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- Hassan, Jasmin, et al.
(författare)
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Reference standards for follicular density in ovarian cortex from birth to sexual maturity
- 2023
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Ingår i: Reproductive BioMedicine Online. - : Elsevier. - 1472-6483 .- 1472-6491. ; 47:4
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Tidskriftsartikel (refereegranskat)abstract
- Research question: Are age-normalized reference values for human ovarian cortical follicular density adequate for tissue quality control in fertility preservation?Design: Published quantitative data on the number of follicles in samples without known ovarian pathology were converted into cortical densities to create reference values. Next, a sample cohort of 126 girls (age 1-24 years, mean +/- SD 11 +/- 6) with cancer, severe haematological disease or Turner syndrome were used to calculate Z-scores for cortical follicular density based on the reference values.Results: No difference was observed between Z-scores in samples from untreated patients (0.3 +/- 3.5, n = 30) and patients treated with (0.5 +/- 2.9, n = 48) and without (0.1 +/- 1.3, n = 6) alkylating chemotherapy. Z-scores were not correlated with increasing cumulative exposure to cytostatics. Nevertheless, Z-scores in young treated patients (0-2 years -2.1 +/- 3.1, n = 10, P = 0.04) were significantly lower than Z-scores in older treated patients (11-19 years, 2 +/- 1.9, n = 15). Samples from patients with Turner syndrome differed significantly from samples from untreated patients (-5.2 +/- 5.1, n = 24, P = 0.003), and a Z-score of -1.7 was identified as a cut-off showing good diagnostic value for identification of patients with Turner syndrome with reduced ovarian reserve. When this cut-off was applied to other patients, analysis showed that those with indications for reduced ovarian reserve (n = 15) were significantly younger (5.9 +/- 4.2 versus 10.7 +/- 5.9 years, P = 0.004) and, when untreated, more often had non-malignant haematologic diseases compared with those with normal ovarian reserve (n = 24, 100% versus 19%, P = 0.009).Conclusion: Z-scores allow the estimation of genetic- and treatment-related effects on follicular density in cortical tissue from young patients stored for fertility preservation. Understanding the quality of cryopreserved tissue facilitates its use during patient counselling. More research is needed regarding the cytostatic effects found in this study.
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- Liffner, Susanne, et al.
(författare)
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Birth characteristics in men with infertility
- 2020
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Ingår i: Reproductive BioMedicine Online. - : ELSEVIER SCI LTD. - 1472-6483 .- 1472-6491. ; 41:3, s. 455-463
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Tidskriftsartikel (refereegranskat)abstract
- Research question: Are low birth weight, prematurity, being born small for gestational age, or both, associated with a higher risk of male factor infertility in adulthood? Design: Retrospective study of a clinical sample of 892 men, diagnosed with an infertility factor (male, female, combined or unexplained) together with their female partner at a University Hospital clinic in Sweden between 2005 and 2010. Data on birth weight and gestational age at birth were retrieved from the Swedish Medical Birth Register. The distribution of non-optimal birth characteristics in relation to infertility factor was described. A control group was created consisting of two men for each index man, born in Sweden in the same year as each index men, as well as a reference group consisting of all men born in Sweden the same years. Results: The likelihood of having been born small for gestational age was almost fivefold higher in men with male factor infertility than in men with unexplained infertility (OR 4.84, 95% CI 1.32 to 1780). Men with male factor infertility were more often born with non-optimal birth characteristics than the control group (14.8% versus 8.5%; P = 0.010) and the reference group (14.8% versus 11.4%; P < 0.001). Men with azoospermia were more often born with non-optimal birth characteristics, compared with men without azoospermia (21.3% versus 12.1%; P = 0.038). Conclusions: The results suggest an association between intrauterine growth restriction and male factor infertility in adulthood.
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- Lind, Judith, 1971-
(författare)
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Child welfare assessments and the regulation of access to publicly funded fertility treatment
- 2020
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Ingår i: Reproductive BioMedicine Online. - : Elsevier. - 1472-6483 .- 1472-6491 .- 2405-6618. ; 10, s. 19-27
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Tidskriftsartikel (refereegranskat)abstract
- Assessment of the psychological and social circumstances of candidates for assisted reproduction is commonly justified with references to the welfare of the intended child. In nine focus group discussions with 64 clinic staff at four public fertility clinics in Sweden, the responsible use of public resources constituted another important justification for such assessments. Theoretically, this study draws on Julia Black’s (2002) identification of the role of regulatory conversations in decision makers’ policy interpretations. Focus groups defined the desired outcome of assisted reproductive technology (ART) treatment as a well - functioning family , and represented the aim of ART treatment as solving problems without creating new problems for the candidates, the intended child or society. In the discourse of solving and preventing problems, the welfare of the child argument, the responsible use of resources argument and the discourse of personal responsibility merge. Lack of consideration for the circumstances in which the child will grow up was not considered a responsible use of resources because ART treatment would then risk creating more problems than it solved. The results of this study suggest that while publicly funded subsidization of fertility treatment has increased accessibility to ART treatment for candidates who lack the financial means to pay, clinic staff justified restricting access to ART treatment with concern for how public resources are spent.
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- Sydsjö, Gunilla, et al.
(författare)
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Long-term follow-up of mental health and satisfaction in a Swedish sample of sperm and egg donors after open-identity donation
- 2023
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Ingår i: Reproductive BioMedicine Online. - : Elsevier. - 1472-6483 .- 1472-6491. ; 47:6
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Tidskriftsartikel (refereegranskat)abstract
- Research question: How is the mental health of open-identity gamete donors and their satisfaction with their contributions 14–17 years after acceptance as a donor?Design: The Swedish Study on Gamete Donation is a longitudinal study comprising women and men who were accepted as donors at seven Swedish university clinics between 2005 and 2008. The latest (fifth) follow-up included 215 open-identity donors (response rate 87%): 123 oocyte donors and 92 sperm donors. The donors answered a questionnaire regarding their perceptions, experiences and expectations after gamete donation 14–17 years previously.Results: The donors were satisfied with the experience of donating, and no differences were detected between sperm and oocyte donors. Oocyte donors were more than twice as likely to feel that family and friends were proud of their donation compared with sperm donors (51% versus 23%, P < 0.001). In total, six donors regretted their donation: four oocyte donors and two sperm donors. Sperm donors were more frequently satisfied with the financial compensation compared with oocyte donors (P = 0.005). No difference in the development of symptoms of anxiety or depression was detected 14–17 years post-donation.Conclusion: Long-term follow-up studies on donors are important for recruiting donors, and for recipients and the children who will be conceived with donated gametes. The results from the current study indicate that donors, generally, have good mental health and do not regret their decision to donate gametes. These findings are reassuring for all parties involved.
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