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Ultrasound in Obstetrics & Gynecology :... Oct 2014To identify, appraise and summarize the available evidence regarding the effectiveness and safety of time-lapse embryo monitoring on the main outcomes of assisted... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To identify, appraise and summarize the available evidence regarding the effectiveness and safety of time-lapse embryo monitoring on the main outcomes of assisted reproductive techniques.
METHODS
In this systematic review and meta-analysis, we included only randomized controlled trials (RCTs) comparing time-lapse embryo imaging with standard embryo monitoring. Our primary outcomes were live births (efficacy) and congenital abnormalities (safety). The secondary outcomes were clinical pregnancy, ongoing pregnancy and miscarriage.
RESULTS
Two RCTs were considered eligible, and their data were extracted and included in a meta-analysis. In both studies embryos were transferred at the blastocyst stage. No studies reported rates of live birth or congenital abnormalities. Our estimates were not sufficiently precise to identify whether time-lapse monitoring provided a small benefit, no effect or minor harm on rates of clinical pregnancy (relative risk (RR), 1.05 (95% CI, 0.80-1.38)) or ongoing pregnancy (RR, 1.05 (95% CI, 0.76-1.45)), based on two studies involving 138 women with moderate-quality evidence. Considering the available data, we were unable to determine whether the intervention poses substantial benefit, no effect or substantial harm in the risk of miscarriage (RR, 0.95 (95% CI, 0.30-2.99)), based on two studies involving 76 clinical pregnancies with low-quality evidence.
CONCLUSIONS
Time-lapse embryo imaging is unlikely to have a large effect on the chance of achieving clinical and/or ongoing pregnancy when transferring embryos at the blastocyst stage. More studies are required to improve the quality of the current evidence and also to examine whether this intervention is useful when transferring embryos at the cleavage stage.
Topics: Adolescent; Adult; Cleavage Stage, Ovum; Embryo Transfer; Female; Humans; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Reproductive Techniques, Assisted; Time-Lapse Imaging; Young Adult
PubMed: 24890582
DOI: 10.1002/uog.13428 -
European Journal of Obstetrics,... Dec 2021Assisted Reproductive Technology by means of oocyte donation is a very successful method leading to psychosocial consequences in donors. The aim of the present study was... (Review)
Review
Assisted Reproductive Technology by means of oocyte donation is a very successful method leading to psychosocial consequences in donors. The aim of the present study was to conduct a systematic review of the existing literature on the psychosocial consequences of oocyte donation in the donors. The present study was conducted as a systematic review based on the PRISMA checklist. Searches were performed in PubMed, Web of Science, Scopus, and SID databases for the documents written between 2000 and 2020 regardless of the research methodology and the employed tools. English and Persian articles focusing on psychological and social issues of oocyte donation were reviewed. From 2,759 studies which were found, finally 14 related ones were selected. Psychosocial challenges of donors were obtained in three dimensions including short-term and long-term psychological reactions to treatment complications, emotional reactions to their function as an oocyte donor, and emotional reactions to the resulting offspring resulting and related social challenges. According to the existing studies, oocyte donation is a challenging process with short-term and long-term psychosocial consequences for donors. In order to prevent the feasible psychosocial hazards caused by the donation process, it is necessary to provide oocyte donors with psychosocial support, proper counseling, and awareness of the facts and possible issues ahead.
Topics: Counseling; Humans; Oocyte Donation; Oocytes; Reproductive Techniques, Assisted; Tissue Donors
PubMed: 34689024
DOI: 10.1016/j.ejogrb.2021.10.009 -
Human Reproduction Update 2015Recent progress in the formation of artificial gametes, i.e. gametes generated by manipulation of their progenitors or of somatic cells, has led to scientific and... (Review)
Review
BACKGROUND
Recent progress in the formation of artificial gametes, i.e. gametes generated by manipulation of their progenitors or of somatic cells, has led to scientific and societal discussion about their use in medically assisted reproduction (MAR). Artificial gametes could potentially help infertile men and women but also post-menopausal women and gay couples conceive genetically related children. This systematic review aimed to provide insight in the progress of biological research towards clinical application of artificial gametes.
