Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reproductive Technologies”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources

Importance of assisted reproductive technologies in the conservation of wild, rare or indigenous ungulates: review article.

Biodiversity is increasingly threatened by intensive agriculture, environmental pollution, extinction of natural habitats and several other factors. Several mammalian species including ungulates have disappeared or are threatened by extinction. However, ungulates play an important role both in the ecosystem and in the economy. In general, species or breeds are considered endangered if their population does not exceed 1,000 individuals. In these cases conservation programmes should be initiated in order to maintain or even increase their number. This review deals with the possibilities and limitations of assisted reproductive technologies (ART) in the conservation of ecologically valuable wild, rare and indigenous ungulates. The methods discussed here are artificial insemination, cryopreservation of semen and embryos, embryo recovery and transfer, in vitro production of embryos, as well as micromanipulation techniques including sperm injection, assisted hatching and cloning. Some of these procedures are already being exploited in the breeding of farm ungulates, but more basic information about the reproductive patterns of wild, rare and indigenous animal species is needed before the routine use of ARTs.

Animals↗

Effects of induction anesthetic agents on outcome of assisted reproductive technology: a comparison of propofol and thiopental sodium.

BACKGROUND: The use of propofol, as compared to barbiturates (e.g. thiopental), for short surgical procedures has been associated with more rapid recovery from the procedure. Propofol, an intravenous anesthetic drug, is frequently used as an adjunct to transvaginal oocyte retrieval but little is known about its effects upon fertilization, embryo development, and pregnancy rate when used drug the for induction of general anesthesia. This study was conducted to compare the outcome of assisted reproductive technology (ART) with the use of propofol versus thiopental sodium for the induction of general anesthesia during oocyte retrieval. METHODS: In this retrospective study, 92 cases of infertile patients who underwent oocyte retrieval under the induction of general anesthesia with, respectively, either propofol (Group I, 72 cases) or thiopental sodium (Group II, 20 cases) were compared for fertilization rate, cleavage rate, and pregnancy rate. RESULTS: The fertilization rate was 68.9% for Group I and 66.7% for group II (p = 0.614). The cleavage rate was 96.5% for Group I and 94.8% for Group II (p = 0.294). The rate of good embryo grading and poor embryo grading was, respectively, 85.1% and 14.9% for Group I, versus 85.7% and 14.3% for Group II (p = 0.887). The pregnancy rate was 30.5% for Group I and 20.0% for Group II (p = 0.354). The implantation rate and abortion rate was, respectively, 9.1% and 18.2% for Group I versus 7.2% and 25.0% for Group II (implantation rate, p = 0.590; abortion rate, p = 0.600). CONCLUSION: There were no significant differences between these two groups for fertilization rate, cleavage rate, pregnancy rate, implantation rate and abortion rate. We suggest cautious use of propofol for the procedure of oocyte retrieval despite its associated more rapid post-operative recovery including less nausea/vomiting.

Anesthetics, Intravenous↗

Double-blind placebo controlled study: human biosynthetic growth hormone for assisted reproductive technology.

OBJECTIVE: To study whether the effect of cotreatment with human biosynthetic GH improves the outcome of poor IVF responders. DESIGN: A double-blind placebo-controlled study using a GnRH agonist (GnRH-a) and gonadotropin in a "boost" flare-up protocol for ovarian stimulation together with either placebo, 4, or 12 IU of human GH followed by oocyte retrieval and IVF-ET. PATIENTS: Twenty-two patients with previously demonstrated poor responses in at least two assisted reproductive technology cycles were recruited. INTERVENTIONS: Pretreatment and post-treatment blood samples and daily morning blood samples during ovarian stimulation were collected after an overnight fast. Human GH or placebo and GnRH-a were administered SC; gonadotropin was administered IM. Oocytes were collected by ultrasound-guided transvaginal aspiration of follicles. Embryos were cultured in vitro and transferred transcervically. MAIN OUTCOME MEASURES: Serum E2, FSH, GH, insulin-like growth factor-I (IGF-1), IGF binding protein 1 (IGFBP-1), and IGFBP-3 concentrations. Number of FSH ampules, follicles, oocytes, embryos, and pregnancies. RESULTS: No improvement in cycle outcome was demonstrated with daily adjuvant human GH administration with either 4 or 12 IU. Serum IGF-I levels were highest in the 12 IU human GH group and lowest in the placebo group. Serum IGFBP-3 levels increased 2 days after IGF-I levels in the 12 IU human GH group only. Serum IGFBP-1 levels were unchanged in all groups. CONCLUSION: Poor IVF responders do not benefit from cotreatment with human GH during their ovarian stimulation.

