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Human Reproduction Update Jun 2016The donation of oocytes has been made feasible as a result of in vitro fertilization (IVF). This treatment offers an answer for infertile women with ovarian conditions,... (Review)
Review
INTRODUCTION
The donation of oocytes has been made feasible as a result of in vitro fertilization (IVF). This treatment offers an answer for infertile women with ovarian conditions, such as primary ovarian insufficiency. Demand for oocyte donors has been on the rise globally, with infertile couples, as well as gay men, increasingly using it as a means to found their families. With an acute shortage of oocyte donors globally, the psychosocial aspects behind oocyte donation are important for fertility clinics to understand. This paper aims primarily to provide an up-to-date systematic review of the psychosocial aspects of oocyte donation from the point of view of oocyte donors and recipients and egg sharers. Its secondary aims are to explore the motives and experiences of donors as well as attitudes towards donor anonymity and disclosure. An emphasis has been placed on the analysis of donors in the UK. No review has analysed together the aforementioned donor groups along with recipient group.
METHODS
A systematic search of English peer-reviewed journals of four computerized databases was undertaken, with no time restriction set for publications.
RESULTS
There were 62 studies which met the inclusion criteria and were included in the systematic review. Attitudes towards donation were positive from both a donor oocyte and recipient point of view, with medical procedures being well tolerated and excellent post-donation satisfaction among all donor groups. There were distinct differences between the different donor groups and recipients in motivation for oocyte donation and decisions for disclosure. Attitudes towards anonymity issues were reassuring with a significant proportion of donors of all types willing to donate as identifiable donors. However, there were methodological limitations identified in the studies reviewed.
CONCLUSION
This review successfully explored the important psychosocial aspects of oocyte donation. In general terms the attitudes and feeling of patients involved from all sides of the donation process were extremely positive. A number of key and consistent issues emerged which demonstrated differences and similarities between the different donor groups, as well as a greater understanding of the recipient. With regard to psychosocial well-being, the results were reassuring throughout all donor groups, especially the egg share donors. Although it seems the 2005 legislative changes in the UK have not caused the anticipated dramatic decrease in gamete donation, oocyte donation still falls far short of demand. The UK has an increasing population of patients from different ethnic backgrounds and same sex relationships seeking oocyte donation, with very few studies including these groups of patients. An increased number of well-designed studies looking into the psychological issues surrounding gamete donation of different patient groups, could allow more directed assessment and counselling of oocyte donors and recipients, with a resulting increase in donor recruitment.
Topics: Disclosure; Female; Fertilization in Vitro; Health Knowledge, Attitudes, Practice; Humans; Infertility, Female; Oocyte Donation; Oocytes; Tissue Donors; Tissue and Organ Procurement
PubMed: 27016289
DOI: 10.1093/humupd/dmw006 -
Transboundary and Emerging Diseases Sep 2022Poultry and poultry-derived products such as meat and eggs are among the main sources of non-typhoidal Salmonella (NTS) transmission to humans. Therefore, we performed a... (Meta-Analysis)
Meta-Analysis Review
Poultry and poultry-derived products such as meat and eggs are among the main sources of non-typhoidal Salmonella (NTS) transmission to humans. Therefore, we performed a systematic review and used random-effects meta-analyses to (1) estimate the prevalence of NTS in poultry samples from birds, products and subproducts and environmental samples, (2) examine the diversity and frequency of their serovars and (3) estimate the prevalence and profiles of anti-microbial resistance (AMR) in NTS isolates reported in studies from the Americas. We included 157 studies from 15 countries comprising 261,408 poultry samples and estimated an overall pooled prevalence of 17.9% (95% Confidence Interval: 10.8-26.3) in birds, 21.8% (17.7-26.1) in products and subproducts and 29.5% (24.2-35.1) in environmental samples. At the national level, the prevalence of NTS was heterogeneous across countries with the highest values in Mexico, the United States and Canada. In total, 131 serovars were identified from 13,388 isolates; Heidelberg, Kentucky, Enteritidis and Typhimurium were the most prevalent in the overall top 10 ranking (range 6.5%-20.8%). At the national level, Enteritidis and Typhimurium were identified in most of the countries, though with national differences in their ranks. The prevalence of AMR increased from 24.1% for 1 antibiotic to 36.2% for 2-3 antibiotics and 49.6% for ≥ 4 antibiotics. Kentucky, Heidelberg, Typhimurium and Enteritidis were the serovars with the highest prevalence of AMR. Besides, tetracycline, ampicillin, streptomycin, ceftiofur and amoxicillin-clavulanic acid were the most frequent antibiotics to which NTS showed resistance. In conclusion, NTS was distributed through the avian production chain with high and heterogeneous values of prevalence in poultry samples. Besides, there were distinctive patterns of serovars distribution across countries and an alarming prevalence of AMR among zoonotic serovars.
