Assistive Technology Research Articles

AI EOS using Wolframe Alpha

Artificial intelligence is crucial to day-to-day life. science of computers defines AI research as the study of intelligent agents. Today, most people, intentionally or not, have turned to some form of computerized information processing technology. Artificial Intelligence (AI) is already changing our lifestyle. A device that senses its surroundings and performs actions that maximize the likelihood of achieving a goal. The input to a database can be a choose to of users and articles, and the output is a ruthless recommendation. Input can be verbally or textually submitted by the user within the system. This paper presents a new approach to intelligent search. Overall, there are many people around the world who use assistants. This paper describes the provocation of applying virtual assistant technology. The paper also introduces the application of virtual assistants that can help open opportunities for humanity in various fields. Voice control is an important growing feature that will change people's lives. Voice assistants are available for laptops, desktops, and mobile phones. Assistant is now available on all electronic devices. A voice assistant is a software agent that can interpret human speech and respond in machine language

Assistive technologies for visual impairments: Development and validation of self‐efficacy scale for preservice teachers

AbstractThis article describes the development and validation process of a scale designed to assess the assistive technology (AT) knowledge of preservice special education teachers related to visual impairment (VI). The scale was administered to two groups of preservice special education teachers, and data from the first group (N = 291) were subjected to an exploratory factor analysis (EFA). The results of the EFA revealed that the scale had a five‐factor structure, which included “braille technologies,” “accessibility for documents and software,” “AT for diverse needs,” “AT for accessing print,” and “AT for transforming content into accessible digital format.” Based on the findings of the EFA, the researchers revised the scale and applied it to the second group of preservice teachers (N = 119) to confirm the five‐factor structure through a confirmatory factor analysis (CFA). The fit indices calculated during the CFA indicated a good model fit. By following a systematic approach, a valid 23‐item scale for assessing AT knowledge related to VI was developed. This study offers a useful assessment tool and knowledge constructs for designing AT courses.

An approach to identify assistive technology attributes for people with locomotor disability by using a refined Kano model

This study aims to identify and evaluate the attributes of assistive products for people with locomotor disabilities using the refined Kano model. Thirty experts from various disciplines (product engineers and designers engineers, rehabilitation professionals, and users of assistive technology with locomotor disabilities) participated in the study. They were asked to complete a survey based on the Kano model questionnaire, which included functional and dysfunctional questions for each attribute. The findings reveal that performance, accessibility, functionality, and repairability are one-dimensional characteristics, while quality, modularity, intuitiveness, and aesthetics are attractive attributes. Affordability and durability are identified as must-be attributes. Subsequently, an importance scale was created on a 5-point Likert scale to further analyze the attributes based on the refined Kano model. The results indicate that functionality, quality, aesthetics, affordability, repairability, and durability are the vital attributes. Following this, a case study was conducted based on these attributes, focusing on the two most commonly used products in India: the ALIMCO basic manual wheelchair and the KARMA basic manual wheelchair. By incorporating identified attributes, manufacturers can establish marketing strategies that promote sustainable product development and enhance assistive product satisfaction among individuals with locomotor disabilities.

Braille-Vox Pro Empowering Inclusive Communication

Braille-Vox Pro is an innovative project with the objective of creating a voice-to-Braille conversion system for individuals with vision impairments. The project intends to overcome the reading and writing difficulties encountered by visually impaired individuals, which can have a substantial impact on their ability to access information and communicate effectively. By turning spoken words into Braille text in real-time, the technology will give a practical answer to these issues, allowing visually impaired people to be more autonomous and productive. The research employs advanced natural language processing algorithms capable of effectively recognizing and interpreting spoken words and translating them to Braille text. Also, the system will include a Braille display device that will allow visually impaired individuals to read the transformed text. The development of this technology will give visually impaired individuals with a new degree of accessibility and inclusion, providing them more effective communication and information access. The Braille-Vox Pro project is a huge advancement in assistive technology, providing visually impaired folks with a much-needed answer to their difficulties. By allowing individuals to read and write Braille with their voice, the technology will enhance their capacity to communicate, gain access to information, and participate more fully in society. This project has the potential to aid millions of visually impaired individuals worldwide, which is a tremendous impact. The Braille-Vox Pro project is an innovative and vital Endeavor that will have a significant influence on the lives of individuals with vision impairments. [1] Keywords— Sub-images, Fuzzy logic, Image enhancement, Histogram, HSV, Image processing.

