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1.
Nat Commun ; 15(1): 1988, 2024 Mar 13.
Article in English | MEDLINE | ID: mdl-38480718

ABSTRACT

The prevalence and intensity of marine heatwaves is increasing globally, disrupting local environmental conditions. The individual and population-level impacts of prolonged heatwaves on marine species have recently been demonstrated, yet whole-ecosystem consequences remain unexplored. We leveraged time series abundance data of 361 taxa, grouped into 86 functional groups, from six long-term surveys, diet information from a new diet database, and previous modeling efforts, to build two food web networks using an extension of the popular Ecopath ecosystem modeling framework, Ecotran. We compare ecosystem models parameterized before and after the onset of recent marine heatwaves to evaluate the cascading effects on ecosystem structure and function in the Northeast Pacific Ocean. While the ecosystem-level contribution (prey) and demand (predators) of most functional groups changed following the heatwaves, gelatinous taxa experienced the largest transformations, underscored by the arrival of northward-expanding pyrosomes. We show altered trophic relationships and energy flux have potentially profound consequences for ecosystem structure and function, and raise concerns for populations of threatened and harvested species.


Subject(s)
Ecosystem , Food Chain , Pacific Ocean , Animals
2.
Mol Ecol ; 2023 Nov 23.
Article in English | MEDLINE | ID: mdl-37994168

ABSTRACT

Understanding population connectivity and genetic diversity is of fundamental importance to conservation. However, in globally threatened marine megafauna, challenges remain due to their elusive nature and wide-ranging distributions. As overexploitation continues to threaten biodiversity across the globe, such knowledge gaps compromise both the suitability and effectiveness of management actions. Here, we use a comparative framework to investigate genetic differentiation and diversity of manta rays, one of the most iconic yet vulnerable groups of elasmobranchs on the planet. Despite their recent divergence, we show how oceanic manta rays (Mobula birostris) display significantly higher heterozygosity than reef manta rays (Mobula alfredi) and that M. birostris populations display higher connectivity worldwide. Through inferring modes of colonization, we reveal how both contemporary and historical forces have likely influenced these patterns, with important implications for population management. Our findings highlight the potential for fisheries to disrupt population dynamics at both local and global scales and therefore have direct relevance for international conservation of marine species.

3.
Science ; 382(6667): 207-211, 2023 10 13.
Article in English | MEDLINE | ID: mdl-37824633

ABSTRACT

Climate change is affecting a wide range of global systems, with polar ecosystems experiencing the most rapid change. Although climate impacts affect lower-trophic-level and short-lived species most directly, it is less clear how long-lived and mobile species will respond to rapid polar warming because they may have the short-term ability to accommodate ecological disruptions while adapting to new conditions. We found that the population dynamics of an iconic and highly mobile polar-associated species are tightly coupled to Arctic prey availability and access to feeding areas. When low prey biomass coincided with high ice cover, gray whales experienced major mortality events, each reducing the population by 15 to 25%. This suggests that even mobile, long-lived species are sensitive to dynamic and changing conditions as the Arctic warms.


Subject(s)
Climate Change , Whales , Animals , Arctic Regions , Biomass , Ice Cover , Population Dynamics
4.
Sci Rep ; 12(1): 6544, 2022 04 21.
Article in English | MEDLINE | ID: mdl-35449381

ABSTRACT

In 2018, the giant manta ray was listed as threatened under the U.S. Endangered Species Act. We integrated decades of sightings and survey effort data from multiple sources in a comprehensive species distribution modeling (SDM) framework to evaluate the distribution of giant manta rays off the eastern United States, including the Gulf of Mexico. Manta rays were most commonly detected at productive nearshore and shelf-edge upwelling zones at surface thermal frontal boundaries within a temperature range of approximately 20-30 °C. SDMs predicted highest nearshore occurrence off northeastern Florida during April, with the distribution extending northward along the shelf-edge as temperatures warm, leading to higher occurrences north of Cape Hatteras, North Carolina from June to October, and then south of Savannah, Georgia from November to March as temperatures cool. In the Gulf of Mexico, the highest nearshore occurrence was predicted around the Mississippi River delta from April to June and again from October to November. SDM predictions will allow resource managers to more effectively protect manta rays from fisheries bycatch, boat strikes, oil and gas activities, contaminants and pollutants, and other threats.


