Use Of Reproductive Techniques Research Articles

To Evaluate the Effect of Increasing Maternal Age on Maternal and Neonatal Outcomes in Pregnancies at Advanced Maternal Age.

Late pregnancies have been a sensitive issue in the society and medical field for many years. The reason for this development could be the increasing use of reproductive techniques, women empowerment and late conceptions. The increased level of education in women, having more responsibilities at work, giving priority to their professional career could be leading to delay in conception and childbearing. Many studies have investigated the effect of advanced maternal age on fetal outcome suggesting higher risk of poor neonatal outcome. Recent studies have debated these outcomes.[1234]. To evaluate the effect of increasing maternal age on maternal and neonatal outcomes in pregnancies at advanced maternal age. The study was conducted on 843 women above the age of 35 years who delivered at Dayanand Medical College and Hospital during 2015-2020. Patients were categorized into 2 groups, Group A comprised of pregnant women aged 35-40 years; group B included pregnant women aged >40 years. Various other parameters including parity, gestation at delivery, whether the pregnancies were spontaneous or conceived through ART (assisted reproductive techniques) and other associated co-morbid conditions were noted. The obstetrical, gynecological, medical, surgical, fetal and neonatal complications were studied in both the groups and the data was analyzed with release 9.4 (SAS Institute Inc, Cary, NC). Out of 843 patients in our study, 81.4% (n=687) belonged to the age group of 35- 40 years. 18.5% (n=156) belonged to the age group of > 40 years. Patients more than 40 years underwent ART for conception more often as compared to group A. Co-morbid medical conditions including chronic hypertension, thyroid diseases, auto immune disorders and obstetric complications such as abortions, oligohydramnios, GDM, placenta previa, PPH was significantly more common in patients with group B. Cesarean delivery rate was significantly more in group B as compared to group A. Neonatal outcome in terms of NICU admissions and preterm birth at less than 35 weeks gestation was seen more frequently in group B as compared to Group A. Our study concludes that the decision to delay childbearing should be discouraged owing to increased maternal and fetal morbidity associated with advanced maternal age, the risks being higher with increasing maternal age.

Development of Sperm Cryopreservation Protocols for Sharks and Rays: New Tools for Elasmobranch Conservation

Elasmobranchs are one of the most endangered vertebrate groups on the planet, but despite this situation the use of reproductive techniques in elasmobranch conservation strategies has been scarce. Among these techniques, sperm preservation is a potential tool forex situconservation and aquaria sustainability. However, there are no widespread preservation protocols for elasmobranch sperm, and shark sperm cryopreservation has never been achieved before. Here we present the establishment of successful cryopreservation protocols for elasmobranch sperm, tested in several species. We have formulated a sperm extender that can be used for different elasmobranch species, capable of maintaining sperm motility for several weeks. Additionally, we achieved the cryopreservation of sperm by previously diluting it in our extender and supplementing it with different combinations of cryoprotectants. The effects of methanol and dimethyl sulfoxide as permeating cryoprotectants were evaluated, as well egg yolk as a non-permeating cryoprotectant. Sperm quality was assessed by studying the motility and membrane integrity post-thawing, demonstrating its effectiveness in the 10 species tested, including two which are considered Critically Endangered. This is the first time that shark sperm cryopreservation has been reported, broadening our knowledge of the reproductive techniques that can be applied to elasmobranchs and laying the foundations for the first cryobanks for shark and ray sperm. Outcomes from this study will be useful forex situconservation efforts developed by public aquaria. A regular supply of frozen sperm will reduce the problems that result from the transport of specimens, inbreeding or lack of synchronized reproductive cycles in captivity.

