Perinatal Complications of Assisted Reproduction

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Perinatal Complications of Assisted Reproduction"

Transcription

1 REVIEW Perinatal Complications of Assisted Reproduction Mohamed A. Aboulghar The Egyptian IVF-ET Center, Maadi, Cairo, Egypt Abstract The main perinatal complications of assisted reproduction include congenital malformation, chromosomal aberrations, multiple pregnancy, and prematurity. Earlier studies and in vitro fertilization (IVF) registries showed that there was no increased incidence of congenital malformations in children conceived by IVF/intracytoplasmic sperm injection (ICSI). However, a large Australian study has found that by one year of age, the incidence of congenital malformations in IVF/ICSI children is increased in comparison with those naturally conceived. Several investigators found a slight but increased risk of chromosomal aberrations in ICSI children. Multiple pregnancy is a major cause of increased perinatal mortality due to increased incidence of both prematurity and congenital malformations. Even in singleton pregnancies conceived by assisted reproductive technologies, the risk of prematurity and newborns small for gestational age is increased. In this article, recently published work on perinatal complications associated with assisted reproductive technologies is reviewed. Croat Med J 2005;46(5): When in vitro fertilization (IVF) was first introduced into clinical practice, there were no data available on its safety. The first reports on the safety of IVF were published by Cohen (1) and the American Society for Reproductive Medicine and Society of Assisted Reproductive Technology (2). Their results were based on the analysis of large registries showed that IVF carried no additional risks in comparison with natural conception. When intracytoplasmic sperm injection (ICSI) was developed, concerns were raised that assisted reproductive techniques might carry an increased risk of chromosomal abnormalities and birth defects. Recent research confirmed the initial concerns and provided strong evidence that there is a high risk of congenital malformation after IVF/ICSI (3). Perinatal complications associated with assisted reproductive technology include congenital malformations, chromosomal aberrations, multiple pregnancy, and premature deliveries. Congenital Malformations Although tens of thousands of children have been born after assisted reproductive technology, the safety of these techniques for the offspring remains controversial. The results of the large comparative study showed that congenital anomalies were not more frequent in children born after IVF and ICSI than in naturally conceived children (4). In this study, major malformations defined as those causing functional impairment or requiring surgical correction were observed at birth in 3.4% of the live-born children after ICSI and in 3.8% of the children born after IVF. Malformation rate in children born after ICSI was not related to sperm origin or sperm quality. The number of stillbirths in children born after 20 weeks of pregnancy was 1.69% in the ICSI group and 1.31% in the IVF group. The comparison of children born after ICSI and IVF who were included in an identical follow-up study did not 751

2 show any increased risk of major malformations and neonatal complications in the ICSI group (4). However, a recently published large Australian study revealed an increased incidence of congenital malformations in children born after IVF and ICSI (3). These children were significantly more likely to have multiple major defects than those conceived naturally. The prevalence of major birth defects diagnosed by one year of age in infants conceived naturally or after ICSI or IVF was determined from the data obtained from three births registries in Western Australia. Twenty-six of the 301 (8.6%) infants conceived after ICSI and 75 of the 837 (9.0%) infants conceived after IVF had a major birth defect diagnosed by the age of one, as compared with 168 of the 4,000 (4.2%) naturally conceived infants. The odds ratio for a major birth defect by one year of age, after adjustment for maternal age and parity, the sex of the infant, and correlation between siblings, was 2.0 (95% confidence interval [CI], ) for children conceived after ICSI and 2.0 (95% CI, ) for those conceived after IVF. In short, these infants had twice as high a risk of a major birth defect as naturally conceived infants. Also, a significantly greater proportion of children conceived after assisted reproductive technology had musculoskeletal and chromosomal defects. The risk of a major birth defect associated with assisted conception remained significantly increased even in term singleton infants. Detailed ultrasonographic examinations of fetal anatomy were performed at weeks of gestation in almost all pregnancies in Western Australia (5). The majority of the defects diagnosed perinatally were clinically obvious at birth, irrespective of the method of conception. As all defects diagnosed up to one year after birth were included in the analysis, and 70% of all major birth defects are detected by that age in Western Australia, the possible bias due to different diagnostic vigilance in evaluation of fetuses after assisted reproduction was minimized (5). Such an approach allowed for comparison of malformation rates between ICSI and IVF children. These reported malformation rates are maximum estimates, since the children were scrutinized for both major and minor malformations. Therefore, the figures obtained from ICSI and IVF registries are higher than the figures in registries such as the Australian registry (6) or the Swedish registries (7). Moreover, definitions in those registers differ and certain conditions, such as pyloric stenosis or inguinal hernia, are sometimes omitted (4). In Sweden, infants born after IVF during the period were registered in all IVF clinics in the country. A study compared children born after IVF with all children born in Sweden during the same period and recorded in the Swedish Medical Birth Register (8). Among 16,280 children born after IVF including 30% conceived after ICSI, a 42% excess of congenital malformations was found in comparison with general population of children. This was explained by parental characteristics and, in some cases, by the high rate of multiple births (8). Despite significant public concern, most studies that assessed birth defects have not revealed significant deleterious effects of IVF (9). The small increase in the overall congenital malformations observed in children conceived after IVF in some studies seem to be attributed to differences in maternal characteristics rather than any aspect of the IVF procedure (10). Recently, Hansen et al (11) carried out a systematic review on the prevalence of birth defects, in infants conceived after IVF and/or ICSI versus spontaneously conceived infants. Out of 25 identified studies, 8 showed a 25% or greater risk of birth defects in infants conceived by assisted reproduction technology, whereas 7 suggested a 30-40% higher risk of birth defects after assisted reproduction technology in comparison with spontaneous conceptions (Table 1). Risk Factors for Birth Defects after Assisted Reproduction Technology Factors that may increase the risk of birth defects include the relatively advanced age of an infertile couple, the underlying cause of their infertility, and the medications used to induce ovulation or to maintain the pregnancy in early stages (3). These factors may also be associated with multiple and preterm birth (12). Dichorionic twins conceived after assisted reproduction technology compared with dichorionic twins conceived naturally had a higher risk for birth defects diagnosed at hospital discharge (14). No difference in malformation rate was observed with respect to different sperm parameters, as malformations were found in 3.4% of 752

