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Human Reproduction Update 2010Due to various sociological factors, couples in developed countries are increasingly delaying childbearing. Besides ethical, economical and sociological issues, this... (Review)
Review
BACKGROUND
Due to various sociological factors, couples in developed countries are increasingly delaying childbearing. Besides ethical, economical and sociological issues, this trend presents us with several complex problems in reproduction. Although it is well-known that maternal age has a negative effect on fertility and increases the risk of adverse outcome during pregnancy and in offspring, the paternal influence on these outcomes is less well researched and not well-known.
METHODS
We performed a systematic search of PubMed, and retrieved original articles and review articles to update our previous survey in this journal.
RESULTS
This review highlights the link between male age and genetic abnormalities in the germ line and summarizes the knowledge about the effects of paternal age on reproductive function and outcome. Increasing paternal age can be associated with decreasing androgen levels, decreased sexual activity, alterations of testicular morphology and a deterioration of semen quality (volume, motility, morphology). Increased paternal age has an influence on DNA integrity of sperm, increases telomere length in spermatozoa and is suggested to have epigenetic effects. These changes may, at least in part, be responsible for the association of paternal age over 40 years with reduced fertility, an increase in pregnancy-associated complications and adverse outcome in the offspring.
CONCLUSION
Although higher maternal age can be an indication for intensive prenatal diagnosis, including invasive diagnostics, consideration of the available evidence suggests that paternal age itself, however, provides no rationale for invasive procedures.
Topics: Age Factors; Chromosome Aberrations; Female; Fertility; Hormones; Humans; Male; Paternal Age; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Semen Analysis; Socioeconomic Factors; Testis
PubMed: 19696093
DOI: 10.1093/humupd/dmp027 -
Journal of Alternative and... May 2012The objective of this article was to conduct a systematic review with meta-analysis of the trials of acupuncture during in vitro fertilization (IVF) or intracytoplasmic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The objective of this article was to conduct a systematic review with meta-analysis of the trials of acupuncture during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment on the outcomes of clinical pregnancy, biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, and miscarriage.
SEARCH STRATEGY
The search was conducted by using MEDLINE(®), SCISEARCH, the Cochrane Menstrual Disorders and Subfertility Group trials register, AMED, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Wanfang Database, China Academic Journal Electronic full text Database in China National Knowledge Infrastructure, Index to Chinese Periodical Literature, ISI Proceedings for conference abstracts, and ISRCTN Register and Meta-register for randomized controlled trials.
DATA COLLECTION AND ANALYSIS
Study selection, quality appraisal, and data extraction were performed independently and in duplicate. The measures of treatment effect were the pooled relative risks (RR) of achieving clinical pregnancy, biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage for women in the acupuncture group compared with women in the control group.
RESULTS
Using the random-effects model, pooling of the effect estimates from all of the 17 trials showed no significant difference in the clinical pregnancy outcome between the acupuncture and the control groups (RR=1.09, 95% confidence interval (CI) 0.94-1.26, p=0.25). No significant differences in the biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage outcomes were found between the acupuncture and the control groups (biochemical pregnancy: RR=1.01, 95% CI 0.84-1.20, p=0.95; ongoing pregnancy: RR=1.20, 95% CI 0.93-1.56, p=0.16; implantation rate: RR=1.22, 95% CI 0.93-1.62, p=0.16; live birth: RR=1.42, 95% CI 0.92-2.20, p=0.11; miscarriage outcomes: RR=0.94, 95% CI 0.67-1.33, p=0.74).
CONCLUSIONS
No significant benefits of acupuncture are found to improve the outcomes of IVF or ICSI.
Topics: Abortion, Spontaneous; Acupuncture Therapy; Embryo Implantation; Female; Fertilization in Vitro; Humans; Live Birth; Pregnancy; Pregnancy Outcome
PubMed: 22540969
DOI: 10.1089/acm.2011.0158 -
Gynecological Endocrinology : the... Sep 2004Our objective was to evaluate whether ovulation induction with an increased clomiphene citrate dose of 150-250 mg/day for 5 days adversely affected pregnancy outcome. A...
Our objective was to evaluate whether ovulation induction with an increased clomiphene citrate dose of 150-250 mg/day for 5 days adversely affected pregnancy outcome. A retrospective chart review of 1910 medical records yielded 119 pregnancies with sufficient information regarding domiphene dose and pregnancy outcome. Of the 84 pregnancies that followed clomiphene doses of 50-100 mg/day, 32.1% ended in spontaneous abortion, 10.7% in ectopic gestation, 1.2% with congenital malformations, 2.4% in stillbirth and 53.6% in normal gestation. Of the 35 pregnancies that followed clomiphene doses of 150-250 mg/day, 34.3% ended in spontaneous abortion, 5.7% in ectopic gestation, 2.9% with congenital malformations, 2.9% in stillbirth and 54.3% in normal gestation. These differences were not statistically significant. These data suggest that a clomiphene dose of 150-250 mg/day does not appear to increase adverse pregnancy outcomes.
