assisted reproductive technology (art)

辅助生殖技术 ( ART )
  • 文章类型: Journal Article
    背景/目标:本文提出的研究旨在研究人格特质和抑郁症状,受对COVID-19的恐惧影响,在不孕夫妇中相互作用,他们即将开始辅助生殖技术(ART)治疗。这项观察性研究的目的是探讨不育夫妇的人格特质与抑郁症状发生之间的关系,考虑到COVID-19恐惧的中介作用。方法:研究样本包括108名女性和71名男性(N=179),所有这些人都接受了不孕症诊断,并表示希望在西西里ART中心开始ART治疗;他们随后被招募.人格量表(PI),贝克抑郁量表(BDI)和对COVID的恐惧(FCV-19S)用于数据收集。结果:FCV-19S与神经质(r=0.25,p=0.001)和同意(r=0.19,p=0.012)均呈显着正相关。此外,FCV-19S(r=0.67,p<0.001)与抑郁症状之间存在显着相关性。中介分析表明,神经质是COVID-19恐惧(β=1.77,p=0.001)和抑郁(β=0.22,p=0.002)的预测因子。此外,对COVID-19的恐惧显著影响(β=0.12,p<0.001)抑郁。结论:这项研究发现,神经质和友善与对COVID-19的恐惧呈正相关,女性表现出明显的轻度情绪障碍。神经质可以预测抑郁和对COVID-19的恐惧,而对COVID-19的恐惧可以预测抑郁症状。然而,调解模型的总功效不显著,从而表明变量不能完全解释这个模型。
    Background/Objectives: The study presented in this paper seeks to examine how personality traits and depressive symptoms, influenced by the fear of COVID-19, interact in infertile couples, who are on the verge of commencing treatments with assisted reproductive technology (ART). The purpose of this observational study was to explore the relationship between personality traits in infertile couples and the occurrence of depressive symptoms, taking into account the mediating effect of COVID-19 fear. Methods: The study sample consisted of 108 women and 71 men (N = 179), all of whom had received an infertility diagnosis and expressed a desire to begin ART treatment at a Sicilian ART center; they were subsequently recruited. The Personality Inventory (PI), Beck Depression Inventory (BDI) and Fear of COVID (FCV-19S) were used for data collection. Results: The FCV-19S demonstrates a significant positive correlation with both neuroticism (r = 0.25, p = 0.001) and agreeableness (r = 0.19, p = 0.012). In addition, there is a significant correlation between FCV-19S (r = 0.67, p < 0.001) and depression symptoms. The mediation analysis reveals that neuroticism is a predictor of fear of COVID-19 (β = 1.77, p = 0.001) and depression (β = 0.22, p = 0.002). Additionally, the fear of COVID-19 significantly influences (β = 0.12, p < 0.001) depression. Conclusions: This study found that neuroticism and agreeableness are positively linked to the fear of COVID-19, and women displayed notable mild mood disorders. Neuroticism predicted both depression and fear of COVID-19, while fear of COVID-19 predicted depressive symptoms. However, the total efficacy of the mediation model was not significant, thereby suggesting that the variables do not fully explain this model.
