Status Of Assisted Reproductive Technology Research Articles

The status of ART in the public health sector in Africa: a multi-country survey

Research questionWhat is the current availability of treatment with assisted reproductive technology (ART) in the public sector in Africa, and what are the facilitators and barriers towards its provision? DesignCross-sectional quantitative and qualitative data were collected in two phases from February 2020 to October 2021. Key informants were identified from countries known to provide ART in Africa based on data from the African Network and Registry for Assisted Reproductive Technology and the 2019 Surveillance from the International Federation of Fertility Societies. Quantitative data were collected via a structured questionnaire (Phase 1); public centre-specific quantitative and qualitative data were then collected via a semi-structured questionnaire followed by a virtual interview (Phase 2). Data were analysed descriptively. ResultsInformants from 18 countries reported the existence of 185 ART centres in 16 countries. Twenty-four centres (13.0%) in 10 of 16 countries (62.5%) were public. The majority of public centres (20/22 [90.9%]) reporting on ART performed <500 ART cycles per annum. Although public institutions covered most of the cost for ART, copayments from patients were universally required. The number of ART cycles per annum was inversely correlated to the copayment. Lack of policy and legislation, high costs and bureaucratic obstacles were identified by participants as the leading challenges in the delivery of public service ART. ConclusionLack of public ART services leads to chronic and profound health inequities. Enablers of public service ART in the region are the same known to support ART services in general, namely policy and legislation, appropriate funding and good health service infrastructure. Addressing these requires the collated efforts of many stakeholders.

Access to infertility care and ART treatment in India: A clinician's perspective

Infertility is a worldwide problem that is increasing with time. The cause of infertility can be due to either male or female factors or both. The food, environmental, occupational and psychological factors do contribute to infertility. The infertility and the present scenario of assisted reproductive technology (ART) in India with regard to the clinics, clinicians and regulatory mechanisms in vogue are discussed. The potential of India as a reproductive tourist destination and surrogacy issues is included. The social, economic, and family problems arising as a consequence of infertility are discussed. The status of ART in India is getting improved and the gap between the West and India is expected to be minimized with the influence of regulatory mechanisms introduced through ART Act in India. The salient features that have a bearing on the infertility treatment outcomes, which are being neglected, or recent findings of research are included with special reference to possible future developments in the field of ART.

Disparities in ART Live Birth and Cumulative Live Birth Outcomes for Hispanic and Asian Women Compared to White Non-Hispanic Women.

BACKGROUND: Conflicting disparities have been seen in assisted reproductive technology (ART) outcomes for Hispanic and Asian women compared to white, non-Hispanic (WNH) women. We, therefore, sought to clarify these disparities and calculated cumulative live birth rates (CLBR) for these racial or ethnic groups using the SARTCORS database. METHODS: We performed an analysis of the 2014–2016 SARTCORS database for member clinics doing at least 50 cycles of ART each year. RESULTS: In comparison to cycles in WNH women, cycles in Hispanic and Asian patients were in older (p < 0.001), more nulliparous women, that were less likely to have a history of endometriosis compared WNH women regardless of prior ART status. ART cycles in Hispanic and Asian women, exhibited lower rates of live birth (LB) per cycle start (p < 0.001) compared to cycles in WNH women. Multivariate logistic regression demonstrated that cycles from Hispanic and Asian women were less likely to have a LB and CLBR than white women (OR 0.86; p = 0.004, OR 0.69; p < 0.001, respectively) independent of age, parity, BMI, etiology of infertility, use of ICSI or number of embryos transferred. CONCLUSIONS: Race or ethnicity continues to be an independent prognostic factor for LB and CLBR for ART. Additional analysis of trends among Hispanic and Asian women is warranted to enable addressing disparities in outcomes in ART treatment.

Theme trends and knowledge structure of assisted reproductive technology and birth defects: A quantitative and co-word analysis.

