| 1. |
- Aittomaki, K, et al.
(författare)
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Genetics and assisted reproduction technology
- 2005
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Ingår i: Acta Obstet Gynecol Scand. - : Wiley. ; 84:5, s. 463-473
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Tidskriftsartikel (refereegranskat)abstract
- In the past 20 years, a significant improvement has been shown in the treatment for infertility in both women and men through the development of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Only donated sperm could be previously used for treatment; now oocytes can also be donated. Furthermore, the combination of IVF and ICSI with advanced genetic methods has made preimplantation genetic diagnosis possible for many genetic conditions. These methods enable genetic testing of the early human embryo by using only a single cell, one blastomere biopsied from the embryo, as the sample from which the diagnosis of many chromosome rearrangements and other inherited diseases can be made. It has also been established that a considerable proportion of infertility is caused by genetic defects, which have several implications for infertility treatment. The purpose of this review is to give a concise introduction on how genetics is involved in assisted reproduction technology to specialists who may not be working in this particular field of gynecology, but who would need some knowledge of this for proper care of their patients.
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| 2. |
- Aittomaki, K, et al.
(författare)
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Safety issues in assisted reproduction technology: should ICSI patients have genetic testing before treatment? A practical proposition to help patient information
- 2004
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Ingår i: Hum Reprod. - : Oxford University Press (OUP). ; 19:3, s. 472-476
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Tidskriftsartikel (refereegranskat)abstract
- ICSI is a highly efficient treatment of male factor infertility and therefore increasingly used to treat infertile men successfully. However, when used to treat patients with a genetic cause for their infertility, there may be an increased risk for the offspring. Chromosome aberrations, Y chromosome microdeletions and CFTR (cystic fibrosis transmembrane conductance regulator) mutations alone may explain up to 25% of azoospermia and severe oligozoospermia. These genetic defects could be identified before treatment, in which case informed decisions could be made by the couple to be treated concerning the treatment, prenatal testing or preimplantation genetic diagnosis. Therefore, we propose that men with very low sperm counts (<5 x 10(6)/ml) considering ICSI should always be informed of the possibility of genetic testing. The information should include a precise statement of the implications of the results for the patient, his family and his offspring, and reassurance that a decision to test or not to test, or the subsequent test results will not be used as a reason for withholding treatment. Testing should always remain voluntary, and the couples themselves should decide whether or not they choose to be tested. If an abnormality is identified, patients should be referred to specialist genetic counselling.
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| 3. |
- Anderheim-Söderqvist, Lisbeth, 1952, et al.
(författare)
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Does psychological stress affect the outcome of in vitro fertilization?
- 2005
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 20:10, s. 2969-75
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the study was to investigate the effect of psychological stress before and during IVF treatment on the outcome of IVF, controlling for known physiological predictors METHODS: This is a prospective, longitudinal study A total of 166 women were studied during their first IVF treatment They answered questionnaires concerning psychological and social factors on two occasions Psychological well-being was measured by the Psychological General Well-Being (PGWB) index and psychological effects of infertility were assessed by 14 items RESULTS: In the analysis of the psychological variables, no differences were found between pregnant and non-pregnant women The total number of good quality embryos, the number of good quality embryos transferred, and the number of embryos transferred were significantly higher in the pregnant than in the non-pregnant group In a multivariate analysis, the number of good quality embryos transferred was the only variable that was independently associated with pregnancy CONCLUSIONS: We found no evidence that psychological stress had any influence on the outcome of IVF treatment When counselling infertile couples, it might be possible to reduce the stress they experience during the treatment procedure by informing them of these findings
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| 4. |
- Bergh, Christina, 1953, et al.