Subject(s)
Elasmobranchii , Skates, Fish , Animals , Atlantic Ocean , Endangered Species , Fisheries , Georgia , United States
5.
PeerJ ; 9: e11994, 2021.
Article in English | MEDLINE | ID: mdl-34589295

ABSTRACT

BACKGROUND: Expanding fisheries in developing nations like Sri Lanka have a significant impact on threatened marine species such as elasmobranchs. Manta and devil (mobulid) rays have some of the most conservative life history strategies of any elasmobranch, and even low to moderate levels of bycatch from gillnet fisheries may lead to significant population declines. A lack of information on life history, demographics, population trends, and fisheries impacts hinders effective management measures for these species. METHOD: We report on mobulid fishery landings over nine years between 2011 and 2020 across 38 landing sites in Sri Lanka. We collected data on catch numbers, body sizes, sex, and maturity status for five mobulid species. We used a Bayesian state-space model to estimate monthly country-wide catch rates and total annual landings of mobulid rays. We used catch curve analyses to estimate total mortality for Mobula mobular, and evaluated trends in recorded body sizes across the study period for M. mobular, M. birostris, M. tarapacana and M. thurstoni. RESULTS: We find that catch rates have declined an order of magnitude for all species across the study period, and that total annual captures of mobulid rays by the Sri Lankan artisanal fishing fleet exceed the estimated annual captures of mobulids in all global, industrial purse seine fisheries combined. Catch curve analyses suggest that M. mobular is being fished at rates far above the species' intrinsic population growth rate, and the average sizes of all mobulids in the fishery except for M. birostris are declining. Collectively, these findings suggest overfishing of mobulid ray populations in the northern Indian Ocean by Sri Lankan artisanal fisheries. We recommend strengthening the management of these species through improved implementation of CITES, CMS, and regional fisheries management actions. In addition, we report on the demographic characteristics of mobulids landed in Sri Lanka and provide the first record of M. eregoodoo in the country.

6.
Curr Biol ; 31(14): 3174-3179.e3, 2021 07 26.
Article in English | MEDLINE | ID: mdl-34087102

ABSTRACT

Whales are now largely protected from direct harvest, leading to partial recoveries in many previously depleted species.1 However, most populations remain far below their historical abundances and incidental human impacts, especially vessel strikes and entanglement in fishing gear, are increasingly recognized as key threats.2 In addition, climate-driven changes to prey dynamics are impacting the seasonal foraging grounds of many baleen whales.2 In many cases these impacts result directly in mortality. But it is less clear how widespread and increasing sub-lethal impacts are affecting life history, individual fitness, and population viability. We evaluated changes in body lengths of North Atlantic right whales (NARW) using aerial photogrammetry measurements collected from crewed aircraft and remotely operated drones over a 20-year period (Figure 1). NARW have been monitored consistently since the 1980s and have been declining in abundance since 2011 due primarily to deaths associated with entanglements in active fishing gear and vessel strikes.3 High rates of sub-lethal injuries and individual-level information on age, size and observed entanglements make this an ideal population to evaluate the effects that these widespread stressors may have on individual fitness. We find that entanglements in fishing gear are associated with shorter whales, and that body lengths have been decreasing since 1981. Arrested growth may lead to reduced reproductive success4,5 and increased probability of lethal gear entanglements.6 These results show that sub-lethal stressors threaten the recoveries of vulnerable whale populations even in the absence of direct harvest.