Fertility Status Among Long-Term Childhood Acute Lymphoblastic Leukemia Survivors Enrolled between 1971 and 1998 in the EORTC Children Leukemia Group Trials 58741, 58831/2 and 58881

BackgroundThe survival of childhood acute lymphoblastic leukemia (ALL) has improved significantly over the last decades, with recently reported overall survival rates in Europe of up to 85% in children (<14 years) and 62% in adolescents (15-19 years) (Trama, Lancet Oncol 2016). The increased number of long-term survivors has made the management of side effects an increasingly important issue in pediatric oncology. In this context, the impact on fertility caused by widely employed ALL treatments such as alkylating agents, cranial radiotherapy, total body irradiation and orchiectomy has been an emerging concern over the last years. The aim of this study was to assess fertility among long-term childhood ALL survivors.MethodsBetween 2012 and 2017, a follow-up study was performed among childhood ALL (and acute lymphoblastic lymphoma) survivors enrolled between 1971 and 1998 in EORTC studies (58741, 58831/2, 58881) in France and Belgium. Patients <18 years (yrs) at diagnosis and ≥18 yrs at the time of the follow-up were eligible to fill out a questionnaire that included information about their fertility. The following fertility-related outcomes were evaluated: having menstrual cycles for females, intention to have children, having children, use of reproductive techniques to become pregnant and occurrence of negative pregnancy outcomes (miscarriage, medical abortion, birth defects), separately for males and females.ResultsOut of 1429 eligible patients, 502 (35%) filled out the questionnaire, 862 (60%) were lost to follow-up, and 65 (5%) refused to participate. Disease characteristics and relapse occurrence within one yr after diagnosis were comparable between these 3 groups.Among respondents (275 females, 227 males), approximately 14% were aged 10-17 yrs at diagnosis and almost 30% belonged to the NCI high risk group (Table 1). Approximately 12% received cranial radiotherapy and 6% of females and 8% of males underwent hematopoietic stem cell transplantation. Relapse occurred in 12% and 14% of females and males, respectively. The median time between the diagnosis and the socioeconomic evaluation was 20 yrs (range: 13-42). The median age at follow-up was 25 yrs (range: 18-53).All but 6 females had ever had menstrual cycles. At the time of the fertility evaluation, 93% out of females younger than 45 yrs of age (N=270) either had menstrual cycles, were pregnant, gave breast feeding or continuously used contraceptives. Among females who had tried to become pregnant, 89% had been pregnant, 75% had children and 12% used medical help to become pregnant. One fifth of the ever pregnant females had ever had a miscarriage. The incidences of other negative pregnancy outcomes (e.g. birth defect, medical abortion) were low.The average number of children females had was 0.36 (95% CI: 0.27-0.44). The expected number of children in a population with the same distribution of country, age, and yr of birth of the mothers based on national population registries was 0.55. However, as 52% of the females had a bachelor or master degree and only 3% had no secondary school diploma, this difference could possibly be explained by an overrepresentation of females with a high level of education in our sample.Among males who had tried to have children, 83% made their partner pregnant, 72% had children and 7% used medical help to make their partner pregnant. The incidence of negative pregnancy outcomes other than miscarriage was low.ConclusionsIn this first disease-specific European cohort study, we evaluated fertility among adult survivors of childhood ALL enrolled in EORTC trials, with a median time from the diagnosis of 20 yrs.Most survivors who tried to have children, succeeded (75% of females, 72% of males). However, the average number of children per female seemed to be lower than in the general population. The incidences of birth defects, and medical abortions were low, both among female survivors and the partners of the male survivors.Despite the large number of potentially eligible patients, we could evaluate only 35% of long-term survivors. We were unable to study the effect of specific treatment exposures due to the large variety of treatments that patients received, the association between some treatments (protocol dependent) and age at the fertility evaluation, and the need to stratify the analyses by sex. Improvements in the follow-up of childhood cancer survivors are needed for a better evaluation of the long-term outcomes. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Dynamic assessment of human sperm DNA damage III: the effect of sperm freezing techniques.

