Support from Healthcare Professionals for Couples/Partners Undergoing Assisted Reproductive Technology in Japan: A Literature Review

Background and Purpose: A growing number of couples/partners have been undergoing assisted reproductive technology (ART) in Japan. The purpose of this study was to clarify the support from healthcare professionals based on the support vectors in the Family Care/Caring Theory proposed by Hohashi (2015) through a literature review. Methods: Using Ichushi-Web, we searched for original articles using the keywords “assisted reproductive technology”, “infertility”, “family”, “couple”, “nursing”, “care”, and “support”. Thirteen articles suitable for the purpose of this study were subjected to content analysis. Family support was encoded and grouped into subcategories and categories, and classified according to support vectors. Results: A total of 21 categories of support from healthcare professionals was extracted. Intervention for family internal environment included seven categories, such as “Nursing professionals stay close to females”. Intervention for family system unit included five categories, such as “Nursing professionals adjust couple/partner relationships”. Intervention for micro system only included “Nursing professionals provide opportunities for peer support to the couples/partners” and intervention for macro system only included “Nursing professionals encourage medical doctors to relate to females”. Intervention for family chrono environment included seven categories, such as “Healthcare professionals resolve female’s anxieties”. Conclusion: The support from healthcare professionals could be organized by the support vectors of Family Care/Caring Theory, but intervention for supra system (culture, religion, etc.) was lacking. Moreover, because most support was directed toward females or couples/partners, male-focused direct and/or indirect support are also needed. .

Embryo quality and chromosomal abnormality in embryos from couples undergoing assisted reproductive technology using preimplantation genetic screening

Objective:To detect common chromosomal aneuploidy variations in embryos from couples undergoing assisted reproductive technology and preimplantation genetic screening and their possible associations with embryo quality.Methods:In this study,359 embryos from 62 couples were screened for chromosomes 13,21,18,X,and Y by fluorescence insitu hybridization.For biopsy of blastomere,a laser was used to remove a significantly smaller portion of the zona pellucida.One blastomere was gently biopsied by an aspiration pipette through the hole.After biopsy,the embryo was immediately returned to the embryo scope until transfer.Embryo integrity and blastocyst formation were assessed on day 5.Results:Totally,282 embryos from 62 couples were evaluated.The chromosomes were normal in 199(70.57%)embryos and abnormal in 83(29.43%)embryos.There was no significant association between the quality of embryos and numerical chromosomal abnormality(P=0.67).Conclusions:Embryo quality is not significantly correlated with its genetic status.Hence,the quality of embryos determined by morphological parameters is not an appropriate method for choosing embryos without these abnormalities.

Assisted Reproductive Technology for HIV-1 Serodiscordant Couples: A Review of Current Controversies

Since 1992, assisted reproductive technology （ART） has been reported as a viable means of helping HIV-1 serodiscordant couples achieve pregnancy while theoretically reducing the risk for viral transmission. While the sum of the evidence suggests that ART is effective and safe, numerous controversies still exist, The follow- ing review addresses several of the important issues involved in the use of ART for HIV-serodiscordant couples, including patient selection, semen processing techniques, post-process HIV testing, the use of lUI vs IVF-ICSI.

Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment

The scope of this review is to focus on the management of benign ovarian cyst in the reproductive-age group of women undergoing ART. Ovarian cysts are a common occurrence in this patient population. The differential diagnosis includes functional cysts, dermoid cysts, endometrioma. The appropriate evaluation includes medical history and physical examination, laboratory tests and imaging. The treatment options include conservative follow-up, medical treatment and surgery. This review will explore the differential diagnosis, appropriate work-up and treatment options to the various cyst types encountered.