METHODS
The electronic database 'Medline/Pubmed' was systematically searched with medical subject heading (MesH) terms, and reference lists of eligible studies were hand searched. Studies in English between January 1970 and December 2013 were selected based on meeting a priori defined starting- and end-points of gamete development, including gamete formation, fertilization and the birth of offspring. For each biologically plausible method to form artificial gametes, data were extracted on the potential to generate artificial gametes that might be used to achieve fertilization and to result in the birth of offspring in animals and humans.
RESULTS
The systematic search yielded 2424 articles, and 70 studies were included after screening. In animals, artificial sperm and artificial oocytes generated from germline stem cells (GSCs), embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have resulted in the birth of viable offspring. Also in animals, artificial sperm and artificial oocytes have been generated from somatic cells directly, i.e. without documentation of intermediate stages of stem- or germ cell development or (epi)genetic status. Finally, although the subsequent embryos showed hampered development, haploidization by transplantation of a somatic cell nucleus into an enucleated donor oocyte has led to fertilized artificial oocytes. In humans, artificial sperm has been generated from ESCs and iPSCs. Artificial human oocytes have been generated from GSCs, ESCs and somatic cells (without documentation of intermediate stages of stem- or germ cell development). Fertilization of a human artificial oocyte after haploidization by transplantation of a somatic cell nucleus into an enucleated donor oocyte was also reported. Normal developmental potential, epigenetic and genetic stability and birth of children has not been reported following the use of human artificial gametes. In animals, artificial oocytes from a male have been created and fertilized and artificial sperm from a female has been fertilized and has resulted in the birth of viable offspring. In humans, artificial sperm has been generated from female iPSCs. To date, no study has reported the birth of human offspring from artificial gametes.
CONCLUSION
Our systematic review of the literature indicated that in animals live births have already been achieved using artificial gametes of varying (cell type) sources. Although experimental biological research is progressing steadily towards future clinical application, data on functionality, safety and efficiency of (human) artificial gametes are still preliminary. Although defining artificial gametes by start- and end-points limited the number of included studies, the search resulted in a clear overview of the subject. Clinical use of artificial gametes would expand the treatment possibilities of MAR and would have implications for society. Before potential clinical use, the societal and ethical implications of artificial gametes should be reflected on.
Topics: Animals; Cell Differentiation; Cell Nucleus; Embryonic Stem Cells; Female; Fertilization; Genetic Engineering; Humans; Infertility; Male; Nuclear Transfer Techniques; Oocytes; Pluripotent Stem Cells; Reproductive Techniques, Assisted; Spermatozoa; Tissue Donors
PubMed: 25609401
DOI: 10.1093/humupd/dmv001 -
The Cochrane Database of Systematic... Nov 2015Many media are commercially available for culturing pre-implantation human embryos in assisted reproductive technology (ART) cycles. It is unknown which culture medium... (Review)
Review
BACKGROUND
Many media are commercially available for culturing pre-implantation human embryos in assisted reproductive technology (ART) cycles. It is unknown which culture medium leads to the best success rates after ART.
OBJECTIVES
To evaluate the safety and effectiveness of different human pre-implantation embryo culture media in used for in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
SEARCH METHODS
We searched the Cochrane Menstrual Disorders and Subfertility Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the National Research Register, the Medical Research Council's Clinical Trials Register and the NHS Center for Reviews and Dissemination databases from January 1985 to March 2015. We also examined the reference lists of all known primary studies, review articles, citation lists of relevant publications and abstracts of major scientific meetings.
SELECTION CRITERIA
We included all randomised controlled trials which randomised women, oocytes or embryos and compared any two commercially available culture media for human pre-implantation embryos in an IVF or ICSI programme.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected the studies, assessed their risk of bias and extracted data. We sought additional information from the authors if necessary. We assessed the quality of the evidence using Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methods. The primary review outcome was live birth or ongoing pregnancy.