Adult↗

Reevaluation of testicular biopsies of males with nonobstructive azoospermia in assisted reproductive technology.

Spermatogenesis was investigated in seminiferous tubules of 100 males with nonobstructive azoospermia. Forty-four (44%) cases had Sertoli-cell-only syndrome, 23 (23%) had spermatogonium in the tubules, 17 (17%) had primary spermatocyte in the tubules, and 16 (16%) had round or late spermatid in the tubules. No cases showed secondary spermatocyte present in the tubules. The mean serum follicle-stimulating hormone (FSH) in males with nonobstructive azoospermia was significantly higher than that in males with obstructive azoospermia (p < .001). The mean concentrations of serum FSH in cases with Sertoli-cell-only syndrome and spermatogonium in the tubules were significantly higher than those in cases with primary spermatocyte and spermatid in the tubules (p < .05-.001). The results indicate that the evaluation of testicular histology using the type of germ cells present in seminiferous tubules is available for assisted reproductive technology.

Biopsy↗

On teaching biopolicy and values in selected reproductive technologies: abortion, in vitro fertilization, and surrogate motherhood.

This article is divided into three parts: "Faculty Preparation: Immersion in the Literature," "Conceptualizing and Organizing the Course," and "Course Design." The first part is addressed particularly to readers without access to a computer search of the literature. It suggests resource materials for each of the technologies. It also speaks to the meanings of and approaches which may be used to study biopolitics. Biopolicy is the approach used in the course. The second part addresses the problem of finding a unifying concept which would bring cohesion to the multiple and diverse materials and issues. It also includes the statement of purpose and course objectives. It is here that the development of identifying and demonstrating the nexus between the reproductive technologies and public policy begins. It also discusses methodologies used in the course. The third part lists the activities that served as a guide in designing the course and cites remaining caveats in course development. The paper concludes with statements about required reading materials, review materials, audio-visual aids, and a broad outline of the course.

Abortion, Induced↗

Assisted reproductive technologies and monozygous twins: implications for future study and clinical practice.

That the zona pellucida (ZP) plays a prominent role in the physiology of some human twinning is an attractive, albeit incompletely proven, medical hypothesis. Indeed, an association has been proposed between manipulation of the ZP and/or native ZP microarchitecture and monozygotic (MZ) twins. Ovulation induction also has been theoretically linked to in vivo ZP alterations facilitating MZ twin development. In vitro fertilization (IVF) relies on necessary (and, in some cases extended) embryo culture techniques potentially creating subtle ZP changes and subsequent MZ twinning. With growing experience in the assisted reproductive technologies and particularly IVF, some preliminary reports have noted an increased frequency of MZ twins after procedures that artificially breach the ZP (i.e., intracytoplasmic sperm injection [ICSI], or 'assisted hatching'). Such ZP manipulations ostensibly enhance oocyte fertilization or facilitate blastocyst hatching, thus improving pregnancy rates for couples undergoing fertility treatment. Evidence exists both to challenge and support the connection between these phenomena and MZ twins. This report outlines the fundamental embryological processes believed responsible for these conflicting observations; the current literature on the subject of human ZP micro-manipulation and MZ twins is also discussed.

Female↗

Assessment and optimization of oocyte quality during assisted reproductive technology treatment.

The health of fetuses, neonates, and adults depends on normal development of the oocytes and embryos from which they arise. In addition, the ability of an embryo to implant, sustain a pregnancy, and give rise to a viable offspring is unquestionably rooted in oogenesis. Therefore, defining markers that can reliably predict the best quality oocytes will prove invaluable in the care and management of infertility patients. Furthermore, identification of the best quality oocyte will also permit the transfer of a single embryo, thereby increasing overall pregnancy rates and reducing multiple rates. Although a few potentially important predictors of oocyte quality have been identified, their application for routine use in the assisted reproductive technology (ART) laboratory remains to be established. With the critical need for markers to be noninvasive, reliable, and assayable with a rapid turnaround, key areas that will take advantage of recent technological advances are identified in this article. Oocyte quality also needs to be improved in the management of human infertility by ART programs. Given that mechanisms determining oocyte quality are multifactorial and complex, several possible areas that continue to necessitate optimization are discussed.

Animals↗

Comparison of implantation and pregnancy rates in African American and white women in an assisted reproductive technology practice.

