The barriers of joining in vitro fertilization programs among infertile couples in developing countries:A scoping review

Objective:To determine the barriers of joining in-vitro fertilization(IVF)programs among infertile couples in developing countries.Methods:This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed,ScienceDirect,EBSCO,ClinicalKey,and Cochrane Library from inception until December 31,2021.Additional search strategies were snowballing literature search and citation tracking.Results:Eleven articles were included in the scoping review.The cost was the greatest barrier of joining IVF program.Limited access and lack of assisted reproductive technology centers,few qualified infertility trained staff,insufficient government support,low priority in government policy,along with sociocultural factors,such as religion and false beliefs or myths were also majorly considered to be associated obstacles.Conclusions:The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.

Geographic Distribution of Mating Types in Magnaporthe grisea and the Relationship Between Fertile Isolates in China

377 isolates of Magnaporthe grisea were collected from 17 provinces in China and their geographic distribution of mating types and their fertility was tested with four standard isolates, KA3 and TH12 (Mat1.1) and Guy11 and TH16 (Mat1.2) provided by CIRAD. 73 fertile isolates were tested with SCAR markers of 13 pairs of primers. Preliminary results showed that the geographic distribution of M.grisea existed among isolates collected from the same location as well as different locations and the genetic relationship between fertile isolates of the fungus in China. The existence of sexual reproduction of M .grisea was explored in the field as well.

Fertilization of IVF/ICSI Using Sibling Oocytes from Couples with Subfertile Male or Unexplained Infertility

The significance of the performance of conventional in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) using sibling oocytes from couples with subfertile male or unexplained infertility was evaluated. A total of 410 sibling oocyte cumulus-corona complexes (OCCC) from 21 couples with subfertile male (group A) and 11 unexplained infertile couples (group B) were randomly divided, in order of retrieval, into two groups inseminated either by conventional IVF or by ICSI. The treatment outcomes and the influence of infertility factors on fertilization in each group were compared. The results showed that although the two pronuclear (2PN) fertilization rate per injected sibling oocytes was significantly higher after ICSI (group A: 68.2 %±28.8 %; group B: 66.2 %±24.9 %) than after conventional IVF (group A: 41.8 %±32.7 %; group B: 40.1 %±22.1 %), the other variables studied included: the fertilization rates of per allocated sibling oocytes IVF/ICSI, the fertilization rates of sibling oocytes IVF/ICSI after excluding failed IVF fertilization cycles, as well as the cleavage rates of normal fertilization were not statistically significant (P>0.05). Similarly, though the total fertilization failure rate in the IVF group (group A: 42.9 %; group B: 36.4 %) was significantly higher than in the ICSI group (group A: 4.8 %; group B: 0), we did not cancel cycles due to the normal fertilization of sibling oocytes. Embryo transfer was possible in all 32 couples. There were 10 clinical pregnancies in the two groups. We also discovered a possible association between some semen parameters and sperm functions of group A, and women age and duration of infertility of group B and fertilization. It is suggested that adoption of the split IVF/ICSI technology in the above cases may help eliminate fertilization failures. This is also a useful method to investigate the effect of single factor on the employment of assisted reproductive technology.

Fertile island effect in the sedimentary process of Tetraena mongolica Maxim nebkhas in steppe–desert ecotones on the Inner Mongolia Plateau,China