Live birth rates of assisted reproductive technology treatment and spontaneous conception among subfertile couples in Singapore: A follow-up study

Objective: To explore the potential predictors of a live birth (LB) outcome among subfertile couples of Asian ethnicity undergoing the first fertility treatment cycle;to assess the cumulative live birth rates after successive cycles;and to determine the incidence rate of spontaneous conception (SC).Methods:Subfertile couples were grouped according to treatment modalities at the first fertility treatment cycle: intrauterine insemination (IUI),in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and no treatment, and were followed-up for duration up to seven years. Multivariable logistic regression analysis was used for statistical analyses. Results: Age of female subjects [35-38 years, odds ratio (OR): 0.39;≥39 years, OR: 0.14], uterine factor subfertility (OR: 5.24), and treatment modalities (ORs: IUI 0.25, IVF 2.33 and ICSI 1.91) significantly predicted a LB outcome (P<0.05). The cumulative live birth rates were 11.7% IUI, 41.5% IVF, 27.5% ICSI and 22.6% from frozen embryo transfer cycles. The cumulative SC rate was 24.6% in the non-treated group and 10.7% in the treated group. All LBs from IVF cycles were delivered by the second cycle and within four years, compared to SC delivery of within five years in the non-treated group and six years in the treated group. Conclusions:Age of female subject, uterine factor and modalities of treatment are significant predictors for LB outcome at the first cycle. Higher delivery rates could be achieved following fewer successive IVF cycles and within a shorter duration compared to SC.

Awareness and perception of assisted reproductive technology practice amongst women with infertility in Northern Nigeria

Background: Involuntary infertility is a tragedy in most African setting. This is due to premium placed on fertility as a result of roles children fulfill in the family and the society. Aetiologic factors of infertility in sub-Saharan Africa are mostly infection related and they are mainly associated with poor treatment outcome to conventional non assisted conception technique. Objective: To evaluate the level of awareness and perception of assisted conception treatment among women attending fertility clinic. Methods: A descriptive cross-sectional study. Results: One hundred and ninety six women attending fertility clinic were interviewed. Mean age was 34.8year and mean duration of infertility of 4.1 years. Of the 196 infertile women interviewed, 150 (76.5%) have heard of Assisted Reproductive Technology treatment. Sources of information were mainly family relation (46%) and friends (28.7%). Knowledge on some of Assisted Reproductive Technology practices showed that 50.7% were aware that the treatment could fail, 36.8% knew it could be applied for male infertility treatment, 9.3% and 18.7% respectively are aware that donor oocyte and sperm could be used for treatment. Perception on babies conceived from assisted conception treatment revealed that 52% of patients interviewed could not comment if they are normal and natural babies. Majority of patients could not affirm if they will agree to the use of donor gamete or zygote for their treatment. Conclusion: Awareness of assisted conception treatment was high, however knowledge on specifics of treatment was low and perception on some of the practices was unfavorable. Sensitization of the public will help overcome some beliefs that may be at tangent to some practices of assisted conception.

Implementation and Evaluation of Infertility Reflection in Early Pregnancy after the Use of Assisted Reproductive Technology: A Feasibility Study

Background: This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of infertility reflection) and 2) outcome evaluation (satisfaction of care needs, anticipatory anxiety towards the loss of a pregnancy or fetus, cognition of infertility experience, and depression and anxiety). Methods: This program evaluation study used a one-group pre-post-test design. The participants were 50 primiparas who had undergone ART at two fertility treatment facilities in a metropolitan area in Japan. For the infertility reflection, they conducted an online reflection. Data were collected three times: at the 5th week of pregnancy (Time 1), the 8th week of pregnancy as the final consultation at the clinic (Time 2), and the 16th week of pregnancy as the final point of early pregnancy (Time 3). Results: The data from 40 participants were analyzed. More than 80% of the users of the online reflection positively evaluated the appropriateness and usefulness of the methods and contents. Organized thoughts and feelings by reflection were shown as the reasons for the usefulness. The evaluation of the online reflection showed a relatively strong correlation with the Care Need Satisfaction Scale (CNSS) for both Time 2 and Time 3, but the online reflection did not show a significant correlation with the other outcome variables. There were no significant differences in outcome variables between users and non-users of online reflection between Time 2 and Time 3. Conclusions: Attempts at the reflection in early pregnancy require modified methods that do not have a negative impact and lead to the fulfillment of needs.

