Lower Abortion Rate Research Articles

Unlocking Infertility: Enhancing Pregnancy Rates With Personalized Embryo Transfers Using Optimal Time for Endometrial Receptivity Analysis in Recurrent Implantation Failure Patients Undergoing In Vitro Fertilization.

Background Infertility remains a significant global challenge, and recurrent implantation failure (RIF) poses a considerable concern in assisted reproductive technology. Understanding the factors contributing to implantation failure is essential for developing accurate diagnostic tools and treatment strategies. Endometrial receptivity (ER) during the window of implantation is crucial for successful embryo implantation in in vitro fertilization (IVF) procedures. Molecular-based endometrial receptivity analysis and next-generation sequencing provide insights into ER, but there is a lack of research on these in the Indian population, particularly in patients with RIF. This retrospective cohort study evaluates the effectiveness of Optimal Timing for Endometrial Receptivity Analysis (OpERA)-guided personalized embryo transfer (pET) in Indian patients with a history of RIF. Methodology The study includes 158 female patients with a history of failed embryo transfers who underwent OpERA testing before frozen embryo transfer. Patients were categorized based on the number of previous failed transfers. OpERA outcomes were assessed, and clinical outcomes were compared between groups undergoing preimplantation genetic testing for aneuploidy (PGT-A) with and without OpERA. Endometrial preparation involved hormone replacement therapy, and OpERA testing was performed at the Neuberg Centre for Genomic Medicine using RNA extraction, cDNA conversion, and sequencing. Results OpERA outcomes showed no significant differences in receptive rates among patient groups. Group 3, with three or more failed transfers, exhibited significantly higher biochemical pregnancy rates (BPRs), clinical pregnancy rates (CPRs), and abortion rates (ARs) compared to Groups 1 and 2. OpERA with PGT-A showed significantly higher BPR, implantation rate, CPR, and lower AR compared to OpERA without PGT-A. Conclusions OpERA-guided pET, especially with PGT-A, demonstrated improved pregnancy outcomes, particularly in patients with a history of RIF. The study emphasizes the importance of OpERA in determining optimal transfer timing, moving beyond the traditional reliance on embryo quality alone.OpERA presents promise in predicting pregnancy outcomes for Indian patients with previous IVF failures. The integration of OpERA and PGT-A represents a significant advancement in personalized reproductive medicine, offering new hope for individuals grappling with infertility complexities.

Polygenic adaptation leads to a higher reproductive fitness of native Tibetans at high altitude

The adaptation of Tibetans to high-altitude environments has been studied extensively. However, the direct assessment of evolutionary adaptation, i.e., the reproductive fitness of Tibetans and its genetic basis, remains elusive. Here, we conduct systematic phenotyping and genome-wide association analysis of 2,252 mother-newborn pairs of indigenous Tibetans, covering 12 reproductive traits and 76 maternal physiological traits. Compared with the lowland immigrants living at high altitudes, indigenous Tibetans show better reproductive outcomes, reflected by their lower abortion rate, higher birth weight, and better fetal development. The results of genome-wide association analyses indicate a polygenic adaptation of reproduction in Tibetans, attributed to the genomic backgrounds of both the mothers and the newborns. Furthermore, the EPAS1-edited mice display higher reproductive fitness under chronic hypoxia, mirroring the situation in Tibetans. Collectively, these results shed new light on the phenotypic pattern and the genetic mechanism of human reproductive fitness in extreme environments.

P-713 Preimplantation DNA methylation screening (PIMS) illustrates the outcome of assisted reproductive technology

