Assisted reproductive techniques Dotaz Zobrazit nápovědu
OBJECTIVE: Evaluation of the development of assisted reproduction methods and their success from the time of their origin to the present. DESIGN: Review article. SETTING: Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague. METHODS: Literature search using the Web of Science, Google Scholar and PubMed databases with keywords (assisted reproduction, in vitro fertilization, infertility, ICSI, ovarian hyperstimulation syndrome, OHSS, uterine transplantation) and analysis of articles published in impact and reviewed journals. RESULTS: At present children born using assisted reproduction methods are not considered as a miracle of modern medicine, but as a more difficult way of human reproduction. Reproductive medicine helps to fulfill the desires of infertile couples for their own child and thus improve the quality of their life. Since its introduction into clinical practice it has made extraordinary progress. Robert Edwards and Patrick Steptoe, thanks to systematic scientific research and clinical work, contributed to the birth of the first „test tube“ baby in 1978. Edwards received the 2010 Nobel Prize in Physiology and Medicine for his discoveries in the field of assisted reproduction. The first child of assisted reproduction in the Czech Republic was born in 1982 in Brno. In 1986, the worlds first cryoembryotransfer was performed. 1990 was the beginning of preimplantation genetic examination. In 1992, the first pregnancy was achieved using intracytoplasmic sperm injection. The work of specialists in reproductive medicine results in more than 8 million births worldwide. CONCLUSION: Despite the fact that around 4000 children are born in the Czech Republic each year using assisted reproduction methods, its methods are rejected by part of the society. Assisted reproduction brings a number of controversies, but the spread of information smog around it should not suppress a rational view of the professional and general public. Indications for assisted reproduction vary, often are on the male side, but the age of the infertile woman is the most important determinant of the success of the process. The question is whether the continuous improvement of medical technologies and scientific discoveries threatens to inadequate manipulation of human gametes or embryos. The society should monitor these controversial aspects through its legislative and control mechanisms and ensure that these methods are not misused for other than strictly medical purposes.
- Klíčová slova
- IVF, OHSS, assisted reproduction, in vitro fertilization, infertility, ovarian hyperstimulation syndrome, uterine transplantation, uterus transplantation,
- MeSH
- asistovaná reprodukce * MeSH
- dítě MeSH
- dospělí MeSH
- fertilizace in vitro MeSH
- intracytoplazmatické injekce spermie MeSH
- lidé MeSH
- ovariální hyperstimulační syndrom * MeSH
- těhotenství MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
In 2012, the Czech Republic established the women's age limit for access to assisted reproduction techniques at age 49 years. In this paper, the acceptability of this age limit from the children's perspective in the Czech Republic is assessed. Although the necessity of balancing the interests of parents and children is acknowledged, little research has taken children's interests into account. We have attempted to map out 'children's interests', asking older children and adolescents (aged 11-25 years) how old they would prefer their parents to be: Czech respondents would prefer to have younger parents. This finding is consistent with the optimal biological childbearing age rather than with the current postponement to a later age. So far, assisted reproduction techniques have been largely regarded as a medical treatment justifying the current women's age limit of 49 years. Had the children's perspective been taken into account, this age limit might have been lower than 49 years. We propose that reproductive health policy should adequately reflect multiple perspectives as an integral part of a multi-layered support system of a society.