The main purpose of our study is to determine the current research status of assisted reproductive technology (ART) and birth defects by means of co-word analysis, to explore the hot spots and weak points of current research, and to provide ideas and opinions for follow-up researchers. The PubMed database was used to investigate the knowledge structures of the applied words ART and birth defects. The published literature was searched until December 31, 2018. The extracted MeSH terms were quantified using the Bibliographic Item Co-Occurrence Matrix Builder and the high-frequency MeSH terms were determined. According to the MeSH term-source article matrix, hierarchical cluster analysis was performed using SPSS 19.0. The high frequency MeSH term co-occurrence matrix was constructed to support strategic diagram and social network analysis (SNA). According to the search strategy, 1635 papers were included. Of all the extracted MeSH terms, 105 high frequency MeSH terms were identified and the hotspots were classified into nine categories. In the strategic diagram, research on the effects of prenatal diagnosis methods and ART on the development of offspring has been well developed. In contrast, research on reproductive ethics, epigenetics, and epidemiology is relatively immature, indicating the need for future research. For SNA results, the position status of each component is described by the center value. By providing a quantitative bibliometric study, it can help with the overall command of the latest topic and guide researchers in their new projects.

Erratum: Assisted reproductive technology service availability, efficacy and safety in mainland China: 2016.

Study question What is the current status of assisted reproductive technology (ART) service availability, efficacy and safety in mainland China? Summary answer In this first national report on ART status in mainland China, data on treatment numbers, outcomes and complications in 2016 are provided and analyzed, respectively. What is known already National ART Service Provision Surveys are conducted in mainland China regularly. Data were analyzed, and this manuscript was written by team members from the National Center for Women and Children's Health, China CDC and the Department of Women and Children Health, National Health Commission of the People's Republic of China. Study design, size and duration A cross-sectional nationwide survey was completed in 2018, in which data regarding ART treatments, performed from 1st January to 31st December2016 in 445 ART clinics located in 31 provinces of mainland China, were collected. Participants/materials, setting and methods There were in total 451 licensed ART clinics (including artificial insemination clinics) in mainland China in 2016, of which 445 submitted service data. A total of 906 840 cycles were provided by 323 in vitro fertilization (IVF) clinics, involving 375 770 conventional IVF cycles, 154 948 intracytoplasmic sperm injection (ICSI) cycles, 367 146 frozen embryo transfer (FET) thawing cycles and 8976 preimplantation genetic diagnosis (PGD) treatment cycles. A total of 161 376 artificial (i.e. intrauterine) insemination (AI) cycles were reported by 443 clinics, with 126 872 cycles using the husband's semen (AIH) and 34 504 using donor semen (AID). Main results and the role of chance In total, 98.7% of the licensed clinics, contributing to 100% of the ART services (including AID and AIH cycles), were included in this report. (Six clinics provided institutional information only and were excluded.) There were 906 840 in vitro fertilization cycles performed in mainland China with a population of over 1.3 billion inhabitants, with cycles per million inhabitants (C/M) increasing from 360 in 2013 to 657 in 2016, nationwide (range among provinces: 45-3676). After treatment with conventional IVF, the clinical pregnancy rate (PR) per oocyte retrieval cycle was 23.2%, the delivery rate (DR) per oocyte retrieval cycle was 18.7% and the proportion of twin delivery among the total deliveries was 27.9%. For ICSI cycles, the PR, DR and TDR were 20.5%, 16.7% and 27.2%, respectively. For FET per thawing cycles, the PR, DR and TDR were 48.2%, 37.6% and 24.2%. For PGD per diagnosis cycles, the PR, DR and TDR were 38.1%, 29.7% and 4.2%. For AIH cycles, the PR and DR were 13.3% and 10.5%; for AID cycles, the PR and DR were 24.3% and 21.1%, respectively. The total number of live infants born in mainland China in 2016, was 18.46 million, and the number of infants born through ART conducted in 2016 was 311 309, which accounted for 1.69% of the total. The reported rate of birth defects was about 87/10 000. The incidence of moderate to severe ovarian hyper-stimulation syndrome (OHSS) was 11.5 per 1000 oocyte retrieval cycles, and other complications were much more rare. Limitations and reasons for caution This report is based on the summary data of ART services provided. The success rates were not calculated by age stratification. A low rate of birth defects was reported, which might be confounded by variations in birth follow-up methods, statistical timing and record taking. Wider implications of the findings ART service availability has improved significantly in recent years in mainland China. Because China is a vast country, significant imbalances in ART service provision do exist; however, the main efficacy and safety indicators were close to those of western countries. Trial registration number N/A. Study funding/competing interest(s) The study was funded by the National Key R&D Program of China (2016YFC1000307-2). There are no competing interests.