3 Table 1. Congenital malformations in children conceived after assisted reproduction techniques (ART) including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) No. of children with anomalies/total (%) Author, year (ref. No.) Procedure ART naturally conceived P OR (95% CI)* Bonduelle et al, 2002 (3) ICSI 96/2,840 (3.4) none IVF 112/2,955 (3.8) none Hansen et al, 2002 (4) ICSI 26/301 (8.6) 168/4,000 (4.2) < ( ) IVF 75/837 (9.0) 168/4,000 (4.2) < ( ) Kallen et al, 2005 (8) IVF and ICSI 982/12,280 (8.0) national registry 42% excess in ART Anthony et al, 2002 (10) IVF 137/4,227 (3.2) 8,526/314,605 (2.7) 1.2 ( ) Hansen et al, 2005 (11) IVF and ICSI meta-analysis of 7 studies 1.4 ( ) IVF and ICSI meta-analysis of 25 studies ( ) Wennerholm et al, 2000 (12) ICSI 87/1,139 (7.6) national registry 1.75 ( ) Loft et al, 1999 (13) ICSI 20/730 (2.7) none *OR odds ratio; CI confidence interval. children conceived with ejaculated sperm, 3.8% of those born after ICSI with epididymal sperm, and 2.9% of those conceived with the testicular sperm (4). In infants born after ICSI, a risk of hypospadias was higher than in the general population, but this was not found in infants born after IVF (12,15). No significant difference for urogenital, urological or genital anomalies between children born after ICSI and IVF was found (4). Data in most registries show that malformation rates are higher in multiples than in singletons, which is an expected finding (12,15-18). Kuwata et al (14) showed that the incidence of birth defects in twins conceived by assisted reproduction technology was significantly higher than in naturally conceived twins, with an odds ratio of 6.9 (95% CI, ), 3.7 (95% CI, ), and 4.3 (95% CI, ) for ICSI, IVF and gamete intrafallopian transfer (GIFT), respectively. The frequency of birth defects in twins conceived by assisted reproduction technology was still significantly higher after adjusting for higher maternal age in that group of children. Chromosomal Abnormalities in ChildrenConceivedafter Intracytoplasmic Sperm Injection Concerns about the safety of ICSI are primarily associated with the procedure-related risk factors, which include physical and/or biochemical disturbance of ooplasm or meiotic spindles, injection of biochemical contaminants, and injection of foreign sperm-associated exogenous DNA (19). Several studies have assessed perinatally chromosomal abnormalities among ICSI fetuses (Table 2). Bounduelle et al (20) found 1.7% de Table 2. Chromosomal abnormalities in children conceived after intracytoplasmic sperm injection Abnormal karyotypes (n) No. of sex autosomal Author, year (ref. No.) childrenchromosome chromosome total (%) Wennerholm et al, (2.7) 2000 (12) Loft et al, 1999 (13) (3.3) Bonduelle et al, 2002 (20) 1, (3.0) Aboulghar et al, 2001 (21) 430 6* 8* 15 (3.5) Govaerts et al, 1998 (22) (3.9) Lam et al, 2001 (23) (2.0) Samli, 2003 (24) (4.2) Jozwiak et al, 2004 (25) 1, (1.5) van Opstal et al, 1997 (26) (12.8) *+1 combined sex chromosome and autosomes. novo aberrations in 1,586 fetuses conceived after ICSI and concluded that increased sex chromosome abnormalities account of this increased incidence. In another study, abnormal karyotypes were detected in only 8 singleton and 0.8% twin pregnancies out of 1,136 (25). In a prospective controlled study, karyotyping of 430 consecutive children conceived after ICSI showed that ICSI carries a small but increased risk of karyotype abnormalities to the offspring. This risk of 3.5% seemed to be equally distributed between autosomal and sex chromosome anomalies (21). The risk of chromosomally aberrant sperm may be higher when non-ejaculated sperm is used for ICSI (27). Moreover, sperm derived from testicular sperm extraction may have a higher rate of compromised or immature centrosome structures leading to mosaicism in embryo (28). However, when embryos derived from testicular sperm extraction were compared with embryos derived from ejaculatory sperm, no difference was found in the frequency of aneuploidy (28). 753

4 In conclusion, it seems that the incidence of chromosomal abnormalities in children conceived after ICSI is slightly increased, and part of it is transmitted from the father. Multiple Pregnancy and Prematurity after Assisted Reproduction Technology Multiple pregnancy is a major problem of assisted reproduction. The unfavorable obstetric and neonatal outcomes of assisted reproductive technology are largely the result of a multiple pregnancies. The transfer of more than one embryo is responsible for the high incidence of multiple pregnancies. High-order multiple pregnancies are associated with a high incidence of malformations and high perinatal morbidity and mortality. Even in singleton pregnancies, the reported perinatal complications have been high. Multiple pregnancy is the main reason for the high incidence of premature births, which considerably contributes to perinatal mortality and morbidity and creates a major burden on the health economics (29). Prematurity associated with assisted reproductive technology pregnancies remains the main cause of the high perinatal mortality. Multiple pregnancies constitute 1-2% of deliveries and 9-12% of perinatal deaths in the US (30). The perinatal mortality rate in multiple gestations is four to ten times higher than in singleton gestations. Although twins account for only 2.6% of live births, they represent 12.2% of all preterm infants, 15.4% of all neonatal deaths, and 9.5% of fetal deaths (31). In the US, twin births have increased substantially as a result of infertility treatment. In 1973, there were 56,777 twin deliveries, whereas in 1992, there were 95,372 (32). The increased hospitalization rate of children conceived with IVF is largely a consequence of the increased incidence of multiple births (33). The data from the European and US assisted reproduction technology registries show manifold higher percentages of multiple pregnancies after assisted reproduction techniques (Table 3). The European data from 1997 showed that out of 13,795 pregnancies after IVF and ICSI, 25.8% were twins and 3.6% were triplets (34). In 1999, twin rate was 24% and triplet rate was 2.2% (35). In the USA, the rate of twin pregnancies after IVF and ICSI in 1998 was 32%, and the rate of triplets Table 3. Multiple pregnancies after in vitro fertilization or intracytoplasmicsperminjectionrecordedineuropeanandus Registries No. of pregnancies (%) Registry, year (ref. No.) total singleton twin triplet or more European, 1997 (33) 39,915 22,859 (57.3) 14,816 (37.1) 2,240 (5.6) European, 1999 (34) 28,085 20,702 (73.7) 630 (24.0) 631 (2.2) American, 1998 (35) 15,367 9,528 (62.0) 4,917 (32.0) 922 (6.0) American, 1999 (36) 16,588 10,517 (63.4) 5,258 (31.7) 813 (4.9) was 6% (36); in 1999, the rates of twin and triplet pregnancies remained almost the same, ie, 31.7% and 4.9%, respectively (37). The Medical Research Council Register report on births resulting from assisted conception in Great Britain demonstrated a high incidence of preterm and low-birth-weight newborns (38). This incidence remained high even when the analysis was restricted to singleton infants. Doyle et al (38) investigated possible risk factors for prematurity, low birth weight and small-for-gestational-age (SGA) in children born from singleton pregnancies after IVF. Analysis by multiple regression indicated that hypertension during pregnancy was an independent risk for preterm delivery, low birth weight and SGA; bleeding during pregnancy was a risk factor for preterm delivery; whereas the number of embryos transferred and the type of infertility was a risk factor for low birth weight (38). Joffe and Li (39) conducted an extensive investigation based on the data on 11,407 children from the National Child Development Study of the United Kingdom. Gestational age and birth weight were significantly reduced in children of women with a time-to-conception >12 months, the standard definition of infertility. The conclusion of the study was that the delay in time-to-conception is a risk factor per se for outcome. A study in Denmark among 12,840 women showed that the risk of preterm birth increased progressively with waiting time to pregnancy (40). The incidence of low birth weight and very low birth weight in infants conceived with assisted reproduction technology was disproportionately increased when compared with spontaneous conceptions. In addition, singleton infants conceived after assisted reproduction technology and born at 37 weeks of gestation were 2.6 times more likely to be of low birth weight (41). 754

