Types Of Fertilizer Treatments Research Articles

A systematic review and meta-analysis of DNA methylation levels and imprinting disorders in children conceived by IVF/ICSI compared with children conceived spontaneously.

Increasing numbers of children are being conceived by assisted reproductive technology (ART). A number of studies have highlighted an altered epigenetic status in gametes from infertile couples and the possibility of an increased risk of imprinting defects and somatic epigenetic changes in ART conceived children, but the results have been heterogeneous. We performed a systematic review of existing studies to compare the incidence of imprinting disorders and levels of DNA methylation in key imprinted genes in children conceived through in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with those in children conceived spontaneously. A detailed search strategy was used to conduct electronic literature searches (spanning 1978 to 2013) on Medline, EMBASE, the Cochrane Library and Web of Science. Abstracts of relevant conference papers were identified. As randomized trials are not feasible in this context, we included observational (cohort and case-control) studies comparing outcomes in children conceived through ART with those conceived spontaneously, irrespective of the language of publication. The outcome measures were DNA methylation and the incidence of imprinting disorders. A total of 351 publications were identified by the initial search. Of these, 26 were excluded as duplicates and 241 were excluded after reviewing the abstracts, then of those remaining 66 were excluded after review of the full text. A total of 18 papers were included in the review. Apart from one case-control study, all were cohort studies. There was a degree of clinical heterogeneity in terms of the study population, type of infertility treatment, and samples obtained from exposed and unexposed children. DNA methylation levels were either presented as categorical data (hypo-, hyper- or normally methylated DNA) or continuous data (i.e. percentage of methylated DNA). The combined odds ratio (95% confidence intervals) of any imprinting disorder in children conceived through ART was 3.67 (1.39, 9.74) in comparison with spontaneously conceived children. Meta-analysis of data from relevant studies revealed that the weighted mean difference (95% confidence intervals) in methylation percent between IVF/ICSI versus spontaneously conceived children were as follows: H19: -0.46(-1.41, 0.49), PEG1-MEST: 0.47 (-2.07, 3.01), GRB10: -0.05 (-0.43, 0.33), IGF2: -0.15 (-1.09, 0.79), SNRPN: -0.55 (-1.55, 0.46), KvDMR/KCNQ10T1: -0.16 (-0.34, 0.02) and PEG3: -0.24 (-1.72, 1.24). There was an increase in imprinting disorders in children conceived though IVF and ICSI but insufficient evidence for an association between ART and methylation in other imprinted genes. Heterogeneity in the types of fertility treatment, the imprinted regions studied, the tissues used and the methods of measurement, reduce our ability to assess the full effect of ART on DNA methylation and imprinting. More controlled studies, using standardized methodologies, in larger, better clinically defined populations are needed.

Modes of conception and multiple pregnancy: a national survey of babies born during one week in 2003 in the United Kingdom

To collect data on every baby born in one week in the United Kingdom with respect to mode of conception, multiplicity of pregnancy, and outcome. A questionnaire completed by the midwife birth attendant. All maternity units in the United Kingdom. All mothers delivering during the week of April 6-12, 2003. Questionnaire survey. Mode of conception (both spontaneous and assisted), type of fertility treatment, multiplicity of pregnancy, mode of delivery, gestational age, and fetal outcome. Data were received from 178 maternity units (72.7%) on 6,913 deliveries: 6,812 (98.54%) were singleton, 100 (1.45%) twin, and 1 (0.01%) triplet. In total, 7,015 babies were born. Of all pregnancies, 6,638 (96%) (including the only triplet) were conceived spontaneously and 133 (1.9%) with assistance. The multiple pregnancy rate was significantly greater in assisted (13.5%) than in spontaneous (1.2%) conceptions. Of the multiple pregnancies after fertility treatment, 16.7% resulted from clomifene citrate therapy, 72.2% from IVF or frozen embryo replacements (FET), and 5.6% from superovulation with intrauterine insemination (IUI). The multiple pregnancy rate after IVF/FET (26%) was significantly higher than the one after clomifene citrate therapy (7.3%). In total, 41 babies were born after clomifene citrate therapy, 50 after IVF/ET, and eight after superovulation IUI. The live birth rate was higher for singleton (98.2%) than multiple pregnancies (93.6%). Multiple pregnancy from IVF and related treatments remains a significant problem and contributes a greater burden than ovulation induction therapies.

Assisted reproduction in male cancer survivors: fertility treatment and outcome in 67 couples.

Many male cancer survivors experience fertility problems due to antineoplastic treatment. We report the fertility outcome in 67 couples referred to assisted reproduction treatment (ART) because of male factor infertility due to cancer. This was a retrospective study assessing the following parameters: diagnosis, cancer treatment, type of fertility treatment and type of sperm used, number of pregnancies and pregnancy outcome. Testicular cancer and lymphomas were the most prevalent diagnoses. Adjuvant treatment with chemo- and/or radiation therapy had been given to 90% of the men. Semen was cryopreserved in 82% of the men prior to treatment. Following antineoplastic treatment, 43% of the men had motile spermatozoa in the ejaculate, but 57% were azoospermic. A total of 151 ART cycles were performed [55 intra-uterine insemination (IUI), 82 ICSI and 14 ICSI-frozen embryo replacement (FER)]. The clinical pregnancy rate per cycle was 14.8% after IUI, 38.6% after ICSI and 25% after ICSI-FER. The corresponding delivery rates were 11.1, 30.5 and 21%. Cryopreserved semen was used in 58% of the pregnancies. The delivery rate per cycle was similar after use of fresh or cryopreserved spermatozoa. Male cancer survivors have a good chance of fathering a child by using either fresh ejaculated sperm or cryopreserved sperm.