Assisted reproductive technology service availability, efficacy and safety in mainland China: 2016.

What is the current status of assisted reproductive technology (ART) service availability, efficacy and safety in mainland China? In this first national report on ART status in mainland China, data on treatment numbers, outcomes and complications in 2016 are provided and analyzed, respectively. National ART Service Provision Surveys are conducted in mainland China regularly. Data were analyzed, and this manuscript was written by team members from the National Center for Women and Children's Health, China CDC and the Department of Women and Children Health, National Health Commission of the People's Republic of China. A cross-sectional nationwide survey was completed in 2018, in which data regarding ART treatments, performed from 1st January to 31st December2016 in 445 ART clinics located in 31 provinces of mainland China, were collected. There were in total 451 licensed ART clinics (including artificial insemination clinics) in mainland China in 2016, of which 445 submitted service data. A total of 906 840cycles were provided by 323 in vitro fertilization (IVF) clinics, involving 375 770 conventional IVF cycles, 154 948 intracytoplasmic sperm injection (ICSI) cycles, 367 146 frozen embryo transfer (FET) thawing cycles and 8976 preimplantation genetic diagnosis (PGD) treatment cycles. A total of 161 376 artificial (i.e. intrauterine) insemination (AI) cycles were reported by 443 clinics, with 126 872cycles using the husband's semen (AIH) and 34 504 using donor semen (AID). In total, 98.7% of the licensed clinics, contributing to 100% of the ART services (including AID and AIH cycles), were included in this report. (Six clinics provided institutional information only and were excluded.) There were 906 840 in vitro fertilization cycles performed in mainland China with a population of over 1.3 billion inhabitants, with cycles per million inhabitants (C/M) increasing from 360 in 2013 to 657 in 2016, nationwide (range among provinces: 45-3676). After treatment with conventional IVF, the clinical pregnancy rate (PR) per oocyte retrieval cycle was 23.2%, the delivery rate (DR) per oocyte retrieval cycle was 18.7% and the proportion of twin delivery among the total deliveries was 27.9%. For ICSI cycles, the PR, DR and TDR were 20.5%, 16.7% and 27.2%, respectively. For FET per thawing cycles, the PR, DR and TDR were 48.2%, 37.6% and 24.2%. For PGD per diagnosis cycles, the PR, DR and TDR were 38.1%, 29.7% and 4.2%. For AIH cycles, the PR and DR were 13.3% and 10.5%; for AID cycles, the PR and DR were 24.3% and 21.1%, respectively. The total number of live infants born in mainland China in 2016, was 18.46 million, and the number of infants born through ART conducted in 2016 was 311 309, which accounted for 1.69% of the total. The reported rate of birth defects was about 87/10 000. The incidence of moderate to severe ovarian hyper-stimulation syndrome (OHSS) was 11.5 per 1000 oocyte retrieval cycles, and other complications were much more rare. This report is based on the summary data of ART services provided. The success rates were not calculated by age stratification. A low rate of birth defects was reported, which might be confounded by variations in birth follow-up methods, statistical timing and record taking. ART service availability has improved significantly in recent years in mainland China. Because China is a vast country, significant imbalances in ART service provision do exist; however, the main efficacy and safety indicators were close to those of western countries. N/A. The study was funded by the National Key R&D Program of China (2016YFC1000307-2). There are no competing interests.

The status of assisted reproductive technology in Korea in 2012.

ObjectiveThis study was designed to report the status of assisted reproductive technology (ART) therapy in South Korea between January 1, 2012 and December 31, 2012.MethodsA localized online survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was first launched and provided to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized as standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI. Thawed embryo transfer (TET) and other related procedures, including surgical sperm retrieval, were surveyed.ResultsData from 33,956 ovum pick-up procedures were provided by 75 clinics in 2012. Of the 33,088 cycles in which ovums were retrieved, a complete transfer was performed in 90.5% (29,932 cycles). In addition, 10,079 FET cycles were confirmed to have resulted in clinical pregnancy, representing a pregnancy rate of 30.5% per ovum pick-up and 33.7% per ET. The most common number of embryos transferred in FET was 2 (41.6%), followed by 3 (34.0%), and non-elective single ETs (10.0%). Of the 10,404 TET cycles in which transfer was completed, 3,760 clinical pregnancies (36.1%) were confirmed by ultrasonography.ConclusionThe overall clinical pregnancy rate for FET and TET cycles in 2012 was higher than in 2011 (33.7% vs. 33.2% and 36.1% vs. 31.1%, respectively). The most common number of embryos transferred in FET cycles was 2, unlike in 2011.