Among the currently available strategies for sperm freezing, vitrification may be considered as the leading alternative to conventional cryopreservation. Nevertheless, a direct comparison of both techniques with respect to the iatrogenic sperm DNA damage has not been performed yet. As such, this study was focused to assess the static and dynamic behavior of human sperm DNA damage following thawing of cryopreserved or vitrified spermatozoa. Semen samples were obtained from fifty donors with a normal spermiogram, and divided into four aliquots. The first aliquot represented the neat sample. In the second aliquot the seminal plasma was discarded, and the resulting sperm pellet was resuspended in PBS. The third fraction was used for slow freezing and the fourth fraction was subjected to vitrification. Each set of samples was incubated at 37°C for 24h and sperm DNA damage (SDF) was assessed using the chromatin-dispersion test following 0h, 2h, 4h and 24h of incubation. When comparing the rate of DNA fragmentation (r-SDF) at 2h, significant differences were observed between the PBS group, cryopreserved (p .000) or vitrified semen (p .015). Furthermore, the sperm longevity comparison using Kaplan-Meier survival curves revealed significant differences between cryopreservation and vitrification (p .000). Our data suggest that exposure of spermatozoa to low temperatures, independently of the chosen freezing protocol, leads to a higher susceptibility of sperm DNA towards damage. This damage is nevertheless lower following vitrification in comparison to traditional cryopreservation. As vitrification leads to a smaller proportion of spermatozoa with DNA damage, we may recommend its use in reproductive techniques which rely on a longer sperm survival, such as artificial insemination.

Teaching coherent descriptive speech to children of senior preschool age with speech underdevelopment problems

Introduction. Today, one of the main requirements of the Federal State Educational Standard of Preschool Education is to ensure the speech development in children, which means mastering them of free, coherent dialogue and monologic speech skills as a means of communication with adults and peers. The indicators of successful speech development are skills to build different types of coherent statements. This requirement fully applies to children with minor speech delays. However, in modern speech therapy, the development of coherent speech is made dependent on the elimination of the shortcomings of unformed language structures and involves the use of reproductive techniques, including mainly constant repetitions of speech patterns. Children are simply asked to copy stereotypical schemes when making their own statements, but the attention is not paid to the process of formulating rules and peculiarities of description texts, the understanding of which is very important to be prepared for school. Thus, it is significantly important to revise well-established techniques to learn oral monologue speech when teaching children with serious speech disorders.The aim of the present article is to discuss the conditions for effective development of coherent descriptive speech in preschool children with speech underdevelopment problems.Methodology and research methods. The methodological framework of the research is based on the theory of speech activity and the theory of developmental education, as well as the systematic analysis of the peculiarities of verbal communication skills in children and modern ideas of correctional pedagogy about the structure of speech defects. In the course of the research, empirical research methods and a pedagogical experiment were employed.Results and scientific novelty. Children aged 5–6 years old (n = 60) with the logopedic report “general underdevelopment of speech of the 3 rd –4 th levels” took part in the experimental research. It was proved that it is necessary to teach preschool children with speech disorders not only to speak by analogy and model structures, but also to formulate detailed meaningful descriptive statements. The entry test demonstrated that most respondents have insufficient formation of coherent descriptive speech: 40% – medium level, 38% – low level. More than half of preschool children in the experimental group (53,6%) improved their results through the targeted and comprehensive correctional work, in the course of which they learned practical description skills. While working on description skills, children learned how to highlight and compare essential features of a subject, to combine individual phrases into a consistent message. The priority areas were identified in each speech task to ensure the greatest impact of its performance. The conducted classes influenced not only speech, but also cognitive development of children. Also, the classes stimulated children’s speech and thought activities, contributed to the activation of visual, auditory and tactile perception, memory, attention and observation.Practical significance. The research materials provide a new direction to determine the technologies for the development of coherent speech in children of senior preschool age with speech underdevelopment.

Genetic parameters for fertility traits in Nellore bulls.