(författare)
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Attitudes towards and management of single embryo transfer among Nordic IVF doctors
- 2007
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 86:10, s. 1222-1230
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Tidskriftsartikel (refereegranskat)abstract
- Background. The objective of this study was to investigate the attitudes towards and management of single embryo transfer (SET) among Nordic in vitro fertilisation (IVF) doctors, and to present the rate of SET and multiple pregnancies in the different countries. Methods. A questionnaire was sent to all IVF doctors in the Nordic countries (n=198, 78.5% responded). Pregnancy rates, SET and multiple births rates were extracted from registries. Main outcome measure was attitudes and management of SET. Results. Almost all doctors thought that a twin pregnancy compared unfavourably to a singleton. A twin rate >10% was acceptable for 5% of Swedish doctors. Corresponding figures for Finnish, Danish and Norwegian doctors were 21, 35 and 35%, respectively. For a woman <36 years, performing her first cycle and with two good quality embryos, almost all doctors would recommend SET. For a woman =36 years in a similar situation, SET would be recommended only in Sweden and Finland. The pregnancy rate per embryo transfer (ET), the SET rate 2003, the multiple birth rate, and the estimated SET rate 2004 were 33.3, 21.5, 22.7 and 25% (Denmark), 31.3, 43.4, 14 and 51% (Finland), 40.5, 10.5, 26.5 and 16% (Iceland), 30.6, 18, 25.2 and 26% (Norway), and 35.3, 55.1, 11.8 and 71% (Sweden). Conclusions. The SET and multiple birth rates reflect the attitudes of Nordic IVF doctors to SET and multiple births well. When introducing SET, the attitude of the IVF doctor seems to be important. © 2007 Taylor & Francis.
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| 5. |
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| 6. |
- Gejervall, Ann-Louise, 1963, et al.
(författare)
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Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients' experiences of well-being after surgery
- 2005
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Ingår i: Hum Reprod. ; 20:3, s. 728-35
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The primary aims were to compare the pain-relieving effect and post-operative well-being between electro-acupuncture analgesia (EA) and conventional analgesia (CA) comprising opiates. Further aims were to compare time for mobilization, and costs for time and drug consumption. METHODS: In all, 160 women undergoing IVF were randomized, according to a computer-generated list, to EA or CA. Well-being was evaluated with the State Trait Anxiety Inventory (STAI). Pain and subjective expectations and experiences were recorded on a visual analogue scale (VAS). Time and drug consumption were recorded. RESULTS: Although VAS pain ratings were significantly higher at oocyte aspiration (P < 0.0001) and after retrieval (P < 0.01) in the EA than in the CA group, they were similar 60 min after surgery. Both groups had similar STAI well-being scores. The EA group was significantly less tired and confused than the CA group after oocyte aspiration. No significant differences in time and costs for drug consumption were noted. CONCLUSION: EA cannot generally be recommended as a pain-relieving method at oocyte aspiration but might be an alternative for women desiring a non-pharmacological method. An advantage of EA is less post-operative tiredness and confusion compared with CA.
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| 7. |
- Heins, Nico, et al.
(författare)
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Derivation, characterization, and differentiation of human embryonic stem cells.
- 2004
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Ingår i: Stem cells (Dayton, Ohio). - 1066-5099. ; 22:3, s. 367-76
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Tidskriftsartikel (refereegranskat)abstract
- The derivation of human embryonic stem (hES) cells establishes a new avenue to approach many issues in human biology and medicine for the first time. To meet the increased demand for characterized hES cell lines, we present the derivation and characterization of six hES cell lines. In addition to the previously described immunosurgery procedure, we were able to propagate the inner cell mass and establish hES cell lines from pronase-treated and hatched blastocysts. The cell lines were extensively characterized by expression analysis of markers characteristic for undifferentiated and differentiated hES cells, karyotyping, telomerase activity measurement, and pluripotency assays in vitro and in vivo. Whereas three of the cell lines expressed all the characteristics of undifferentiated pluripotent hES cells, one cell line carried a chromosome 13 trisomy while maintaining an undifferentiated pluripotent state, and two cell lines, one of which carried a triploid karyotype, exhibited limited pluripotency in vivo. Furthermore, we clonally derived one cell line, which could be propagated in an undifferentiated pluripotent state.