Clinical study of different fertilization methods of assisted reproductive technology on neonatal birth defects

Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases of singleton deliver by infertile patients under 35 years old who received IVF/ICSI-ET in our center were analyzed.According to different fertilization methods,they were divided into IVF group(2967 cases)and ICSI group(1262 cases).The general situation of birth,birth defects and the location of defects were compared between the two groups.Results:a total of 38 cases of neonatal birth defects were found,the incidence of birth defects was 0.89%,including 30 cases(1.01%)in IVF group and 8 cases(0.64%)in ICSI group.There was no significant difference in the incidence of birth defects between the two groups(P>0.05).There was also no significant difference in birth weight,gestational age and gender ratio between the two groups(P>0.05).Conclusion:Different fertilization methods in assisted reproductive technology do not increase the incidence of neonatal birth defects.

Pregnancies Outcome after Assisted Reproductive Technology: A Multicenter Case Control Study in a Low Income Setting Douala, Cameroon

The objective was to assess the outcome of pregnancies after assisted reproductive technology (ART). It was a case-control study carried out in four health facilities in Douala-Cameroon, over a period of five years. The cases were pregnant women who conceived through ART and the controls were those who conceived naturally. Cases and controls were matched for maternal age and parity (one case for two controls). A logistic regression analysis was used to compute Odds ratios. Statistical significance was set at 0.05. A total of 174 women who conceived through ART and 348 who conceived naturally were enrolled. Some independent factors associated with ART were: age over 45 years [aOR: 7.55; 95% CI (1.55 - 36.76);p: 0.01], twin pregnancies [aOR: 16.55; 95% CI (7.91 - 34.60);p < 0.01], Cervical cerclage [aOR: 3.04; 95% CI (1.23 - 7.50);p: 0.01], miscarriages [aOR: 11.73; 95% CI (5.07 - 27.10);p: 0.01], elective cesarean section [aOR: 4.63; 95% CI (2.27 - 9.45);p: 0.01] and low birth weight [aOR: 3.32; 95% CI (1.90 - 5.82);p < 0.01]. Women who conceived by ART were older with higher rates of multiple pregnancy and complications. We recommend transfer of a single embryo.

The relationship between maternal body fat and pre-implantation embryonic weight: Implications for survival and long-term development in an assisted reproductive environment

There can be little argument that embryo quality is one of the most critical factors in the success of assisted reproductive techniques. Yet the current methods of grading embryos are subjective at best. While a number of different groups have described more qualitative means of assessing embryo quality, the current standard remains morphology. Morphology has proven a good standard, but it does not allow for the detection of chromosomal abnormalities nor can it assess the biochemical status of the embryo prior to transfer. This laboratory recently described a method to estimate embryo weight and suggested weight might be a good indicator of biochemical status. The objective of the present study was to determine the relationship between maternal body composition and embryo weight and determine the influence maternal chemistry had on embryo development. The data continue to suggest that maternal body composition, especially body fat, influences the chemical nature of the embryo and may play a critical role in long-term survival.