5 Infertility can predispose to preterm birth and low birth weight. In assisted reproduction technology, although the major issue seems to be the increased occurrence of multiple pregnancies, risks of preterm birth and obstetric complications are higher even in singleton pregnancies (41). In a case-control study of all assisted reproduction technology pregnancies in the Dutchspeaking part of Belgium (42), perinatal outcome of singleton pregnancies after IVF was significantly worse than that of pregnancies after spontaneous conception, mainly because of the increased rate of preterm births. The outcome of twin pregnancies after IVF is comparable with that of normally conceived twins. For both singleton and twin pregnancies after IVF, the incidence of cesarean delivery was increased. High-order multiple births are common following gonadotrophin administration for intrauterine insemination cycles (41), and result in a high rate of perinatal mortality and morbidity. In conclusion, the perinatal mortality and morbidity in the offspring conceived with assisted reproduction technology is increased in comparison with naturally conceived babies due to the high rate of multiple pregnancies, prematurity, congenital anomalies, and chromosomal aberrations. References 1 Cohen J, Mayaux MJ, Guihard-Moscato ML. Pregnancy outcomes after in vitro fertilization. A collaborative study on 2342 pregnancies. Ann N Y Acad Sci. 1988; 541: Assisted reproductive technology in the United States and Canada: 1993 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 1995; 64: Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. N Engl J Med. 2002;346: Bonduelle M, Liebaers I, Deketelaere V, Derde MP, Camus M, Devroey P, et al. Neonatal data on a cohort of 2889 infants born after ICSI ( ) and of 2995 infants born after IVF ( ). Hum Reprod. 2002; 17: Bower C, Rudy E, Ryan A, Cosgrove P. Report of the Birth Defects Registry of Western Australia Perth, Australia: King Edward Memorial Hospital; Lancaster P, Shafir E and Huang J. Assisted Conception, Australia and New Zealand, 1992 and Sydney (Australia): AIHW National Perinatal Statistics Unit; p Bergh T, Ericson A, Hillensjo T, Nygren KG, Wennerholm UB. Deliveries and children born after in-vitro fertilisation in Sweden : a retrospective cohort study. Lancet. 1999;354: Kallen B, Finnstrom O, Nygren KG, Olausson PO. In vitro fertilization (IVF) in Sweden: risk for congenital malformations after different IVF methods. Birth Defects Res A Clin Mol Teratol. 2005;73: Van Steirteghem A, Bonduelle M, Liebaers I, Devroey P. Children born after assisted reproductive technology. Am J Perinatol. 2002;19: Anthony S, Buitendijk SE, Dorrepaal CA, Lindner K, Braat DD, den Ouden AL. Congenital malformations in 4224 children conceived after IVF. Hum Reprod. 2002;17: Hansen M, Bower C, Milne E, de Klerk N, Kurinczuk JJ. Assisted reproductive technologies and the risk of birth defects a systematic review. Hum Reprod. 2005;20: Wennerholm UB, Bergh C, Hamberger L, Lundin K, Nilsson L, Wikland M, et al. Incidence of congenital malformations in children born after ICSI. Hum Reprod. 2000;15: Loft A, Petersen K, Erb K, Mikkelsen AL, Grinsted J, Hald F, et al. A Danish national cohort of 730 infants born after intracytoplasmic sperm injection (ICSI) Hum Reprod. 1999;14: Kuwata T, Matsubara S, Ohkuchi A, Watanabe T, Izumi A, Honma Y, et al. The risk of birth defects in dichorionic twins conceived by assisted reproductive technology. Twin Res. 2004;7: Ericson A, Kallen B. Congenital malformations in infants born after IVF: a population-based study. Hum Reprod. 2001;16: Kallen B. Congenital malformations in twins: a population study. Acta Genet Med Gemellol (Roma). 1986;35: Doyle PE, Beral V, Botting B, Wale CJ. Congenital malformations in twins in England and Wales. J Epidemiol Community Health. 1991;45: Westergaard HB, Johansen AM, Erb K, Andersen AN. Danish National IVF Registry 1994 and Treatment, pregnancy outcome and complications during pregnancy. Acta Obstet Gynecol Scand. 2000;79: Simpson JL, Lamb DJ. Genetic effects of intracytoplasmic sperm injection. Semin Reprod Med. 2001;19: Bonduelle M, Van Assche E, Joris H, Keymolen K, Devroey P, Van Steirteghem A, et al. Prenatal testing in ICSI pregnancies: incidence of chromosomal anomalies in 1586 karyotypes and relation to sperm parameters. Hum Reprod. 2002;17: Aboulghar H, Aboulghar M, Mansour R, Serour G, Amin Y, Al-Inany H. A prospective controlled study of karyotyping for 430 consecutive babies conceived through intracytoplasmic sperm injection. Fertil Steril. 2001;76: Govaerts I, Devreker F, Koenig I, Place I, Van den Bergh M, Englert Y. Comparison of pregnancy outcome after intracytoplasmic sperm injection and in-vitro fertilization. Hum Reprod. 1998;13: Lam R, Ma S, Robinson WP, Chan T, Yuen BH. Cytogenetic investigation of fetuses and infants conceived through intracytoplasmic sperm injection. Fertil Steril. 2001;76:

6 24 Samli H, Solak M, Imirzalioglu N, Beyatli Y, Simsek S, Kahraman S. Fetal chromosomal analysis of pregnancies following intracytoplasmic sperm injection with amniotic tissue culture. Prenat Diagn. 2003;23: Jozwiak EA, Ulug U, Mesut A, Erden HF, Bahceci M. Prenatal karyotypes of fetuses conceived by intracytoplasmic sperm injection. Fertil Steril. 2004;82: Van Opstal D, Los FJ, Ramlakhan S, Van Hemel JO, Van Den Ouweland AM, Brandenburg H, et al. Determination of the parent of origin in nine cases of prenatally detected chromosome aberrations found after intracytoplasmic sperm injection. Hum Reprod. 1997;12: Van Assche E, Bonduelle M, Tournaye H, Joris H, Verheyen G, Devroey P, et al. Cytogenetics of infertile men. Hum Reprod. 1996;11 Suppl 4: Silber S, Escudero T, Lenahan K, Abdelhadi I, Kilani Z, Munne S. Chromosomal abnormalities in embryos derived from testicular sperm extraction. Fertil Steril. 2003;79: Blazar AS, Seifer DB. Reproductive technology and multiple births. In: Penzias AS, editor. Multiple pregnancy. Infertility and reproductive medicine. Clinics of North America. Philadelphia (PA): Saunders; p Hrubec Z, Robinette CD. The study of human twins in medical research. N Engl J Med. 1984;310: Gardner MO, Goldenberg RL, Cliver SP, Tucker JM, Nelson KG, Copper RL. The origin and outcome of preterm twin pregnancies. Obstet Gynecol. 1995;85: Taffel SM. Demographic trends in twin births: USA. In: Keith LG, Papiernik E, Keith DM, Luke B, editors. Multiple pregnancy: epidemiology, gestation and perinatal outcome. New York (NY): Parthenon Publishing Group; p Ericson A, Nygren KG, Olausson PO, Kallen B. Hospital care utilization of infants born after IVF. Hum Reprod. 2002;17: Nygren KG, Andersen AN. Assisted reproductive technology in Europe, Results generated from European registers by ESHRE. European IVF-Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod. 2001;16: Nygren KG, Andersen AN. Assisted reproductive technology in Europe, Results generated from European registers by ESHRE. Hum Reprod. 2002;17: Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine. Assisted reproductive technology in the United States: 1998 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 2002;77: American Society for Reproductive Medicine; Society for Assisted Reproductive Technology Registry. Assisted reproductive technology in the United States: 1999 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 2002;78: Doyle P, Beral V, Maconochie N. Preterm delivery, low birthweight and small-for-gestational-age in liveborn singleton babies resulting from in-vitro fertilization. Hum Reprod. 1992;7: Joffe M, Li Z. Association of time to pregnancy and the outcome of pregnancy. Fertil Steril. 1994;62: Henriksen TB, Baird DD, Olsen J, Hedegaard M, Secher NJ, Wilcox AJ. Time to pregnancy and preterm delivery. Obstet Gynecol. 1997;89: Filicori M, Cognigni GE, Gamberini E, Troilo E, Parmegiani L, Bernardi S. Impact of medically assisted fertility on preterm birth. BJOG. 2005;112 Suppl 1: Dhont M, De Sutter P, Ruyssinck G, Martens G, Bekaert A. Perinatal outcome of pregnancies after assisted reproduction: a case-control study. Am J Obstet Gynecol. 1999;181: Received: May 19, 2005 Accepted: July 13, 2005 Correspondence to: Mohamed Aboulghar 10GeziretElArabSt. Mohandessin 12411, Cairo, Egypt 756