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  • 文章类型: Journal Article
    背景:由于辅助生殖技术,双胎妊娠的发生率在世界范围内呈上升趋势。宫颈扩张是常见的并发症,可以认为是双胎妊娠早产的原因。体外受精(IVF)双胞胎更容易早产。在双胞胎中,不建议使用正常宫颈长度的常规宫颈环扎术,但是没有对试管婴儿双胞胎进行研究。所以,本研究旨在评估宫颈长度正常的双胎IVF妊娠常规经阴道环扎术对母胎结局的影响。
    方法:2016年1月至2019年12月在印度东部一家妇产医院进行了一项回顾性病例对照研究,分娩超过21800例。采取两组,病例是那些宫颈长度正常的IVF双胞胎,其中宫颈环扎术是由IVF中心转诊到我们医院进行的,而对照中没有进行宫颈环扎术,因为他们是从其他IVF中心转诊的,其中环扎术不是常规方案。我们排除了为历史做的环扎,超声显示,子宫异常,和单绒毛膜双胞胎.在病例和对照中招募了15名参与者。
    结果:在我们的研究2(6.66%)中,4(13%),和26(86%)的试管婴儿双胞胎在<28周胎龄分娩,28-32周,32-37周,分别。参与者的平均年龄,分娩时的平均胎龄,病例和对照组的出生体重为35.27±5.98岁(min:23;max:45),32.40±5.54年(最小:25;最大:44);34周2天±3.28(最小:31;最大:37),33周5天±1.66(min:25;max:37);1961.33±340克,1899.33±437.48克,结果无统计学差异(p=0.186,p=1,p=0.668)结论:常规经阴道环扎术对宫颈长度正常的双胎IVF妊娠预防早产无效。IVF双胞胎妇女通常在晚期出现,他们的出生体重也很低。
    BACKGROUND: The incidence of twin pregnancies is on the rise worldwide due to assisted reproductive technologies. Cervical dilatation is a frequent complication and can be considered a cause of premature births in twin pregnancies. In vitro fertilization (IVF) twins are more prone to preterm delivery. Routine cervical cerclage with normal cervical length is not recommended in twins, but studies were not done on IVF twins. So, this study aims to evaluate the effectiveness of routine transvaginal cerclage in twin IVF pregnancies with normal cervical length on maternofetal outcome.
    METHODS: A retrospective case-control study was conducted at a maternity hospital in eastern India from January 2016 to December 2019 with over 21800 deliveries. Two groups were taken, cases were those IVF twins with normal cervical length in whom cervical cerclage was done as they have referred to our hospital from the IVF centers for cerclage and in control no-cervical cerclage as they are referred from other IVF centers where cerclage was not a routine protocol. We have excluded cerclage done for history, ultrasound indicated, uterine anomalies, and monochorionic twins. Fifteen participants were recruited in both cases and controls.
    RESULTS: In our study 2 (6.66%), 4 (13%), and 26 (86%) were IVF twins delivered at a gestational age of <28 weeks, 28-32 weeks, and 32-37 weeks, respectively. The mean age of participants, mean gestation age at delivery, and birth weight in cases and control were 35.27 ± 5.98 years (min: 23; max: 45), 32.40 ± 5.54 years (min: 25; max: 44); 34 weeks 2 days ± 3.28 (min: 31; max: 37), 33 weeks 5 days ± 1.66 (min: 25; max: 37); 1961.33 ± 340 gram, 1899.33 ± 437.48 gram, respectively with no statistical significant difference (p = 0.186, p = 1, p = 0.668, respectively) Conclusion: Routine transvaginal cerclage is not effective in twin IVF pregnancies with normal cervical length for preventing preterm births. IVF twin women usually present at a late age and their birth weight are also low.
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  • 文章类型: Journal Article
    BACKGROUND: Hepatitis B virus (HBV) is one of the most widespread viruses worldwide and a major cause of hepatitis, cirrhosis, and hepatocellular carcinoma. Previous studies have revealed the impacts of HBV infection on fertility. An increasing number of infertile couples with chronic hepatitis B (CHB) virus infection choose assisted reproductive technology (ART) to meet their fertility needs. Despite the high prevalence of HBV, the effects of HBV infection on assisted reproduction treatment remain limited and contradictory. OBJECTIVE: The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes, vertical transmission, pregnancy complications, and viral activity during ART treatment. METHODS: We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022. RESULTS: HBV infection negatively affected fertility in both males and females. Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment. The impact of HBV infection on the pregnancy outcomes of ART is still controversial. Current evidence does not support that ART increases the risk of vertical transmission of HBV, while relevant studies are limited. With the development of ART, the risk of HBV reactivation (HBVr) is increasing, especially due to the wide application of immunosuppressive therapy. CONCLUSIONS: Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART. The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.