Assessment of Risk of Carrier Waves in the Assisted Reproductive Laboratory

Assisted reproductive technology (ART) laboratories represent the marriage of the most basic of biological activities with the most cutting edge technologies. While this association has worked well, the mixture of biology and technology can create risks to normal embryo development. Recently a significant amount of literature has explored the risks of manmade, electrically induced magnetic fields and carrier waves on reproduction, which some studies have suggested will lower functional gamete numbers in the males and potentially induce genetic issues in embryos. However, little is known about these phenomena within the ART laboratory, a laboratory filled with electronic equipment. The object of the present study was to explore the potential exposure of gametes and early stage embryos to two of the most prevalent fields and waves utilized in manmade technologies seen in the general environment, electromagnetic fields (EMF) and radio frequency waves (RF), and determine the effect varying levels of these energetic forces had on gamete function and embryo development. Results indicated that while extremely high concentrations of EMF (approximately 50-100X of laboratory background) caused negative outcomes in both gametes and embryos, levels consistent will the majority of lab equipment did not appear to impact growth, or function. Further, even extremely high RF appeared to have no impact cellular function. Results suggest few issues with EMF or RF on gamete and embryo function at normal laboratory levels for the relatively short exposure times seen in the ART laboratory.

Russian Collaborative Development of Reproduction Technologies for the Sustainable Management of Amphibian Biodiversity

Reproduction technologies(RTs)can provide for the reliable reproduction of amphibians,as well as perpetuation of species genetic variation with the use of biobanks.In 1982,in anticipation of the biodiversity conservation crisis,major Russian institutions collaborated in a dynamic program to develop and implement RTs for the sustainable management of amphibian biodiversity.An initial primary focus was the captive breeding of threatened Russian endemic anuran and caudate species,using RTs that varied from environmental manipulation to the use of exogenous gonadotropic hormones to stimulate reproduction.These species were mostly from Palearctic or cool mountain regions,but also included a wide range of species from warm regions.Other early achievements included the successful cryopreservation of anuran spermatozoa and anuran diploid pluripotent cell nuclei,in order to store both the matrilineal and patrilineal genomes in biobanks,with their subsequent development to the blastula stage after implantation into enucleated oocytes.After the turn of the 21st Century,in support of the priorities of the Amphibian Conservation Action Plan(2007),we developed RTs for the refrigerated storage of testicular or urinary spermatozoa for days to weeks at 4℃,the cryopreservation of urinary spermatozoa using anovel cryoprotectant,the in vitro fertilisation of hormonally induced oocytes either fresh or after refrigerated ex situ or in situ storage,and the artificial insemination of salamanders with fresh spermatozoa.In this article,we describe previously unpublished techniques and techniques from obscure Russian sources.

Impacts of assisted reproductive technology on perinatal outcomes and offspring health

Assisted reproductive technology(ART)has evolved rapidly over the last 40 years,offering hope to individuals and couples struggling with infertility.As technology continues to evolve,simulating a realistic female reproductive system environment has become a common goal for all types of ARTs,thereby reducing the impact of the artificial microenvironment on perinatal and offspring health.In this review,we provide a brief history of the development of each major ART and discuss the impact of ART on perinatal and offspring health.We also explore how the negative consequences of ART may be overcome and how its benefits can be maximized.

Influence of assisted reproductive technology and uterine leiomyoma on pregnancy outcomes in women with adenomyosis

Aim To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma(UL).Methods We performed a retrospective study.Fifty-three singleton pregnancy cases complicated with adenomyosis were included in this study.In the study group,15 women became pregnant with assisted reproductive technology(ART)and 21 women combined with UL.Pregnancy outcomes were compared between ART and non-ART,UL and non-UL groups.Results The prevalence for such complications as hypertensive disorder complicating pregnancy(HDCP)and postpartum hemorrhage(PPH)were significantly higher in the women conceived by ART(33.3%vs.5.3%,P​=​0.023)and(53.3%vs.23.7%,P​=​0.037),respectively.And women concurrent with UL of which the diameter≥4​cm were more likely to have severe PPH(44.4%vs.0%,P​=​0.021).Conclusion ART may increase the risk of adverse pregnancy outcomes such as HDCP and PPH in women with adenomyosis and UL of which the diameter≥4​cm may further increase the risk of severe PPH.