- Klíčová slova
- age limit, assisted reproduction, delayed childbearing, fertility, preferences,
- MeSH
- asistovaná reprodukce * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- věkové faktory * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: We sought to compare measurements of circulating cell-free DNA as well as Down syndrome test results in women with naturally conceived pregnancies with those conceived using assisted reproductive technologies. METHODS: Data regarding assisted reproductive technologies were readily available from seven enrollment sites participating in an external clinical validation trial of nested case/control design. Measurements of circulating cell-free fetal and total DNA, fetal fraction (ratio of fetal to total DNA), chromosome-specific z-scores, and karyotype results were available for analysis. RESULTS: Analyses were restricted to 632 euploid (5.2% assisted reproductive technologies) and 73 Down syndrome (13.7% assisted reproductive technologies), including 16 twin pregnancies. No differences were found for fetal or total circulating cell-free DNA, or for the fetal fraction in euploid (P = 0.70) or Down syndrome (P = 0.58) pregnancies by method of conception. There appeared to be systematic z-score reductions for chromosomes 21, 18, and 13 in assisted reproductive technologies versus natural euploid pregnancies (P = 0.048, 0.0032, and 0.36, respectively). CONCLUSION: Assisted reproductive technologies and naturally conceived pregnancies contribute similar levels of circulating cell-free DNA into maternal circulation. Small differences in the z-scores of pregnancies achieved by assisted reproductive technologies were observed and do not appear to be test-related artifacts. However, the findings need confirmation before any consideration of changes to testing and reporting protocols.
- MeSH
- aneuploidie * MeSH
- asistovaná reprodukce škodlivé účinky MeSH
- DNA krev genetika MeSH
- Downův syndrom diagnóza epidemiologie genetika MeSH
- genetické testování MeSH
- lidé MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- DNA MeSH
OBJECTIVE: To study the incidence of monozygotic twinning (MZT) in patients using in vitro fertilization, relative to their age, genetic background, ovarian function, and assisted reproductive techniques used. DESIGN: Analysis of a collected database. SETTING: Infertility treatment center. PATIENT(S): A total of 1,876 patients receiving infertility treatment between 2000 and 2012. Pregnancies with monozygotic twins (A: 23) were compared with deliveries of dizygotic twins (B: 423), singleton pregnancies (C: 880), and aborted pregnancies (D: 389). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): A genetic survey on multiple pregnancies in the extended family. Measures were micromanipulation technique, the length of embryo cultivation, type of cultivation media, basal follicle-stimulating hormone level, estradiol level on the day of human chorionic gonadotropin administration, number of oocytes, total consumption of gonadotropins, and consumption of gonadotropins needed for recovery of 1 oocyte. RESULT(S): No differences were found between the incidence of MZT in cycles that did vs. did not use micromanipulation techniques. In addition, the length of embryo cultivation or type of cultivation media used did not affect the results. Estradiol levels and implantation rates were significantly higher in group A. The incidence of MZT in families in group A was significantly higher than that in groups B and C. CONCLUSION(S): We propose that the high incidence of MZT in infertility-clinic patients is conditioned by hereditary factors, and good ovarian function only facilitates the expression. The resulting recommendation is that young women with a positive family history and good ovarian function undergo elective single-embryo transfer, and proper counseling is advisable.
- Klíčová slova
- Monozygotic twins, assisted reproduction techniques, genetics, incidence, infertility,
- MeSH
- asistovaná reprodukce statistika a číselné údaje MeSH
- dospělí MeSH
- dvojčata monozygotní * genetika statistika a číselné údaje MeSH
- incidence MeSH
- lidé MeSH
- novorozenec MeSH
- přenos embrya metody statistika a číselné údaje MeSH
- rozdělení zygoty * genetika MeSH
- těhotenství s dvojčaty genetika statistika a číselné údaje MeSH
- těhotenství MeSH
- úhrn těhotenství na počet žen v reprodukčním věku MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cellular proteins and the mRNAs that encode them are key factors in oocyte and sperm development, and the mechanisms that regulate their translation and degradation play an important role during early embryogenesis. There is abundant evidence that expression of microRNAs (miRNAs) is crucial for embryo development and are highly involved in regulating translation during oocyte and early embryo development. MiRNAs are a group of short (18-24 nucleotides) non-coding RNA molecules that regulate post-transcriptional gene silencing. The miRNAs are secreted outside the cell by embryos during preimplantation embryo development. Understanding regulatory mechanisms involving miRNAs during gametogenesis and embryogenesis will provide insights into molecular pathways active during gamete formation and early embryo development. This review summarizes recent findings regarding multiple roles of miRNAs in molecular signaling, plus their transport during gametogenesis and embryo preimplantation.