Abstract Study question It is unknown whether using DNA methylation can improve the outcome of ART and can exclude the imprinted gene diseases. Summary answer Our study provides a criterion on selecting blastocyst according to DNA methylome, which can improve live birth rate and decrease birth defect rate. What is known already How to select the embryos is one key factor that can determine the successful rate of ART. As aneuploidy exists in 20-30% of blastocysts, preimplantation genetic screening (PGS) has been widely used, which increases the live birth rate. Unfortunately, the live birth rate remains around 50% even with the help of PGS. DNA methylation is known to play important function during embryogenesis. Previous study has shown that a large proportion of human embryos have abnormal DNA methylome. However, whether DNA methylation pattern can affect the clinical outcome of ART has not been investigated in clinics. Study design, size, duration To determine whether PIMS method can increase live birth rate during ART, the whole genome DNA methylation of 3-5 biopsied cells from trophectoderm were measured. The methylation level and chromosome copy number variation (CNV) were analyzed by using the methylome data. elective single embryo transfer (eSET) will be performed for embryos with euploid chromosome. The live birth rate, pregnant rate and abortion rate will be examined. 182 families including 800 blastocysts were enrolled in PIMT. Participants/materials, setting, methods Eligible couples include advanced maternal age, recurrent pregnancy loss with unknown reason, recurrent implantation failure with unknown reason, severe oligoteratozoospermia. Eligible couples must have two or more good-quality blastocysts. We call a blastocyst as good quality if the blastocyst is 4BC or better according to the Gardner morphologic criteria on day 5-6 of embryo culture. Main results and the role of chance No one has ever performed clinical trial to investigate the impact of DNA methylation of blastocyst on the outcome of artificial assisted reproductive (ART). Here, we performed PIMS using the biopsied trophectoderm of 800 blastocysts. Chromosome copy number variation and DNA methylation pattern were analyzed by using methylome data. 162 of euploid embryos were transferred. Our data show that significant variation of DNA methylation level of blastocysts can be observed in both younger women (£37 years old) and older women (>37 years). Blastocysts with global methylation level around 0.26 have the highest birth and pregnancy rate, but the lowest abortion rate. The higher the difference methylation value from 0.26 is, the lower the birth rate becomes. Furthermore, by using artificial intelligence method according to different methylated regions between the embryos succeeding in live-birth and those failing in live-birth, we can robustly predict the clinical outcome of blastocysts. PIMS method can find the abnormality of DNA methylation states in the imprinted control regions which can cause the imprinted diseases. Our study provides a criterion on selecting blastocyst according to DNA methylome during ART, which can potentially improve the live birth rate and decrease the birth defect rate. Limitations, reasons for caution Because of the low coverage of single cell DNA methylome, PIMS method cannot cover all imprinted control regions. Wider implications of the findings PIMS method can potentially find more human diseases which is caused by DNA methylation mutation. Trial registration number NCT03642574

Relation between semen oxidative reduction potential in initial semen examination and IVF outcomes.

The MiOXSYS system is a new technique to analyze the semen oxidative reduction potential (ORP) that may use to classify the level of sperm DNA integrity. It does not clearly explain how the semen ORP values could help to change the IVF outcomes. We have analyzed correlations between semen ORP value and the IVF results. Four hundred and thirty couples were enrolled. The male counterparts were divided into two groups according to their semen ORP values and compared the fertilization rate, cell cleavage rate, and embryo quality, following the IVF procedures. The relations between ORP values and the clinical pregnancy, live birth, and abortion rates were analyzed. The ORP values show negative and positive correlations with some conventional semen parameters. The fertilization and the cleavage rate did not show any differences in those two groups, but the transferable embryo rate was significantly high in patients with high semen ORP. However, the patients with high ORP show a tendency to lower clinical pregnancy with a low abortion rate compared to the low ORP group. The main purpose of measuring the ORP value in semen is still questionable and shows controversial results.

Sexual Education on Instagram, How is The Reception of Young People?

Sexual education is a sensitive issue in Indonesia. Conservative groups claim that sex education is taboo. On the other hand, the high rates of prenuptial pregnancies shows a lack of sexual education. Reproductive health education is often considered inadequate as consideration of decision-making in sexual activities. Account @sisilsm2.0 as an alternative media information about reproductive health through Instagram media. @sisilsm2.0 aim to prevent an unplanned increase in pregnancies, abortions and the transmission of sexual diseases because sex education is now considered taboo. This study aims to know the audience's reception content of the sex education by @sisilism2.0 account. This study uses a descriptive qualitative type of research method with reception analysis. There are six informers in this research including men and women who follow @sisilsm2.0 Instagram account and has a background and that has never been dating and has been dating. Four informers are in negotiating positions by stating the importance of sex education was delivered at school at an early age but cannot lower rates of abortion and transmission of sexually transmitted diseases. The other two informants are in dominant position by stating that sex education is a must that can lower abortion rates and transmission of sexually transmitted diseases. The background of the informants and their interaction with media, especially digital media, became the deciding factors in their encoding-decoding position. Young people who active and interact with social media get more sex education information and become a reference in looking at sex education.

Abortion Surveillance - United States, 2020.

CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and number of abortion-related deaths in the United States. 2020. Each year, CDC requests abortion data from the central health agencies for the 50 states, the District of Columbia, and New York City. For 2020, a total of 49 reporting areas voluntarily provided aggregate abortion data to CDC. Of these, 48 reporting areas provided data each year during 2011-2020. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births), respectively. Abortion-related deaths from 2019 were assessed as part of CDC's Pregnancy Mortality Surveillance System (PMSS). A total of 620,327 abortions for 2020 were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2011-2020, in 2020, a total of 615,911 abortions were reported, the abortion rate was 11.2 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 198 abortions per 1,000 live births. From 2019 to 2020, the total number of abortions decreased 2% (from 625,346 total abortions), the abortion rate decreased 2% (from 11.4 abortions per 1,000 women aged 15-44 years), and the abortion ratio increased 2% (from 195 abortions per 1,000 live births). From 2011 to 2020, the total number of reported abortions decreased 15% (from 727,554), the abortion rate decreased 18% (from 13.7 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 9% (from 217 abortions per 1,000 live births).In 2020, women in their 20s accounted for more than half of abortions (57.2%). Women aged 20-24 and 25-29 years accounted for the highest percentages of abortions (27.9% and 29.3%, respectively) and had the highest abortion rates (19.2 and 19.0 abortions per 1,000 women aged 20-24 and 25-29 years, respectively). By contrast, adolescents aged <15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.7%, respectively) and had the lowest abortion rates (0.4 and 2.6 abortions per 1,000 women aged <15 and ≥40 years, respectively). However, abortion ratios were highest among adolescents (aged ≤19 years) and lowest among women aged 25-39 years.Abortion rates decreased from 2011 to 2020 among all age groups. The decrease in abortion rate was highest among adolescents compared with any other age group. From 2019 to 2020, abortion rates decreased or did not change for all age groups. Abortion ratios decreased from 2011 to 2020 for all age groups, except adolescents aged 15-19 years and women aged 25-29 years for whom abortion ratios increased. The decrease in abortion ratio was highest among women aged ≥40 years compared with any other age group. From 2019 to 2020, abortion ratios decreased for adolescents aged <15 years and women aged ≥35 and increased for women 15-34 years.In 2020, 80.9% of abortions were performed at ≤9 weeks' gestation, and nearly all (93.1%) were performed at ≤13 weeks' gestation. During 2011-2020, the percentage of abortions performed at >13 weeks' gestation remained consistently low (≤9.2%). In 2020, the highest percentage of abortions were performed by early medical abortion at ≤9 weeks' gestation (51.0%), followed by surgical abortion at ≤13 weeks' gestation (40.0%), surgical abortion at >13 weeks' gestation (6.7%), and medical abortion at >9 weeks' gestation (2.4%); all other methods were uncommon (<0.1%). Among those that were eligible (≤9 weeks' gestation), 63.9% of abortions were early medical abortions. In 2019, the most recent year for which PMSS data were reviewed for pregnancy-related deaths, four women died as a result of complications from legal induced abortion. Among the 48 areas that reported data continuously during 2011-2020, overall decreases were observed during 2011-2020 in the total number, rate, and ratio of reported abortions. From 2019 to 2020, decreases also were observed in the total number and rate of reported abortions; however, a 2% increase was observed in the total abortion ratio. Abortion surveillance can be used to help evaluate programs aimed at promoting equitable access to patient-centered quality contraceptive services in the United States to reduce unintended pregnancies.

Causes of abortion in Iranian sheep flocks and associated risk factors

Abortion is a major issue in sheep husbandry. It can result in significant economic losses and a severe public health risk. This survey assessed the infectious and non-infectious causes of abortion in Iranian sheep flocks and determined the main risk factors. In this cross-sectional survey, causes of abortion were evaluated in 757 sheep flocks, and risk factors were analysed. A checklist containing general animal information for each abortion outbreak evaluated was filled in. Data were analysed using univariate tests and multivariable binary logistic regression analysis. In this sense, parity, gestational age of the aborted fetus, vaccination protocol, mineral supplementation and history of stillbirth showed significant associations with abortion. Infectious agents such as Coxiella burnetti (22.7%), Chlamydia abortus (12.3%) and Brucella melitensis (10.4%) were the most frequently isolated in the investigated flocks, with more than 2% of abortion rates. On the other hand, non-infectious agents such as trauma, pregnancy toxaemia and vitamin E/Se deficiency were involved in those flocks with low abortion rates (less than 10%). Results revealed multiple causes of abortion outbreaks among Iranian sheep flocks, which need careful investigation to identify possible aetiology and risk factors. Further studies are necessary to evaluate if these factors are similar to other countries in the same region.