Minimum standards for ICSI use, screening, patient information and follow-up in WA fertility clinics. January 2006

Minimum standards for ICSI use, screening, patient information and follow-up in WA fertility clinics. January 2006 Minimum standards for ICSI use, screening, patient information and follow-up in WA fertility clinics January 2006 1. BACKGROUND ICSI has been shown to be effective for male factor infertility and it also

More information

Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study

Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study Anna-Karina Aaris Henningsen, M.D., a Anja Pinborg,

More information

Assisted reproductive technologies (ART) in Canada: 2011 results from the Canadian ART Register

Assisted reproductive technologies (ART) in Canada: 2011 results from the Canadian ART Register 1 Assisted reproductive technologies (ART) in Canada: 2011 results from the Canadian ART Register Joanne Gunby, M.Sc. CARTR Co-ordinator Email: gunbyj@mcmaster.ca Supported by the IVF Directors Group of

More information

In vitro fertilization is associated with an increase in major birth defects

In vitro fertilization is associated with an increase in major birth defects In vitro fertilization is associated with an increase in major birth defects Christine K. Olson, M.D., M.P.H., a Kim M. Keppler-Noreuil, M.D., b Paul A. Romitti, Ph.D., c William T. Budelier, c Ginny Ryan,

More information

IN VITRO FERTILIZATION AND CEREBRAL PALSY: THE PETŐ INSTITUTE EXPERIENCE

IN VITRO FERTILIZATION AND CEREBRAL PALSY: THE PETŐ INSTITUTE EXPERIENCE Practice and Theory in Systems of Education, Volume 8 Number 3 2013 IN VITRO FERTILIZATION AND CEREBRAL PALSY: THE PETŐ INSTITUTE EXPERIENCE Anna KELEMEN, Gabriella FILICZKI, Janka DEBRECZENI, Éva SZABÓ

More information

Intracytoplasmic sperm injection (ICSI) has gained

Intracytoplasmic sperm injection (ICSI) has gained Incidence of First Trimester Miscarriage among Women Undergoing ICSI According to Origin of Sperm for Male Factor and Non-male Factor ALKA GAHLOT*, ML SWARANKAR, RAVIKANT SONI ABSTRACT Prior to the development

More information

Outcomes for offspring of men having ICSI for male factor infertility

Outcomes for offspring of men having ICSI for male factor infertility (2012) 14, 116 120 ß 2012 AJA, SIMM & SJTU. All rights reserved 1008-682X/12 $32.00 www.nature.com/aja REVIEW Outcomes for offspring of men having ICSI for male factor infertility Jane Halliday 1,2 Since

More information

DOES ASSISTED REPRODUCTIVE TECHNOLOGY (ART) INCREASE THE RISK OF BIRTH DEFECTS? JOE LEIGH SIMPSON, M.D. SENIOR VICE PRESIDENT FOR RESEARCH AND GLOBAL PROGRAMS MARCH OF DIMES FOUNDATION WHITE PLAINS, NY,

More information

Recent Progress in In Vitro Fertilization and Intracytoplasmic Sperm Injection Technologies in Japan

Recent Progress in In Vitro Fertilization and Intracytoplasmic Sperm Injection Technologies in Japan Research and Reviews Recent Progress in In Vitro Fertilization and Intracytoplasmic Sperm Injection Technologies in Japan JMAJ 52(1): 29 33, 2009 Kaoru YANAGIDA* 1 Abstract The three basic pillars of fertility

More information

Psychological follow-up study of 5-year-old ICSI children

Psychological follow-up study of 5-year-old ICSI children Human Reproduction Page 1 of 7 Hum. Reprod. Advance Access published September 9, 2004 doi:10.1093/humrep/deh511 Psychological follow-up study of 5-year-old ICSI children I.Ponjaert-Kristoffersen 1,7,

More information

Preimplantation Genetic Diagnosis (PGD) in Western Australia

Preimplantation Genetic Diagnosis (PGD) in Western Australia Preimplantation Genetic Diagnosis (PGD) in Western Australia Human somatic cells have 46 chromosomes each, made up of the 23 chromosomes provided by the egg and the sperm cell from each parent. Each chromosome

More information

Birth Defects in Assisted Reproductive Technology and Spontaneously Conceived Children: A Meta-analysis

Birth Defects in Assisted Reproductive Technology and Spontaneously Conceived Children: A Meta-analysis Journal of Reproduction & Contraception doi: 10.7669/j.issn.1001-7844.2013.04.0237 2013 Dec.; 24(4):237-252 E-mail: randc_journal@163.com Birth Defects in Assisted Reproductive Technology and Spontaneously

More information

European IVF Monitoring (EIM) Year: 2008

European IVF Monitoring (EIM) Year: 2008 European IVF Monitoring (EIM) Year: 2008 Name of country POLAND Name and full address of contact person. professor Rafal Kurzawa MD PhD Fertility and Sterility Special Interest Group Polish Gynaecological

More information

AUSTRALIA AND NEW ZEALAND FACTSHEET

AUSTRALIA AND NEW ZEALAND FACTSHEET AUSTRALIA AND NEW ZEALAND FACTSHEET What is Stillbirth? In Australia and New Zealand, stillbirth is the death of a baby before or during birth, from the 20 th week of pregnancy onwards, or 400 grams birthweight.

