mare serum gonadotropin (PMSG), and human chorionic gonadotrophin (HCG) increases the number of MII oocytes and helps to increase maturation of oocytes. It could be concluded that MGO can increase the efficiency of super ovulating hormones due to increase in adsorption of serum hormones and growth factors.
To examine the association between serum antimüllerian hormone (AMH) and live birth among women aged ≥41 years undergoing in vitro fertilization (IVF).
Retrospective cohort study using the 2012–2014 ...Society for Assisted Reproductive Technology Clinic Outcome Reporting System database.
Fertility clinics reporting to the Society for Assisted Reproductive Technology.
The analysis included 7,819 patients aged ≥41 years who underwent a first fresh, autologous IVF cycle during the study period. Cycles with preimplantation genetic testing were excluded.
None.
Live birth rate.
The empirical distribution of AMH was examined, and extreme values were observed. Therefore, the natural logarithm transformation of AMH (log-AMH) was used in all analyses. Before adjustment for covariates, a one-unit increase in log-AMH was associated with doubling of the odds of live birth up to a log-AMH of −0.34 (equivalently, AMH, 0.71 ng/mL; odds ratio OR, 2.02; 95% confidence interval CI, 1.66–2.46). Above an AMH level of 0.71 ng/mL, the odds of live birth increased by only 40% with each unit increase in log-AMH (OR, 1.40; 95% CI, 1.22–1.61). After adjusting for covariates, the odds of live birth increased by 91% with each unit increase in log-AMH up to −0.34 (AMH, 0.71 ng/mL; OR, 1.91; 95% CI, 1.56–2.34). Above an AMH level of 0.71 ng/mL, the odds of live birth increased by only 32% with each unit increase in log-AMH (OR, 1.32; 95% CI, 1.15–1.53).
Among women aged ≥41 years undergoing fresh, autologous IVF, the odds of live birth significantly increase with increasing serum AMH level. As the AMH level increases above 0.71 ng/mL, the association maintains statistical significance, but the effect size is diminished.
Purpose
This study aims to make an account of the children born following transplantation of frozen-thawed ovarian tissue worldwide with specific focus on the perinatal outcome of the children. ...Furthermore, perinatal outcome of seven deliveries (nine children) from Denmark is reported.
Methods
PubMed was searched for papers of deliveries resulting from ovarian tissue cryopreservation (OTC). Seven women underwent OTC prior to chemotherapy. Four of these women still had low ovarian function and had tried to conceive. They therefore had tissue autotransplanted to augment their fertility. The other three women had developed premature ovarian insufficiency (POI) after the end of treatment.
Results
Worldwide, approximately 95 children have been born or will be born in the near future from OTC, including these 9 new children. Information on the perinatal outcome was found on 40 children. The mean gestational age was 39 weeks and the mean birth weight was 3168 g of the singleton pregnancies, which is within internationally recognized normal standards. Furthermore, half the singletons resulted from natural conception and all twins resulted from in vitro fertilization treatment. All seven Danish women became pregnant within 1–3 years after transplantation. They gave birth to nine healthy children.
Conclusion
The data is reassuring and further suggests that cryopreservation of ovarian tissue is becoming an established fertility preservation method. The seven Danish women reported in this study were all in their early thirties when OTC was performed. Most other reported cases were in the women’s twenties. This suggests that the follicular pool in the thirties is large enough and sufficient to sustain fertility.
Primary ovarian insufficiency (POI) and polycystic ovarian syndrome are ovarian diseases causing infertility. Although there is no effective treatment for POI, therapies for polycystic ovarian ...syndrome include ovarian wedge resection or laser drilling to induce follicle growth. Underlying mechanisms for these disruptive procedures are unclear. Here, we explored the role of the conserved Hippo signaling pathway that serves to maintain optimal size across organs and species. We found that fragmentation of murine ovaries promoted actin polymerization and disrupted ovarian Hippo signaling, leading to increased expression of downstream growth factors, promotion of follicle growth, and the generation of mature oocytes. In addition to elucidating mechanisms underlying follicle growth elicited by ovarian damage, we further demonstrated additive follicle growth when ovarian fragmentation was combined with Akt stimulator treatments. We then extended results to treatment of infertility in POI patients via disruption of Hippo signaling by fragmenting ovaries followed by Akt stimulator treatment and autografting. We successfully promoted follicle growth, retrieved mature oocytes, and performed in vitro fertilization. Following embryo transfer, a healthy baby was delivered. The ovarian fragmentation-in vitro activation approach is not only valuable for treating infertility of POI patients but could also be useful for middle-aged infertile women, cancer patients undergoing sterilizing treatments, and other conditions of diminished ovarian reserve.
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