RESUMEN
PURPOSE: Are trends in singleton donor oocyte IVF perinatal outcomes consistent over time among four international ethnically diverse infertility centers? METHODS: This retrospective cohort consisted of an infertility network of four international IVF centers across three continents. Singleton live births resulting from fresh and frozen donor oocyte embryo transfers from January 1, 2012 to December 31, 2018 were included. The main outcome measures were birth weight (BW), preterm birth (PTB), large for gestational age (LGA), small for gestational age (SGA) and gestational age (GA) at delivery. RESULTS: The entire cohort (n = 6640) consisted of 4753 fresh and 1887 frozen donor oocyte embryo transfers. Maternal age, parity, body mass index, neonatal sex and GA at delivery were similar for fresh and frozen donor oocyte embryo transfers in the entire cohort and within each infertility center. All four centers had a trend of decreased BW and rates of PTB before 32 weeks annually, although significance was not reached. Three of the four centers had annual increased trends of PTB before 37 weeks and LGA newborns, although significance was not reached. BWs for the entire cohort for fresh and frozen donor embryo transfers were 3166 g ± 601 g and 3137 g ± 626 g, respectively. CONCLUSION: Similar trends in perinatal outcomes were present across four international infertility centers over 7 years. The overall perinatal trends in donor oocyte IVF may be applicable to centers worldwide, but further studies in more geographic regions are needed.
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Infertilidad , Nacimiento Prematuro , Embarazo , Femenino , Recién Nacido , Humanos , Fertilización In Vitro , Estudios Retrospectivos , Nacimiento Prematuro/epidemiología , Transferencia de Embrión , Nacimiento Vivo/epidemiologíaRESUMEN
PURPOSE: Are trends in singleton autologous IVF perinatal outcomes consistent over time among five international infertility centers? METHODS: This was a retrospective cohort study from January 1, 2012, to December 31, 2018. This study was performed through a large infertility network at five international infertility centers in which patients who had a singleton live birth resulting from fresh and frozen autologous IVF cycles were included. The primary outcome was live birth weight (BW) with secondary outcomes of preterm birth (PTB), large for gestational age (LGA), small for gestational age (SGA), and gestational age at delivery. RESULTS: The entire cohort (n = 13,626) consisted of 6941 fresh and 6685 frozen autologous IVF cycles leading to singleton deliveries. Maternal age, parity, body mass index, neonatal sex, and GA at delivery were similar for fresh and frozen IVF cycles in the entire cohort and within each infertility center. Four centers had a trend of decreased BW and three centers had decreased rates of PTB before 32 and 28 weeks and LGA newborns annually, although significance was not reached. Three IVF centers had annual increased trends of PTB before 37 weeks and four centers had increased rates of SGA newborns, although significance was not reached. CONCLUSION: Similar trends in perinatal outcomes were present across five international infertility centers over 7 years. Additional studies are crucial to further assess and optimize perinatal outcomes at an international level.
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Enfermedades del Recién Nacido , Infertilidad , Nacimiento Prematuro , Embarazo , Femenino , Recién Nacido , Humanos , Fertilización In Vitro , Nacimiento Prematuro/epidemiología , Estudios Retrospectivos , Retardo del Crecimiento Fetal , Infertilidad/epidemiología , Infertilidad/terapiaRESUMEN
RESEARCH QUESTION: What are the main research interests among patients of assisted reproductive technologies (ART)? DESIGN: Cross-sectional study consisting of an anonymous online survey sent to 2112 patients from eight centres in four countries in 2018. Patients were asked to identify research questions relevant to them in the field of infertility and ART. Answers were categorized into topics and ranked by frequency. A long list of the top 30 research topics was extracted from the aggregate results, from which a short list of the top 10 research topics was created. Ten research questions were finally formulated. RESULTS: A total of 945 responses were analysed. Main interests were side-effects, success rates, infertility prevention and emotional support. The 10 research questions were: 1. What are the side-effects of drugs used in ART treatments? (51.6%). 2. What are the most effective methods to cope with infertility from the psychological point of view? (35.7%). 3. What effects could diet have on fertility? (25.9%). 4. What are ART success rates per clinical profile? (24.8%). 5. Are there some habits and lifestyle factors that could prevent infertility? (20.0%). 6. What are the long-term risks associated with ART in mother and child? (18.5%). 7. Are alternative therapies such as acupuncture, yoga and meditation effective to treat/prevent infertility? (18.5%). 8. What is the impact of exercise on fertility? (15.4%). 9. How does oocyte quantity and quality affect fertility? (9.5%). 10. What are the genetic patterns or hereditary conditions causing/related to infertility? (9.5%). CONCLUSIONS: Researchers and clinicians should keep in mind that, in addition to success rates and safety, patients greatly value research into causes, prevention and emotional aspects of infertility.
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Fertilidad , Infertilidad , Técnicas Reproductivas Asistidas , Investigación , Terapias Complementarias , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
Age-related fertility decline (ARFD) knowledge has been evaluated in the past decade, showing that there is a general knowledge of the reduction of fertility with age. Here we review the studies published up to date which quantitatively measure this ARFD knowledge, to answer the question: how aware about ARFD is our society? We searched the terms "age", "fertility knowledge", "fertility awareness", "reproduction knowledge", "reproductive knowledge" and "reproductive health knowledge" in PubMed, Web of Science, PsychINFO and Scopus, within January 2000 and December 2016. We found 41 studies that quantitatively measured ARFD knowledge by asking for the most fertile age for a woman and/or when there are a slight and a marked decrease in female fertility. We obtained this searching for the questions: What is the most fertile age for a woman? (Q1). When there is a slight decrease in female fertility? (Q2) and, When there is a marked decrease in female fertility? (Q3). We further evaluated the knowledge increase in the 6 studies assessing an educational intervention, 4 of them randomized controlled trials (RCT). Participants reporting the most fertile age for women to be at 20-24 y.o. ranged 16%-89.4% (Q1); participants reporting a slight decrease in female fertility at 25-29 y.o. ranged 5.1%-83% (Q2), and those reporting that a marked decrease occurs between 35-39 y.o. ranged 5.6%-60% (Q3). On the whole, the studies included in this review conclude that ARFD knowledge is insufficient, particularly in determining when female fertility markedly decreases. ARFD knowledge can be increased through targeted campaigns, but few interventional studies have been performed up to date. In view of these results, ARFD campaigns targeted to reproductive age people and healthcare providers are necessary; this would help the society to make informed reproductive decisions throughout life.