Enhanced Accessibility for Visually Impaired & Blind Artists (EAVIBA) using Machine Learning

This research paper introduces EAVIBA, an innovative voice-driven interface aimed at empowering individuals with visual impairments and blindness in the domain of art and creativity. Rooted in principles of accessible design, EAVIBA integrates advanced features including voice commands, text-to-speech functionality, and a customizable graphical user interface, exemplifying a commitment to inclusive technology. The paper delves into the intricacies of EAVIBA's development, elucidating its architectural framework, seamless integration of assistive technologies, and adherence to recognized accessibility standards such as the Web Content Accessibility Guidelines (WCAG). Employing a comprehensive approach, the research paper outlines the iterative process of user testing, providing both qualitative and quantitative insights into critical aspects such as interface clarity, voice command recognition accuracy, and the efficacy of customization options. The results of these evaluations affirm EAVIBA's remarkable success in delivering an inclusive, accessible, and empowering environment for individuals with visual impairments to engage in artistic expression, thereby contributing significantly to the broader landscape of assistive technologies and accessible interfaces. Keywords: Visually impaired, blind artists, voice-driven interface, assistive technologies, voice recognition, machine learning.

Teaching advanced technology (ADAS) and use of touch screens in driver training in Norway

AbstractAs many as 4,601 people were injured or killed on the roads in Norway in 2022. This number is too high and highlights the necessity of putting road safety on the agenda. The car industry today is represented by a vast increase in advanced technology for drivers to interact with, and knowing how and when to use this technology is crucial for safe driving. Thus, our research question was: Does the Norwegian driver training industry teach advanced driver assistance technology (ADAS) and touch screens in their driver training?A survey was distributed to 1,058 driving schools in Norway, resulting in 333 responses. The results showed that driving instructors spend considerably more effort on teaching inbuilt driving assist technologies that enhance driving safety than on those that are designed to enhance safety but that, if not understood well, could lead to hazardous outcomes. Suggestions on how to improve driver training and driving instructor education are made. Research and practical implications are presented to make sure that driving education is updated and aligned with technological advancements in the automobile industry and to ensure traffic safety for all road users.

Is the Risk of Intrahepatic Cholestasis Increased with Supplemental Progesterone?

This study aimed to evaluate the relationship between supplemental progesterone use during pregnancy and the development of intrahepatic cholestasis of pregnancy (ICP). A retrospective, matched case-control study was conducted among a population of women who delivered at George Washington University Hospital (GW) between 2012 and 2022. Women diagnosed with ICP (cases) were identified using International Statistical Classification of Diseases (ICD) codes, and data were collected via chart abstraction. Descriptive data included patient demographics, pregnancy characteristics, and medical history. Laboratory values related to ICP were collected. Cases were matched on a 1:3 ratio by maternal age, body mass index, and gravidarum to women who delivered at GW during the same month and did not carry a diagnosis of ICP (controls). A univariate logistic regression model was created to assess the use of supplemental progesterone between groups, adjusting for the use of assisted reproductive technology in the current pregnancy, and a history of liver disease. One hundred and twenty women who delivered during the study period were confirmed to have a diagnosis of ICP. Cases were matched with 360 controls and measures compared between the two groups. Cases were significantly more likely to have a history of liver disease (5.9 vs. 1.7%, p = 0.0021), multiple gestation (10.0 vs. 3.3%, p < 0.0001), a history of ICP in a previous pregnancy (10.0 vs. 0%, p < 0.0001), and to have delivered at an earlier gestational age (mean 37.1 vs. 38.6 weeks, p < 0.0001) as compared with controls. No differences were seen in the odds of supplemental progesterone use in both unadjusted and adjusted models (OR 1.14, 95% CI 0.30-4.34; adjusted Odds Ratio [aOR] 0.98 0.24-3.94). Contrary to recent evidence, no association was seen with the use of supplemental progesterone. It is possible that the associated risk with supplemental progesterone is dependent on medication formulation or route of administration. · Supplemental progesterone use in pregnancy may increase the risk of developing ICP.. · Previous investigations of progesterone and ICP have demonstrated mixed results.. · The association may be dependent on the route of administration and formulation of progesterone..