P-523 rs2277698 Single nucleotides polymorphisms in tissue inhibitors of metalloproteinases 2 (TIMP2) affected clinical outcomes of women undergoing in vitro fertilization

Abstract Study question Is there any association between clinical outcomes of women undergoing in vitro fertilization (IVF) and the polymorphic variants of matrix metalloproteinases (MMPs) or tissue inhibitors of metalloproteinases (TIMPs)? Summary answer Our findings suggested that clinical outcomes of women undergoing IVF were associated with rs2277698 SNPs in TIMP2. What is known already The extracellular matrix proteolytic machinery is one of the most important mechanisms for regulating trophoblast invasion. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), which are involved in the extracellular matrix proteolysis process, have the ability to regulate the degradation of the extracellular matrix and play a critical role in trophoblast invasion. Study design, size, duration A prospective study was composed of 1014 women undergoing their first fresh IVF cycle with non-donor from January 2014 to December 2015. Participants/materials, setting, methods The present study was carried out in Lee Women’s Hospital, Taiwan. DNA was extracted from the peripheral blood of all participants, and the SNPs were genotyped by real-time polymerase chain reaction. The effects of the following three single nucleotide polymorphisms (SNPs) on IVF outcomes were explored: TIMP1 (rs4898 C/T), TIMP2 (rs2277698 C/T) and MMP2 (rs243865 C/T). The SNP genotype, correlation with clinical pregnancy, embryo implantation, abortion and live birth rates of IVF were analyzed. Main results and the role of chance In the analysis of 1014 patients attempting their first cycle of IVF, the genotypes frequencies of the study population showed a statistically significant association between TIMP2 (rs2277698 C/T) and clinical outcome. For TIMP2 polymorphisms, women with wild genotype (CC) hadhigher clinical pregnancy rate (34.8% v.s 28.0%; p = 0.032), embryo implantation rate (19.4% v.s 15.4%; p = 0.009), live birth rate (29.8% v.s 22.1%; p = 0.006), and lower abortion rate (7.0% v.s 17.1%; p = 0.005) compared women with CT/TT genotype. On the other hand, the clinical outcomes in different TIMP1 or MMP2 gene polymorphisms groups were no statistically significant difference. Limitations, reasons for caution The size number of the study samples. Wider implications of the findings This study showed that the TIMP2 SNP polymorphisms CT/TT was associated with low trend of clinical outcomes. The mechanism of TIMP2 gene T allele affected the outcomes of IVF remains to be determined. Further studies should focus on the mechanism of these associations in a larger, more heterogeneous cohort. Trial registration number CS13194

Trait Selection for Yield Improvement in Foxtail Millet (Setaria italica Beauv.) under Climate Change in the North China Plain

Weather factors and drought could impact the yield of foxtail millet, and varieties with traits that could alleviate the negative effects of deteriorating weather factors in the future should be developed. A total of 25 foxtail millet varieties were evaluated in experiments from 2016 to 2020 under well-watered (WW) and water-stressed (WS) treatments. Future climate change might favor an increased temperature that impedes grain yield, so varieties with characters that are less sensitive to temperature change are preferred. Varieties with a high panicle dry-weight per plant, thousand grain weight, leaf area and water productivity in deep soil layer usually gave better grain production under both water treatments. Under the WW treatment, low grain abortion rate, optimal chlorophyll and canopy temperature and more roots in the upper soil layer could favor a high yield and drought resistance. Under the WS treatment, varieties with a high harvest index, low rate of water loss and more roots in the upper soil layer usually produced a high yield.

Study of some microbial infections of recurrent miscarriage in women

Background: some microbial infections can be passed to the fetus before or during birth and damage the fetus or cause a miscarriage, like infection with ToRCH agents and salmonella enterica. The current study aims to investigate the extent of the involvement of salmonella enteria serovars, proteus spp. and Brucella spp. in recurrent miscarriage in women during first trimester. Material and method: The 50 blood samples were collected from women age rage (19-39), who had repeated miscarriages during the first trimester during periods extended from October 2021 to February 2022,. The study control includes the 20 fertile women with no miscarried history. Two tests were conducted which are ToRCH IgM and febril antigen slid test for identification infectious agents associated with pregnancy loss. Results: The present results showed that the most frequent recurrent miscarriage (RM) was in the age group 35-39 years at a percentage 34%, while the lowest abortion rate was 18% at the age group of 25-29 years.