Subject(s)
Anthropogenic Effects , Body Size , Whales , Animals , Climate , Hunting , Unmanned Aerial Devices
7.
Sci Rep ; 11(1): 937, 2021 01 13.
Article in English | MEDLINE | ID: mdl-33441580

ABSTRACT

The whale shark (Rhincodon typus) is an endangered species with a declining global population. The South Ari Atoll Marine Protected Area (SAMPA), Maldives, is one of few locations globally where year-long residency of individuals occurs. This SAMPA aggregation appears to consist almost exclusively of immature males. Due to its year-round residency, this local aggregation is subjected to a high degree of tourism pressure. This ecotourism contributes to the high level of interest and protection offered to whale sharks by the local community. Unfortunately, if regulations are not followed or enforced, tourism can bring with it major stressors, such as accidental injuries. We used POPAN capture-mark-recapture models and lagged identification rate analysis to assess the effect of major injuries on whale shark residency within SAMPA. Injuries may be obtained outside SAMPA. We found individuals with major injuries had a higher apparent survival in the area than those without. Lagged identification rates also demonstrated that sharks with major injuries are more likely to return to the area. We suggest that major injuries result in sharks prolonging their time in the developmental habitat. These findings have implications for individual fitness and the population viability of this endangered species. We propose targeted conservation strategies be considered to protect sharks from further injury. Based on the presented spatio-temporal distributions of sharks, and current local knowledge of sighting patterns, speed limit zones and propeller-exclusion zones should be implemented and enforced. If carried out alongside tourist education, these measures will contribute to the protection of whale sharks within SAMPA and beyond. Furthermore, our results can aid research direction, alongside regulation and enforcement development, at similar sites worldwide.


Subject(s)
Mortality/trends , Sharks/injuries , Sharks/physiology , Animal Migration , Animals , Ecosystem , Endangered Species , Environment , Indian Ocean Islands , Physical Fitness/physiology , Seasons
8.
Mol Ecol ; 29(24): 4783-4796, 2020 12.
Article in English | MEDLINE | ID: mdl-33164287

ABSTRACT

Practical biodiversity conservation relies on delineation of biologically meaningful units. Manta and devil rays (Mobulidae) are threatened worldwide, yet morphological similarities and a succession of recent taxonomic changes impede the development of an effective conservation strategy. Here, we generate genome-wide single nucleotide polymorphism (SNP) data from a geographically and taxonomically representative set of manta and devil ray samples to reconstruct phylogenetic relationships and evaluate species boundaries under the general lineage concept. We show that nominal species units supported by alternative data sources constitute independently evolving lineages, and find robust evidence for a putative new species of manta ray in the Gulf of Mexico. Additionally, we uncover substantial incomplete lineage sorting indicating that rapid speciation together with standing variation in ancestral populations has driven phylogenetic uncertainty within Mobulidae. Finally, we detect cryptic diversity in geographically distinct populations, demonstrating that management below the species level may be warranted in certain species. Overall, our study provides a framework for molecular genetic species delimitation that is relevant to wide-ranging taxa of conservation concern, and highlights the potential for genomic data to support effective management, conservation and law enforcement strategies.


Subject(s)
Biodiversity , Genome , Gulf of Mexico , Phylogeny
9.
Mar Pollut Bull ; 145: 604-610, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31590830

ABSTRACT

A floating plastic monitoring program was conducted for two years on a weekly basis in Banderas Bay, Mexico. A total of 94 samples were collected from May 2016 to April 2018 in the southern part of the bay. Half (57%) of them contained plastic debris; 79% of it being <5 mm in length. Polypropylene and Polyethylene were the most abundant polymers, accounting for 45% and 43% of the plastic pieces (pp), respectively. The highest abundance of plastic pieces was found in July 2016, with a maximum of 0.3 pp/m3 found in one sample. The amount of floating plastics was significantly higher in the hurricane season compared to the dry season (p < 0.001). This suggests that rainfall may play a significant role in the offload of plastics from land-based sources into the bay.