Topics: Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Animals; Anti-Bacterial Agents; Humans; Ovum; Poultry; Prevalence; Salmonella; Salmonella Infections, Animal; Serogroup; Streptomycin; Tetracycline; United States
PubMed: 34724337
DOI: 10.1111/tbed.14362 -
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 -
Journal of Gynecology Obstetrics and... Jun 2021There are conflicting reports regarding circulating leptin and its relationship between pregnancy outcomes in infertile women undergoing in vitro fertilization (IVF) or... (Meta-Analysis)
Meta-Analysis
There are conflicting reports regarding circulating leptin and its relationship between pregnancy outcomes in infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). We performed a systematic review and meta-analysis to assess the association between serum or follicular fluid (FF) leptin concentrations reported for infertile women and their IVF outcome. A systematic search was undertaken in available databases (PubMed, Scopus, Web of Science, The Cochrane Library and Embase) to find studies published up to Aug 2020 and the standardized mean difference with 95 % confidence interval was taken from 14 eligible studies. Both graphical (funnel plots) and test methods (Egger's regression test and the Begg) assessed the presence of publication bias. Subgroup analysis was used to investigate the source of heterogeneity. Pooled effect sizes based on the eligible papers indicated that of there is no statistically significant correlation between leptin levels in follicular fluid and serum on the day of ovum pick-up (OPU) and day of HCG (human chorionic gonadotrophin) administration in pregnant and non-pregnant women who underwent IVF/ICSI cycles. However, combination of leptin in serum and/or FF with other parameters may be a useful marker to predict IVF outcome.
Topics: Biomarkers; Female; Fertilization in Vitro; Follicular Fluid; Humans; Leptin; Pregnancy; Pregnancy Rate; Sperm Injections, Intracytoplasmic
PubMed: 33007525
DOI: 10.1016/j.jogoh.2020.101924 -
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 -
Reproductive Biomedicine Online Aug 2014Oocyte cryopreservation is a rapidly developing technology, which is increasingly being used for various medical, legal and social reasons. There are inconsistencies in... (Meta-Analysis)
Meta-Analysis Review
Oocyte cryopreservation is a rapidly developing technology, which is increasingly being used for various medical, legal and social reasons. There are inconsistencies in information regarding survival rate and fertility outcomes. This systematic review and meta-analysis provides evidence-based information about oocyte survival and fertility outcomes post warming to help women to make informed choices. All randomized and non-randomized, controlled and prospective cohort studies using oocyte vitrification were included. The primary outcome measure was ongoing pregnancy rate/warmed oocyte. Sensitivity analysis for donor and non-donor oocyte studies was performed. Proportional meta-analysis of 17 studies, using a random-effects model, showed pooled ongoing pregnancy and clinical pregnancy rates per warmed oocyte of 7%. Oocyte survival, fertilization, cleavage, clinical pregnancy and ongoing pregnancy rates per warmed oocyte were higher in donor versus non-donor studies. Comparing vitrified with fresh oocytes, no statistically significant difference was observed in fertilization, cleavage and clinical pregnancy rates, but ongoing pregnancy rate was reduced in the vitrified group (odds ratio 0.74), with heterogeneity between studies. Considering the age of women and the reason for cryopreservation, reasonable information can be given to help women to make informed choices. Future studies with outcomes from oocytes cryopreserved for gonadotoxic treatment may provide more insight.
Topics: Female; Fertility; History, 21st Century; Humans; Oocytes; Pregnancy; Pregnancy Rate; Vitrification
PubMed: 24931362
DOI: 10.1016/j.rbmo.2014.03.024 -
Reproductive Biology and Endocrinology... Sep 2021Sequential embryo transfer has been proposed as a way to improve embryo implantation in women for in vitro fertilization (IVF), but the effect on pregnancy outcomes...
BACKGROUND
Sequential embryo transfer has been proposed as a way to improve embryo implantation in women for in vitro fertilization (IVF), but the effect on pregnancy outcomes remains ambiguous. This systematic review was conducted to investigate the efficacy of sequential embryo transfer on IVF outcomes.
METHODS
A literature search was performed in the PubMed, Web of Science, Cochrane Library, ScienceDirect and Wanfang databases. Data were pooled using a random- or fixed-effects model according to study heterogeneity. The results are expressed as relative risks (RRs) with 95% confidence intervals (CIs). Heterogeneity was evaluated by the I statistic. The study protocol was registered prospectively on INPLASY, ID: INPLASY202180019.