Assisted Reproductive Technology in Iran: The First National Report on Centers, 2011.

Due to the worldwide increase in infertility, it is both necessary and important to have assisted reproductive technology (ART) registries. In Iran, donation and surrogacy programs are approved by decrees from religious scholars. ART has been used since 1984 in Iran and the first Iranian infant conceived by gamete intra-fallopian transfer (GIFT) was born in 1989. This report, however, is the first national report on Iranian ART centers. This cross-sectional study, conducted under the supervision of the Iranian Ministry of Health, presented a summary of the numbers and percentages of centers that provided infertility services in Iran, as well as the status of ART in Iran during 2011. A total of 52 centers reported treatment cycles and performed approximately 29000 intrauterine insemination (IUI), in addition to 35000 in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) cycles. Iran has considerable potential to provide IVF services for both Iranians as well as other nationalities throughout the region. This proves the need for a national center that will implement a registry system.

Maternal Smoking Among Women With and Without Use of Assisted Reproductive Technologies.

To estimate smoking prevalence during the year before pregnancy and during pregnancy and adverse outcomes among women who delivered infants with and without assisted reproductive technology (ART) using linked birth certificates (BC) and National ART Surveillance System (NASS) data. Data were analyzed for 384,390 women and 392,248 infants born in Massachusetts and Michigan during 2008-2009. Maternal smoking prevalence was estimated using smoking indicated from BC by ART status. For ART users, to evaluate underreporting, prepregnancy smoking was estimated from BC, NASS, or both sources. Effect of prenatal smoking on preterm and mean birthweight (term only) for singleton infants were examined by ART status. Maternal smoking prevalence estimates were significantly lower for ART users than nonusers (prepregnancy = 3.2% vs. 16.7%; prenatal = 1.0% vs. 11.1%, p < 0.05). When combining smoking information from BC and NASS, prepregnancy smoking prevalence estimates for ART users could be as high as 4.4% to 6.1%. Adverse effects of smoking on infant outcomes in ART pregnancies were consistent with the effects seen in non-ART pregnancies, specifically decline in infant birthweight and increase in preterm delivery, although association between smoking and preterm was not significant. A low, but substantial proportion of ART users smoked before and during pregnancy. As ART users are highly motivated to get pregnant, it should be clearly communicated that smoking can decrease fertility and adversely affect pregnancy outcomes. Continued efforts are needed to encourage smoking cessation and maintain tobacco abstinence among all women of reproductive age.

Antenatal Hospitalizations Among Pregnancies Conceived With and Without Assisted Reproductive Technology.

To describe the prevalence of antenatal hospitalizations, compare characteristics of women with and without antenatal hospitalizations, and compare timing, length of stay, and reason for hospitalization among pregnancies conceived with and without assisted reproductive technology (ART). We performed a retrospective cohort analysis using linked ART surveillance, vital records, and hospital discharge data from Michigan to calculate the hospitalization ratio as the number of antenatal admissions per 100 live birth deliveries for ART and non-ART deliveries during 2004-2012 and compare trends by ART status. We then restricted analysis to 2008-2012 and used logistic, multinomial, and Poisson regression analysis to model antenatal admissions, trimester of admission, and length of stay, respectively, for ART compared with non-ART deliveries. We examined reason for hospitalization by ART status. Between 2004 and 2012, the hospitalization ratio for ART deliveries decreased from 14.6 to 12.3 per 100 deliveries (P<.001). Of 557,708 live deliveries during 2008-2012, 22,763 (4.1%) had an antenatal hospitalization. Assisted reproductive technology was a risk factor for having any antenatal admission (singletons adjusted risk ratio [RR] 1.63, 95% confidence interval [CI] 1.43-1.83; multiples adjusted RR 1.24, 95% CI 1.12-1.38) and two or more admissions (singletons adjusted RR 1.86, 95% CI 1.25-2.75; multiples adjusted RR 1.33, 95% CI 1.14-1.54). The percent of time (days) hospitalized during the antenatal period was greater for ART deliveries than non-ART deliveries (singleton adjusted RR 1.28, 95% CI 1.09-1.51; multiples adjusted RR 1.14, 95% CI 1.01-1.29). The most common reason for antenatal admission was preterm labor among all non-ART and multiple gestation deliveries and vaginal bleeding among ART singleton gestations. Deliveries after ART were associated with increased risk of antenatal admissions and longer hospitalizations compared with non-ART deliveries.