Nellore is the main cattle breed used in Brazil, being the largest commercial herd in the world. Beyond the importance of male reproductive efficiency for farm profit, the use of reproductive techniques, mainly artificial insemination, turns the evaluation of male reproductive traits even more important. Estimation of genetic parameters increases the knowledge on traits variances and allows envisaging the possibility of the inclusion of new traits as selection criterion. Genetic parameters for fifteen traits that can be classified as testicular biometry or physical and morphological semen traits were estimated for a Nellore bull population ranging from 18 to 36months. Single-trait and bi-trait animal models were used for (co)variance components estimation. The contemporary group was considered as fixed effect and age at measurement as covariable. Scrotal circumference presented heritability of 0.47±0.12. This value is similar to the heritabilities found for all testicular biometry traits (0.34-0.48). Sperm progressive motility, which has a direct effect on bull fertility, presented low heritability (0.07±0.08). Major and total sperm defects presented moderate to high heritabilities (0.49±0.18 and 0.39±0.15, respectively), indicating that great genetic gain can be obtained through selection against sperm defects. High and positive genetic correlations were observed among testicular biometry traits, which also presented favourable genetic correlations with physical and morphological traits of the semen with magnitude ranging from high to low. Scrotal circumference presented moderate to high and favourable genetic correlations with sperm progressive motility, sperm turbulence, major sperm defects and total sperm defects. Thus, the selection for scrotal circumference results in favourable correlated genetic response for semen quality. The results show that the use of scrotal circumference as reference trait for bull fertility is appropriate, since it presents high heritability and favourable genetic correlation with semen quality.

Wrongful genetic connection: neither blood of my blood, nor flesh of my flesh.

The use of reproductive techniques and the eventual reproductive negligence from the provider of reproductive services gave rise to situations in which the intended parents are deprived of raising a child genetically connected to them. Courts have been dealing with cases of those for years, but have systemically denied claimants (the prospective parents) compensation, failing to recognise as damage the loss of genetic connection. In 2017, for the first time, the Singapore High Court provided compensation for that damage, labelled "loss of genetic affinity" (ACB v Thomson Medical Pte Ltd and Others [2017] SGCA 20). This paper will argue that the damage in question is the loss of genetic connection (wrongful genetic connection) and results from a violation of reproductive rights (and eventually also the right to found a family) because a key element of reproductive rights is to have children with whom we keep a genetic bond and raise them. The paper will explain why the arguments classically argued against such compensation are unfounded and it will argue for a compensation covering both patrimonial and non-patrimonial damages.

Technical recommendations for artificial insemination in sheep

Artificial insemination (AI) was the first important biotechnology applied to improve the genetics of farm animals. It allows the rapid and massive diffusion of desirable characteristics of males with high productive potential. We describe the different types of estrus induction and synchronization techniques and the use of the AI with fresh, chilled or frozen semen. Through the adequacy of the protocols of estrus synchronization and AI to the different production systems, the efficient use of reproductive techniques is possible, reaching acceptable pregnancy rates. Summary of reproductive results obtained using cervical and laparoscopic AI are presented.

Prevalence and risk factors associated with anti-Neospora caninum antibodies in dairy herds in the central region of Minas Gerais State, Brazil.

Neospora caninum is one of the parasites that frequently causes reproductive loses in cattle herds all over the world. Surveys have shown a high prevalence of the parasite in herds; in certain locations, 90% to 100% of dairy holdings are positives according serological tests. The aim of this study was to estimate the prevalence and risk factors associated with the increased number of seropositive dairy cattle in the central region of Minas Gerais, the largest milk producer state in Brazil. Samples were collected from 151 dairy herds and from 2915 lactating cows, and were evaluated by an indirect ELISA assay. According to results, animal prevalence was 21.9% (CI 95%: 18.9 to 24.9%), while the herd prevalence it was 98.5% (CI 95%: 97.0 to 99.9%). Poisson regression estimate the herd risk factors associated with the increased number of cases. An increased number of positive animals was related to the previous history of abortion and the presence of dogs. The use of individual natural colostrum feeding and reproductive techniques such as embryo transfer and in vitro fertilization are associated with a reduced number of seropositive animals in the herd. In conclusion, Neospora caninum is overspread across the dairy herds of the region, and it may be causing major economic losses for dairy farmers. The use of reproduction techniques, the access of dogs to the herds and the management of calf colostrum are important issues to be considered in the control of the disease.