RESULTS
Ten eligible studies with 2658 participants compared sequential embryo transfer and cleavage transfer, while four studies with 513 participants compared sequential embryo transfer and blastocyst transfer. The synthesis results showed that the clinical pregnancy rate was higher in the sequential embryo transfer group than in the cleavage embryo transfer group (RR 1.42, 95% CI 1.26-1.60, P< 0.01) for both women who did experience repeated implantation failure (RIF) (RR 1.58, 95% CI 1.17-2.13, P< 0.01) and did not experience RIF (Non-RIF) (RR 1.44, 95% CI 1.20-1.66, P< 0.01). However, sequential embryo transfer showed no significant benefit over blastocyst embryo transfer.
CONCLUSION
The current systematic review demonstrates that sequential cleavage and blastocyst embryo transfer improve the clinical pregnancy rate over conventional cleavage embryo transfer. For women with adequate embryos, sequential transfer could be attempted following careful consideration. More high-grade evidence from prospective randomized studies is warranted.
Topics: Blastocyst; Cleavage Stage, Ovum; Embryo Transfer; Embryo, Mammalian; Female; Fertilization in Vitro; Humans; Infertility; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Treatment Outcome
PubMed: 34521412
DOI: 10.1186/s12958-021-00824-y -
International Journal of Molecular... Aug 2022Worldwide, infertility affects between 10 and 15% of reproductive-aged couples. Female infertility represents an increasing health issue, principally in developing... (Review)
Review
Worldwide, infertility affects between 10 and 15% of reproductive-aged couples. Female infertility represents an increasing health issue, principally in developing countries, as the current inclinations of delaying pregnancy beyond 35 years of age significantly decrease fertility rates. Female infertility, commonly imputable to ovulation disorders, can be influenced by several factors, including congenital malformations, hormonal dysfunction, and individual lifestyle choices, such as smoking cigarettes, stress, drug use and physical activity. Moreover, diet-related elements play an important role in the regulation of ovulation. Modern types of diet that encourage a high fat intake exert a particularly negative effect on ovulation, affecting the safety of gametes and the implantation of a healthy embryo. Identifying and understanding the cellular and molecular mechanisms responsible for diet-associated infertility might help clarify the confounding multifaceted elements of infertility and uncover novel, potentially curative treatments. In this view, this systematic revision of literature will summarize the current body of knowledge of the potential effect of high-fat diet (HFD) exposure on oocyte and follicular quality and consequent female reproductive function, with particular reference to molecular mechanisms and pathways. Inflammation, oxidative stress, gene expression and epigenetics represent the main mechanisms associated with mammal folliculogenesis and oogenesis.
Topics: Animals; Diet, High-Fat; Female; Humans; Infertility, Female; Mammals; Oocytes; Oogenesis; Ovulation; Pregnancy
PubMed: 36012154
DOI: 10.3390/ijms23168890 -
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 -
BJOG : An International Journal of... May 2021Advances in vitrification techniques have enabled planned oocyte cryopreservation ('Planned OC'). (Meta-Analysis)
Meta-Analysis
BACKGROUND
Advances in vitrification techniques have enabled planned oocyte cryopreservation ('Planned OC').
OBJECTIVES
To explore the cost-efficiency and utilisation of planned OC, as well as patients' perspectives on the process.
SEARCH STRATEGY
A systematic search in PubMed/MEDLINE, Embase, Cochrane Database and PsychINFO, for all relevant studies published between January 2007 and December 2019.
SELECTION CRITERIA
The protocol followed PRISMA guidelines in PECO format, and was registered with PROSPERO.
DATA COLLECTION AND ANALYSIS
Two independent reviewers evaluated all manuscripts for inclusion eligibility. Authors were contacted for missing data. Included studies were assessed for risk of bias and for heterogeneity. Weighted effects were measured and plotted.
MAIN RESULTS
The search yielded 12 545 records, of which 43 were included. Planned OC is cost-efficient at 35, assuming 60% utilisation; and at 37 assuming utilising donor sperm when necessary. At 38 it is cost-efficient to defer planned OC in favour of undergoing 2 IVF cycles. Currently, utilisation of banked-oocytes within 22-58 months, is up to 15%. Nine percent of warmed banked oocytes result in life births. Online resources and treating physicians are equally important sources of information regarding planned OC. Most patients think planned OC is ideal before age 35 and are not fully aware of what the process entails and tend to overestimate the success rates. The main barrier to wider endorsement of planned OC is being wary of potential health implications or of limited success.
CONCLUSION
Planned OC is an adequate method for preserving fertility. However, knowledge gaps result in under-utilisation leading to reduced cost-efficiency.
TWEETABLE ABSTRACT
Identifying facilitators and barriers for wider adoption of banking oocytes can enhance the cost-efficiency of this modality.
Topics: Cost-Benefit Analysis; Cryopreservation; Fertility Preservation; Humans; Oocytes; Procedures and Techniques Utilization; Vitrification
PubMed: 33021076
DOI: 10.1111/1471-0528.16555