Subject(s)
Plastics/analysis , Water Pollutants, Chemical/analysis , Bays , Environmental Monitoring , Mexico , Plastics/chemistry , Polyethylene/analysis , Polyethylene/chemistry , Polypropylenes/analysis , Polypropylenes/chemistry , Seasons , Waste Products/analysis
10.
PLoS One ; 14(8): e0220854, 2019.
Article in English | MEDLINE | ID: mdl-31390369

ABSTRACT

In the eastern Pacific Ocean, the tropical tuna purse-seine fishery incidentally captures high numbers of five mobulid bycatch species; all of which are classified as mortalities by the Inter-American Tropical Tuna Commission due to uncertainties in post-release mortality rates. To date, the factors (operational or environmental) leading to the capture of these species by the fishery have not been well studied. Here, we developed Generalized Additive Models for fisheries observer data to analyze the relationships between the presence/absence of Mobula mobular bycatch and oceanographic conditions, the spatial and temporal variability in fishing location, and the set type (associated with dolphins, free-swimming tuna schools or floating objects). Our results suggest that chlorophyll concentration and sea surface height are the most important variables to describe the presence of M. mobular in conjunction with geographic location (latitude and longitude) and set type. Presence of the species was predicted in waters with chlorophyll concentrations between 0.5-1 mg·m-3 and with sea surface height values close to 0; which indicates direct relationships with productive upwelling systems. Seasonally, M. mobular was observed more frequently during December-January and August-September. We also found the highest probability of presence observed in School sets, followed by Dolphin sets. Three areas were observed as important hotspots: the area close to the coastal upwelling of northern Peru, the area west to Islands Colon Archipelago (Galapagos) and the area close to the Costa Rica Dome. This information is crucial to identify the mobulids habitat and hotspots that could be managed and protected under dynamic spatial management measures to reduce the mortality of mobulid rays in the eastern Pacific purse-seine fishery and, hence, ensure the sustainability of the populations of these iconic species.


Subject(s)
Chlorophyll/analysis , Elasmobranchii , Environment , Seasons , Animals , Conservation of Natural Resources , Costa Rica , Ecosystem , Pacific Ocean , Peru
11.
J Assist Reprod Genet ; 36(10): 2057-2066, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31418108

ABSTRACT

OBJECTIVE: To test a novel method to select spermatozoa with high chromatin integrity. DESIGN: Specimens with high sperm chromatin fragmentation (SCF) were selected by density gradient selection (DGS) and microfluidic sperm sorting (MSS). SETTING: Academic medical center. PATIENT(S): Ejaculates from consenting men were processed by DGS/MSS. Couples underwent ICSI cycles with spermatozoa processed by DGS/MSS. Clinical outcomes were evaluated after embryo transfer. INTERVENTION(S): SCF was measured by TUNEL. ICSI with spermatozoa selected by DGS and MSS was performed. MAIN OUTCOME MEASURE(S): Fertilization, embryo implantation, and pregnancy outcomes were compared between DGS and MSS. RESULT(S): A total of 23 men had an average SCF of 20.7 ± 10%. After DGS and MSS, the SCF was 12.5 ± 5% and 1.8 ± 1%, respectively. In couples who underwent ICSI, the average SCF was 28.8 ± 9%, which fell to 21.0 ± 9% after DGS and 1.3 ± 0.7% after MSS. Four couples underwent 11 ICSI cycles with DGS and achieved one (25%) pregnancy that resulted in pregnancy loss. In four subsequent ICSI cycles with MSS, an ongoing clinical pregnancy rate of 50% was achieved. Five additional couples underwent 12 cycles of ICSI with DGS. After preimplantation genetic testing for aneuploidy, 30.3% of the embryos were euploid. One pregnancy was achieved, resulting in pregnancy loss. With MSS, 31.5% of the embryos were euploid and 4 couples obtained a pregnancy. Finally, sixteen couples underwent 20 ICSI cycles solely with MSS at our center. Of these couples, 8 had failed 13 ICSI cycles with DGS elsewhere. These couples achieved an overall implantation of 34.5% (10/29) and a pregnancy rate of 58.8% (10/17). CONCLUSION(S): Microfluidic selection yielded spermatozoa with optimal genomic integrity and improved chances of obtaining a euploid conceptus.