    乙型肝炎病毒(HBV)是世界范围内传播最广泛的病毒之一,也是肝炎、肝硬化和肝细胞癌的主要病因。既往研究已经揭示了HBV感染对生育能力的影响。近年来越来越多患有乙肝的不孕夫妇选择通过辅助生殖技术(ART)来满足他们的生育需求。尽管HBV感染率很高,但目前其感染对辅助生殖治疗影响的研究仍较为有限且存在矛盾。本研究旨在全面概述HBV感染对生育能力的影响,并讨论其对妊娠结局、垂直传播、妊娠并发症和ART治疗期间病毒活性的影响。我们通过在PubMed上检索1996年至2022年间发表的关于HBV和ART的研究,发现HBV感染对男性和女性的生育能力均存在负面的影响。现有研究表明,在接受ART治疗的夫妇中,HBV感染可能会增加妊娠并发症的风险。HBV感染对ART妊娠结局的影响目前仍然存在争议,且现有的证据不支持ART增加HBV垂直传播风险的观点,同时相关研究较为有限。随着ART的发展,特别是免疫抑制疗法的广泛应用,HBV再激活(HBVr)的风险正在增加。综上所述,定期进行HBV感染筛查和HBVr风险分层及管理对预防ART期间的HBVr至关重要,但ART期间预防性抗HBV治疗的最佳策略和时机的确定仍需进一步研究。.
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  • 文章类型: Journal Article
    子宫内膜容受性阵列(ERA)是一种革命性的分子诊断工具,它通过分析子宫内膜组织的基因表达谱来确定胚胎移植的最佳时机。这篇综合综述了ERA在整倍体胚胎移植周期中的意义和应用。其中植入具有正确数量的染色体的胚胎对于实现成功的妊娠结局至关重要。这篇综述强调了它在提高植入率和通过评估进化减少妊娠损失中的作用。方法论,临床应用,功效,以及与ERA相关的挑战。与传统方法相比,ERA在识别植入窗口方面具有更高的准确性。改善辅助生殖技术(ART)周期的临床结局。尽管有好处,审查承认诸如成本、可访问性,以及标准化的需要。临床实践建议强调将ERA整合到常规ART方案中,全面的病人咨询,以及多学科合作的重要性。审查概述了有希望的前景,包括使ERA更具成本效益的技术进步,完善的基因表达谱的发展,以及与其他新兴ART技术的潜在集成。进一步的研究方向包括对ERA指导的妊娠结局的长期研究,并探索其在复发性植入失败和无法解释的不孕症病例中的应用。总的来说,ERA代表了生殖医学的重大进步,提供一种个性化的胚胎移植时机方法,可以显着提高整倍体胚胎移植的成功率。
    The Endometrial Receptivity Array (ERA) is a revolutionary molecular diagnostic tool that determines the optimal timing for embryo transfer by analyzing the gene expression profile of endometrial tissue. This comprehensive review examines the significance and application of ERA in euploid embryo transfer cycles, where the implantation of embryos with the correct number of chromosomes is critical for achieving successful pregnancy outcomes. This review underscores its role in enhancing implantation rates and reducing pregnancy loss by assessing the evolution, methodology, clinical applications, efficacy, and challenges associated with ERA. Key findings highlight ERA\'s superior accuracy in identifying the window of implantation compared to traditional methods, resulting in improved clinical outcomes in assisted reproductive technology (ART) cycles. Despite its benefits, the review acknowledges challenges such as cost, accessibility, and the need for standardization. Recommendations for clinical practice emphasize the integration of ERA into routine ART protocols, comprehensive patient counseling, and the importance of multidisciplinary collaboration. The review outlines promising prospects, including technological advancements to make ERA more cost-effective, the development of refined gene expression profiles, and the potential integration with other emerging ART technologies. Further research directions include long-term studies on the outcomes of ERA-guided pregnancies and exploring its application in cases of recurrent implantation failure and unexplained infertility. Overall, ERA represents a significant advancement in reproductive medicine, offering a personalized approach to embryo transfer timing that can significantly improve the success rates of euploid embryo transfers.