Phytogenic mounds(nebkhas)formed by shrubs are a common phenomenon in arid and semiarid areas.The formation of nebkhas is accompanied by the appearance of the fertile island effect.Quantitative evaluation of the shrub sand compost island effect is a key link in preventing soil erosion and nutrient loss.This study took the typical shrub Tetraena mongolica in desert areas as the research object and quantified the sand-trapping capacity of the shrub.We revealed the influence of sediment texture and volumetric soil water content on fertile islands during the development of T.mongolica nebkhas.The results showed that(1)the single shrub intercepted large amounts of sediments due to the high density of branches of T.mongolica,forming nebkhas that were positively correlated with the shrub size.(2)The overall soil nutrient content below the shrub was greater than the soil nutrient content outside the shrub,forming a typical fertile island effect.The soil organic carbon(SOC),alkaline hydrolytic nitrogen(AHN),available phosphorus(AP),and available K(AK)content all increased gradually with increasing nebkha volume.Compared with the deep soil of nebkhas,the nutrient content of the surface soil was generally higher.(3)There was a positive correlation between the volumetric water content and nutrient content in nebkhas.(4)The semi-ellipsoid shape of T.mongolica enabled it to intercept large amounts of coarse-grained material.Fine sand(100–250μm)was the main particle size in the sediment aggregates inside the nebkhas.The fine sand content generally increased with increasing shrub size.Redundancy analysis(RDA)revealed that the fine sand content of the nebkha sediments had a strong positive correlation with the soil nutrient content.This paper provides an example for evaluating the fertile island effect during the deposition process of nebkhas in the desert transition zone.

A Fertility Assessment of Infertile Men with Varicocele by Means of Doppler Ultrasound

The diameters of spermatic veins and blood reflux in sixty-two male patients with infertility caused by varicocele were assessed with Doppler ultrasound in this study. Scrotal thermograph, testes volume and semen analysis were also applied to analysis of these patients. Among sixty-two patients, thirty-one received high ligation of internal spermatic vein. The results showed: 1. The diameter of spermatic veins was negatively correlated with fertility index and positively correlated with Doppler grading of blood reflux. 2. In operative patients, the effect of surgery was better in patients with blood reflux than in those without blood reflux. It was suggested the diameter of spermatic veins probably reflects the duration and serious degree of blood reflux in spermatic vein, and may be used for assessment of severity of male infertility in combination with semen analysis.

Analysis of the Epididymal Sperm Parameters in Fertile Men

The left and right epididymial.fouids from 73 normal.fertile men were respectively collected by cannulating foe vas deferens dtring the operation of vaseclomy.The parameters of epididymal spermatozoa were analysed.The results indicated that the sperm motility(%),normal sperm morphology,(%),sperm viability(%) and hypoosmotic swelling test (HOST)(%) wers within the normal range as compared with those in the ejaculated spermatozoa. However, the sperm concenlration in epididymis (6220.6± 5300.8 million per ml) was higher than that in semen.It is fo interesl foal the sperm concentration in the right epididymis was significantly than that in the left.It was also demonstrated that the percentage of abnormal Kremer's lest in the left epididymal spermatozoa was significantly higher than that in the right.The above phenomenon was discussed.There was no anti-sperm antibody on foe surface of spermatozoa from epididymis as determined by the sperm cervical mucus contact test(SCMC)and Immunobead test (IBT).These data will be usefull for foe research fo male reproductive physiology,male contraceptive and vasectomy.

Distinguishing male sterile and fertile cytoplasms in indica rice(Oryza sativa L.) by OPA 12

The majority of off-type plants in in-dica hybrid rice were CMS and itsmaintainer lines.Discrimination ofmaintainer and CMS could only beconducted at heading stage.If main-tainer and CMS line could be distin-guished earlier,it would be useful toavoid yield losses caused by usingcontaminated seeds.In this study,three pairs of A and B,Minghui 63,and Fand Fplants of Zhenshan97A/Minghui 63 were used to find

The change of the cationic peroxidase in the leaves at the fertile transformation period in Nongken 58s

Nongken 58s is a type of photoperiod sensitivegenie male sterile rice which gives rice to malesterility when illuminated time is longer than13.75 h/d.The photoperiod sensitive stagesare from the differentiation of primary branchprimordum(Ⅱ)in young ears to fullness ofcontents of the pollen(Ⅶ).The changes ofactivity and isoenzymes in cation peroxidase atph0toperiod sensitive stages and the relation-ship between this enzyme and feritility of rice

Untreated Prior Pulmonary Tuberculosis Adversely Affects Pregnancy Outcomes in Infertile Women Undergoing in vitro Fertilization and Embryo Transfer: A Large Retrospective Cohort Study

Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.