Investigation of Personality Traits between Infertile Women Submitted to Assisted Reproductive Technology or Surrogacy.

Personality traits affect human relationships, social interactions, treatment procedures, and essentially all human activities. The purpose of this study is to investigate the personality traitsincluding sensation seeking, flexibility, and happiness among a variety of infertile women who were apt to choose assisted reproductive technology (ART) or surrogacy. This is a cross-sectional study that was performed on 251 infertile women who visited Isfahan and Tehran Reproductive Medicine Center. These fertility clinics are located in Isfahan and Tehran, Iran. In this study, 201 infertile women who underwent treatment using ART and 50 infertile women who tended to have surrogacy were chosen by convenience sampling. Zuckerman's Sensation Seeking Scale Form V (SSS-V), Psychological Flexibility Questionnaire (adapted from NEO Personality Inventory-Revised) and Oxford Happiness Questionnaire (OHQ) were used as research instruments. All participants had to complete the research instruments in order to be included in this study. Data were analyzed by descriptive-analytical statistics and statistical tests including multivariate analysis of variance (MANOVA) and Z Fisher. Statistically significant effects were accepted for P<0.05. In the sensation-seeking variable, there was a meaningful difference between under-study groups. However, the flexibility and happiness variables did not have a significant difference between under-study groups (P<0.001). Interaction between education, employment, and financial status was effective in happiness of infertile women underwent ART (P<0.05), while age, education and financial status were also effective in happiness of infertile women sought surrogacy (P<0.05). A positive meaningful relationship was seen between sensation seeking and flexibility variables in both groups (P<0.05). And a negative meaningful relationship was seen between sensation seeking and happiness in infertile women who sought surrogacy (P<0.05). The difference in rate of relationship between sensation seeking and flexibility was meaningful in infertile women who sought either ART or surrogacy (P<0.05). Sensations seeking as a personality trait is lower in infertile women who underwent treatment using ART compared women who tended to have surrogacy. This study shows that demographic variables are effective in happiness of infertile women. Also, there is a significant relation among sensation seeking, flexibility and happiness in infertile women.

Current status of assisted reproductive technology in Korea, 2011.

ObjectiveThe number of assisted reproductive technology (ART) clinics, ART cycles, clinical pregnancy rate (CPR), and number of newborns conceived using ART have steadily increased in South Korea. This aim of this study was to describe the status of ART in South Korea between January 1 and December 31, 2011.MethodsA localized online survey was created and sent to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized depending on whether standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI procedures were used. Thawed embryo transfer (TET) and other related procedures were surveyed.ResultsData from 36,990 ART procedures were provided by 74 clinics. Of the 30,410 cycles in which oocytes were retrieved, a complete transfer was performed in 91.0% (n=27,683). In addition, 9,197 cycles were confirmed to be clinical pregnancies in the FET cycles, representing a pregnancy rate of 30.2% per oocyte pick-up and 33.2% per ET. The most common number of embryos transferred in the FET procedures was three (38.1%), followed by two (34.7%) and one (14.3%). Of the 8,826 TET cycles, 3,137 clinical pregnancies (31.1%) were confirmed by ultrasonography.ConclusionWhile the overall clinical pregnancy rate for the TET cycles performed was lower than the rate reported in 2010 (31.1% vs. 35.4%), the overall CPR for the FET cycles was higher than in 2010 (33.2% in 2011 and 32.9% in 2010). The most common number of embryos transferred in FET cycles was three, as was the case in 2010.

Current status of assisted reproductive technology in Korea, 2010.