More information

Assisted reproductive technologies in Canada: 2005 results from the Canadian Assisted Reproductive Technologies Register

Assisted reproductive technologies in Canada: 2005 results from the Canadian Assisted Reproductive Technologies Register Assisted reproductive technologies in Canada: 2005 results from the Canadian Assisted Reproductive Technologies Register Joanne Gunby, M.Sc., a Francxois Bissonnette, M.D., b Clifford Librach, M.D., c

More information

Risks and complications of assisted conception

Risks and complications of assisted conception Risks and complications of assisted conception August 005 Richard Kennedy British Fertility Society Factsheet www.fertility.org.uk No medical treatment is entirely free from risk and infertility treatment

More information

Current status of assisted reproductive technology in Korea, 2009

Current status of assisted reproductive technology in Korea, 2009 Review Obstet Gynecol Sci 2013;56(6):353-361 http://dx.doi.org/10.5468/ogs.2013.56.6.353 pissn 2287-8572 eissn 2287-8580 Current status of assisted reproductive technology in Korea, 2009 Committee for

More information

European IVF Monitoring (EIM) Year: 2010

European IVF Monitoring (EIM) Year: 2010 European IVF Monitoring (EIM) Year: 2010 Name of country: Poland Name and full address of contact person: Professor Rafal Kurzawa, MD PhD Fertility and Sterility Special Interest Group Polish Gynaecological

More information

Pregnancy Outcomes After Assisted Reproductive Technology

Pregnancy Outcomes After Assisted Reproductive Technology JOINT SOGC CFAS GUIDELINE JOINT SOGC CFAS GUIDELINE No 173, March 2006 Pregnancy Outcomes After Assisted Reproductive Technology This guideline has been reviewed by the Genetics Committee and the Reproductive

More information

World Collaborative Report on Assisted Reproductive Technology, 2002

World Collaborative Report on Assisted Reproductive Technology, 2002 Human Reproduction, Vol.1, No.2 pp. 1 11, 2009 doi:10.1093/humrep/dep098 Hum. Reprod. Advance Access published May 27, 2009 ORIGINAL ARTICLE Reproductive epidemiology World Collaborative Report on Assisted

More information

Elective Single-Embryo Transfer versus Double-Embryo Transfer in in Vitro Fertilization

Elective Single-Embryo Transfer versus Double-Embryo Transfer in in Vitro Fertilization The new england journal of medicine original article Elective Single-Embryo versus Double-Embryo in in Vitro Fertilization Ann Thurin, M.D., Jon Hausken, M.D., Torbjörn Hillensjö, M.D., Ph.D., Barbara

More information

Ethical Aspects of Multiple Pregnancy

Ethical Aspects of Multiple Pregnancy Ethics, Legal, Social, Counselling Article Ethical Aspects of Multiple Pregnancy Jacques Milliez, M.D. 1 *, Bernard Dickens, M.D. 2 1. Hospital Saint Antoine, Paris, France 2. Faculty of Law, University

More information

Fertility Facts and Figures 2008

Fertility Facts and Figures 2008 Fertility Facts and Figures 2008 Contents About these statistics... 2 Accessing our data... 2 The scale of fertility problems... 3 Treatment abroad... 3 Contacts regarding this publication... 3 Latest

More information

A single center experience with 1000 consecutive cases of multifetal pregnancy reduction

A single center experience with 1000 consecutive cases of multifetal pregnancy reduction A single center experience with 1000 consecutive cases of multifetal pregnancy reduction Joanne Stone, MD, Keith Eddleman, MD, Lauren Lynch, MD, and Richard L. Berkowitz, MD New York, NY, and San Juan,

More information

The Risk of Malformation Following Assisted Reproduction Hilke Bertelsmann, Helena de Carvalho Gomes, Monika Mund, Susanne Bauer, Katja Matthias

The Risk of Malformation Following Assisted Reproduction Hilke Bertelsmann, Helena de Carvalho Gomes, Monika Mund, Susanne Bauer, Katja Matthias ORIGINAL ARTICLE The Risk of Malformation Following Assisted Reproduction Hilke Bertelsmann, Helena de Carvalho Gomes, Monika Mund, Susanne Bauer, Katja Matthias SUMMARY Introduction: Intracytoplasmatic

More information

Transitioning from IVF practice to restorative reproductive medicine.

Transitioning from IVF practice to restorative reproductive medicine. Transitioning from IVF practice to restorative reproductive medicine. Tadeusz Wasilewski Białystok Białystok Medical University in Branicki Palace - town of the first in vitro in Poland Cathedral - Divine

More information

Perinatal Outcomes in Singletons Following In Vitro Fertilization: A Meta-Analysis

Perinatal Outcomes in Singletons Following In Vitro Fertilization: A Meta-Analysis REVIEW Perinatal Outcomes in Singletons Following In Vitro Fertilization: A Meta-Analysis Rebecca A. Jackson, MD, Kimberly A. Gibson, MD, MPH, Yvonne W. Wu, MD, MPH, and Mary S. Croughan, PhD OBJECTIVE:

More information

Welcome to chapter 2. The following chapter is called "Indications For IVF". The author is Dr Kamini A. Rao.

Welcome to chapter 2. The following chapter is called Indications For IVF. The author is Dr Kamini A. Rao. Welcome to chapter 2. The following chapter is called "Indications For IVF". The author is Dr Kamini A. Rao. The indications for an IVF treatment have increased since the birth of the first IVF baby. The

More information

Cancer Risk in Children and Young Adults Conceived by In Vitro Fertilization

Cancer Risk in Children and Young Adults Conceived by In Vitro Fertilization Cancer Risk in Children and Young Adults Conceived by In Vitro Fertilization WHAT S KNOWN ON THIS SUBJECT: No clear-cut increase in cancer risk after IVF has been found, but most studies were too small

More information

THE birth of Louise Brown in 1978

THE birth of Louise Brown in 1978 Infants & Young Children Vol. 20, No. 1, pp. 2 10 c 2007 Lippincott Williams & Wilkins, Inc. Developmental Outcomes of Children Born After Assisted Reproductive Technologies Jane Squires, PhD; Paul Kaplan,

More information

Review Article Is ICSI Risky?

Review Article Is ICSI Risky? Obstetrics and Gynecology International Volume 2013, Article ID 473289, 6 pages http://dx.doi.org/10.1155/2013/473289 Review Article Is ICSI Risky? May Y. W. Wong 1 and William L. Ledger 1,2 1 School of

More information

OHTAC Recommendation. In Vitro Fertilization and Multiple Pregnancies

OHTAC Recommendation. In Vitro Fertilization and Multiple Pregnancies OHTAC Recommendation In Vitro Fertilization and Multiple Pregnancies October 19, 2006 The Ontario Health Technology Advisory Committee (OHTAC) met on October 19, 2006 and reviewed the health technology

More information

ASSISTED REPRODUCTIVE TECHNOLOGIES (ART)

ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) Dr. Herve Lucas, MD, PhD, Biologist, Andrologist Dr. Taher Elbarbary, MD Gynecologist-Obstetrician Definitions of Assisted Reproductive Technologies Techniques

More information

Trends in Male Reproductive Health

Trends in Male Reproductive Health Trends in Male Reproductive Health Paul A.L. Lancaster University of New South Wales Thanks very much Prof. Hirahara, and I would like to add my thanks to the Ministry of the Environment and especially

More information

Assisted reproductive technology and major structural birth defects in the United States

Assisted reproductive technology and major structural birth defects in the United States Human Reproduction pp. 1 7, 2008 Hum. Reprod. Advance Access published November 16, 2008 doi:10.1093/humrep/den387 Assisted reproductive technology and major structural birth defects in the United States

More information

Cerebral palsy (CP) was defined before the specific

Cerebral palsy (CP) was defined before the specific Perinatal Factors Associated With Cerebral Palsy in Children Born in Sweden Kristina Thorngren-Jerneck, MD, PhD, and Andreas Herbst, MD, PhD OBJECTIVE: To identify perinatal factors associated with cerebral

More information

Clinical Policy Committee

Clinical Policy Committee Northern, Eastern and Western Devon Clinical Commissioning Group South Devon and Torbay Clinical Commissioning Group Clinical Policy Committee Commissioning policy: Assisted Conception Fertility assessment