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  • 文章类型: Journal Article
    辅助生殖技术(ART)彻底改变了生殖医学领域,为数百万面临不孕症挑战的个人和夫妇带来希望。近年来,整合机器人技术和人工智能(AI)已经成为推进ART的一个有希望的途径。这篇全面的综述探讨了机器人和人工智能对ART的变革性影响,审视最近的进展,技术应用,临床意义,和道德考虑。机器人能够实现精确和微创的程序,提高各种生殖技术的效率和准确性,如精子提取,胚胎处理,和手术干预。同时,AI提供预测分析,个性化的治疗方案,和根据患者个人需求量身定制的决策支持系统,优化治疗结果并扩大获得生殖保健的机会。主要发现强调了机器人和人工智能在ART中取得的重大进展,包括提高成功率,降低风险,增强患者体验。然而,诸如监管考虑等挑战,采用障碍,必须解决道德困境,以实现这些技术的全部潜力。机器人和人工智能对ART的变革性影响是深远的,塑造全球生育治疗和家庭建设的未来。继续研究,跨学科合作,和投资对于进一步利用机器人和人工智能在推进生殖医学和确保可获得方面的潜力至关重要,公平,以及对所有个人和夫妇的有效护理。
    Assisted reproductive technology (ART) has revolutionized the field of reproductive medicine, offering hope to millions of individuals and couples facing infertility challenges. In recent years, integrating robotics and artificial intelligence (AI) has emerged as a promising avenue for advancing ART. This comprehensive review explores the transformative impact of robotics and AI on ART, examining recent advancements, technological applications, clinical implications, and ethical considerations. Robotics enables precise and minimally invasive procedures, enhancing the efficiency and accuracy of various reproductive techniques such as sperm retrieval, embryo handling, and surgical interventions. Meanwhile, AI offers predictive analytics, personalized treatment protocols, and decision support systems tailored to individual patient needs, optimizing treatment outcomes and expanding access to reproductive care. Key findings highlight the significant advancements made possible by robotics and AI in ART, including improved success rates, reduced risks, and enhanced patient experience. However, challenges such as regulatory considerations, adoption barriers, and ethical dilemmas must be addressed to realize the full potential of these technologies. The transformative impact of robotics and AI on ART is profound, shaping the future of fertility treatment and family-building worldwide. Continued research, interdisciplinary collaboration, and investment are essential to further harness the potential of robotics and AI in advancing reproductive medicine and ensuring accessible, equitable, and effective care for all individuals and couples.
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  • 文章类型: Journal Article
    卵巢纤维化,以卵巢成纤维细胞的过度增殖和细胞外基质(ECM)的积累为特征,是卵巢功能障碍的主要原因之一。尽管卵巢纤维化在维持哺乳动物卵巢的正常生理功能方面具有关键作用,对这种情况的研究被大大低估了,这导致临床上对纤维化引起的卵巢功能障碍缺乏治疗选择。本文综述了卵巢纤维化分子机制的研究进展,包括TGF-β,细胞外基质,炎症,和其他促纤维化因素导致卵巢异常纤维化。此外,我们总结了目前针对卵巢纤维化的卵巢功能障碍的治疗方法,包括抗纤维化药物,干细胞移植,和外泌体疗法。本文就卵巢纤维化的研究进展作一综述,提出针对卵巢纤维化治疗卵巢功能障碍的潜在治疗策略。
    Ovarian fibrosis, characterized by the excessive proliferation of ovarian fibroblasts and the accumulation of extracellular matrix (ECM), serves as one of the primary causes of ovarian dysfunction. Despite the critical role of ovarian fibrosis in maintaining the normal physiological function of the mammalian ovaries, research on this condition has been greatly underestimated, which leads to a lack of clinical treatment options for ovarian dysfunction caused by fibrosis. This review synthesizes recent research on the molecular mechanisms of ovarian fibrosis, encompassing TGF-β, extracellular matrix, inflammation, and other profibrotic factors contributing to abnormal ovarian fibrosis. Additionally, we summarize current treatment approaches for ovarian dysfunction targeting ovarian fibrosis, including antifibrotic drugs, stem cell transplantation, and exosomal therapies. The purpose of this review is to summarize the research progress on ovarian fibrosis and to propose potential therapeutic strategies targeting ovarian fibrosis for the treatment of ovarian dysfunction.
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  • 文章类型: Journal Article
    自从体外受精(IVF)开始以来,传统上,控制卵巢刺激(COS)的监测涉及许多超声和实验室测试的预约,以指导药物使用和给药,确定触发时间,并考虑采取措施降低卵巢过度刺激综合征(OHSS)的风险。辅助生殖技术(ART)领域的最新进展对COS监测预约的时间和频率提出了质疑,正如本评论所讨论的。
    Since the inception of in vitro fertilization (IVF), monitoring of controlled ovarian stimulation (COS) has traditionally involved numerous appointments for ultrasound and laboratory testing to guide medication use and dosing, determine trigger timing, and allow for measures to reduce the risk of ovarian hyperstimulation syndrome (OHSS). Recent advances in the field of assisted reproductive technology (ART) have called into question the timing and frequency of COS monitoring appointments, as discussed in this commentary.