- Klíčová slova
- Embryogenesis, Gametogenesis, MicroRNA, Preimplantation,
- MeSH
- asistovaná reprodukce * MeSH
- embryonální vývoj * genetika MeSH
- gametogeneze genetika MeSH
- lidé MeSH
- mikro RNA * genetika metabolismus MeSH
- oocyty metabolismus MeSH
- vývojová regulace genové exprese MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- mikro RNA * MeSH
BACKGROUND & OBJECTIVE: To analyze whether there is an association between pre-pregnancy lipid parameters and gestational diabetes mellitus (GDM) in women undergoing assisted reproductive technologies (ART), a group especially at risk for GDM, and if so, which parameter is associated the strongest. METHODS: Data was collected at the Reproductive and Genetic Hospital CITIC-Xiangya in Changsha, China from January 2017 to December 2018. The measured lipid parameters include LDL (low-density lipoprotein), HDL (high-density lipoprotein), TC (total cholesterol), and TG (triglycerides). RESULTS: 119 (15.5%) of the 767 patients developed GDM. On average, women who developed GDM were older, had a higher BMI, LDL, TC, and TG, and lower HDL. After adjusting for confounders, LDL and HDL showed a significant association with GDM (p < 0.05), but TC and TG did not. Binary LDL/HDL and TC/HDL ratios showed the strongest association with GDM incidence (OR 1.957 [95%CI 1.258-3.044] and 1.942 [1.243-3.034] respectively). Subgroup analysis showed that an elevated LDL/HDL ratio also increased GDM risk in subgroups with a typically lower prevalence of GDM, such as young women with a low BMI and low blood pressure. Both lipid ratios (LDL/HDL and TC/HD) show strong interactions with baseline age, fasting plasma glucose, and LH. CONCLUSIONS: In this cohort of Chinese women undergoing ART, pre-pregnancy LDL/HDL and TC/HDL were associated with GDM the strongest from the lipid parameters and could be useful to estimate GDM risk even before ART treatments and pregnancy. CLINICAL TRIAL NUMBER: NCT03503006 registered on the 21st of March 2018 (on clinicaltrials.gov). https://clinicaltrials.gov/study/NCT03503006?locStr=Changsha,%20Hunan,%20China&country=China&state=Hunan&city=Changsha&cond=ivf&rank=2 .
- Klíčová slova
- Assisted reproductive technologies, Dyslipidemia, Gestational diabetes mellitus, In vitro fertilization, Ldl hdl ratio,
- MeSH
- asistovaná reprodukce * MeSH
- cholesterol krev MeSH
- dospělí MeSH
- gestační diabetes * krev epidemiologie diagnóza MeSH
- HDL-cholesterol * krev MeSH
- LDL-cholesterol krev MeSH
- lidé MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- triglyceridy krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Čína epidemiologie MeSH
- Názvy látek
- cholesterol MeSH
- HDL-cholesterol * MeSH
- LDL-cholesterol MeSH
- triglyceridy MeSH
OBJECTIVE: The goal of this article is to present the current knowledge of Klinefelter syndrome and its impact on male reproductive function as well as the current treatment options. METHODS: PubMed/Medline, WoS and Scopus were searched for articles indexed until November 2021. TEXT: Klinefelter syndrome is a chromosomal aberration with an additional X chromosome in males. This may adversely affect testicular growth and spermatogenesis, thus resulting in male infertility. Recently, new knowledge has appeared about the treatment of male infertility. CONCLUSION: Interdisciplinary approach enables early dia-gnosis and treatment of patients with Klinefelter syndrome. Assisted reproductive technology is essential for infertility treatment in patients with Klinefelter syndrome.