Subject(s)
Abortion, Spontaneous/epidemiology , Chromatin/ultrastructure , DNA/ultrastructure , Infertility, Male/genetics , Spermatozoa/ultrastructure , Abortion, Spontaneous/pathology , Adult , Chromatin/genetics , DNA/genetics , DNA Fragmentation , Embryo Implantation/genetics , Embryo Transfer/methods , Family Characteristics , Female , Fertilization in Vitro , Humans , Male , Pregnancy , Pregnancy Outcome , Pregnancy Rate , Reproductive Techniques, Assisted/adverse effects , Spermatozoa/pathology
12.
Clin Obstet Gynecol ; 62(2): 282-292, 2019 06.
Article in English | MEDLINE | ID: mdl-30994483

ABSTRACT

Infertility is estimated to affect about 10% to 15% of couples. Most cases of infertility have etiologies that can be attributed to tubal factors, ovulatory dysfunction, endometriosis, uterine factor, male factor, or diminished ovarian reserve, while the remainder often do not have a known attributable cause, that is, unexplained infertility. The current manuscript summarizes the contemporary management of unexplained infertility.


Subject(s)
Infertility/therapy , Clothing , Diet , Female , Fertilization in Vitro , Hot Temperature/adverse effects , Humans , Male , Ovulation Induction , Sperm Injections, Intracytoplasmic
14.
Genet Med ; 20(9): 957-964, 2018 09.
Article in English | MEDLINE | ID: mdl-29267266

ABSTRACT

PURPOSE: Fragile X premutation (PM) carriers may experience difficulties conceiving a child probably due to fragile X-associated diminished ovarian reserve (FXDOR). We investigated which subgroups of carriers with a PM are at higher risk of FXDOR, and whether the number of AGG interruptions within the repeat sequence further ameliorates the risk. METHODS: We compared markers of ovarian reserve, including anti-Müllerian hormone, antral follicle count, and number of oocytes retrieved between different subgroups of patients with a PM. RESULTS: We found that carriers with midrange repeats size (70-90 CGG) demonstrate significantly lower ovarian reserve. Additionally, the number of AGG interruptions directly correlated with parameters of ovarian reserve. Patients with longer uninterrupted CGG repeats post-AGG interruptions had the lowest ovarian reserve. CONCLUSION: This study connects AGG interruptions and certain CGG repeat length to reduced ovarian reserve in carriers with a PM. A possible explanation for our findings is the proposed gonadotoxicity of the FMR1 transcripts. Reduction of AGG interruptions could increase the likelihood that secondary RNA structures in the FMR1 messenger RNA are formed, which could cause cell dysfunction within the ovaries. These findings may provide women with guidance regarding their fertility potential and accordingly assist with their family planning.


Subject(s)
Fragile X Syndrome/genetics , Primary Ovarian Insufficiency/genetics , Trinucleotide Repeats , Adult , Anti-Mullerian Hormone/blood , Female , Fragile X Mental Retardation Protein/genetics , Gene Frequency , Heterozygote , Humans , Oocytes/cytology , Ovarian Reserve , RNA, Messenger/genetics , Trinucleotide Repeat Expansion
16.
R Soc Open Sci ; 4(5): 161060, 2017 May.
Article in English | MEDLINE | ID: mdl-28572998

ABSTRACT

Mobulid rays have a conservative life history and are caught in direct fisheries and as by-catch. Their subsequent vulnerability to overexploitation has recently been recognized, but fisheries management can be ineffective if it ignores habitat and prey preferences and other trophic interactions of the target species. Here, we assessed the feeding ecology of four mobulids (Manta birostris, Mobula tarapacana, M. japanica, M. thurstoni) in the Bohol Sea, Philippines, using stomach contents analysis of fisheries specimens landed between November and May in 2013-2015. We show that the mobulids feed heavily on euphausiid krill while they are in the area for approximately six months of the year. We found almost no trophic separation among the mobulid species, with Euphausia diomedeae as the major prey item for all species, recorded in 81 of 89 total stomachs (91%). Mobula japanica and M. thurstoni almost exclusively had this krill in their stomach, while M. tarapacana had a squid and fish, and Ma. birostris had myctophid fishes and copepods in their stomachs in addition to E. diomedeae. This krill was larger than prey for other planktivorous elasmobranchs elsewhere and contributed a mean of 61 364 kcal per stomach (±105 032 kcal s.e., range = 0-631 167 kcal). Our results show that vertically migrating mesopelagic species can be an important food resource for large filter feeders living in tropical seas with oligotrophic surface waters. Given the conservative life history of mobulid rays, the identification of common foraging grounds that overlap with fishing activity could be used to inform future fishing effort.