ObjectiveGreat advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea. This study was designed to report on the current status of ART therapy in South Korea between January 1 and December 31 of 2010.MethodsA revised survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was sent to all available ART centers via email in 2013. Fresh embryo transfer (FET) cases were categorized into standard IVF or intracytoplasmic sperm injections. These cases, the thawing embryo transfer (TET) cases, and other related procedures were surveyed.ResultsData from 30,785 ART procedures were provided by 78 clinics. Of the 28,200 cycles in which oocytes were retrieved, 92.2% of these cycles were completely transferred. In addition, 8,075 cycles were confirmed to be clinical pregnancies in the FET cycles, which represent a pregnancy rate of 28.6% per oocyte pick-up and 31.1% per embryo transfer. The most common number of embryos transferred in the FET was three embryos (37.3%) followed by two embryos (36.3%) and one embryo (14.0%). Of the 6,648 TET cycles transferred, 2,356 clinical pregnancies were confirmed by ultrasonography. The most common number of embryos in the TET group was two embryos (43.4%) followed by three embryos (25.4%) and one embryo (18.9%).ConclusionThe clinical pregnancy rate per transfer in the FET cycles was similar in 2009 and 2010. Among the FET cycles where one or two embryos were transferred, the clinical pregnancy rate per transfer slightly increased from 2009 (28.7%) to 2010 (32.9%).

In vitro fertilization in Japan - early days of in vitro fertilization and embryo transfer and future prospects for assisted reproductive technology.

Assisted reproductive technology (ART) such as in vitro fertilization (IVF) and embryo transfer (ET) has been essential in the treatment of infertility. The world’s first IVF-ET baby was born in 1978 based on the technique developed by Dr. Robert Edwards and Dr. Patrick Steptoe.1) In Japan, the first IVF-ET birth was reported in 1983 by Prof. Masakuni Suzuki at Tohoku University School of Medicine.2,3)IVF-ET is a procedure used to achieve pregnancy that consists of extracting oocytes from an infertile woman, fertilizing them in vitro, and transferring fertilized eggs into the patient’s uterine cavity (Fig. 1). Since the first report of successful IVF-ET, numerous techniques related to ART, such as cryopreservation of oocytes and embryos, gamete intrafallopian transfer (GIFT), and microinsemination, have been developed and refined (Table 1).Herein we describe the history of basic research in IVF-ET that led to human applications, how the birth of the first IVF-ET baby was achieved in Japan, the current status of ART in Japan, issues related to ART, and future prospects for ART.

Current status of assisted reproductive technology in Korea, 2009.

Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea in the year of 1985. However, it deserve to say that the invaluable data from fertility centers may serve as a useful source to find out which factors affect successful IVF outcome and to offer applicable information to infertile patients and fertility clinics. This article intended to report the status of ART in 2009 Korean Society of Obstetrics and Gynecology surveyed. The current survey was performed to assess the status and success rate of ART performed in Korea, between January 1 and December 31, 2009. Reporting forms had been sent out to IVF centers via e-mail, and collected by e-mail as well in 2012. With International Committee Monitoring Assisted Reproductive Technologies recommendation, intracytoplasmic sperm injection (ICSI) and non-ICSI cases have been categorized and also IVF-ET cases involving frozen embryo replacement have been surveyed separately. Seventy-four centers have reported the treatment cycles initiated in the year of 2009, and had performed a total of 27,947 cycles of ART treatments. Among a total of 27,947 treatment cycles, IVF and ICSI cases added up to 22,049 (78.9%), with 45.3% IVF without ICSI and 54.7% IVF with ICSI, respectively. Among the IVF and ICSI patients, patients confirmed to have achieved clinical pregnancy was 28.8% per cycle with oocyte retrieval, and 30.9% per cycle with embryo transfer. The most common number of embryos transferred in 2009 is three embryos (40.4%), followed by 2 embryos (28.4%) and a single embryo transferred (13.6%). Among IVF and ICSI cycles that resulted in multiple live births, twin pregnancy rate was 45.3% and triple pregnancy rate was 1.1%. A total of 191 cases of oocyte donation had been performed to result in 25.0% of live birth rate. Meanwhile, a total of 5,619 cases of frozen embryo replacement had been performed with 33.7% of clinical pregnancy rate per cycle with embryo transfer. When comparing with international registry data, clinical pregnancy rate per transfer from fresh IVF cycles including ICSI (34.1%,) was comparable to clinical pregnancy rate per transfer in European Society for Human Reproduction and Embryology report was 32.5% though lower than 45.0% for USA data. There was no remarkable difference in status of assisted reproductive technology in Korea between the current report and the data reported in 2008. The age of women trying to get pregnant was reconfirmed to be the most important factor that may have impact on success of ART treatment.