OBJECTIVE: To compare IVF outcomes between infertile African American and white women. DESIGN: Retrospective cohort study. SETTING: Hospital-based IVF practice. PATIENT(S): Women undergoing IVF procedures between November 1996 and June 2000. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Implantation and pregnancy rates. RESULT(S): There were 24 African American and 273 white women < or =40 years of age who underwent 25 and 333 IVF cycles, respectively. African American women were more likely to have had tubal factor as a primary diagnosis, to have had a child, and to have undergone fewer previous assisted reproductive technology (ART) cycles as compared to white women. No differences between the two groups for clinical variables were noted with the exception of body mass index (BMI [kg/m(2)], 27.1 in African Americans vs. 24.8 in whites). Implantation rates were higher in African American than in white women (35% vs. 23%, respectively). Pregnancy rates were 71% in African Americans and 48% in whites. After adjustment for tubal factor, BMI, and parity, the odds ratio for pregnancy in African American women versus white women increased from 2.6 to 3.3. CONCLUSION(S): This is the first study to demonstrate a significantly higher clinical pregnancy rate in African American women as compared to white women undergoing ART. These data strongly contradict a recent study comparing the same two groups of women undergoing ART. We urge other ART centers to report their data pertaining to race.

Adult↗

A protocol of electroejaculation and systematic assisted reproductive technology achieved high efficiency and efficacy for pregnancy for anejaculatory men with spinal cord injury.

OBJECTIVE: To help anejaculatory men with spinal cord injury (SCI) to procreate. DESIGN: Prospective, clinical study. SETTING: A team of physiatrists, urologists, and gynecologists at a university hospital in Taiwan. PARTICIPANTS: Ten infertile men with SCI seen at our hospital between 1995 and 2001. INTERVENTIONS: Electroejaculation induced their seminal emission. Depending on semen parameters, the couples were treated with intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), surgical retrieval of sperm, cryopreservation of sperm, or donor sperm. MAIN OUTCOME MEASURES: Fertilization and pregnancy. RESULTS: Ten couples underwent assisted reproductive technology (ART). One couple achieved pregnancy after the second cycle of electroejaculation and IUI. Seven couples underwent 8 cycles of ICSI, 4 cycles with fresh electroejaculates, 2 with cryopreserved samples, and 2 with cryopreserved samples with addition of pentoxifylline. Seven (88%) clinical pregnancies were achieved, 2 of which ended with spontaneous abortion. One couple accomplished pregnancy by ICSI with cryopreserved sperm from vasal aspiration. The percentages of fertilization and pregnancy of ICSI cycles using sperm from men with SCI were comparable to men without SCI. One couple attained pregnancy by using donor sperm. The cumulative successful pregnancy rate per couple was 80% (8/10). CONCLUSION: Electroejaculation and systematic ART are highly efficient for achieving pregnancy with the spouses of men with SCI. The neurologic deficit and electroejaculation did not affect the outcome of ICSI. Using cryopreserved sperm for ICSI may reduce risk from electroejaculation or surgery.

Adult↗

Male infertility: the impact of assisted reproductive technologies.

Spermatozoal abnormalities are present in up to 40% of infertile couples. Multiple etiologies may be responsible for these disorders, including pretesticular, testicular, and ductal causes. An adequate andrologic consultation, including history, physical examination, and repeated semen analysis, should be performed routinely in these cases. Evaluation of the basic sperm parameters, including sperm concentration, motion parameters (as evaluated by computer-assisted semen analysis), and sperm morphology (as judged by strict criteria), constitute the first obligatory step for a critical evaluation of male factor patients. Patients in whom fertilization disorders are suspected should be evaluated through bioassays of sperm-oocyte interaction, including the heterologous sperm penetration assay and hemizona assay, a bioassay of sperm-zona binding capacity highly predictive of in vitro fertilization outcome. Male disorders can be subjected to specific therapies (surgical or medical), or to empiric therapeutic modalities. Assisted reproductive technologies have enhanced our understanding of the physiopathology of spermatozoal disorders and also have ostensibly improved pregnancy rates in male factor patients.

Female↗

The role of animal studies in supporting human assisted reproductive technology.