Advanced Paternal Age in Focus: Unraveling Its Influence on Assisted Reproductive Technology Outcomes

As global demographics shift toward increasing paternal age, the realm of assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), faces new challenges and opportunities. This study provides a comprehensive exploration of the implications of advanced paternal age on ART outcomes. Background research highlights the social, cultural, and economic factors driving men toward later fatherhood, with a focus on the impact of delayed paternity on reproductive outcomes. Methods involve a thorough review of existing literature, centering on changes in testicular function, semen quality, and genetic and epigenetic shifts associated with advancing age. Study results point to intricate associations between the father’s age and ART outcomes, with older age being linked to diminished semen quality, potential genetic risks, and varied impacts on embryo quality, implantation rates, and birth outcomes. The conclusions drawn from the current study suggest that while advanced paternal age presents certain risks and challenges, understanding and mitigating these through strategies such as sperm cryopreservation, lifestyle modifications, and preimplantation genetic testing can optimize ART outcomes. Future research directions are identified to further comprehend the epigenetic mechanisms and long-term effects of the older father on offspring health. This study underscores the need for a comprehensive approach in navigating the intricacies of delayed fatherhood within the context of ART, aiming for the best possible outcomes for couples and their children.

The effects of endometrial thickness on outcomes of pregnancy following embryo transfer: A retrospective cohort.

The safety of assisted reproductive technology can be assessed by examining birth weight as an outcome measure. The objective of this study was to evaluate the effect of endometrial thickness during embryo transfer on newborn birth weight and preterm labor. We conducted a retrospective cohort study at the infertility department of a teaching hospital affiliated with a university of medical sciences. Eligible women were ≥18 years old and conceived a singleton pregnancy with embryo transfer and an endometrial thickness of ≥7 mm. None of the patients had diabetes, blood hypertension, and polycystic ovarian syndrome. We assessed maternal and newborn characteristics and perinatal pregnancy outcomes. In total, 100 eligible patients with a mean (SD) age of 32.8 (6.2) years were included. The mean endometrial thickness during embryo transfer was 9.1 (1.2) mm, and the mean birth weight was 3040.7 (565.3)g. There were no statistically significant associations between endometrial thickness and preterm labor (p=0.215) and between endometrial thickness and stillbirth or intra-uterine fetal death (p=0.880). However, after adjusting for confounding factors, the association of endometrial thickness with birth weight was statistically significant [b=124.6 (51.6), p=0.018]. Within the range of ≥7mm, endometrial thickness during embryo transfer is a predictor of newborn weight; however, it is not related to the risk of preterm labor, stillbirth, or intra-uterine fetal death.

Analysis of Assisted Reproductive Technology Treatment of 126 Uterine Adenomyosis Patients Diagnosed via Ultrasonography

Background: Uterine Adenomyosis (Ut-Ad) is a condition in which the endometrial glands and stroma invade extensively into the uterine myometrium, causing the uterus to enlarge and leading to treatment-resistant infertility. In this study, we diagnosed Ut-Ad in the absence of concomitant ovarian endometriosis using ultrasound and conducted assisted reproductive technology (ART) on 126 patients desiring pregnancy. We report our clinical outcomes and discuss potential future treatments. Methods: Ut-Ad was diagnosed independently, without concurrent external endometriosis. We retrospectively analyzed the clinical pregnancy, live birth, and miscarriage rates of 126 patients with Ut-Ad who underwent ART at our clinic, comparing them with 2,472 non-Ut-Ad individuals as controls. Additionally, we examined CA-125 levels and assessed the severity of dysmenorrhea. Results: The Ut-Ad group exhibited significantly lower pregnancy and live birth rates, along with lower gestational age and birth weight, compared to the non-Ut-Ad group. However, embryonic development until embryo transfer was comparable between the Ut-Ad and non-Ut-Ad groups. Notably, the miscarriage rate in the Ut-Ad group was significantly higher than that in the control group. Conclusions: Historically, clinical outcomes for Ut-Ad have been suboptimal, even with the use of modern ART treatments, resulting in low pregnancy rates. While the exact cause of Ut-Ad remains elusive, recent ultrasound findings suggest that minor disruptions in the uterine endometrium may contribute to adenomyosis development in young women with symptoms. Continuous monitoring via transvaginal ultrasound could facilitate early diagnosis and treatment, potentially offering substantial benefits for Ut-Ad management in the future.