Sons of a Minor God: Use of Reproductive Techniques by Single People and Gay Couples.

The progressive recognition of new family units (mono-parental and same-sex families) as objects of legal protection is the product of enormous changes in society and in the way we understand our sexual choices. One of the consequences of this societal transformation involves access to assisted reproductive techniques (ART). Access to ART is traditionally allowed only for married people (obviously of the opposite gender, as opposite-sex marriage is still the regular standard and the only legal option in many parts of the world). Access to ART is sometimes allowed for heterosexual couples living in a de facto relationship. Today, some legal systems already permit the use of ART by single people and gay couples. Brazil is a good example, but in the remaining Latin-American countries as well as in Asia, restrictive solutions take precedence, although in most cases there is no proper regulation regarding ART. Most legal systems around the world still impose restrictions based on marital status and/or sexual orientation. Such legal prohibitions are problematic from a juridical perspective. In fact, it is recognized that reproduction is a fundamental right and a human right (instead of a mere aspiration or a whim), as has been stated by various courts around the world, including the Inter-American Court of Human Rights. This conclusion also results from the interpretation of some rights expressly recognized in national constitutions – namely, the right to privacy and the right to create a family – as including reproduction within their scope of protection, leading to the conclusion that reproduction is actually a constitutionally protected right. If this is so, any restriction on access to ART is actually limiting the fundamental right to reproduce, which can only be legally limited in the face of a particularly strong justification, such as the protection of the rights of others or of prominent constitutional values. To avoid criticism on constitutional grounds, the supporters of restrictive access to ART have invoked an apparently unbeatable argument: the protection of the future child. These advocates claim that if the child were born into a mono-parental family or moreover into a same-sex family, then its well-being would be jeopardized and its rights violated. However, this argument does not withstand strict constitutional scrutiny, as on the one hand it is too simplistic to justify limitations to constitutionally protected and fundamental rights and on the other hand no one has thus far adequately defined a ‘child's best interest’. This paper intends to demonstrate that these are largely moral arguments that have no juridical foundations and are therefore incapable of attaching limitations to reproductive rights.

Role of the Oviduct in Early Embryo Development

This review highlights the role of the oviduct in early embryo development, which has to fulfil many aligned and well-tuned tasks during early embryogenesis. The oviductal lining is subjected to dynamic changes to timely accomplish gamete transport, fertilization and embryo development and to deliver a competent and healthy conceptus to the endometrium which can implant and develop to term. Although knowledge about the role of the oviduct is limited, we know that embryos are very sensitive to the environment in which they develop. The success of in vitro embryo production techniques demonstrates that it is possible to bypass the oviduct during early development and, to a certain extent, replicate the conditions in vitro. However, comparative studies show that embryos developed in vivo are superior to their in vitro produced counterparts, underlining our relatively poor knowledge of the biology of the oviduct. Oviduct activity is orchestrated by various factors, depending on cyclic dynamics, which crucially affect the success of tubal transfer and/or (re-)collection of embryos in embryo transfer studies. This paper reviews data which demonstrate that in vivo culture of embryos in the bovine oviduct is a useful tool for the assessment of embryos developed under various conditions (e.g. superovulation vs single ovulation, lactating dairy cows vs non-lactating cows). It is concluded that more work in the field of early embryo development within the oviduct would contribute to improved ART protocols leading to healthy pregnancies and offspring.