Topics: Abortion, Spontaneous; Clomiphene; Congenital Abnormalities; Female; Humans; Ovulation Induction; Pregnancy; Pregnancy Outcome; Pregnancy, Ectopic
PubMed: 15697075
DOI: 10.1080/09513590400007234 -
Obstetrics and Gynecology Jan 2010
Topics: Adult; Female; Humans; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Research Design; Risk Assessment; Thrombophilia
PubMed: 20027026
DOI: 10.1097/AOG.0b013e3181c879ca -
Journal of Quality in Clinical Practice Jun 1997Clinical indicators associated with the process of childbirth are either gross (e.g. perinatal mortality rate) or measures of intervention (e.g. Caesarean section rate)....
Clinical indicators associated with the process of childbirth are either gross (e.g. perinatal mortality rate) or measures of intervention (e.g. Caesarean section rate). Morbidity and process are rarely, if ever, addressed. We developed and piloted a simple pregnancy outcome score as a comparative indicator of outcome. This scoring system is easy to apply, and there was a positive and significant correlation between the pregnancy outcome score and the risk status of the patients.
Topics: Female; Humans; Infant Mortality; Infant, Newborn; Morbidity; Outcome Assessment, Health Care; Pilot Projects; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Queensland
PubMed: 9178215
DOI: No ID Found -
Journal of the National Medical... Nov 2003
Review
Topics: Black or African American; Female; Humans; Models, Psychological; Pregnancy; Pregnancy Outcome; Stress, Physiological; Stress, Psychological; United States
PubMed: 14651379
DOI: No ID Found -
Journal of Perinatology : Official... Dec 1992
Topics: Female; Humans; Obstetrics; Physician-Patient Relations; Pregnancy; Pregnancy Outcome
PubMed: 1479470
DOI: No ID Found -
The Journal of Maternal-fetal &... Jan 2014
Topics: Female; Humans; Parity; Pregnancy; Pregnancy Outcome
PubMed: 23663157
DOI: 10.3109/14767058.2013.804055 -
Statistical Methods in Medical Research Apr 2006Using epidemiology to elucidate the causes of adverse pregnancy outcomes offers unique opportunities and poses distinctive challenges. The context of pregnancy includes...
Using epidemiology to elucidate the causes of adverse pregnancy outcomes offers unique opportunities and poses distinctive challenges. The context of pregnancy includes contraception and planning, medical interventions altering the natural history, and the tendency for selective participation in demanding research protocols. Several key pervasive issues are considered in detail: 1) the close temporal proximity of determinants and outcomes, which makes separation of causes and effects difficult and introduces the real possibility of reverse causality; 2) non-random allocation of exposure, often done consciously in response to concerns about having a healthy pregnancy or to the health of the pregnancy itself, making confounding a major concern; 3) heterogeneity of pregnancy outcomes, with endpoints such as pregnancy loss and preterm birth arising through diverse pathways that are not easily identified and if grouped, could diminish the magnitude of observed associations; and 4) racial and ethnic disparities, which pose a public health challenge in the USA and offer a potentially important opportunity for identifying preventable causes of adverse pregnancy outcome. Sophisticated biological and statistical methods are needed to advance epidemiologic research in this area.
Topics: Epidemiologic Studies; Female; Humans; Pregnancy; Pregnancy Outcome; United States
PubMed: 16615651
DOI: 10.1191/0962280206sm433oa -
European Journal of Obstetrics,... Oct 2023This retrospective single centre study considers the predictive value of specific ultrasound features of sub-chorionic haemorrhage (SCH) as potential indicators of...
INTRODUCTION
This retrospective single centre study considers the predictive value of specific ultrasound features of sub-chorionic haemorrhage (SCH) as potential indicators of adverse pregnancy outcome.
METHODS
Ultrasound reports and images were reviewed for 160 participants presenting to an early pregnancy assessment unit from January 2018 to January 2019. Participants were selected based upon the presence of SCH within the first trimester. The outcome of each pregnancy and the features of SCH, including the size, location and echogenicity were recorded and multinominal logistic regression was used to establish predictive value.
RESULTS
The majority of participants were asymptomatic and delivered healthy babies. 24% miscarried prior to delivery or had stillborn babies; the features of bleed within this group revealed an increased prevalence of adverse outcome in the presence of moderate sized haemorrhage (p = 0.02). 61% of miscarried pregnancies presented with "wrapping" SCH, in which haemorrhage encased the gestation sac, suggesting wrapping posed a probable risk (p = 0.01). 71% of miscarriages occurred within 5 + 0-10 + 0 weeks gestation. Persistent SCH was of greater incidence within those participants with adverse outcome (57%). There was no association between fetal abnormality and miscarriage. Jaundice babies and premature delivery occurred more frequently (p = 0.001) and may be a secondary finding following SCH.
CONCLUSION
There was a strong correlation between presence of SCH in early pregnancy and rate of miscarriage. Specific ultrasound features of SCH, most notably a wrapping location with moderate size, may be indicative of increased risk of miscarriage or post-natal complications. Jaundice and premature births may have an association with placental compromise.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Retrospective Studies; Placenta; Pregnancy Outcome; Pregnancy Trimester, First; Hemorrhage; Premature Birth; Ultrasonography
PubMed: 37619520
DOI: 10.1016/j.ejogrb.2023.08.009