Effect of Progestin-primed Ovarian Stimulation Protocol on Outcomes of Aged Infertile Women Who Failed to Get Pregnant in the First IVF/ ICSI Cycle： A Self-controlled Study

This study aimed to explore the outcomes of progestin-primed ovarian stimulation protocol （PPOS） in aged infertile women who failed to get pregnant in the first IVF/ICSI-ET cycles with GnRH-a long protocol. A self-controlled study was conducted to retrospectively investigate the clinical outcomes of 104 aged infertile patients who didn＇t get pregnant in the first IVF/ICSI-ET treatment by stimulating with GnRH-a long protocol （non-PPOS group）, and underwent PPOS protocol （PPOS group） in the second cycle between January 2016 and December 2016 in the Center for Reproductive Medicine, Renmin Hospital of Wuhan University. The primary outcomes included clinical pregnancy rate of frozen-thawed embryos transfer （FET） in PPOS group, and good-quality embryo rate in both groups. The secondary outcomes were fertilization rate, egg utilization rate and cycle cancellation rate. The results showed that there were no significant differences in basal follicle stimulating hormone （bFSH）, antral follicle count （AFC）, duration and total dosage of gonadotropin （Gn）, number of oocytes retrieved, intracytoplasmic sperm injection （ICSI） rate, fertilization rate, and cycle cancellation rate between the two groups （P〉0.05）. However, the oocyte utilization rate and good-quality embryo rate in PPOS group were significantly higher than those in non-PPOS group （P〈0.05）. By the end of April 2017, 62 FET cycles were conducted in PPOS group. The clinical pregnancy rate and embryo implantation rate were 22.58% and 12.70%, respectively. In conclusion, PPOS protocol may provide better clinical outcomes by improving the oocyte utilization rate and good-quality embryo rate for aged infertile patients who failed to get pregnant in the first IVF/ ICSI-ET cycles.

Body mass index is not associated with sperm-zona pellucida binding ability in subfertile males

Lifestyle factors, such as weight and nutritional status may affect male fertility, including sperm fertilization ability. The objective of this retrospective study was to evaluate the association between body mass index （BMI） and sperm-zona pellucida binding ability assessed according to the zona binding （ZB） test, which has been described to be a relevant diagnostic tool for the prediction of in vitro fertilization （IVF） ability. Three hundred and six male patients from couples diagnosed with primary idiopathic or mild male factor infertility were included. Correlations between BMI and semen parameters according to ZB test indices were assessed, together with frequencies of positive and negative tests across the BMI categories. In this selected population, BMI was not related to conventional semen parameters or sperm quality assessed according to the ability of spermatozoa to bind to the zona pellucida. The previously described poor outcomes of IVF procedures in cases of male obesity could be due to other sperm defects, such as alterations of sperm capacitation or acrosome reaction. The link between male BMI and biological outcomes during IVF procedures, such as fertilization rates, should be further evaluated.

Quantification of human telomerase RNA(hTR)and human telomerase reverse transcriptase(hTERT)mRNA in testicular tissue of infertile patients

Aim:To evaluate the quantitative detection of human telomerase RNA(hTR)and human telomerase reverse tran-scriptase(hTERT)mRNA as diagnostic parameters in the workup of testicular tissue specimens from patients presentingwith non-obstructive azoospermia.Methods:hTR and hTERT mRNA expression were quantified in 38 cryopre-served testicular tissue specimens by fluorescence real-time reverse transcription-polymerase chain reaction(RT-PCR)in a LightCycler(r).This was paralleled by conventional histological workup in all tissue specimens and additionalsemithin sectioning preparation in cases with maturation arrest(n=12)and Sertoli-cell-only syndrome(n=12).Re-sults;The average normalized hTERT expression(N_(hTERT))was 131.9±48.0 copies(mean±SD)in tissue speci-mens with full spermatogenesis,N_(hTERT)=51.2±17.2 copies in those with maturation arrest and N_(hTERT)=2.7±2.4copies in those with Sertoli-cell-only syndrome(SCOS).The discriminant analysis showed that detection of N_(hTERT)(N_(hTR))had a predictive value of 86.8%(55.3%)for correct classification in one of the three histological subgroups.Conclusion;Our results demonstrate that quantitative detection of hTERT mRNA expression in testicular tissue en-ables a molecular-diagnostic classification of gametogenesis.Quantitative detection of hTERT in testicular biopsies isthus well suited for supplementing the histopathological evaluation.