More information

Assisted reproductive technology in Australia and New Zealand 2010

Assisted reproductive technology in Australia and New Zealand 2010 Assisted reproductive technology in Australia and New Zealand 2010 ASSISTED REPRODUCTION SERIES Number 16 Assisted reproductive technology in Australia and New Zealand 2010 Alan Macaldowie Yueping A Wang

More information

Population prevalence rates of birth defects: a data management and epidemiological perspective

Population prevalence rates of birth defects: a data management and epidemiological perspective Population prevalence rates of birth defects: a data management and epidemiological perspective Merilyn Riley Abstract The Victorian Birth Defects Register (VBDR) is a population-based surveillance system

More information

Topic: Male Factor Infertility

Topic: Male Factor Infertility Topic: Male Factor Infertility Topic Overview: Male Factor Infertility Comparisons of pregnancy rates at insemination based on total motile sperm counts from the 1999 and 21 World Health Organization (WHO)

More information

Male Infertility and Intracytoplasmic Sperm Injection (ICSI) in the Middle East

Male Infertility and Intracytoplasmic Sperm Injection (ICSI) in the Middle East Male Infertility and Intracytoplasmic Sperm Injection (ICSI) in the Middle East Marcia C. Inhorn The Male Infertility Problem 1 Infertility is the inability to conceive after 12 months of regular, unprotected

More information

Disclosure. Objectives 2/21/2016

Disclosure. Objectives 2/21/2016 Recurrent Pregnancy Loss: The myths, the controversies and the evidence Mamie McLean, MD Assistant Professor Reproductive Endocrinology and Infertility University of Alabama at Birmingham Disclosure I

More information

Areas of Concern. Reproductive Ethics: Issues &

Areas of Concern. Reproductive Ethics: Issues & Reproductive Ethics: Issues & Areas of Concern Conception Control: under what conditions is conception control in harmony with a Christian ethic? Genetic Screening & Counseling: under what conditions should

More information

LEUKODYSTROPHY GENETICS AND REPRODUCTIVE OPTIONS FOR AFFECTED FAMILIES. Leila Jamal, ScM Kennedy Krieger Institute, Baltimore MD

LEUKODYSTROPHY GENETICS AND REPRODUCTIVE OPTIONS FOR AFFECTED FAMILIES. Leila Jamal, ScM Kennedy Krieger Institute, Baltimore MD LEUKODYSTROPHY GENETICS AND REPRODUCTIVE OPTIONS FOR AFFECTED FAMILIES Leila Jamal, ScM Kennedy Krieger Institute, Baltimore MD 2 Outline Genetics 101: Basic Concepts and Myth Busting Inheritance Patterns

More information

Can In Vitro Fertilization enhance fertility in Europe? A scenario study

Can In Vitro Fertilization enhance fertility in Europe? A scenario study Can In Vitro Fertilization enhance fertility in Europe? A scenario study Gijs Beets 3 On behalf of Egbert te Velde 4, J. Dik F. Habbema 1, Marinus J.C. Eijkemans 1, and Geeta Nargund 2 1 Department of

More information

Informatie aan de pers

Informatie aan de pers Informatie aan de pers Datum : 22 januari 2004 Vrije Universiteit Brussel Partner Universitaire Associatie Brussel Rectoraat Dienst Interne & Externe Communicatie Jeroen De Samblancx T. 02-629.12.31 Fax

More information

Endometriosis, Fertility and Pregnancy

Endometriosis, Fertility and Pregnancy This leaflet covers endometriosis and fertility. It provides information for women who have been diagnosed with endometriosis who would like to know if and how this can affect their fertility, and for

More information

Project proposal. Reproductive tourism in India: A description of surrogate mothers and their offspring. Medical student Malene Tanderup Kristensen

Project proposal. Reproductive tourism in India: A description of surrogate mothers and their offspring. Medical student Malene Tanderup Kristensen Project proposal Reproductive tourism in India: A description of surrogate mothers and their offspring Background Medical student Malene Tanderup Kristensen Traditional surrogacy is defined as where the

More information

RECURRENT PREGNANCY LOSS DR.RAJALAKSHMI SRINIVASAN SPECIALIST GYNECOLOGIST ZULEKHA HOSPITAL DUBAI

RECURRENT PREGNANCY LOSS DR.RAJALAKSHMI SRINIVASAN SPECIALIST GYNECOLOGIST ZULEKHA HOSPITAL DUBAI RECURRENT PREGNANCY LOSS DR.RAJALAKSHMI SRINIVASAN SPECIALIST GYNECOLOGIST ZULEKHA HOSPITAL DUBAI RECURRENT PREGNANCY LOSS -RM Clinically recognized consecutive or non consecutive pregnancy losses before

More information

Complications of medically assisted conception in 3,500 cycles

Complications of medically assisted conception in 3,500 cycles FERTILITY AND STERILITY VOL. 70, NO. 4, OCTOBER 1998 Copyright 1998 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. Complications of medically

More information

Balanced. translocations. rarechromo.org. Support and Information

Balanced. translocations. rarechromo.org. Support and Information Support and Information Rare Chromosome Disorder Support Group, G1, The Stables, Station Rd West, Oxted, Surrey. RH8 9EE Tel: +44(0)1883 723356 info@rarechromo.org I www.rarechromo.org Balanced Unique

More information

SWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies

SWISS SOCIETY OF NEONATOLOGY. Umbilical cord complications in two subsequent pregnancies SWISS SOCIETY OF NEONATOLOGY Umbilical cord complications in two subsequent pregnancies June 2006 2 Hetzel PG, Godi E, Bührer C, Department of Neonatology (HPG, BC), University Children s Hospital, Basel,

More information

Ethical issues in assisted reproductive technologies. Effy Vayena

Ethical issues in assisted reproductive technologies. Effy Vayena Ethical issues in assisted reproductive technologies Effy Vayena Assisted Reproductive Technologies (ART) All treatments or procedures that include the in vitro handling of human oocytes and human sperm

More information

Clinical Policy Title: Home uterine activity monitoring

Clinical Policy Title: Home uterine activity monitoring Clinical Policy Title: Home uterine activity monitoring Clinical Policy Number: 12.01.01 Effective Date: August 19, 2015 Initial Review Date: July 17, 2013 Most Recent Review Date: July 15, 2015 Next Review

More information

Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions

Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in * (MBChB, FICMS, CABOG) **Sawsan Talib Salman (MBChB, FICMS, CABOG) ***Huda Khaleel Ibrahim (MBChB) Abstract Background: - Although

More information

INDUCED ABORTION IN WESTERN AUSTRALIA

INDUCED ABORTION IN WESTERN AUSTRALIA INDUCED ABORTION IN WESTERN AUSTRALIA 999-2004 REPORT OF THE WA ABORTION NOTIFICATION SYSTEM JULY 2005 Maternal and Child Health Unit Information Collection and Management Department of Health Western

More information

Guidelines for the Number of Embryos to Transfer Following In Vitro Fertilization

Guidelines for the Number of Embryos to Transfer Following In Vitro Fertilization JOINT SOGC CFAS GUIDELINE No 182, September 2006 Guidelines for the Number of Embryos to Transfer Following In Vitro Fertilization This guideline was reviewed by the Reproductive Endocrinology and Infertility

More information

Recommended Ethical Principles. Regarding the Use of Assisted Reproduction. in HIV Infected Individuals

Recommended Ethical Principles. Regarding the Use of Assisted Reproduction. in HIV Infected Individuals Recommended Ethical Principles Regarding the Use of Assisted Reproduction in HIV Infected Individuals April 2004 Committee on Promoting Acceptance of People Living with HIV/AIDS (CPA) of the Hong Kong

More information

The best possible start to life

The best possible start to life The best possible start to life April 2007 A consultation document on multiple births after IVF Chair s foreword My main concern as Chair of the Human Fertilisation and Embryology Authority is probably

More information

A test your patients can trust.