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| 8. |
- Holter, Herborg, 1960, et al.
(författare)
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First IVF treatment--short-term impact on psychological well-being and the marital relationship
- 2006
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Ingår i: Hum Reprod. ; 21:12, s. 3295-302
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this study was to assess infertile couples' short-term emotional responses to their first IVF treatment (the women's and men's emotional reactions and their experiences of the marital relationship at different stages of the first treatment) and to relate these responses to the outcome of the IVF treatment METHODS: The study was part of a prospective, longitudinal study where 117 couples participated The women and men answered questionnaires separately concerning psychological and social factors at three occasions: before, during and 1 month after treatment RESULTS: Women's and men's emotional reactions related to first IVF treatment were dependent on whether they achieved a pregnancy or not Those who failed to become pregnant rated their emotional well-being worse, whereas those who became pregnant rated their emotional well-being better than before treatment started The women reported stronger emotional reactions about their infertility than their husbands However, the men reacted in the same emotional pattern as their wives when pregnancy was not achieved A majority reported that the marital relationship improved during treatment CONCLUSION: Couples undergoing their first IVF treatment are as a group well adjusted and manage to handle the short-term emotional strain under treatment The determining factor for short-term emotional response of treatment was whether pregnancy was achieved
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| 9. |
- Holter, Herborg, 1960, et al.
(författare)
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The psychological influence of gender infertility diagnoses among men about to start IVF or ICSI treatment using their own sperm
- 2007
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Ingår i: Hum Reprod. ; 22:9, s. 2559-65
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND The aim of the present study was to investigate the psychological influence of gender infertility diagnoses among men in couples about to start their first IVF or ICSI treatment METHODS The study was a part of a prospective study of 65 men with male infertility diagnosis and 101 men in couples with female, mixed and unexplained infertility diagnoses Of the 200 men invited, 166 agreed to participate (83% response rate) The men answered questionnaires concerning psychological and social factors on three occasions, at the information meeting held 2-4 weeks prior to first treatment, 1 h before oocyte retrieval and 2 weeks after the pregnancy test RESULTS The main findings of this study gave no indication that male infertility influenced men negatively concerning their experience of infertility, view of life and relationships and psychological well-being We found that men with a male factor infertility diagnosis reacted in a similar way as compared with men in couples where the diagnosis was female, mixed or unexplained infertility CONCLUSIONS In general, men are well adjusted with regard to a first IVF/ICSI treatment cycle, independent of gender infertility diagnoses
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| 10. |
- Kahnberg, A, et al.
(författare)
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Prediction of ovarian hyperstimulation syndrome in women undergoing in vitro fertilization
- 2009
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Ingår i: Acta Obstet Gynecol Scand.
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. Ovarian hyperstimulation syndrome (OHSS) is a severe side effect of in vitro fertilization (IVF). The aim of this study was to identify independent predictors which could be used to identify IVF patients at risk for OHSS. Design. A prospective observational study. Setting: University hospital. Population. Six hundred and twenty-four consecutive patients treated with conventional IVF or intracytoplasmic sperm injection. Methods. Observational clinical data were compared. Main outcome measures. Patients who developed OHSS were compared with patients who did not develop OHSS using univariate and multivariate analyses. Results. Twenty-eight patients developed OHSS considered as severe and requiring hospitalization. Independent predictors of OHSS were number of follicles at oocyte aspiration, number of aspirated oocytes and total number of medium/large-sized follicles before hCG. When these variables were combined in a receiver operating characteristic (ROC) curve they showed a sensitivity of 82.1% and a specificity of 90% for OHSS. The only independent predictor of OHSS before the ovulatory dose of hCG was total number of medium/large-sized follicles before hCG. A corresponding ROC found a sensitivity of 82.1% and specificity of 79.4%. Conclusion. Prediction of OHSS that is of severity requiring hospitalization can be done with reasonable high sensitivity and specificity both before and after the ovulatory dose of hCG.
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