AI- POWERED BASED BLIND AND VISUALLY IMPAIRED SYSTEM FOR SMART GLASS

Visual impairment causes serious problems in daily life and mobility for millions of people worldwide. Against this background, smart assistive technology is gaining momentum to improve the independence and quality of life of the blind and visually impaired. They have difficulty in daily life because they cannot detect the problems around them, and one of their biggest problems is identifying people. Besides automation, there are many unexplored uses of search engines. This project includes an app that uses search to help blind people see things in front of them safely, and a facial recognition system with visual feedback that can help visually impaired people see familiar and unfamiliar people. The speaker will provide them with sound support. In this work, we use deep learning-based Regional Convolutional Neural Network (Faster R-CNN) to detect and identify people and objects in the environment. Faster local convolutional neural network technology processes and distributes images captured by cameras. The operator takes the image as input. Therefore, this model helps visually impaired people in a simpler way than a white cane. Keywords—Visuallmpairment,Objectdetection,Faster Region Convolutional Neural Network.

Sperm Incubation in Biggers-Whitten-Whittingham Medium Induces Capacitation-Related Changes in the Lizard Sceloporus torquatus.

Sperm capacitation involves biochemical and physiological changes that enable sperm to fertilize the oocyte. It can be induced in vitro under controlled conditions that simulate the environment of the oviduct. While extensively studied in mammals, its approach in lizards remains absent. Understanding the mechanisms that ensure reproduction is essential for advancing the implementation of assisted reproductive technologies in this group. We aimed to perform a sperm analysis to determine if capacitation-related changes were induced after incubation with capacitating media. Fifteen males of Sceloporus torquatus were collected during the early stage of the reproductive season. The sperm were isolated from the seminal plasma and then diluted up to a volume of 150 μL using BWW medium to incubate with 5% CO2 at 30 °C for a maximum duration of 3 h. A fraction was retrieved hourly for ongoing sperm assessment. The sperm analysis included assessments of its motility, viability, the capacitation status using the chlortetracycline (CTC) assay, and the acrosome integrity with the lectin binding assay to detect changes during incubation. We found that total motility was maintained up to 2 h post incubation, after which it decreased. However, sperm viability remained constant. From that moment on, we observed a transition to a deeper and less symmetrical flagellar bending in many spermatozoa. The CTC assay indicated a reduction in the percentage of sperm showing the full (F) pattern and an increase in those exhibiting the capacitated (B) and reactive (RA) patterns, accompanied by an elevation in the percentage of damaged acrosomes as revealed by the lectin binding assay. In mammals, these changes are often associated with sperm capacitation. Our observations support the notion that this process may also occur in saurian. While sperm analysis is a valuable method for assessing certain functional changes, additional approaches are required to validate this process.

SOLAR BASED WHEEL CHAIR FOR DISABLED

The Solar Based Wheelchair for Disabled (SBWCD) is a groundbreaking project aimed at enhancing mobility and independence for individuals with disabilities by harnessing the power of solar energy. Traditional wheelchairs often rely on manual propulsion or battery-powered motors, which can be limiting in terms of range, accessibility to charging stations, and environmental impact. In response to these challenges, the SBWCD project introduces a novel approach by integrating solar panels into the design of wheelchairs to harness solar energy and convert it into electrical power for propulsion. This innovative solution offers numerous benefits, including extended range, reduced reliance on grid electricity, and decreased carbon footprint. The SBWCD features a lightweight and durable frame equipped with high-efficiency solar panels mounted on the backrest and armrests, maximizing exposure to sunlight while maintaining user comfort and ergonomics. The solar panels are connected to an onboard battery system, which stores excess energy generated during daylight hours for use during periods of low sunlight or at night. This hybrid power system ensures continuous operation of the wheelchair regardless of environmental conditions, providing users with greater autonomy and freedom of movement. Moreover, the SBWCD is designed with user-centric features and accessibility in mind. Adjustable seating, armrests, and footrests accommodate users of varying sizes and preferences, while ergonomic controls and intuitive interfaces ensure ease of operation for individuals with limited mobility or dexterity. Additionally, safety features such as anti-tip mechanisms, seat belts, and obstacle detection systems enhance user confidence and mitigate risks associated with wheelchair use in diverse environments. In summary, the Solar Based Wheelchair for Disabled (SBWCD) project represents a significant advancement in assistive technology, offering a sustainable and user-friendly solution for individuals with disabilities. By harnessing the abundant and renewable energy of the sun, SBWCD empowers users to navigate their surroundings with greater independence, efficiency, and environmental consciousness. As the demand for accessible and eco-friendly mobility solutions continues to grow, the SBWCD project serves as a beacon of innovation and inclusivity in the field of assistive technology.

