ABSTRACT
OBJECTIVES@#To identify, examine and summarize the available evidence on the effectiveness and safety of acupuncture for in vitro fertilisation (IVF) outcomes.@*METHODS@#Eight electronic databases, including PubMed, EMBASE, Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Database and VIP Database, were searched, supplemented by manual searches. Two researchers independently conducted the literature screening, data extraction, and methodological quality assessments. A narrative description was provided to show the general information and specific characteristics of the included studies. A bubble plot was used to visually display the overall effects of acupuncture on IVF outcomes.@*RESULTS@#Eighty-two studies were identified, including 64 primary studies and 18 systematic reviews. Transcutaneous electrical acupoint stimulation, electric acupuncture and manual acupuncture were applied in most studies and compared with no acupuncture, sham acupuncture and placebo acupuncture control groups. Sixty-three (98.4%) primary studies reported clinical pregnancy rate, and positive effects of acupuncture were found in 34 studies (54.0%). Live birth rate was reported in only 18 (28.1%) primary studies, of which 10 (55.6%) showed positive results. In addition, only 8 and 2 systematic reviews showed that acupuncture could increase clinical pregnancy events and live birth events, respectively. However, none of these reviews was of high methodological quality.@*CONCLUSIONS@#Available evidence suggests that acupuncture therapy could improve clinical pregnancy rates. However, whether acupuncture could increase live birth events was difficult to determine based on the few studies that have reported this outcome indicator. Furthermore, the methodological quality of most systematic reviews was assessed as critically low or low. Studies with a rigorous design and standardized implementation should be performed to refine the available evidence.
Subject(s)
Female , Humans , Pregnancy , Acupuncture Therapy/methods , China , Fertilization in Vitro , Pregnancy RateABSTRACT
Intrahepatic cholestasis of pregnancy (ICP) is an important complication of pregnancy requiring increased surveillance by the obstetricians due to its increased foetal morbidity and mortality in the form of preterm birth, foetal distress, RDS including sudden IUD and stillbirth. The incidence of ICP is increasing due to IVF and routine administration of progesterone in early pregnancy. ICP usually presents in late second and third trimester. Here authors are presenting a case of early onset ICP (14 weeks) which developed in an IVF conception.
ABSTRACT
Objective To compare the effectiveness and safety of recombinant luteinizing hormone (rLH) combined with recombinant follicle-stimulating hormone (rFSH) and rFSH alone in women undergoing in vitro fertilisation/intracytoplasmic sperm microinjection (IVF/ICSI) applied gonadotrophin-releasing hormone (GnRH) antagonist. Methods The databases including PubMed, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, VIP and Wanfang Data were electronically searched to collect the randomized controlled trials (RCT) applied GnRH antagonist using rLH+rFSH or rFSH alone in IVF/ISCI cycles from inception to Dec. 2018. Following the Cochrane system evaluation and according to the criteria for inclusion and exclusion, two reviewers independently screened literature, extracted data and evaluated the bias risk for inclusion in studies, and then meta-analysis was conducted by RevMan 5.3 software. Results A total of 10 RCT studies involving 1965 patients were included, of them 988 cases in rFSH+rLH group and 977 cases in rFSH alone group. Meta-analysis showed no significant difference between rFSH alone group and rLH+rFSH group in clinical pregnancy rate (RR=1.02, 95%CI 0.82-1.27, P=0.85), ongoing pregnancy rate (RR=1.06, 95%CI 0.86-1.32, P=0.57), miscarriage rate (RR=1.38, 95%CI 0.75-2.54, P=0.29), incidence of adverse events canceled due to ovarian hyporesponsiveness (RR=0.90, 95%CI 0.42-1.93, P=0.78), and the incidence of adverse events canceled due to ovarian hyperstimulation syndrome (OHSS) (RR=1.06, 95%CI 0.56-1.99, P=0.86). Conclusions Current evidence shows that, compared with rFSH alone group, the rLH+rFSH group showed no effect on the clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, incidence of adverse events canceled due to ovarian hyporesponsiveness, and the incidence of adverse events canceled due to OHSS. The above conclusions need to be verified by more high quality research since the quality and quantity limited of included studies.
ABSTRACT
Abstract: This paper analyses the efficacy data from assisted reproduction clinics, obtained from both scientific society reports and from studies published in specialised journals, in order to compare them with information published by Spanish assisted reproduction clinics on their websites. It aims to verify whether this information matches the reality of the findings in the media analysed or, in contrast, differs from the aforementioned scientific evidence. Our study shows marked discrepancies between the evidence of existing statistical data, and figures published by most of the clinics on their websites, which could constitute false advertising.
Resumen: Este estudio analiza los datos de eficacia de clínicas de reproducción asistida, obtenidos tanto de informes de sociedades científicas como de estudios publicados en revistas especializadas, para compararlos con la información publicada por las clínicas de reproducción asistida de España en sus sitios web. El objetivo es verificar si esta información es conforme a los hallados en informes y revistas o, por el contrario, difiere de la evidencia científica mencionada. Nuestro estudio demuestra marcadas discrepancias entre la evidencia de datos estadísticos existentes y las cifras publicadas por la mayoría de los sitios web de las clínicas, lo cual constituye falsa publicidad.
Resumo: Este artigo analisa os dados de eficácia de clínicas de reprodução assistida, obtidas de relatórios da sociedade científica e de estudos publicados em revistas especializadas, a fim de compará-los com informações publicadas por clínicas de reprodução assistida espanholas em seus websites. O artigo visa verificar se esta informação coincide com a realidade dos resultados encontrados nos meios de comunicação analisados ou, por outro lado, difere da evidência científica acima mencionada. Nosso estudo mostra discrepâncias entre a evidência dos dados estatísticos existentes e indicadores publicados pela maioria das clínicas em seus sites, que podem constituir falsa publicidade.