Mapping and characterizing areas with high levels of malaria in pregnancy in Brazil: A spatiotemporal analysis

Malaria in pregnancy (MiP) is a public health problem in the Brazilian Amazon region that requires special attention due to associated serious adverse consequences, such as low birth weight, increased prematurity and spontaneous abortion rates. In Brazil, there have been no comprehensive epidemiological studies of MiP. In this study, we aimed to explore the spatial and spatiotemporal patterns of MiP in Brazil and epidemiologically characterize this population of pregnant women over a period of 15 years. We performed a national-scale ecological analysis using a Bayesian space-time hierarchical model to estimate the incidence rates of MiP between 1 January 2004 and 31 December 2018. We mapped the high-incidence clusters among pregnant women aged 10-49 years old using a Poisson model, and we characterized the population based on data from the Epidemiological Surveillance Information System for Malaria (SIVEP-Malaria). We consolidated the data of 61,833 women with MiP in Brazil. Our results showed a reduction of 50·1% (95% CI: 47·3 to 52·9) in the number of malaria cases over the period analysed, with Plasmodium vivax malaria having the highest incidence. MiP was widely distributed throughout the Amazon region, and spatial and spatiotemporal analyses revealed statistically significant clusters in some municipalities of Amazonas, Acre, Rondônia and Pará. In addition, we observed that younger pregnant women had a higher risk of infection, and the administration of appropriate treatment requires more attention. This nationwide study provides robust evidence that, despite the reduction in the number of MiP cases in the country, it remains a serious public health problem, especially for young pregnant women. Our analyses highlight focus areas for strengthening interventions to control and eliminate MiP. FAPESP and CNPq - Brazil.

Levothyroxine treatment for subclinical hypothyroidism improves the rate of live births in pregnant women with recurrent pregnancy loss: a randomized clinical trial

Objective: This study aimed to assess whether the use of levothyroxine was beneficial in pregnant women with subclinical hypothyroidism (SCH) or women who were positive for thyroid peroxidase antibody (TPOAb+). Study design: This was a randomized clinical trial involving 1736 populations of pregnant women. Our study was conducted into two groups: normal pregnant group and recurrent pregnancy loss (RPL) pregnant group. Both patients were divided into SCH and TPOAb+ groups, respectively; the patients of four groups were randomized into either the L-T4 treatment or control groups. Results: There was no significant difference between the two groups in the prevalence of SCH and TPOAb+ (p > .05); The live births rate of normal pregnant group was higher than that of the RPL pregnant Group (79.5% vs. 70.8%, p < .05); Considering normal pregnant women, whether women who were TPOAb + or SCH, there was no significant difference between the treatment and control group in the live birth rate and the pregnancy loss rate. In RPL group, whether women who were TPOAb + or SCH, L-T4 treatment can obtain higher live birth rate and lower abortion rate compared to the control. Conclusion: There was no significant difference between normal and RPL pregnant women in the prevalence of SCH and TPOAb+.Treatment with L-T4 decreased the risk of pregnancy loss and increased the live birth rate in RPL pregnant women who were positive for TPOAb or subclinical hypothyroidism. Levothyroxine therapy is recommended for SCH and TPOAb + women in pregnant women with recurrent pregnancy loss.

Management factors affecting reproductive performance and causes of infertility of Ardi goats in Saudi Arabia

Abstract The aim of this study was to investigate the effect of age at first service ( 50), breeding season (all the year vs. specific season), housing system (shelter vs. grazing and shelter), manager education level ( 200), flock size ( 200) and their interactions on kidding, twining, abortion and stillbirth rates of Ardi goats in Saudi Arabia. Data were collected from 34 goat flocks containing 3700 heads. GLM procedures were used for analysis. The dependent variables in the model were lambing, twining, abortion, and stillbirth rates, while the main effects in the model were age at first service, male/females ratio, breeding season, housing system, manager education level, flock size, and worker/animals ratio. Barren does (n = 104) were examined for the causes of infertility. The results revealed that the means of kidding, twining, abortion and stillbirth rates were 91.5 ± 1.2%, 50.09 ± 5.24%, 3.5 ± 1.4% and 9.47 ± 2.2%, respectively. Does mated by or after 8 months had more twins than those mated before this age (P = 0.006). Flocks with male/females ratio of 1:>50 showed higher stillbirth rate (P = 0.01). Shelter-raised goats had a higher twining rate (P = 0.01) and a lower abortion rate (P = 0.001). Flocks raised in a shelter system with a worker/animal ratio of 1:100 had a higher kidding rate (P = 0.02) and lower abortion rate (P = 0.0001) than those with the same ratio but raised in a mixed grazing and shelter system. Flocks with managers with a ≥ secondary school education had a higher twining rate (P = 0.002). The most common findings in barren goats were pyometra, ovarian inactivity, abnormal vaginal discharges, and hydrometra. In conclusion, management has a profound effect on the reproductive performance of Ardi goats in Saudi Arabia and should be always considered when attempting to improve their production.