A Survey of Correlation Infertility Self-Efficacy with Behavioral Health Scales in Infertile Women

Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value

Investigation into Semen Characteristics of Naturally-Fertile Pairs in Vitro and Their correlation with Fertility in Florida Sandhill Crane

Semen characteristics of naturally fertile pairs and their correlation with fertility of eggs in Florida sandhill crane (Grus canadensis pratensis) were examined. Six pairs were used in this experiment, and all of them that had bred before were housed in open individual pens. These pairs were isolated physically each other but not visually and audibly. Semen was collected twice (Tuesday morning and Friday afternoon) from February 26 to June 4, 1993. The standard methods at Patuxent Wildlife Research Center were used collecting and evaluating the semen and spermatozoa. and incubating the eggs. There were statistically individual variations (p<0.05) about successful collecting attempts, semen volume, semen concentration, spermatozoon’s motility,spermatozoon’s number per collection, live spermatozoon’s number, male’s response to semen collection, and morphology of spermatozoa except the giant cell. There was a significantly (p<0.05, correlation coefficient was (0.73 or (1 .00) negative correlation between fertility of eggs and the multiple value of semen (sperm) characteristics of naturally fertile pairs in Florida sandhill crane.

Old climatically-buffered infertile landscapes(OCBILs):more than harsh habitats,Atlantic Forest inselbergs can be drivers of evolutionary diversity

Granite-gneiss rock outcrop inselbergs are ancient stable ecosystems with old,climaticallybuffered infertile landscapes(OCBILs).Although inselbergs provide key ecosystem services,little is done for their conservation and,so far,a lot of their unknown evolutionary history has already been lost by human activities.Using a fine-scale approach,here we tested if habitat and environmental filtering(the inselberg’s harshness)affect the evolutionary diversity of an Atlantic Forest inselberg in Brazil.We recorded all trees with a diameter at breast height≥5cm in 20 plots in four habitat types(total sampled area of 0.8 hectares),from highest to lowest:island,hillside,foothill,and semideciduous forest(matrix).We also collected soil samples for chemical,textural and physical soil characterization.We fitted linear models to test the effects of soil and habitat on plotlevel metrics of phylogenetic diversity and structure,lineage diversity,phylogeneticβ-diversity,and evolutionary distinctiveness.We found that the upper inselberg habitats contain a distinct set of ancient,closely related,harsh-tolerant lineages,as well as a subset of lineages that persist under harsh conditions with a certain degree of water availability.The inferior inselberg habitats harbor higher lineage diversity than expected by chance.Soil strongly predicted evolutionary diversity.We concluded that soil depth,slope,nutrients and texture(environmental filtering)and habitat types and topography(habitat filtering)shape the evolutionary history contained in fine-scale inselberg habitats,which should encourage the conservation of these ancient ecosystems.

Relationship between apoptotic markers in semen from fertile men and demographic, hormonal and seminal characteristics

Apoptosis in the testis has two putative roles during normal spermatogenesis; limitation of the germ cell population to numbers that can be supported by the Sertoli cells, and, possibly, selective depletion of meiotic and postmeiotic abnormal germ cells. We investigated the demographic and biological correlates of the pro-apoptotic marker Fas and the anti-apoptotic marker Bcl-xL in sperm cells of fertile men. Six hundred and four men from Greenland, Poland and Ukraine were consecutively enrolled during their pregnant wife＇s antenatal visits. Semen analysis was performed as recommended by the World Health Organization. Immunofluorescence coupled to flow cytometry was utilized for detection of apoptotic markers in the sperm cell. DNA damage was assessed by flow cytometry using both the sperm chromatin structure assay （SCSA） and the terminal deoxynucleotidyl transferase dUTP nick end labelling （TUNEL） assay. The percentage of Fas-positive sperm cells was higher in men with high total sperm count （P〈O.01）, more motile sperms （P=-O.04） and fewer sperm head defects （P=-O.05）. These associations were consistent within and across study regions. Furthermore, testosterone, follicle-stimulating hormone （FSH） and sexual hormone-binding globulin （SHBG） were significantly negatively correlated with Fas within and across regions as well. The data indicated no association between the anti-apoptotic Bcl-xL marker and semen or personal characteristics. The finding of Fas-positive sperm cells associated with better semen quality in a cohort of spouses of pregnant women seems different from previous data obtained in infertile men and warrants further investigation to clarify the biological significance of sperm apoptotic markers.