Obesity, Assisted Reproductive Technology, and Early Preterm Birth--Florida, 2004-2006

Florida resident birth certificates for 2004-2006 were linked to the Centers for Disease Control and Prevention's National ART Surveillance System and were used to investigate 1) whether the association of assisted reproductive technology (ART) with preterm birth varies by prepregnancy body mass index and 2) whether the association varies by plurality. Preterm birth was defined as early preterm birth (gestation <34 weeks) and late preterm birth (gestation 34-36 weeks). Descriptive statistics and multinomial logistic regression were used to explore maternal and infant differences by ART status and plurality. Of 581,403 women included in the study, 24.0% were overweight, 18.6% were obese, 7.3% had late preterm birth, 2.6% had early preterm birth, and 0.67% conceived through ART. Among singleton births, ART was associated with increased early preterm birth risk among underweight (odds ratio (OR) = 2.94, 95% confidence interval (CI): 1.27, 6.81), overweight (OR = 1.75, 95% CI: 1.12, 2.72), and obese (OR = 2.37, 95% CI: 1.51, 3.71) women. Among twins, ART was significantly associated with increased risk among overweight (OR = 1.61, 95% CI: 1.12, 2.32) and obese (OR = 1.85, 95% CI: 1.18, 2.90) women. Differences in the associations between ART and early preterm birth by body mass index and plurality warrant further investigation.

Singleton Preterm Birth: Risk Factors and Association with Assisted Reproductive Technology

The objectives of this study were to determine risk factors for early (less than 34 weeks gestation) and late (34-36 weeks gestation) preterm singleton birth, by assisted reproductive technology (ART) status. We linked data from Massachusetts birth records and ART records representing singleton live births from 1997 through 2004. Using multinomial regression models, we assessed risk factors for early and late preterm birth by ART status. From 1997 to 2004 in Massachusetts, among non-ART births, risk factors for early and late preterm birth were similar and included women <15 and ≥ 35 years of age, those of non-white race or Hispanic ethnicity, those with ≤ 12 years of education, those with chronic diabetes, those with gestational diabetes, those with gestational hypertension, those who smoked during pregnancy, those who used fertility medications, and those who had not had a previous live birth. Among ART births, risk factors for early and late preterm birth differed and odds of early preterm birth were increased among women with ≤ 12 years of education while odds of late preterm birth were increased among women with gestational diabetes. Odds of both early and late preterm birth were increased among women of non-white race or Hispanic ethnicity and among women with gestational hypertension. Among non-ART births, increased risk for preterm birth was more strongly related to socioeconomic factors than among ART births. Medical conditions were associated with an increased risk for preterm birth regardless of women's ART status. Efforts to prevent preterm births should focus on reducing modifiable risk factors.

Current status of assisted reproductive technology in Korea, 2008

Current status of assisted reproductive technology in Korea, 2008

Current status of assisted reproductive technology in Korea, 2007

Current status of assisted reproductive technology in Korea, 2007

Regulation of assisted reproductive technologies in the United States

The regulation of any social activity is a complex activity, and perhaps this is no more so than in medicine where the interests of patients, profes sionals, society, and government can be in conflict. A special area of regula tory concern involves assisted reproductive technologies (ART), which are medical procedures involving the laboratory manipulation of gametes (sperm and eggs). In vitro fertilization (IVF) is the most commonly performed ART, whereas other technologies include intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis/screening (PGD/S) and assisted hatching (AH). The use of donor eggs (oocytes) and surrogates (gestational carrier, host uterus) are also considered ART procedures. Donor insemina tion (DI) by itself is generally not considered an ART procedure. Somatic cell nuclear transfer (SCNT) or "cloning" has been classified into thera peutic cloning or the use of SCNT to produce cells and tissues that can be used to treat disease, and is considered appropriate by many people, and reproductive cloning, the use of SCNT to create a genetically "identical" individual, which is considered an inappropriate use of technology by almost everyone. ART technologies are also used to create stem cells for both research and potential therapeutic purposes. Why should these technologies be regulated, what should be regulated, how should it be done, and who should be responsible? These are difficult questions that have been answered differently in many countries and by