A test your patients can trust. A test your patients can trust. A simple, safe, and accurate non-invasive prenatal test for early risk assessment of Down syndrome and other conditions. informaseq Prenatal Test Simple, safe, and accurate

More information

IN VITRO FERTILIZATION AND THE LAW: HOW LEGAL AND REGULATORY NEGLECT COMPROMISED A MEDICAL BREAKTHROUGH

IN VITRO FERTILIZATION AND THE LAW: HOW LEGAL AND REGULATORY NEGLECT COMPROMISED A MEDICAL BREAKTHROUGH IN VITRO FERTILIZATION AND THE LAW: HOW LEGAL AND REGULATORY NEGLECT COMPROMISED A MEDICAL BREAKTHROUGH Steve P. Calandrillo * and Chryssa V. Deliganis ** The rise of assisted reproductive technology like

More information

A review of ten years experience of ICSI

A review of ten years experience of ICSI Human Reproduction Update, Vol.10, No.1 pp. 19±28, 2004 DOI: 10.1093/humupd/dmh004 A review of ten years experience of ICSI P.Devroey 1 and A.Van Steirteghem Centre for Reproductive Medicine, Dutch-speaking

More information

East and North Hertfordshire CCG Fertility treatment and referral criteria for tertiary level assisted conception. December 2014

East and North Hertfordshire CCG Fertility treatment and referral criteria for tertiary level assisted conception. December 2014 East and North Hertfordshire CCG Fertility treatment and referral criteria for tertiary level assisted conception December 2014 1 1. Introduction This policy sets out the entitlement and service that will

More information

Original Article Vitrified/warmed single blastocyst transfer in preimplantation genetic diagnosis/preimplantation genetic screening cycles

Original Article Vitrified/warmed single blastocyst transfer in preimplantation genetic diagnosis/preimplantation genetic screening cycles Int J Clin Exp Med 2015;8(11):21605-21610 www.ijcem.com /ISSN:1940-5901/IJCEM0013500 Original Article Vitrified/warmed single blastocyst transfer in preimplantation genetic diagnosis/preimplantation genetic

More information

The National Down Syndrome Cytogenetic Register for England and Wales: 2008/9 Annual Report

The National Down Syndrome Cytogenetic Register for England and Wales: 2008/9 Annual Report 0 The National Down Syndrome Cytogenetic Register for England and Wales: 2008/9 Annual Report Joan K Morris, Elizabeth De Souza December 2009 National Down Syndrome Cytogenetic Register Queen Mary University

More information

University Hospitals Coventry and Warwickshire NHS Trust. Centre for Reproductive Medicine. We Care. We Achieve. We Innovate.

University Hospitals Coventry and Warwickshire NHS Trust. Centre for Reproductive Medicine. We Care. We Achieve. We Innovate. University Hospitals Coventry and Warwickshire NHS Trust Centre for Reproductive Medicine We Care. We Achieve. We Innovate. Introduction We were the first NHS Hospital in the West Midlands to set up a

More information

OET: Listening Part A: Influenza

OET: Listening Part A: Influenza Listening Test Part B Time allowed: 23 minutes In this part, you will hear a talk on critical illnesses due to A/H1N1 influenza in pregnant and postpartum women, given by a medical researcher. You will

More information

Authorized By: Holly C. Bakke, Commissioner, Department of Banking and Insurance.

Authorized By: Holly C. Bakke, Commissioner, Department of Banking and Insurance. INSURANCE DIVISION OF INSURANCE Actuarial Services Benefit Standards for Infertility Coverage Proposed New Rules: N.J.A.C. 11:4-54 Authorized By: Holly C. Bakke, Commissioner, Department of Banking and

More information

Genetics and Pregnancy Loss

Genetics and Pregnancy Loss Genetics and Pregnancy Loss Dorothy Warburton Genetics and Development (in Pediatrics) Columbia University, New York Estimates of Pregnancy Loss from Conception 1000 fertilized eggs (27% are lost) 728

More information

FREEDOM OF INFORMATION ACT 2000 Birmingham CrossCity CCG Ref: FOI/002790 IVF Funding Policy

FREEDOM OF INFORMATION ACT 2000 Birmingham CrossCity CCG Ref: FOI/002790 IVF Funding Policy Our Ref: FOI/002790 08 th August 2014 Bartholomew House 1 st Floor 142 Hagley Road Birmingham B16 9PA www.bhamcrosscityccg.nhs.uk Email: bham.crosscity@nhs.net Tel. 0121 255 0700 FREEDOM OF INFORMATION

More information

SIMULTANEOUS PUBLICATION Infertility

SIMULTANEOUS PUBLICATION Infertility Human Reproduction, Vol.24, No.11 pp. 2683 2687, 2009 Advanced Access publication on October 4, 2009 doi:10.1093/humrep/dep343 SIMULTANEOUS PUBLICATION Infertility The International Committee for Monitoring

More information

Assisted reproductive technologies (ARTs): Evaluation of evidence to support public policy development

Assisted reproductive technologies (ARTs): Evaluation of evidence to support public policy development Nardelli et al. Reproductive Health 2014, 11:76 REVIEW Open Access Assisted reproductive technologies (ARTs): Evaluation of evidence to support public policy development Alexa A Nardelli 1*, Tania Stafinski

More information

acknowledged: We make huge adjustments to make the numbers turn out right. More than 50 percent of some numbers 7 ABSTRACT

acknowledged: We make huge adjustments to make the numbers turn out right. More than 50 percent of some numbers 7 ABSTRACT Maternal and Neonatal Health and Abortion: 40-Year Trends in Great Britain and Ireland Byron C. Calhoun, M.D., John M. Thorp, M.D., Patrick S. Carroll, M.A. ABSTRACT National data on maternal and neonatal

More information

THE LABOUR ADMISSION CTG An assessment of the test s predictive values, reliability and effect How the test is perceived by practicing midwives

THE LABOUR ADMISSION CTG An assessment of the test s predictive values, reliability and effect How the test is perceived by practicing midwives THE LABOUR ADMISSION CTG An assessment of the test s predictive values, reliability and effect How the test is perceived by practicing midwives Ellen Blix Doctoral thesis at the Nordic School of Public

More information

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010 Extended MPH Degree Program School of Public Health Department of Epidemiology University of Washington Epidemiology 521 Epidemiology of Maternal and Child Health Problems Winter / Spring, 2010 Instructor:

More information

Act of 5 December 2003 No. 100 relating to the application of biotechnology in human medicine, etc

Act of 5 December 2003 No. 100 relating to the application of biotechnology in human medicine, etc Act of 5 December 2003 No. 100 relating to the application of biotechnology in human medicine, etc Cf. earlier Acts of 5 August 1994 No. 56 and 12 June 1987 No. 68 Chapter 1. Purpose and scope 1-1. Purpose

More information

AGE & FERTILITY: Effective Evaluation & Treatment I. LANE WONG, MD, FACOG. www.hopefertilitycenter.com www.hopeivf.com