Ethical Considerations Arising from the Use of Assisted Reproductive Technologies

The rapid growth of reproductive medicine has in many cases occurred faster than societies have been able to assimilate the changes and incorporate them into the social fabric. Oftentimes, the widespread use of reproductive techniques and fertility-enhancing medications has occurred before the ethical implications of these technologies have been considered. This article introduces ethical concepts that can be used as tools to understand the moral dilemmas inherent in the practice of reproductive medicine. These concepts are then used to form a framework for discussing specific ethically charged issues including the increasing prevalence of multiple pregnancies and the option of multifetal pregnancy reduction, ethical considerations in the prevention of ovarian hyperstimulation syndrome, and access to fertility treatments among different populations. Furthermore, considerations of when to offer these technologies and situations in which care may be refused are discussed. In closing, the role of ethics committees as an approach to navigating difficult clinical situations is introduced.

Anatomical Stages of Penile Erection in the Agouti (Dasyprocta leporina) Induced by Electro‐Ejaculation

The reproductive system of the male agouti is not well documented. This study describes the specific anatomical features of the free part of the penis occurring during penile erection in the agouti. Electro-ejaculation was used to induce erection in three male agoutis that had previously produced offspring. Results proved that there were four stages in the erection process. Stage 1 involved protrusion of the penis from the preputial orifice. The lateral penile cartilages were then spread (stage 2). During stage 3, there was the blooming of the head of the glans penis (penile flower) and eversion of the intromittent sac. The protrusion of the keratinaceous styles and ejaculation occurred during stage 4. This information could assist in semen collection for use in reproductive techniques for the agouti such as artificial insemination.

Multifetal Gestation – Maternal and Perinatal Outcome of 112 Pregnancies

Purpose: Multifetal pregnancy reduction is a widespread ‘therapy’ to diminish the risk of prematurity and adverse outcome for the survivors in higher order multiple gestation. The aim of our study was to determine the maternal and neonatal outcome of multifetal pregnancies under a conservative pregnancy management. Study Design: A retrospective review of 112 multifetal pregnancies is presented. All higher order multiple pregnancies delivered after 25 weeks of gestation and managed at a single institution between 1982 and 1999 are included. Results: Triplets, quadruplets and quintuplets were delivered at a mean gestational age of 31 + 5, 29 + 5 and 28 + 4 weeks, respectively. The perinatal mortality was 14 for triplets and 36 for quadruplets. No quintuplet died in the perinatal period. Respiratory distress syndrome occurred in 23% of triplets, 65% of quadruplets and 75% of quintuplets, intracranial hemorrhage was diagnosed in 14% of triplets, 15% of quadruplets and 10% of quintuplets and retinopathy of prematurity was found in 10% of triplets, 9% of quadruplets and 25% of quintuplets. Discussion: Despite a low neonatal mortality, morbidity of higher order multiple gestations remains significant. Mortality and morbidity are related to preterm delivery but do not exceed the rates of singletons or twins of an identical gestational age. Favorable prognostic landmarks are a gestational age >30 weeks and a number of fetuses per pregnancy ≤4. Conclusion: The risks of multifetal pregnancies are significant. Therefore, evidence-based counseling of couples seeking treatment for infertility and prevention of higher order multiple pregnancies through the prudent use of reproductive techniques attains paramount importance.

Compulsory sterilisation in Sweden.

In the Fall of 1997 the leading Swedish newspaper, Dagens Nyheter, created a media hype over the Swedish policy of compulsory sterilisation that had been in operation between 1935 and 1975. In the discussion that followed, the moral condemnation of our medical past was unanimous. However, the reasons for rejecting what had gone on were varied and mutually inconsistent. Three strands of criticism were common: the argument from autonomy, the argument from caution, and the argument from biological scepticism. In the paper it is argued that what point of departure you choose in your criticism of the past should be of consequence also for your ideas about present and future medical practice. In particular, if you rely on the argument from autonomy, you should be prepared to accept a liberal (present and future) use of reproductive techniques.