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  • 文章类型: Journal Article
    不孕症是一项重大的全球健康挑战,影响着全世界数百万对夫妇。大约一半的不育夫妇表现出精液质量受损,表明男性生育能力下降。虽然男性不育的诊断传统上依赖于精液分析,它在对男性生殖健康进行全面评估方面的局限性促使人们努力鉴定新的生物标志物.精浆,含有蛋白质的复杂液体,脂质,和代谢物,已成为此类指标的丰富来源。生殖在很大程度上取决于精浆,男性生殖腺化学物质的主要转运蛋白。它为泌尿生殖系统诊断提供了非侵入性样品,并已证明在鉴定与男性生殖系统疾病有关的生物标志物方面具有潜力。精液蛋白的丰富使人们对其生物学功能有了更深入的了解,起源,以及在与男性不育相关的各种条件下的差异表达,包括无精子症,弱精子症,少精子症,畸形精子症,在其他人中。由于当前诊断技术的局限性,男性不育的真实患病率被低估了。这篇综述批判性地评估了精浆生物标志物的现状及其在评估男性不育中的实用性。通过弥合研究与临床实践之间的差距,精浆生物标志物的综合评估为全面评估男性不育提供了一种多模式方法.
    Infertility represents a significant global health challenge impacting millions of couples worldwide. Approximately half of all infertile couples exhibit compromised semen quality, indicative of diminished male fertility. While the diagnosis of male infertility traditionally relies on semen analysis, its limitations in providing a comprehensive assessment of male reproductive health have spurred efforts to identify novel biomarkers. Seminal plasma, a complex fluid containing proteins, lipids, and metabolites, has emerged as a rich source of such indicators. Reproduction depends heavily on seminal plasma, the primary transporter of chemicals from male reproductive glands. It provides a non-invasive sample for urogenital diagnostics and has demonstrated potential in the identification of biomarkers linked to illnesses of the male reproductive system. The abundance of seminal proteins has enabled a deeper understanding of their biological functions, origins, and differential expression in various conditions associated with male infertility, including azoospermia, asthenozoospermia, oligozoospermia, teratozoospermia, among others. The true prevalence of male infertility is understated due to the limitations of the current diagnostic techniques. This review critically evaluates the current landscape of seminal plasma biomarkers and their utility in assessing male infertility. Βy bridging the gap between research and clinical practice, the integrative assessment of seminal plasma biomarkers offers a multimodal approach to comprehensively evaluate male infertility.
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  • 文章类型: Journal Article
    这篇全面的综述探讨了辅助生殖技术(ART)领域内精子选择技术的发展。我们的分析深入研究了一系列方法,从传统方法如密度梯度离心到先进技术,如磁激活细胞分选(MACS)和胞浆内形态选择精子注射(IMSI)。我们严格评估这些方法在精子运动性方面的功效,形态学,DNA完整性,和其他功能属性,提供了他们的临床结果的详细比较。我们强调了从传统精子选择方法的转变,主要关注物理特征,更复杂的技术,提供精子分子特性的全面评估。这种转变不仅有望增强对受精成功的预测,而且对提高胚胎质量和增加活产的机会具有重要意义。通过综合各种研究和研究论文,我们对ART中不同精子选择程序的可预测性进行了深入分析.该综述还讨论了这些方法的临床适用性,强调他们在塑造辅助生殖未来方面的潜力。我们的研究结果表明,在ART中整合先进的精子选择策略可以导致更具成本效益的治疗,缩短持续时间和更高的成功率。这篇综述旨在为生殖医学的临床医生和研究人员提供有关ART中精子选择技术的现状和未来前景的全面见解。
    This comprehensive review explores the evolving landscape of sperm selection techniques within the realm of Assisted Reproductive Technology (ART). Our analysis delves into a range of methods from traditional approaches like density gradient centrifugation to advanced techniques such as Magnetic-Activated Cell Sorting (MACS) and Intracytoplasmic Morphologically Selected Sperm Injection (IMSI). We critically assess the efficacy of these methods in terms of sperm motility, morphology, DNA integrity, and other functional attributes, providing a detailed comparison of their clinical outcomes. We highlight the transition from conventional sperm selection methods, which primarily focus on physical characteristics, to more sophisticated techniques that offer a comprehensive evaluation of sperm molecular properties. This shift not only promises enhanced prediction of fertilization success but also has significant implications for improving embryo quality and increasing the chances of live birth. By synthesizing various studies and research papers, we present an in-depth analysis of the predictability of different sperm selection procedures in ART. The review also discusses the clinical applicability of these methods, emphasizing their potential in shaping the future of assisted reproduction. Our findings suggest that the integration of advanced sperm selection strategies in ART could lead to more cost-effective treatments with reduced duration and higher success rates. This review aims to provide clinicians and researchers in reproductive medicine with comprehensive insights into the current state and future prospects of sperm selection technologies in ART.