17.
Zoology (Jena) ; 119(5): 406-413, 2016 10.
Article in English | MEDLINE | ID: mdl-27461910

ABSTRACT

Foraging drives many fundamental aspects of ecology, and an understanding of foraging behavior aids in the conservation of threatened species by identifying critical habitats and spatial patterns relevant to management. The world's largest ray, the oceanic manta (Manta birostris) is poorly studied and threatened globally by targeted fisheries and incidental capture. Very little information is available on the natural history, ecology and behavior of the species, complicating management efforts. This study provides the first data on the diving behavior of the species based on data returned from six tagged individuals, and an opportunistic observation from a submersible of a manta foraging at depth. Pop-off archival satellite tags deployed on mantas at the Revillagigedo Archipelago, Mexico recorded seasonal shifts in diving behavior, likely related to changes in the location and availability of zooplankton prey. Across seasons, mantas spent a large proportion of their time centered around the upper limit of the thermocline, where zooplankton often aggregate. Tag data reveal a gradual activity shift from surface waters to 100-150m across the tagging period, possibly indicating a change in foraging behavior from targeting surface-associated zooplankton to vertical migrators. The depth ranges accessed by mantas in this study carry variable bycatch risks from different fishing gear types. Consequently, region-specific data on diving behavior can help inform local management strategies that reduce or mitigate bycatch of this vulnerable species.


Subject(s)
Feeding Behavior/physiology , Skates, Fish/physiology , Animal Identification Systems , Animals , Diving , Endangered Species , Seasons
18.
Fertil Steril ; 106(3): 597-602, 2016 Sep 01.
Article in English | MEDLINE | ID: mdl-27143516

ABSTRACT

OBJECTIVE: To compare IVF outcomes between women undergoing frozen transfers of blastocysts verified as euploid by preimplantation genetic screening (PGS) with patients undergoing fresh nonbiopsied blastocyst transfers. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): All patients undergoing IVF-PGS cycles between January 2010 and November 2014 were included (n = 274). Patients were compared with a control group consisting of all fresh blastocyst transfers that occurred during the same period (n = 863). INTERVENTION(S): Patients underwent IVF-PGS with 24-chromosome screening. Patients with euploid embryos had transfer of one to two embryos in a subsequent frozen ET cycle. MAIN OUTCOME MEASURE(S): Implantation, clinical intrauterine gestation (CIG), miscarriage, biochemical pregnancy (BC), and live birth (LB) rates were compared. RESULT(S): Odds ratios (ORs) were estimated for outcomes in women undergoing PGS versus controls. Among patients ≤37 years old, there were no differences in CIG and LB rates for single (adjusted ORs [aORs], 1.20 [95 %confidence interval {CI}, 0.66-2.21]; 1.21 [95% CI, 0.66-2.2]) and double ETs (aORs, 1.09 [95% CI, 0.54-2.18]; 0.87 [95% CI, 0.44-1.7]). BC and miscarriage rates were also similar. For patients >37 years old, CIG and LB rates were increased for single (aORs, 3.86 [95% CI, 1.25-11.9]; 8.2 [95% CI, 2.28-29.5]) and double ETs (aORs, 9.91 [95% CI, 2.0-49.6]; 8.67 [95% CI, 2.08-36.2]) with no difference in BC and miscarriage rates. A per-retrieval analysis of the >37 group failed to demonstrate any difference in CIG or LB rates. CONCLUSION(S): Among patients ≤37, IVF-PGS does not improve CIG, LB, and miscarriage rates. IVF-PGS in women >37 improved CIG and LB rates. However, per cycle, the PGS advantage in this age group does not persist.