Bio-Inspired Sensory Receptors for Artificial-Intelligence Perception.

In the era of artificial intelligence (AI), there is a growing interest in replicating human sensory perception. Selective and sensitive bio-inspired sensory receptors with synaptic plasticity have recently gained significant attention in developing energy-efficient AI perception. Various bio-inspired sensory receptors and their applications in AI perception are reviewed here. The critical challenges for the future development of bio-inspired sensory receptors are outlined, emphasizing the need for innovative solutions to overcome hurdles in sensor design, integration, and scalability. AI perception can revolutionize various fields, including human-machine interaction, autonomous systems, medical diagnostics, environmental monitoring, industrial optimization, and assistive technologies. As advancements in bio-inspired sensing continue to accelerate, the promise of creating more intelligent and adaptive AI systems becomes increasingly attainable, marking a significant step forward in the evolution of human-like sensory perception. This article is protected by copyright. All rights reserved.

Female smoking does not affect live birth rate after frozen thawed blastocyst transfer cycle

PurposeThe development of vitrification and blastocyst culture have recently led to a rapidly growing number of single frozen thawed blastocyst transfer (FBT) cycles worldwide. Although the impact of female smoking on spontaneous fertility is well established, its effect on assisted reproductive technologies (ART) outcome is still controversial, and no study has specifically evaluated its effect on FBT cycles’ outcome. MethodsThis retrospective study was conducted in all consecutive FBT cycles conducted between 2012 and 2021 in a single University-based ART centre. Endometrial preparation was standard and based on hormonal replacement therapy. One or two blastocysts were transferred according to couple's history and embryo quality. Female smoking status was recorded for each cycle, and the association between female smoking status and Live Birth Rate (LBR) after FBT cycle was evaluated with univariate and multivariate analysis. ResultsA total of 1537 FBT cycles performed in non-smoking women and 397 FBT cycles performed in smoking women were included in the analysis. No independent association between female smoking status and LBR in FBT cycles was found after logistic regression (OR=1.07 [0.79–1.45], p = 0.649). ConclusionOur study suggests that female smoking might not impair endometrial receptiveness in non-stimulated FBT cycles. Further studies should nevertheless consider assessing more precisely the current smoking exposure.

Footwear-Based Assistive Technology for Lower Limb Amputees

Men and women with lower limb amputations struggle with managing the balance between prosthesis alignment and shoe heel rise. A novel prosthetic ankle-feet system is being developed to support a wider range of footwear options for men and women with lower limb amputations. Each rigid foot is customized to fit the footwear of choice and can be rapidly attached to (or released from) an ankle unit which remains attached to the prosthesis. The proposed system consists of two key components: a transmitter shoe and a receiver shoe. The transmitter shoe is worn on the intact limb and is equipped with sensors, including accelerometers and gyroscopes to capture the wearer's ankle movements accurately. These sensor data are wirelessly transmitted to the receiver shoe worn on the amputated limb, which houses actuators, such as stepper motors, to replicate the natural ankle movements. The hypothesis was that the orientation of the roll-over shapes of these systems would be altered with even small changes in shoe heel height. Seven prosthetic ankle-foot systems were mechanically loaded to determine their roll-over shapes while using a no-heel shoe and a low-heel shoe. This system was developed specifically to allow users the ability to switch between shoes of different heel heights (i.e., it is a heel-height-adjustable system). Additional loading trials were performed with the heel-height-adjustable system in which the ankle alignment was altered to accommodate the change in heel height between shoes.