AGE & FERTILITY: Effective Evaluation & Treatment I. LANE WONG, MD, FACOG. www.hopefertilitycenter.com www.hopeivf.com Page 1 of 6 AGE & FERTILITY: Effective Evaluation & Treatment I. LANE WONG, MD, FACOG. www.hopefertilitycenter.com www.hopeivf.com Age has a profound effect on female fertility. This is common knowledge,

More information

A. Evidence for an individually adjustable standard to assess birth weight:

A. Evidence for an individually adjustable standard to assess birth weight: Customised antenatal growth charts are designed to facilitate better supervision of fetal growth. The chart is printed out in early pregnancy, after confirmation of pregnancy dates, and allows serial plotting

More information

Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy

Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy C. Jouquelet-Royer September 2012 Fondation Merieux NAME OF PRESENTATION 1 Presentation Outline Background Company

More information

Differentiation between normal and abnormal fetal growth

Differentiation between normal and abnormal fetal growth Differentiation between normal and abnormal fetal growth JASON GARDOSI MD FRCSE FRCOG Director, West Midlands Perinatal Institute, St Chad s Court, 213 Hagley Road, Birmingham B16 9RG, U.K. Tel +44 (0)121

More information

HUMAN SEMEN QUALITY IN THE NEW MILLENIUM: A MATTER OF CONCERN?

HUMAN SEMEN QUALITY IN THE NEW MILLENIUM: A MATTER OF CONCERN? HUMAN SEMEN QUALITY IN THE NEW MILLENIUM: A MATTER OF CONCERN? Niels Jørgensen, Ulla N. Joensen, Tina K. Jensen, Martin B. Jensen, Kristian Almstrup, Inge A. Olesen, Elisabeth Carlsen, Jørgen H. Petersen,

More information

Medical Policy Preimplantation Genetic Testing

Medical Policy Preimplantation Genetic Testing Medical Policy Preimplantation Genetic Testing Table of Contents Policy: Commercial Coding Information Information Pertaining to All Policies Policy: Medicare Description References Authorization Information

More information

In vitro babies medical and legal aspects: a European and North American perspective

In vitro babies medical and legal aspects: a European and North American perspective BioTechnologia vol. 93(1) C pp. 9-26 C 2012 Journal of Biotechnology, Computational Biology and Bionanotechnology OPINIONS In vitro babies medical and legal aspects: a European and North American perspective

More information

Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes - a prospective cohort study

Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes - a prospective cohort study Murphy et al. BMC Pregnancy and Childbirth 2013, 13:8 RESEARCH ARTICLE Open Access Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes - a prospective

More information

Lesbian Pregnancy: Donor Insemination

Lesbian Pregnancy: Donor Insemination Lesbian Pregnancy: Donor Insemination (Based on an article originally published in the American Fertility Association 2010 National Fertility and Adoption Directory. Much of this information will also

More information

In Vitro Fertilization (IVF) Page 1 of 11

In Vitro Fertilization (IVF) Page 1 of 11 In Vitro Fertilization (IVF) Page 1 of 11 This document is a part of your informed consent process. Both partners should read the entire document carefully. In vitro fertilization (IVF) is a treatment

More information

Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes a prospective cohort study

Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes a prospective cohort study Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes a prospective cohort study Deirdre J. Murphy MD, FRCOG, Professor of Obstetrics Academic Department

More information

CT FERTILITY ASSOCIATES Informed Consent for Frozen Embryo Transfer

CT FERTILITY ASSOCIATES Informed Consent for Frozen Embryo Transfer CT FERTILITY ASSOCIATES Informed Consent for Frozen Embryo Transfer Patient s Name: D.O.B. Partner s Name: (if applicable) D.O.B. We (I), the undersigned, request, authorize and consent to the thawing

More information

Cerebral Palsy An Expensive Enigma

Cerebral Palsy An Expensive Enigma Cerebral Palsy An Expensive Enigma Rhona Mahony National Maternity Hospital A group of permanent disorders of the development of movement and posture, causing activity limitation that are not attributed

More information

Pregnancy Outcomes After Assisted Human Reproduction

Pregnancy Outcomes After Assisted Human Reproduction SOGC CLINICAL PRACTICE GUIDELINES No. 302, January 2014 (Replaces No. 173, February 2006) Pregnancy Outcomes After Assisted Human Reproduction This clinical practice guideline has been prepared by the

More information

Preimplantation Genetic Diagnosis. Evaluation for single gene disorders

Preimplantation Genetic Diagnosis. Evaluation for single gene disorders Preimplantation Genetic Diagnosis Evaluation for single gene disorders What is Preimplantation Genetic Diagnosis? Preimplantation genetic diagnosis or PGD is a technology that allows genetic testing of

More information

Management fertility sparing degli endometriomi Errico Zupi

Management fertility sparing degli endometriomi Errico Zupi Management fertility sparing degli endometriomi Errico Zupi Università Tor Vergata Roma Management of endometrioma Pain Infertility Surgical treatment Medical treatment Infertility clinic Both medical

More information

Ehlers-Danlos Syndrome Fertility Issues. Objectives

Ehlers-Danlos Syndrome Fertility Issues. Objectives Ehlers-Danlos Syndrome Fertility Issues Baltimore Inner Harbor Independence Day Brad Hurst, M.D. Professor Reproductive Endocrinology Carolinas Medical Center - Charlotte, North Carolina Objectives Determine

More information

Professor Robert Edwards and assisted reproductive technology: life from a test tube

Professor Robert Edwards and assisted reproductive technology: life from a test tube Claire Durrans University of Oxford Professor Robert Edwards and assisted reproductive technology: life from a test tube Assisted reproductive technology (ART) is a relatively young branch of science allowing

More information

Lecture 2 Conception and Pregnancy Loss

Lecture 2 Conception and Pregnancy Loss This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Crohn's disease and pregnancy.

Crohn's disease and pregnancy. Gut, 1984, 25, 52-56 Crohn's disease and pregnancy. R KHOSLA, C P WILLOUGHBY, AND D P JEWELL From the Gastroenterology Unit, Radcliffe Infirmary, Oxford SUMMARY Infertility and the outcome of pregnancy

More information

Fast Track to IVF. Objectives

Fast Track to IVF. Objectives Disclosure statement: Richard H. Reindollar, M.D. has no relevant financial relationships with any manufacturers of pharmaceuticals, laboratory supplies, or medical devices. Fast Track to IVF Richard H.

More information

Delayed Child-Bearing

Delayed Child-Bearing SOGC Committee Opinion No. 271, January 2012 Delayed Child-Bearing This Committee Opinion has been prepared by the Genetics Committee, reviewed by the Reproductive Endocrinology and Infertility Committee,

More information

Chapter 16 Reproductive Technology, Gene Therapy, and Stem Cells (modified)

Chapter 16 Reproductive Technology, Gene Therapy, and Stem Cells (modified) Chapter 16 Reproductive Technology, Gene Therapy, and Stem Cells (modified) Assisted Reproductive Technologies (ART) Artificial insemination (AI) In vitro fertilization (IVF) Gamete intrafallopian transfer

More information

FERTILITY AND AGE. Introduction. Fertility in the later 30's and 40's. Am I fertile?

FERTILITY AND AGE. Introduction. Fertility in the later 30's and 40's. Am I fertile? FERTILITY AND AGE Introduction Delaying pregnancy is a common choice for women in today's society. The number of women in their late 30s and 40s attempting pregnancy and having babies has increased in

More information