Research on the Application of CAI Computer Technology in the Teaching of Western Art History

The purpose of the computer aided instruction(CAI)is to improve the teachers'teaching efficiency and stimulate the students'interests in their learning.By using the modem means of the computer aided instruction(CAI),we can do a better job in our teaching.The application of the computer-aided instruction(CAI)in the art teaching should be guided by the new ideas and concepts in the best environment for the students to leam in the most efficient and intuitive way to promote the development of the educational modernization.The current situation of the CAI courseware assistant teaching is good as a whole,but there are still some shortcomings in three aspects:the teachers'CAI skill proficiency,the integration and sharing of the CAI teaching resources,and the frequency of the CAI courseware teaching.The teaching of the art history needs to be improved.

Imprinting methylation and assisted reproductive technology

Assisted reproductive technology （ART） is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.

Birth Defects in Assisted Reproductive Technology and Spontaneously Conceived Children:A Meta-analysis

Objective To evaluate the risk of birth defects in children born following assisted reproductive technology （ART） and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART （IVF and for ICSI） compared with those spontaneously conceived and also compared birth defects between subgroups of lVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk （RR） estimated for these studies ranged from 0.44 to 5.51, a signifieantly increased risk of birth defects was observed （RR=l.36, 95%CI=1.25-1.47） in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects （RR=0.90, 95%CI=0.80 1.02）, but ICSI had a higher risk in subgroups of clinical research （RR=O. 76, 95%CI=0.65-0.89） and crude RR value （RR=O. 78, 95%CI=0.67 0.91）. Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or 1CS1 using a summative analysis, however, 1CS1 had a significant higher risk in birth defect risk comparing with 1VF when using subgroup analyses of sample size and RR value.

Cerebral palsy in children born after assisted reproductive technology: a meta-analysis

Background Several studies have assessed the association between cerebral palsy(CP)and assisted reproductive technology(ART),but the results remain controversial.We conducted a meta-analysis to evaluate the risk of CP after ART compared with natural conceptions and to examine CP risk separately in ART singletons,multiples and preterm births.Methods Web-based databases(PubMed,Embase,the Cochrane Library,and Web of Science)were searched until November 22,2020.Studies which compare CP rates after ART with natural conceptions were included.The Newcastle–Ottawa Scale was used to assess the quality of the included studies.Effect estimates were extracted and combined using the fixed-effects or random-effects model depending on the heterogeneity test.Results There were nine studies included in the meta-analysis.The included studies were of moderate or high quality.A significantly higher risk of CP[odds ratio(OR)=2.17,95%confidence interval(CI)1.72–2.74]was found in ART children(n=89,214)compared with naturally conceived children(n=4,160,745).The significantly higher risk decreased when data were restricted to singletons(OR=1.36,95%CI 1.16–1.59)and disappeared when data were restricted to multiples(OR=1.05,95%CI 0.86–1.29)or preterm births(OR=1.53,95%CI 0.66–3.56).Subgroup and sensitivity analyses indicated that the overall results were robust.Conclusions The risk of CP is increased more than two-fold after ART.This increased risk is largely due to increased rates of multiple birth and preterm delivery in ART children.

Cost-effectiveness of varicocele surgery in the era ot assisted reproductive technology

The advent of innovative techniques for addressing infertility has made for exciting times in the arena of andrology. The success of microTESE for retrieving sperm has enabled azoospermic men to have the opportunity to father biological children when it was previously impossible. The ability to offer a variety of assisted reproductive techniques that includes intracytoplasmic sperm injection has opened the door for couples with male factor infertility who were otherwise untreatable. With the multitude of options available to infertile couples, however, comes an unsurprising degree of controversy regarding what treatments should be offered and when. Complicating the picture is the question of if and when varicocele repair should be undertaken, and the financial implications of the treatment decisions that are made. The infertile couple with varicocele warrants careful consideration. The overall efficacy of varicocele repair as well as cost-effectiveness of repair compared to immediate microTESE in azoospermic men and assisted reproductive technology in men with suboptimal semen parameters will be reviewed.