The impact of endometrial mechanical stimulation in women with normal hysteroscopic findings undergoing IVF/ICSI: a meta-analysis

Background: To investigate whether hysteroscopic endometrial mechanical stimulation improves pregnancy outcomes in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Methods: We conducted a systematic search in electronic databases including PubMed, Embase, Cochrane Library, Web of Science from their inception to Feb 20th, 2021, as well as a manual search. All publications on the impact of hysteroscopic endometrial mechanical stimulation on IVF/ICSI outcomes were retrieved. Two reviewers independently screened the retrieved studies using stringent inclusion and exclusion criteria; data were subsequently extracted, and risk of bias was assessed. Meta-analysis of the selected studies was performed using Revman 5.3. Results: Eight studies involving 1494 patients were eligible for inclusion, including 5 randomized controlled trials and 3 prospective non-randomized simultaneous controlled experimental studies. We found that compared with the control group, hysteroscopic endometrial mechanical stimulation effectively increased live birth rate [risk ratio (RR) = 2.15, 95% confidence interval (CI) (1.78, 2.60), p &lt; 0.00001] and clinical pregnancy rate [RR = 1.95, 95% CI (1.28, 2.98), p = 0.002], and also decreased abortion rate [RR = 0.54, 95% CI (0.35, 0.86), p = 0.009]. Subgroup analyses revealed that, hysteroscopic endometrial mechanical stimulation administered in the luteal phase in patients undergoing their first IVF/ICSI cycle was associated with significantly higher live birth rate and clinical pregnancy rate, as well as a significantly lower abortion rate. Discussion: Endometrial mechanical stimulation may improve live birth rate, clinical pregnancy rate and reduce abortion rate in patients with normal hysteroscopic findings who are undergoing IVF/ICSI. The benefits may be even greater if this therapy is given in the luteal phase and in patients who are in their first IVF/ICSI cycle. However, due to the limited quantity and quality of the included studies and variable stimulation methods, these findings should be interpreted with caution, and more high-quality studies are needed to confirm this conclusion.

What will and won't happen when abortion is banned.

For the past 50 years, abortion opponents have fought for the power to ban abortion without little attention to how things might change when they won. The battle to make abortion illegal has been predicated on three nebulous assumptions about how abortion bans work. First, supporters believe banning abortion will deter it. Second, they hope bans will send a message about abortion—specifically, that abortion is immoral. And third, they expect bans to be competently implemented and enforced. Drawing on empirical work from within and outside of the U.S., this Article offers an evidence-based assessment of each of these assumptions. Part One examines the question of deterrence by exploring findings from countries with relatively high and relatively low abortion rates. After explaining why restrictive abortion laws alone do not reduce aggregate abortion rates, I consider the matter of individual deterrence. By identifying those most likely to be deterred by U.S. abortion bans, I illustrate how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children. Part Two tests the idea that abortion bans send a message. I consider the bans’ meaning in context with U.S. laws and policies affecting families, exposing the difference between laws discouraging abortion, and those encouraging childbirth. Then, drawing from literature on the expressive function of the law, I assess the limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitment to children living in poverty. Part Three turns to the expectation that abortion bans will be competently enforced, noting the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans. This article concludes by considering why the consequences and limitations of abortion bans should matter to supporters and opponents, alike.