Although average success rates of human IVF have increased progressively during the past two decades, the efficiency of this technique, based on each embryo produced or transferred, is still low. High success rates are usually achieved by transferring several embryos to the patient, which is often associated with multiple pregnancies. The quality of in vitro produced embryos is a major area that needs attention. Because there is no in vivo database for human embryos, the properties of normal embryos are not known, and so it is difficult to know how to improve quality and viability. In addition, selection of the most viable embryos for transfer is a rather subjective process. The origins of human assisted reproductive technology (ART) are based on animal ART; however, the two areas of research (animal and human ART) appear to have become disconnected. Re-examination of progress in animal ART could help improve human embryo quality and thereby assist efforts to sustain high pregnancy rates with only one or two embryos transferred. Some key areas in which animal ART can help guide progress in human ART are discussed.

Animals↗

Effect of age on pregnancy outcome without assisted reproductive technology in women with elevated early follicular phase serum follicle-stimulating hormone levels.

There are data suggesting that patients with elevated early follicular phase serum follicle-stimulating hormone (FSH) levels have a poor fertility outcome. This has been attributed to a high rate of aneuploidy in the oocytes. It is not clear whether the spindle defects leading to nondisjunction are related to the high FSH levels or the age of the oocyte. The study presented herein retrospectively evaluated 6-month pregnancy rates in women with elevated early follicular phase serum FSH levels according to age. Only cases without in vitro fertilization were used, since the elevated FSH levels were deemed likely to interfere with multiple egg recruitment needed for assisted reproductive technology. The 6-month clinical and ongoing pregnancy rates were significantly higher in the women <40 years of age (46.1 and 34.6%, respectively) than in those aged 40 or older (10.5 and 5.3%). These data suggest that women with elevated follicular-phase serum FSH levels have a better fertility prognosis when they are younger.

Adult↗

In vitro blastocyst development from serially split mouse embryos and future implications for human assisted reproductive technologies.

OBJECTIVE: To assess the efficacy of serial splitting of mouse embryos with respect to blastocyst development. DESIGN: Prospective study. SETTING: Commercial research facility. ANIMAL(S): Commercially available mouse embryos from B6C3F-1 x B6D2F-1. INTERVENTION(S): One, two, and three blastomeres were biopsied from two-, four-, and six-cell embryos, respectively, and were inserted into empty zona pellucida recipients (first split). These embryos were cultured to reach their original cell number status and then were split again (second split). Once these embryos regained their original cell status, they were split yet again (third split). MAIN OUTCOME MEASURE(S): Blastocyst development of embryos split serially at the two-, four-, and six-cell stages. RESULT(S): The blastocyst development rate for two-, four-, and six-cell embryos subjected to a first split was 74.3%, 75.0%, and 66.6%, respectively, as compared with 71.8%, 62.6%, and 48.4% (second split) and 48.4%, 38.1%, and 10.6% (third split). CONCLUSION(S): First and second splitting of cleavage-stage embryos has yielded high efficiency rates for blastocyst development when compared with the third splitting, which did not provide any beneficial advantage for further embryo splitting and multiplication. This is the first study reporting on three serial embryo splittings in a mammalian species. Embryo splitting may have significant impact and applications in human assisted reproductive technology.

Animals↗

Safety issues in assisted reproduction technology. From theory to reality--just what are the data telling us about ICSI offspring health and future fertility and should we be concerned?

Concerns about the effects of ICSI on offspring health and fertility include the rate of chromosomal anomalies, cystic fibrosis (CF) gene mutations associated with congenital bilateral absence of the vas deferens (CBAVD) and Y-chromosome microdeletions. The evidence in favour of screening for these in the presence of azoospermia or severe oligozoospermia is beyond debate. Concerns requiring further investigation include the effects of ICSI on imprinted genes and genes involved in DNA replication error repair. There is evidence of an increased risk of low birth weight, cerebral palsy and major birth defects following assisted reproductive technologies (ART), including ICSI, although the causes remain unknown. Given the large studies required to investigate these questions, particularly for rarer genetic conditions, we may simply have to accept that we may not know for many years if there are increased risks associated with ICSI. It would be prudent, however, to acknowledge this as a possibility and counsel patients accordingly. In terms of certainty of outcome and magnitude of impact the single most important health effect of ART for the offspring remains the iatrogenic multiple pregnancy rate. A reduction of iatrogenic multiples is the single most important and achievable means of preventing cerebral palsy currently available. Once achieved, the occurrence of rare genetic conditions will assume greater importance.

Child Welfare↗

Assisted reproductive technologies may obviate apparent immunologic infertility.