Subject(s)
Blastocyst/pathology , Chromosome Aberrations , Fertility , Fertilization in Vitro , Genetic Testing , Infertility/therapy , Ploidies , Preimplantation Diagnosis/methods , Abortion, Spontaneous/etiology , Adult , Chi-Square Distribution , Cryopreservation , Embryo Implantation , Embryo Transfer , Female , Fertilization in Vitro/adverse effects , Humans , Infertility/diagnosis , Infertility/physiopathology , Live Birth , Logistic Models , Multivariate Analysis , Odds Ratio , Predictive Value of Tests , Pregnancy , Pregnancy Rate , Retrospective Studies , Risk Factors , Treatment Outcome
19.
J Assist Reprod Genet ; 33(5): 657-662, 2016 May.
Article in English | MEDLINE | ID: mdl-26943918

ABSTRACT

PURPOSE: The purpose of this study is to investigate if female patients with lymphoma demonstrate diminished ovarian reserve prior to initiation of the lymphoma treatment. METHODS: Sixty-four patients with newly diagnosed lymphoma undergoing controlled ovarian hyperstimulation for fertility preservation were compared with 365 healthy controls undergoing elective oocyte cryopreservation (controlled ovarian hyperstimulation (COH)) and 128 patients with other types of malignancy prompting fertility preservation. The data of all lymphoma patients, all elective, and all the patients with other types of malignancy who met the inclusion criteria and underwent COH for fertility preservation during the study period were retrospectively analyzed. Primary outcomes included serum anti-Müllerian hormone (AMH) levels (ng/mL) and antral follicle count (AFC). RESULTS: Patients in the lymphoma group demonstrated significantly lower AMH levels and AFC and had less oocytes harvested and cryopreserved when compared to healthy controls as well as patients with other malignancies. CONCLUSION: Patients with lymphoma demonstrate diminished ovarian reserve when compared with healthy controls and patients with other malignancies. This should be taken into consideration when deciding on the dose for COH.


Subject(s)
Anti-Mullerian Hormone/blood , Fertility Preservation , Infertility, Female/complications , Lymphoma/complications , Ovarian Reserve , Adolescent , Adult , Cryopreservation , Female , Humans , Ovulation Induction , Retrospective Studies , Treatment Outcome
20.
Int J Gynaecol Obstet ; 131(2): 142-6, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26365573

ABSTRACT

OBJECTIVE: To assess the availability and capacity of US-based integrated centers for the management of Lynch syndrome. METHODS: A cross-sectional survey of practice patterns in the care of patients with Lynch syndrome was conducted at 33 National Cancer Institute-designated cancer centers in the USA from March 1 to June 1, 2013. Each cancer center was contacted by telephone and the caller used a uniform scripted greeting and survey format. RESULTS: All centers routinely recommended colonoscopy. Other recommended screening modalities were hysterectomy and bilateral salpingo-oophorectomy (29/33; 88%), endoscopy (27/33; 82%), urinalysis (23/33; 70%), endometrial sampling (21/33; 64%), dermatologic examination (19/32; 59%), pelvic ultrasonography (18/33; 55%), serum CA125 level (14/33; 42%), urine cytology (14/33; 42%), computed tomography (1/33; 3%), and magnetic resonance imaging (1/33; 3%). Each center had a multidisciplinary team but the composition varied. A designated team leader was present at 21 centers (64%). Having a team leader was associated with an increased likelihood of recommending endoscopy (P=0.04) and dermatologic surveillance (P=0.01). Only 23 centers (70%) had a system in place for communicating follow-up with patients. CONCLUSION: The lack of consensus in practice patterns recorded among participating centers probably reflected the limited existing evidence on the usefulness of most screening modalities.


Subject(s)
Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis , Delivery of Health Care, Integrated/statistics & numerical data , Early Detection of Cancer/methods , Population Surveillance/methods , Practice Patterns, Physicians'/statistics & numerical data , Adult , Cross-Sectional Studies , Delivery of Health Care, Integrated/standards , Early Detection of Cancer/standards , Endoscopy, Gastrointestinal , Female , Gynecologic Surgical Procedures , Humans , Middle Aged , Practice Guidelines as Topic , Practice Patterns, Physicians'/standards , United States
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