Pregnancy and live birth rate after fresh embryo transfer versus freeze-all strategy: A prospective observational study

Objectives. To evaluate which type of embryo transfer (ET) has a superior pregnancy rate. Material and method. Prospective observational non-randomized study including 79 women that underwent 145 ET. Outcomes. The results show that the highest biochemical pregnancy rate (BPR) was in the fresh day 3 ET group (47.62%), but in this group there were also the highest abortion rate (80%) and the highest premature birth rate (100%), giving that, after 21 fresh day 3 ET did not result any term live birth. The frozen day 3 embryo has the lowest BPR (30%), but also the lowest abortion rate (33.33%) and the lowest premature birth rate (0%), in the present study after 13 frozen day 3 ET resulting 2 full-term births (15.38%). The results for the fresh day 5 blastocyst show a good BPR (43.48%), a low abortion rate (33.33%) and the lowest premature birth rate (0%), giving that in the study performed after 23 day 5 ET resulted 4 newborns at term (15.38%). The frozen day 5 blastocyst has a very good BPR (46.07%), the highest birth rate (21.62%), a high abortion rate (37.14%) and a low premature birth rate (7.41%), taking into account that in the present study after 89 day 5 frozen ET resulted 24 newborns, of which 22 full-term births (24.71%). Conclusions. The use of frozen day 5 blastocysts had the best results in terms of the ultimate goal - the birth of a live fetus at term.

Abortion Surveillance - United States, 2019.

Problem/ConditionCDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and number of abortion-related deaths in the United States.Period Covered2019.Description of SystemEach year, CDC requests abortion data from the central health agencies for 50 states, the District of Columbia, and New York City. For 2019, 49 reporting areas voluntarily provided aggregate abortion data to CDC. Of these, 48 reporting areas provided data each year during 2010–2019. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15–44 years) and ratios (number of abortions per 1,000 live births), respectively. Abortion-related deaths from 2018 were assessed as part of CDC’s Pregnancy Mortality Surveillance System (PMSS).ResultsA total of 629,898 abortions for 2019 were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2010–2019, in 2019, a total of 625,346 abortions were reported, the abortion rate was 11.4 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 195 abortions per 1,000 live births. From 2018 to 2019, the total number of abortions increased 2% (from 614,820 total abortions), the abortion rate increased 0.9% (from 11.3 abortions per 1,000 women aged 15–44 years), and the abortion ratio increased 3% (from 189 abortions per 1,000 live births). From 2010 to 2019, the total number of reported abortions, abortion rate, and abortion ratio decreased 18% (from 762,755), 21% (from 14.4 abortions per 1,000 women aged 15–44 years), and 13% (from 225 abortions per 1,000 live births), respectively.In 2019, women in their 20s accounted for more than half of abortions (56.9%). Women aged 20–24 and 25–29 years accounted for the highest percentages of abortions (27.6% and 29.3%, respectively) and had the highest abortion rates (19.0 and 18.6 abortions per 1,000 women aged 20–24 and 25–29 years, respectively). By contrast, adolescents aged <15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.7%, respectively) and had the lowest abortion rates (0.4 and 2.7 abortions per 1,000 women aged <15 and ≥40 years, respectively). However, abortion ratios in 2019 were highest among adolescents (aged ≤19 years) and lowest among women aged 25–39 years. Abortion rates decreased from 2010 to 2019 for all women, regardless of age. The decrease in abortion rate was highest among adolescents compared with any other age group. From 2018 to 2019, abortion rates decreased or did not change among women aged ≤24 years; however, the abortion rate increased among those aged ≥25 years. Abortion ratios also decreased or did not change from 2010 to 2019 for all age groups, except adolescents aged <15 years. The decrease in abortion ratio was highest among women aged ≥40 years compared with any other age group. From 2018 to 2019, abortion ratios increased for all age groups, except adolescents aged <15 years.In 2019, 79.3% of abortions were performed at ≤9 weeks’ gestation, and nearly all (92.7%) were performed at ≤13 weeks’ gestation. During 2010–2019, the percentage of abortions performed at >13 weeks’ gestation remained consistently low (≤9.0%). In 2019, the highest proportion of abortions were performed by surgical abortion at ≤13 weeks’ gestation (49.0%), followed by early medical abortion at ≤9 weeks’ gestation (42.3%), surgical abortion at >13 weeks’ gestation (7.2%), and medical abortion at >9 weeks’ gestation (1.4%); all other methods were uncommon (<0.1%). Among those that were eligible (≤9 weeks’ gestation), 53.7% of abortions were early medical abortions. In 2018, the most recent year for which PMSS data were reviewed for pregnancy-related deaths, two women died as a result of complications from legal induced abortion.InterpretationAmong the 48 areas that reported data continuously during 2010–2019, overall decreases were observed during 2010–2019 in the total number, rate, and ratio of reported abortions; however, from 2018 to 2019, 1%–3% increases were observed across all measures.Public Health ActionAbortion surveillance can be used to help evaluate programs aimed at promoting equitable access to patient-centered quality contraceptive services in the United States to reduce unintended pregnancies.