MAIN RESULTS
We included 32 studies in this review. Seventeen studies randomised women (total 3666), three randomised cycles (total 1018) and twelve randomised oocytes (over 15,230). It was not possible to pool any of the data because each study compared different culture media.Only seven studies reported live birth or ongoing pregnancy. Four of these studies found no evidence of a difference between the media compared, for either day three or day five embryo transfer. The data from the fifth study did not appear reliable.Six studies reported clinical pregnancy rate. One of these found a difference between the media compared, suggesting that for cleavage-stage embryo transfer, Quinn's Advantage was associated with higher clinical pregnancy rates than G5 (odds ratio (OR) 1.56; 95% confidence interval (CI) 1.12 to 2.16; 692 women). This study was available only as an abstract and the quality of the evidence was low.With regards to adverse effects, three studies reported multiple pregnancies and six studies reported miscarriage. None of them found any evidence of a difference between the culture media used. None of the studies reported on the health of offspring.Most studies (22/32) failed to report their source of funding and none described their methodology in adequate detail. The overall quality of the evidence was rated as very low for nearly all comparisons, the main limitations being imprecision and poor reporting of study methods.
AUTHORS' CONCLUSIONS
An optimal embryo culture medium is important for embryonic development and subsequently the success of IVF or ICSI treatment. There has been much controversy about the most appropriate embryo culture medium. Numerous studies have been performed, but no two studies compared the same culture media and none of them found any evidence of a difference between the culture media used. We conclude that there is insufficient evidence to support or refute the use of any specific culture medium. Properly designed and executed randomised trials are necessary.
Topics: Abortion, Spontaneous; Culture Media; Embryo Transfer; Embryo, Mammalian; Female; Fertilization in Vitro; Humans; Live Birth; Oocytes; Pregnancy; Pregnancy Rate; Pregnancy, Multiple; Randomized Controlled Trials as Topic; Sperm Injections, Intracytoplasmic
PubMed: 26585317
DOI: 10.1002/14651858.CD007876.pub2 -
Journal of Animal Physiology and Animal... Apr 2018The purpose of this systematic review was to evaluate the evidence that the injection of carbohydrate-based solutions into embryonated eggs improves broiler performance.... (Review)
Review
The purpose of this systematic review was to evaluate the evidence that the injection of carbohydrate-based solutions into embryonated eggs improves broiler performance. A literature search was conducted in April 2017 using the keywords broiler, carbohydrate, in ovo, nutrition and poultry. Only papers that involved in ovo carbohydrate injections in poultry were used in this study. After specific selection criteria, 17 papers were selected. The quality scoring system of the selected studies was based on the injection methodology, use of control groups, type of solution injected, period of injection, egg and hens characteristics, number of variables analysed and the statistical design. Among papers, there was no standardised procedure in to inoculate the solutions. Nevertheless, in general, in ovo feeding of carbohydrates decreases the hatch rate, improves the hatch weight, but it does not seem to influence the post-hatch performance of broilers. The inoculation of 75 mg of glucose in the albumen seems to bring better results. Further studies are needed to improve the technical methodology of in ovo injections for commercial use.
Topics: Animals; Carbohydrates; Chick Embryo; Injections; Ovum
PubMed: 29067716
DOI: 10.1111/jpn.12807 -
The Cochrane Database of Systematic... Sep 2014Oocyte cryopreservation is a technique with considerable potential in reproductive medicine, including fertility preservation, as a way of delaying childbearing and as... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Oocyte cryopreservation is a technique with considerable potential in reproductive medicine, including fertility preservation, as a way of delaying childbearing and as part of oocyte donation programs. Although the technique was relatively ineffective at first more recently numerous modifications have led to higher success rates.
OBJECTIVES
To compare the effectiveness and safety of vitrification and slow freezing as oocyte cryopreservation techniques for fertility outcomes in women undergoing assisted reproduction.
SEARCH METHODS
We searched electronic databases, trial registers and websites, including the Cochrane Menstrual Disorders and Subfertility Group Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO (date of search 3 March 2014).
SELECTION CRITERIA
Two review authors independently selected randomised controlled trials (RCTs) comparing vitrification and slow freezing for oocyte preservation in women undergoing assisted reproduction.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted the data from eligible studies and assessed their risk of bias. Any disagreements were resolved by discussion or by a third review author. Data extracted included study characteristics and outcome data. The overall quality of the evidence was assessed using GRADE methods.