Spermatozoal autoantibodies have been associated with reduced fertilization by natural coital methods. Nine subfertile men were evaluated who repeatedly tested positive for spermatozoal autoantibodies as characterized by direct immunobead test. Using the hemizona assay, we determined whether tight binding of spermatozoa to the zona pellucida was reduced in these test males as compared to a fertile male whose semen had been cryopreserved and thawed immediately prior to testing. The average number of spermatozoa tightly bound to the zona pellucida from the subfertile male was significantly reduced compared to the fertile male (mean +/- SD, P less than or equal to 0.01) 19.5 +/- 8 versus 77.1 +/- 49. Seven of the nine couples eventually had successful fertilization using intrauterine insemination or gamete intrafallopian tube transfer and one couple conceived with natural coital insemination. Our findings, albeit limited, suggest that greater caution should be used in implicating associations of spermatozoal autoantibodies with absolute infertility, because novel assisted reproductive technologies often may obviate conventional encumbrances on opportunities for pregnancy.

Adult↗

Genetics and assisted reproduction technology.

In the past 20 years, a significant improvement has been shown in the treatment for infertility in both women and men through the development of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Only donated sperm could be previously used for treatment; now oocytes can also be donated. Furthermore, the combination of IVF and ICSI with advanced genetic methods has made preimplantation genetic diagnosis possible for many genetic conditions. These methods enable genetic testing of the early human embryo by using only a single cell, one blastomere biopsied from the embryo, as the sample from which the diagnosis of many chromosome rearrangements and other inherited diseases can be made. It has also been established that a considerable proportion of infertility is caused by genetic defects, which have several implications for infertility treatment. The purpose of this review is to give a concise introduction on how genetics is involved in assisted reproduction technology to specialists who may not be working in this particular field of gynecology, but who would need some knowledge of this for proper care of their patients.

Female↗

Therapeutic strategy after microsurgical varicocelectomy in the modern assisted reproductive technology era.

In this study, we searched for prognostic factors at preoperative examination for the improvement in spermatogenesis of patients undergoing varicocelectomy. Eighty patients with varicocele testis underwent microsurgical varicocelectomy. Before surgery, the seminogram, testicular volume, varicocele grade, and serum FSH, LH, testosterone, prolactin, and estradiol were evaluated. Postoperatively, semen analysis was performed every 3 months. We assessed the associations between the preoperative variables and postoperative seminogram improvement. 0f 80 patients, 37 showed improvement, usually by 6 months. Patient age, duration of sterility, testicular volume, sperm motility, morphology, semen volume, serum LH, testosterone, prolactin, and estradiol showed little difference between responders and non-responders. A small left testis, or a grade III varicocele decreased the likelihood of improvement. Patients with a sperm count of 10-20 x 10(6)/ml were significantly more likely to respond to varicocelectomy than those with sperm counts <5 x 10(6)/ml. Patients with elevated FSH were less likely to respond, as were those with a Johnsen score below 6. Varicocelectomy alone is unlikely to improve sperm counts of patients with a sperm count below 5 x 10(6)/ml, high FSH, small left testes, or Johnsen scores below 6. In conclusion, for couples in this situation, assisted reproductive technology coupled with varicocelectomy should be proposed.

Adolescent↗

[Assisted reproduction technologies and the risk of fetal, chromosomal and genetic malformations].

BACKGROUND: Assisted reproduction techniques allowed thousands of otherwise infertile couples to attain pregnancy. As this technology moves into the mainstream of infertility treatment, it has become more critical to reassess its safety. OBJECTIVE: To review the birth outcome of patients undergoing conventional in-vitro fertilization and intracyto- plasmic sperm injection regarding fetal malformations, chromosomal and genetic abnormalities. METHODS: Selective review of the literature. RESULTS: Most of the published data is from observational studies and is not randomized or blinded. Unfortunately, most articles are inherently biased. Chromosomal and genetic abnormalities are increased probably only as a direct corollary to the underlying parental risk and not due to the technology itself. There is a slight increase in the congenital malformations rate, but inspection of these malformations reveal no clustering of any specific abnormality. CONCLUSIONS: Children born after assisted reproduction technologies have an increased risk of a major congenital malformation and chromosomal abnormalities compared with those born after natural conception. The risk is mainly due to paternal and maternal risk factors, which are more prevalent in couples who use assisted reproduction techniques for reproduction. Infertility-linked risk is highly probable for the observed findings. A technique-related risk, however, cannot be ruled out. Intracytoplasmic sperm injection appears to be a safe alternative for couples who otherwise would be unable to achieve pregnancy. The inherent risks associated with these genetically "at risk" couples mandate thorough evaluation and counseling before undertaking ICSI.

Congenital Abnormalities↗