Can Greater Flamingo Recognize Fertile <i>vs.</i>Infertile Egg? A Single Case Study

Fertility of captive flamingos varies between flocks, species and seasons. Individuating infertile eggs could be helpful to facilitate important decisions. Wild animals could be encouraged to abandon the nest or not, whereas in captivity removing non-viable egg would lead birds to lay a new one. The aim of this study was to investigate the parental behaviour of a pair of greater flamingos (Phoenicopterus roseus) in the presence of a fertile and an infertile egg. Data on the posture and behaviours of the pair on the nest were collected over two different periods: first period—an infertile egg was laid;second period—a fertile egg was laid. For each period, 28 ten-minute sessions per flamingo partner were run. Results revealed that female flamingo spent significantly more time standing on the nest in the first than in the second period (P = 0.010). Moreover, when standing on the nest, the female performed significantly more egg-care behaviour (attention to the egg, egg rotation/moving) in the first than in the second period (P = 0.010). No significant differences between periods emerged in the male flamingo posture on the nest and behaviours. Findings from this study suggest that female flamingos stand on the nest longer if the egg is infertile, paying more attention and examining it deeply. This study provides new insights into greater flamingo parent-embryo communication. Future research is needed to improve our knowledge on this topic, as well as on the husbandry of this species in the controlled environment.

Medical versus surgical treatment for early pregnancy loss in infertile patients: Which approach facilitates more rapid return to subsequent treatment cycle?

Patients and physicians confront a challenging dynamic when an early pregnancy loss (EPL) occurs after fertility treatment (FT). Our study focused on the time to resumption of FT in patients managed medically (Cytotec) compared to in those managed surgically with dilatation and curettage (D&C). A retrospective analysis from 2003-2010 of patients receiving treatment for an EPL. Misoprostol (Cytotec) patients were compared with a randomly selected control group (D&C). Both the time from the date of treatment to the date at which βhCG reached x2. No statistical significance was observed for resumption of FT between groups. Cytotec group had a greater maintenance of retained products of conception versus D&C population (26% vs 2%;p = 0.01). More D&C patients received karyotype results (68% vs 5%). A significant difference was not found in resumption time to the next fertility treatment between the medically and surgical treatment. More medically managed patients RPOC requiring D&C. Although a D&C is more likely to provide karyotype results, medical management is a viable alternative.

Effect of Fasting of Ramadan on Infertile Women Undergoing In-Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Prospective Cohort Study

Objective: To determine the effects of fasting of Ramadan in patients undergoing in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Design: A prospective cohort study conducted during Ramadan. Setting: Ain Shams University IVF centre. Population: Three hundred fasting, infertile women undergoing their first trial of IVF/ICSI and 300 non-fasting matched controls undergoing the same procedure during Ramadan. Methods: Anxiety and depression were measured by the Hospital Anxiety and Depression Scale, at the start of the induction protocol. All the successful pregnant women were followed up until delivery. Main Outcome Measures: The primary outcome measure was the live birth rate. Results: The live birth rate was higher in the fasting group than in the non-fasting group;this was not significant (43% vs. 40%, P = 0.46). The fasting group needed higher doses and durations of induction. Embryo quality did not differ between both groups. The pregnancy complication rate among successful cases was higher in the fasting group (52.9% vs. 40.4%, P = 0.03);however, the frequencies of anxiety and depression were significantly lower than those in the non-fasting group (18% vs. 38%, P P < 0.00001, respectively). Conclusion: Fasting during Ramadan does not seem to significantly affect the IVF/ICSI outcome;however, it significantly decreased the anxiety and depression usually associated with these procedures.