MAIN RESULTS
Two RCTs were included in the review (106 participants). Neither study reported live birth rate. Vitrification was associated with an increased clinical pregnancy rate compared to slow freezing (RR 3.86, 95% CI 1.63 to 9.11, P = 0.002, 2 RCTs, 106 women, I(2) = 8%, moderate quality evidence). The effect of vitrification compared to slow freezing on ongoing pregnancy rates was only reported in one small study, with inconclusive findings (RR 6.07, 95% CI 0.86 to 43.04, P = 0.07, one RCT, 28 women, low quality evidence).No data were reported on adverse effects, nor were any other outcomes reported in the included trials. The evidence was limited by imprecision. We assessed the included studies as at low to unclear risk of bias as the methods were not well described.
AUTHORS' CONCLUSIONS
Oocyte vitrification compared to slow freezing probably increases clinical pregnancy rates in women undergoing assisted reproduction. However, the total number of women and pregnancies were low and the imprecision is high which limits applicability. The effect on ongoing pregnancy is uncertain as data were sparse. No data were available on live births or adverse effects.
Topics: Cryopreservation; Female; Freezing; Humans; Oocytes; Pregnancy; Pregnancy Rate; Randomized Controlled Trials as Topic; Vitrification
PubMed: 25192224
DOI: 10.1002/14651858.CD010047.pub2 -
Medicine Dec 2017Pretreatment of myoinositol is a very new method that was evaluated in multiple small studies to manage poor ovarian response in assisted reproduction. This study was to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Pretreatment of myoinositol is a very new method that was evaluated in multiple small studies to manage poor ovarian response in assisted reproduction. This study was to determine the efficacy of myoinositol supplement in infertile women undergoing ovulation induction for intracytoplasmic sperm injection (ICSI) or in vitro fertilization embryo transfer (IVF-ET).
METHODS
A meta-analysis and systematic review of published articles evaluating the efficacy of myo-inositol in patients undergoing ovulation induction for ICSI or IVF-ET was performed.
RESULTS
Seven trials with 935 women were included. Myoinositol supplement was associated with significantly improved clinical pregnancy rate [95% confidence interval (CI), 1.04-1.96; P = .03] and abortion rate (95% CI, 0.08-0.50; P = .0006). Meanwhile, Grade 1 embryos proportion (95% CI, 1.10-2.74; P = .02), germinal vescicle and degenerated oocytes retrieved (95% CI, 0.11-0.86; P = .02), and total amount of ovulation drugs (95% CI, -591.69 to -210.39; P = .001) were also improved in favor of myo-inositol. There were no significant difference in total oocytes retrieved, MII stage oocytes retrieved, stimulation days, and E2 peak level.
CONCLUSIONS
Myoinositol supplement increase clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET. It may improve the quality of embryos, and reduce the unsuitable oocytes and required amount of stimulation drugs.
Topics: Adult; Dietary Supplements; Embryo Transfer; Female; Fertilization in Vitro; Humans; Infertility, Female; Inositol; Oocytes; Ovulation Induction; Pregnancy; Pregnancy Rate; Sperm Injections, Intracytoplasmic
PubMed: 29245250
DOI: 10.1097/MD.0000000000008842 -
Poultry Science Mar 2022Globally, the production of Pekin ducks for meat and eggs is considerable, with an estimated >200 million ducks slaughtered yearly for their meat in the United States... (Review)
Review
Globally, the production of Pekin ducks for meat and eggs is considerable, with an estimated >200 million ducks slaughtered yearly for their meat in the United States and the European Union alone. However, despite the size of the Pekin duck industries, there is a lack of research-based guidance regarding the welfare of the ducks. The purpose of this systematic review is to examine and summarize available scientific literature related to the welfare of Pekin ducks raised on commercial farms for meat and eggs. Specifically, we aimed to identify topics where sufficient literature exists to support best-practice duck welfare recommendations, as well as further research needs. The literature search targeted original research papers and review articles published in English. Six pre-establish inclusion/exclusion criteria were applied, yielding 63 publications. We summarized their content based their main topic of focus. For all original studies, we additionally recorded the country where the study was executed, scale of the project (commercial or experimental barns), general information about the housing system and management (waterers, flooring, ventilation, group size, and space allowance), and the types of outcome variables collected. We begin with an overview of key publication trends. We then synthesize and discuss welfare outcomes related to key housing/management decisions: bathing water, flooring and litter, stocking density and space availability, ventilation/air quality, lighting, outdoor access, and for egg laying birds the availability of nest boxes. Throughout, we outline specific research gaps, as well as overarching research needs.