Intelligent environments and assistive technologies for assisting visually impaired people: a systematic literature review

Intelligent environments and assistive technologies for assisting visually impaired people: a systematic literature review

Pregnancy outcomes of monochorionic diamniotic and dichorionic diamniotic twin pregnancies conceived by assisted reproductive technology and conceived naturally: a study based on chorionic comparison

ObjectiveTo evaluate monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twin pregnancies conceived by assisted reproductive technology (ART) and conceived naturally.MethodsWe retrospectively analyzed the data on twin pregnancies conceived by ART from January 2015 to January 2022,and compared pregnancy outcomes of MCDA and DCDA twins conceived by ART with those of MCDA and DCDA twins conceived naturally, pregnancy outcomes between MCDA and DCDA twins conceived by ART, and pregnancy outcomes of DCT and TCT pregnancies reduced to DCDA pregnancies with those of DCDA pregnancies conceived naturally.ResultMCDA pregnancies conceived by ART accounted for 4.21% of the total pregnancies conceived by ART and 43.81% of the total MCDA pregnancies. DCDA pregnancies conceived by ART accounted for 95.79% of the total pregnancies conceived by ART and 93.26% of the total DCDA pregnancies. Women with MCDA pregnancies conceived by ART had a higher premature delivery rate, lower neonatal weights, a higher placenta previa rate, and a lower twin survival rate than those with MCDA pregnancies conceived naturally (all p < 0.05). Women with DCDA pregnancies conceived naturally had lower rates of preterm birth, higher neonatal weights, and higher twin survival rates than women with DCDA pregnancies conceived by ART and those with DCT and TCT pregnancies reduced to DCDA pregnancies (all p < 0.05).ConclusionOur study confirms that the pregnancy outcomes of MCDA pregnancies conceived by ART are worse than those of MCDA pregnancies conceived naturally. Similarly, the pregnancy outcomes of naturally-conceived DCDA pregnancies are better than those of DCDA pregnancies conceived by ART and DCT and TCT pregnancies reduced to DCDA pregnancies.

Time and power dependence of laser-induced photodamage on human sperm revealed by longitudinal rolling measurement using optical tweezers

Lasers are widely applied in assisted reproductive technologies, including sperm fixation, sperm selection and intracytoplasmic sperm injections, to reduce procedure time and improve consistency and reproducibility. However, quantitative studies on laser-induced photodamage of sperm are lacking. In this study, we demonstrated that, by using optical tweezers, the kinematic parameters of freely swimming sperm are correlated with the frequency as well as the percentage of pausing duration of longitudinal rolling of the same sperm head in the optical trap. Furthermore, by trapping individual sperm cells using 1064-nm optical tweezers, we quantitatively characterized the time-dependence of longitudinal rolling frequency and percentage of pausing duration of sperm under different laser powers. Our study revealed that, as trapping time and the laser power time increase, the longitudinal rolling frequency of the optically trapped sperm decreases with an increasing percentage of pausing duration, which characterizes the effect of laser power and duration on the photodamage of individual sperm cells. Our study provides experimental basis for the optimization of laser application in assisted reproductive technology, which may reduce the photodamage-induced biosafety risk in the future.

Zygotic-splitting after in vitro fertilization and prenatal parenthood testing after suspected embryo mix-up - a case report.

After in vitro fertilization with a single embryo, the parents learned about being pregnant with twins in the 10th week with various indications that an embryonic mix-up could have taken place. The affected couple thus expressed the urgent desire for a clarification of parenthood considering an abortion. However, the prenatal test results would not have been available until the 14/15th week of pregnancy. Legally, then, severe physical or mental distress of the pregnant woman must be claimed by physicians to justify an abortion after the twelfth week. However, a lack of genetic relatedness could lead to serious psychological distress for the parents, making a pregnancy termination possible even after the twelfth week, which is discussed in this case study alongside the interdisciplinary team's ethical, legal, and medical considerations.For the invasive relationship testing, cultivated chorionic villi samples (CVS) from both unborn and saliva samples from the putative parents were genetically analyzed using classical short tandem repeats (STR) analysis. The perfect match of both CVS profiles suggested the occurrence of an unusual late twin shaft, for which, fortunately, parenthood could be confirmed. To our knowledge, this is the first report on a prenatal investigation of a suspected embryo mix-up after assisted reproductive technology (ART), in which parenthood should be fixed. We want to draw attention to this unthinkable scenario, which may increase in the future with ART-induced rising multiple pregnancies.