Clinical Pregnancy and Incidence of Ovarian Hyperstimulation Syndrome in High Ovarian Responders Receiving Different Doses of hCG Supplementation in a GnRH-Agonist Trigger Protocol.

Objective Ovarian hyperstimulation syndrome (OHSS) is a side effect of the exogenous human chorionic gonadotropin (hCG) hormones used to trigger oocyte maturation. High ovarian responders represent a population with a higher risk of OHSS and are characterized by an exaggerated response to gonadotropin administration. In this study, we compared clinical pregnancy and incidence of OHSS in high ovarian responders receiving different doses of hCG supplementation in a GnRH-agonist trigger protocol. Methods A total of 205 high ovarian responders who were to undergo in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles were recruited and randomly assigned to receive different doses of hCG supplementation in a GnRH-agonist trigger protocol: GnRH-a (n = 42), GnRH-a + 1000 IU hCG (n = 49), GnRH-a + 2000 IU hCG (n = 54), and GnRH-a + 3000 IU hCG (n = 60) groups. Results The GnRH-a + 1000 IU hCG, GnRH-a + 2000 IU hCG, and GnRH-a + 3000 IU hCG groups had more oocytes retrieved, embryos, high-quality embryos, and a higher rate of high-quality embryos than the GnRH-a group (p < 0.05). The GnRH-a + 1000 IU hCG group demonstrated more oocytes retrieved, embryos, high-quality embryos, and a higher rate of high-quality embryos than the GnRH-a + 2000 IU hCG and GnRH-a + 3000 IU hCG groups (p < 0.05). No moderate and severe OHSS cases occurred in the GnRH-a and GnRH-a + 1000 IU hCG groups. The incidence rate of moderate and severe OHSS was remarkably lower in the GnRH-a group and GnRH-a + 1000 IU hCG groups than in the GnRH-a + 2000 IU hCG and GnRH-a + 3000 IU hCG groups (p < 0.05). The GnRH-a + 1000 IU hCG, GnRH-a + 2000 IU hCG, and GnRH-a + 3000 IU hCG groups had a higher clinical pregnancy rate than the GnRH-a group, showing no significant difference (p > 0.05). The GnRH-a + 1000 IU hCG, GnRH-a + 2000 IU hCG, and GnRH-a + 3000 IU hCG groups had a lower abortion rate than the GnRH-a group (p < 0.05). Conclusion Based on the data obtained from this prospective study, we recommend 1000 IU hCG supplementation in a GnRH-agonist trigger protocol for high ovarian responders during IVF/ICSI cycles considering a higher rate of high-quality embryos, a lower incidence rate of moderate and severe OHSS, and a lower abortion rate.

Effect of paternal health on pregnancy loss-A review of current evidence.

Pregnancy loss has multifactorial causes, and the maternal risk factors are the most investigated. Therefore, this review investigates the current literature regarding the effect of paternal health on pregnancy loss. This review is conducted according to the PRISMA guidelines. The electronic databases PubMed and Medline were the primary sources of information. The online tool covidence.org was used for the screening process. The Newcastle-Ottawa Scale was used for assessment of risk of bias across the non-RCT (Randomized Controlled Trials) included studies. Six cohort studies and one randomised clinical trial were included for assessment in this review. Especially three large retrospective studies reported that circulatory paternal health issue, increasing metabolic syndrome diagnoses and paternal age was significantly associated with a higher risk of pregnancy loss. Lower pregnancy loss was also found in couples with diabetes in the man compared to couples without diabetes. One study suggests a connection between varicocelectomy and improved sperm DNA fragmentation and lower abortion rate. This review confirms that paternal age, somatic health and particularly health regarding cardiovascular and metabolic disease are associated positively with risks of pregnancy loss. However, further research may lead to evidence, which are more conclusive.

Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study

ObjectivesTo estimate age-specific abortion incidence and unintended pregnancy in Kinshasa, Democratic Republic of Congo and compare care experiences between adolescents (15–19 years) and older women (20–49 years).DesignWe used the age-specific...