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  • 文章类型: Journal Article
    人们对SARS-CoV-2大流行可能影响性健康和生殖健康的担忧已大大增加。在这篇叙述性评论中,综述了SARS-CoV-2感染对性健康和生殖健康影响的最新研究。该审查最初是通过研究SARS-CoV-2对女性月经周期的可能后果开始的。病毒可能会干扰月经周期,这可能会影响激素合成和子宫内膜反应,根据最新的证据。月经失血可能受COVID-19影响内皮细胞功能和全身止血的潜力影响。下丘脑闭经可能是由严重的COVID-19疾病引起的。关于这个问题的研究很少,尽管大多数女性在1-2个月的休养后恢复正常的月经周期。该综述还研究了SARS-CoV-2感染如何影响辅助生殖技术(ART)治疗。临床数据很少,尽管一些研究指出了对胚胎质量的潜在影响。总的来说,ART结果,然而,与流行前相比,没有实质性变化。当怀孕期间发生SARS-CoV-2感染时,产科问题更有可能发生,尤其是在妊娠晚期。即使产妇死亡率仍然很低,孕妇,尤其是那些有合并症的人,更有可能经历严重的疾病。该评论强调了COVID-19疫苗如何影响月经周期,显示简短,适度的修改,没有严重的健康危害。还包括大流行期间计划生育选择的心理影响。总之,这篇叙述性综述全面评估了SARS-CoV-2对性健康和生殖健康的复杂和不断变化的影响.强调了大流行期间和之后人们和夫妇的不同要求,强调持续研究和专业医疗实践的必要性。
    Concerns about the SARS-CoV-2 pandemic\'s possible impact on sexual and reproductive health have grown significantly. In this narrative review, the latest research on the effects of SARS-CoV-2 infection on several facets of sexual and reproductive health is reviewed. The review starts initially by going through the possible consequences of SARS-CoV-2 on female menstrual cycles. The virus may interfere with the menstrual cycle, which could affect hormone synthesis and endometrial reactions, according to newly available evidence. Menstrual blood loss may be impacted by COVID-19\'s potential to influence endothelial cell function and systemic hemostasis. Hypothalamic amenorrhea may be brought on by severe COVID-19 disease. There is little research on this subject, although most women resume their regular menstrual cycles after 1-2 months of recuperation. The review also examines how SARS-CoV-2 infection may affect assisted reproductive technology (ART) treatments. There are few clinical data, although some research points to potential effects on embryo quality. Overall, ART results, however, did not materially change from the time before the epidemic. Obstetric problems are more likely when SARS-CoV-2 infection occurs during pregnancy, especially in the third trimester. Even though the maternal death rate is still low, pregnant women, especially those with comorbidities, are more likely to experience serious sickness. The review emphasizes how the COVID-19 vaccine affects menstrual cycles, showing brief, modest modifications without serious health hazards. Also included are the psychological effects of family planning choices during the pandemic. In conclusion, this narrative review offers a thorough assessment of the complicated and changing effects of SARS-CoV-2 on sexual and reproductive health. The different requirements of people and couples during and after the pandemic are highlighted, underscoring the necessity for ongoing study and specialized healthcare practices.
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