Topics: Animal Welfare; Animals; Ducks; Meat; Ovum
PubMed: 35042179
DOI: 10.1016/j.psj.2021.101614 -
Molecular Human Reproduction Jan 2022Sperm DNA damage is considered a predictive factor for the clinical outcomes of patients undergoing ART. Laboratory evidence suggests that zygotes and developing embryos...
Sperm DNA damage is considered a predictive factor for the clinical outcomes of patients undergoing ART. Laboratory evidence suggests that zygotes and developing embryos have adopted specific response and repair mechanisms to repair DNA damage of paternal origin. We have conducted a systematic review in accordance with guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify and review the maternal mechanisms used to respond and repair sperm DNA damage during early embryonic development, how these mechanisms operate and their potential clinical implications. The literature search was conducted in Ovid MEDLINE and Embase databases until May 2021. Out of 6297 articles initially identified, 36 studies were found to be relevant through cross referencing and were fully extracted. The collective evidence in human and animal models indicate that the early embryo has the capacity to repair DNA damage within sperm by activating maternally driven mechanisms throughout embryonic development. However, this capacity is limited and likely declines with age. The link between age and decreased DNA repair capacity could explain decreased oocyte quality in older women, poor reproductive outcomes in idiopathic cases and patients who present high sperm DNA damage. Ultimately, further understanding mechanisms underlying the maternal repair of sperm DNA damage could lead to the development of targeted therapies to decrease sperm DNA damage, improved oocyte quality to combat incoming DNA insults or lead to development of methodologies to identify individual spermatozoa without DNA damage.
Topics: Aged; Animals; DNA Damage; DNA Repair; Embryonic Development; Female; Humans; Male; Oocytes; Pregnancy; Spermatozoa
PubMed: 34954800
DOI: 10.1093/molehr/gaab071 -
Reviews in Endocrine & Metabolic... Dec 2023Polycystic ovary syndrome (PCOS) is recognized as one of the most prevalent endocrinopathy in women at reproductive age. As affected women tend to have poorer assisted... (Review)
Review
Polycystic ovary syndrome (PCOS) is recognized as one of the most prevalent endocrinopathy in women at reproductive age. As affected women tend to have poorer assisted reproductive technology (ART) outcomes, PCOS has been suggested to endanger oocyte quality and competence development. The aim of this systematic review was to summarize the available evidence on how the follicular fluid (FF) profile of women with PCOS undergoing in vitro fertilization (IVF) treatment differs from the FF of normo-ovulatory women. For that, an electronic search in PubMed and Web of Science databases was conducted (up to December 2021). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines were followed, and the Newcastle-Ottawa Scale was used to assess the risk of bias in the included studies. Data retrieved from papers included (n=42), revealed that the FF composition of women with PCOS compared to those without PCOS predominantly diverged at the following molecular classes: oxidative stress, inflammatory biomarkers, growth factors and hormones. Among those biomarkers, some were proposed as being closely related to pathophysiological processes, strengthening the hypothesis that low-grade inflammation and oxidative stress play a critical role in the pathogenesis of PCOS. Notwithstanding, it should be noticed that the available data on PCOS FF fingerprints derives from a limited number of studies conducted in a relatively small number of subjects. Furthermore, phenotypic heterogeneity of PCOS hampers wider comparisons and weakens putative conclusions. Therefore, future studies should be focused at comparing well characterized patient subgroups according to phenotypes.
Topics: Female; Humans; Polycystic Ovary Syndrome; Follicular Fluid; Fertilization in Vitro; Oocytes; Biomarkers
PubMed: 37493841
DOI: 10.1007/s11154-023-09819-z