Subject(s)
Humans , Marketing of Health Services/ethics , Advertising/ethics , Reproductive Techniques, Assisted/ethics , Fertilization in Vitro/ethicsABSTRACT
Background: Exposure to cyclophosphamide (CPA) for cancer treatment results in over-production of reactive oxygen species and oxidative stress thus affecting the DNA in male germ cell inducing sperm defects. Our goal is to assess the potential effects of Nigella sativa extract (NSE) and thymoquinone (TQ) on sperm and embryo quality following fertlization of sperm produced from germ cells which have been exposed to the damaging alkylating effects of CPA. Methods: Thirty six male ICR mice were divided into six groups; (I) Vehicle-treated control (normal saline), (II) CPA-only, (III) TQ-only, (IV) NSE-only, (V) CPA followed by TQ and (VI) CPA followed by NSE. Treatment with 200mg/kg CPA and 10mg/kg of both NSE and TQ were given by intraperitoneal injection. Animals were sacrificed at 33 days by cervical dislocation and sperm from caudal epidydymis were taken for analysis and in vitro fertilization (IVF) with eggs from untreated female. Fertilization rates and embryo development were monitored for 5 days. The result were analysed by using SPSS 16.Results: TQ and NSE supplementation to CPA-exposed male mice have no significant effect (p>0.05) on the total number of sperm if compared to CPA-only exposed mice. NSE and TQ supplementation have been shown to have significant effect (p<0.05) on the percentage of motile sperm as well as the number of abnormal sperm. Four types of abnormalities of the sperm were found which includes folded sperm, amorphous, banana-like and the head lacking of the usual hook. Finally, the embryo quality shows a significant improvement by the supplementation of TQ and NSE to CPA-exposed male mice (p<0.05). Conclusion: Overall, both NSE and TQ have indicated chemopreventive potential against the cytotoxicity of cyclophosphamide on the reproductive capacity and fertility.
ABSTRACT
OBJECTIVES: To examine the impact of intracytoplasmic sperm injection (ICSI) on the treatment of subfertile couples in Jamaica. METHOD: A review of the outcome of treatment cycles for infertile couples that underwent in-vitro fertilisation (IVF) and ICSI from 2003-05 at the Hugh Wynter Fertility Management Unit (HWFMU) of the University of the West Indies. Fertilisation and pregnancy rates for the cycles as well as the factors determining the success of the procedure were reviewed. SPSS 11.1 was used to do statistical calculations. RESULTS: Ninety-six ICSI cycles were done from January 1, 2003 to December 31, 2005. For couples with previous poor or no fertilisation in a standard IVF group (n = 12), the fertilisation rate was 72%; for those with substandard semen (n = 73), the fertilisation rate was 77.5%, for those with semen retrieved by surgical sperm method (n = 11), the fertilisation rate was 59%. The resulting live births were 0%, 12.5% and 27.3% respectively. There was a statistically significant impact ofage on pregnancy rates as the mean age ofthe females in the previously poor or no fertilisation in a standard IVF group (39.08 ± 5.14) was greater than those of the substandard semen group (35.93 ± 4.22) ]p = 0.023[ as well as the group with surgical sperm retrieval (32.82 ± 6.65) ]p = 0.019[. CONCLUSION: With ICSI, the fertilisation and pregnancy rates in Jamaica are comparable to international rates regardless of the cause of infertility. However, the age of the female partner does have a significant impact on the pregnancy rate following ICSI.
OBJETIVO: Examinar el impacto de la inyección de esperma intracitoplasmático (IEIC) en el tratamiento de las parejas subfértiles en Jamaica. MÉTODO: Se realizó un examen del resultado de los ciclos de tratamiento para las parejas infértiles que recurrieron a la fertilización in vitro (FIV) y a la IEIC de 2003 a 2005 en la Unidad de Tratamiento de la Fertilidad Hugh Wynter del Hospital Universitario de West Indies (HWFMU). Se examinaron las tasas de fertilización y embarazos en todos los ciclos así como los factores que determinan el éxito del procedimiento. Se usó el programa SPSS para realizar los cálculos estadísticos. RESULTADOS: Se realizaron noventa y seis ciclos de IEIC del 1ero de enero de 2003, al 31 de diciembre de 2005. Para parejas con ninguna o pobre fertilización en un grupo estándar de FIV (n - 12), la tasa de fertilización fue 72%; para aquellos con semen subestándar (n = 73), la tasa de fertilización fue 77.5%; para aquellos con semen recuperado mediante recuperación quirúrgica de esperma (n = 11), la tasa de fertilización fue 59%. Los nacimientos vivos resultantes fueron 0%, 12.5%, y 27.3% respectivamente. Hubo un impacto estadísticamente significativo de la edad sobre las tasas de comembarazo, ya que la edad promedio de las hembras en la fertilización previamente pobre o sin fertilización en un grupo FIV estándar (39.08 ± 5.14) fue mayor para las del grupo de semen subestándar (35.93 ± 4.22) ]p = 0.023[ así como las del grupo con recuperación quirúrgica del esperma (32.82 ± 6.65) ]p = 0.019[. CONCLUSIÓN: Con el uso de IEIC, las tasas de fertilización y embarazo en Jamaica, son comparables a las tasas internacionales, independientemente de cual sea la causa de la infertilidad. Sin embargo, la edad de la pareja hembra no tiene un impacto significativo sobre la tasa de embarazo una vez aplicada la IEIC.