Comment:A few articles on time-lapse embryology, link to a new Andrology book, a great review by ACE on embryo culture media, and several archive links to FertAids chronology, and a paper on the generational risk to male smoking.
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The role of seminal plasma for improved outcomes during in vitro fertilization treatment: review of the literature and meta-analysis
CONCLUSIONS There are significantly improved outcomes when women are exposed to seminal plasma around the time of ovum pick-up or embryo transfer, with statistical significance for clinical pregnancy but not for ongoing pregnancy/live birth rates being achieved. This meta-analysis is limited by the small number of studies of variable methodology.
Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review
The studies in this review indicate that children born through ART have positive parent–adolescent relationships and are well adjusted, with some slight differences based on different ART. - - Some differences were however identified based on the type of ART used. In particular, the sex of the parent and child, along with age and process of disclosure of the adolescent's conception were identified as key mediators of parent–adolescent relationshi
Normal live birth after vitrified/warmed oocytes intracytoplasmic sperm injection with immotile spermatozoa in a patient with Kartagener's syndrome
The present article is a report on two cases of male Kartagener's syndrome enrolled in intraconjugal IVF programme due to akinetospermia. Viable spermatozoa were selected using a hypo-osmotic swelling test (HOST) and pentoxifylline activation and subsequently microinjected into vitrified/warmed oocytes. The treatment enabled one of these two couples to achieve a pregnancy and to give birth to a healthy baby girl
An economic assessment of embryo diagnostics (Dx) - the costs of introducing non-invasive embryo diagnostics into IVF standard treatment practices [no
This study shows that improved embryo diagnosis combined with SET may have the potential to reduce the cost per live birth per couple treated in IVF treatment practices. The results of this study are likely more sensitive to changes in the ongoing pregnancy rate and consequently the live birth rate than the diagnosis costs. The introduction of a validated Embryo-Dx technology will further support a move towards increased eSET procedures in IVF cl
How strict should specimen acceptance or rejection criteria be for diagnostic semen analysis? An opinion.
However, such criteria were originally developed by the World Health Organization in order to standardise analysis rather than reject testing outright, and should therefore be implemented with caution. Rejecting samples with normal semen parameters because they fail to meet some of the criteria as outlined above would be a waste of resources and adversely affect user (the person who requested or provided the sample) satisfaction. This document ev
At the end of the meeting, the following consensus discussion points were acknowledged as requiring further consideration:(1) There is strong evidence for beneficial effects of low oxygen during culture.
(2) No individual commercially available culture system has been definitively shown to be better than others in terms of embryo viability.(3) Concerns exist regarding possible epigenetic and long-term culture effects and require further investig
A.R.T. and history, 1678–1978 [Archive, Chronology]
Louise Brown, the first baby conceived after IVF, was born on 25 July 1978 and turned 27 last year. From one perspective, her birth can be seen as the culmination of 300 years of medical and scientific investigation aimed at understanding the fascinating process of reproduction.
Effects of dietary interventions on neonatal and infant outcomes: a systematic review and meta-analysis
All dietary interventions and those focused on macronutrient intake also increased birth weight (P < 0.01) and length (P < 0.05) and reduced the incidence of low birth weight (P < 0.01). Dietary interventions in low-income countries and underweight or nutritionally at-risk populations increased birth weight (P < 0.05) and reduced the incidence of low birth weight (P = 0.01). No effects were seen for the following other outcomes: placental weight,
Damaging legacy: maternal cigarette smoking has long-term consequences for male offspring fertility
This study represents the first comprehensive animal model of maternal smoking on male offspring reproductive function, suggesting that exposure during the gestational/weaning period causes long-term defects in male offspring fertility. This is due to a compromised spermatogonial stem cell population resulting from gonocyte apoptosis and impaired spermatogenic development. This results in significant germ cell damage and Sertoli cell dysfunction
Interpretation - We describe the first livebirth after uterus transplantation. This report is a proof-of-concept for uterus transplantation as a treatment for uterine factor infertility. Furthermore, the results show the feasibility of live uterus donation, even from a postmenopausal donor.
Reproducibility of a time-lapse embryo selection model based on morphokinetic data in a sequential culture media setting [Note Free PDF]
The outcomes of the embryos based on the dynamic score do not comply with the results of the preconstructed model. Each IVF
laboratory is unique based on its practice. Therefore, we suggest that each IVF laboratory should determine its own embryo selection criteria
based on its own data instead of using a preconstructed model.
Time-lapse in the IVF-lab: how should we assess potential benefit?
In this opinion paper, we explore the lack of evidence of benefit of this novel intervention, analyse the methodological flaws of current studies, offer ideal study designs that assess the various features of time-lapse imaging, and discuss forthcoming studies. In particular, we emphasize the ethical aspects of hastily adopting a costly technology without current high level evidence of improved live birth rates, safety and cost effectiveness.
Laser-assisted zona pellucida thinning does not facilitate hatching and may disrupt the in vitro hatching process: a morphokinetic study in the mouse
The experiments demonstrate that zona thinning is not equivalent to zona opening for assisted hatching. The study provides reason for systematic reviews of assisted hatching trials to take the method of assisted hatching into consideration and not combine the results of zona thinning and zona opening procedures.
Ovarian tissue, egg freezing should be made widely available to prevent age-related infertility, say leading fertility experts
Over the past 10 years, researchers have restored the fertility of female cancer patients who would otherwise have been left infertile after treatment, having been offered oocyte cryopreservation. The technique enables women to freeze their eggs and use them at a later time to conceive a child. Several babies have been born to cancer patients using this technique, which is no longer classed as experimental.
Damaging legacy: Mothers who smoke affect the fertility of their sons
Mothers who smoke while they are pregnant or breast feeding may be damaging the future fertility of their sons, according to new findings. The study is the first comprehensive animal model to show the mechanism by which smoking can affect the fertility of male offspring. Until now, the effects on the fertility of male offspring and the mechanisms involved have been unclear - a problem that has been confounded by the lack of animal studies in whic
World's first child born after uterus transplantation
Seven Swedish women have had embryos reintroduced after receiving wombs from living donors. Now the first transplanted woman has delivered a baby – a healthy and normally developed boy.
An economic assessment of embryo diagnostics (Dx) - the costs of introducing non-invasive embryo diagnostics into IVF standard treatment practices -
Conclusions: This study shows that improved embryo diagnosis combined with SET may have the potential to reduce the cost per live birth per couple treated in IVF treatment practices. The results of this study are likely more sensitive to changes in the ongoing pregnancy rate and consequently the live birth rate than the diagnosis costs.
Male Infertility: Sperm Diagnosis, Management and Delivery provides a comprehensive understanding of various aspects of male infertility and its treatment. The book opens with an introduction to basic anatomy and physiology and includes subsequent chapters on the causes and effects of poor semen quality, guidance on how to perform semen analysis, cryo-banking and oncology, ethical and regulatory requirements of using male gametes for fertility tr
A concise summary of the current state of play with the use of culture media in IVF. To summaries briefly, all we believe to be true (from mouse work) may not be so for human IVF culture
Comment
This well produced summary of a weekend meeting in the UK in 2013 is an easy read with sections on the evolution of media (Henry Leese), embryo metabolism (Roger Sturmey), sequential media (Michael Summer), growth factors (Daniel Brison), embryo damage (John Huntriss), optimisation of culture (Thomas Ebner). A survey of the major clinics showed a diversity of practice that may or may not have an impact. The meeting appeared very critical of the current state of play with a poor level of confirmatory studies and display of components by media manufacturers.
Title
Effects of dietary interventions on neonatal and infant outcomes: a systematic review and meta-analysis
Summary
An article of interest to IVF clients and any couple considering pregnancy.
Comment
Using meta-analysis methodology, the study suggests that the risk of a low birth weight birth can be mitigated by improved diet but there was no specific diet that could be recommended. Diet did not appear to influence other pregnancy issues including perinatal mortality. IVF clinics, now practicing in almost every country, probably has a limited duty of care about helping their clients manage their pregnancies but low birthweight continues to be an issue for ART conceptions and every effort needs to be made to normalise this. Perhaps clinics may mention in their information brochures a comment relating diet to pregnancy outcome.
Title
How strict should specimen acceptance or rejection criteria be for diagnostic semen analysis?
Summary
An opinion paper discussing the need for tolerance in rejecting a semen sample for collection violations where the analysis is normal is a timely reminder to Andrology workers.
Comment
In this article Woodward and Tomlinson explore the various reason why samples may be rejected including patient identification, sexual abstinence, Completeness of a sample, collection interval and transport temperature, medication and container. In essence they argue that with the exception of post vasectomy samples and patient identification, if the sample is normal then there needs to be a pragmatic view to reject a sample if say the sample is incomplete or the duration or transport temperature is outside a laboratory guidelines. Since these and other factors may act to diminish the quality of a sample, a normal sample clearly means that these outliers had little or no impact on the quality of the sample or that if there was an effect, the sample can only have been better than reported but it would still have normal. They argue that there are no external influences that can improve the quality of a semen sample so that rejection of a normal sample can only causes the client inappropriate actions and that a sensible compromise is suggested that the samples are not rejected (but the report should contain a comment that the sample breached lab guidelines for acceptance of a sample but was accepted post analysis showing it be normal).
IVF Training - Questions relating to mailout links -
Open Challenge and complete Questions
Question
Type
Options
On culture media, there is strong evidence that low oxygen during culture is beneficial
1
2
On culture media, concerns over epigenetic effects remain valid
1
2
On culture media, there are no concerns over depletion of nutrients during prolonged culture
1
2
On culture media, there are no concerns over accumulation of waste products during prolonged culture
1
2
Large multicentrered trials are needed to validate different culture media
1
2
Improved diet reduces the risk of low birth weight pregnancies
1
2
Improved diet reduces the risk of prenatal mortaility
1
2
What information should be recorded on a semen sample for diagnostic otr therapeutic purposes.
2
8
What Information Should Be Recorded On A Semen Sample For Post Vasectomy Semen Analysis
2
8
What is the minimum requirement for patient identifiers at collection
1
5
Which of these identifiers are suitable for identification of a sample?
2
11
Rejection of samples are rare but the reference cites another study suggesting the rate of rejection of samples is in the order of:
1
5
Which of the following statements on sexual abstinence is true:
2
10
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Vit Kit - Warm NX is an adaptable, cost-effective system for use in the thawing of oocytes, pronuclear zygotes, cleavage stage embryos, and blastocyst stage embryos. Unlike many vitrification kits that feature a mono-buffered system and M199 base med
Vit Kit - Freeze NX is an adaptable, cost-effective system for use in the vitrification of oocytes, pronuclear zygotes, cleavage stage embryos, and blastocyst stage embryos. Vit Kit - Freeze NX is the latest advancement in vitrification media aimed t
S-Cryolock is the slimmer version of the original. It is a versatile, simple and efficient vitrification device that is intended for the holding, cryopreservation and storage of oocytes or embryos in liquid nitrogen.
Source
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