- Klíčová slova
- Aneuploidy, Klinefelter syndrome, assisted reproduction, disorders of spermatogenesis, genetic testing, male sterility,
- MeSH
- asistovaná reprodukce škodlivé účinky MeSH
- chromozomální aberace MeSH
- Klinefelterův syndrom * komplikace genetika MeSH
- lidé MeSH
- mužská infertilita * genetika terapie MeSH
- spermatogeneze MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Creation of both gametes, sperm and oocyte, and their fusion during fertilization are essential step for beginning of life. Although molecular mechanisms regulating gametogenesis, fertilization, and early embryonic development are still subjected to intensive study, a lot of phenomena remain unclear. Based on our best knowledge and own results, we consider gasotransmitters to be essential for various signalisation in oocytes and embryos. In accordance with nitric oxide (NO) and hydrogen sulfide (H2S) physiological necessity, their involvement during oocyte maturation and regulative role in fertilization followed by embryonic development have been described. During these processes, NO- and H2S-derived posttranslational modifications represent the main mode of their regulative effect. While NO represent the most understood gasotransmitter and H2S is still intensively studied gasotransmitter, appreciation of carbon monoxide (CO) role in reproduction is still missing. Overall understanding of gasotransmitters including their interaction is promising for reproductive medicine and assisted reproductive technologies (ART), because these approaches contend with failure of in vitro assisted reproduction.
- MeSH
- asistovaná reprodukce * MeSH
- gametogeneze fyziologie MeSH
- gasotransmitery metabolismus fyziologie MeSH
- lidé MeSH
- oocyty metabolismus fyziologie MeSH
- oxid dusnatý metabolismus fyziologie MeSH
- oxid uhelnatý metabolismus fyziologie MeSH
- posttranslační úpravy proteinů MeSH
- sulfan metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- gasotransmitery MeSH
- oxid dusnatý MeSH
- oxid uhelnatý MeSH
- sulfan MeSH
The article evaluates the prevalence of infertility problems in the Czech population, identifies methods used by individuals or couples attempting to achieve pregnancy and evaluates in more detail the use of assisted reproduction technology (ART) in contemporary Czech society. The results show that 27% of women and men in their forties declare they have experienced a time when they were trying to get pregnant but did not conceive within at least 12 months. In the general population of reproductive age, one in five declares experience with methods helping to get pregnant. Methods that do not require a doctor's visit are the most frequently used (one in ten declare monitoring ovulation), and 5% of the general population have experience of ART. Among those who have experienced some period of infertility, the experience of methods to assist conception is significantly higher (3/4 of men and 2/3 of women), and the use of medically assisted reproduction is also higher (a quarter have experience of taking medication and a quarter of assisted reproduction).
- Klíčová slova
- infertility, infertility treatment, IVF, assisted reproduction technology,
- MeSH
- asistovaná reprodukce * MeSH
- dospělí MeSH
- infertilita * MeSH
- lidé středního věku MeSH
- lidé MeSH
- stárnutí fyziologie MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: Delayed childbearing in European countries has resulted in an increase in the number of women having children later in life. Thus more women face the problem of age-related infertility and cannot achieve their desired number of children. Childbearing postponement is one of the main reasons for the increasing use of assisted reproductive technology (ART) and conversely, the latter may be one of the factors contributing to the rise in female childbearing age. The research goal of our article is to evaluate the demographic importance of ART increased use and to examine its impact on both the fertility rate and birth timing. METHODS: Comparative analysis based on demographic and ART data collected by the European IVF-monitoring (EIM) Consortium for the European Society of Human Reproduction and Embryology (ESHRE). RESULTS: Most countries with a higher total fertility rate (TFR) also registered a higher number of treatment cycles per 1 million women of reproductive age. Despite the positive relationship between the postponement rate and the demand for ART among women aged 35 and older, the highest share of children born after ART was not found in countries characterized by a "delayed" fertility schedule. Instead, the highest proportion of ART births was found in countries with fertility schedules concentrated on women aged between 25 and 34. Accordingly, the effective use of ART can be expected in populations with a less advanced postponement rate. CONCLUSIONS: ART can have a demographic relevancy when women take advantage of it earlier rather than later in life. Furthermore it is suggested that the use of ART at a younger age increases women's chance of achieving their reproductive goals and reduces the risk of age-related infertility and failed ART. Based on a demographic approach, reproductive health policy may become an integral part of policies supporting early childbearing: it may keep women from delaying too long having children and increase the chance of diagnosing potential reproductive health problems requiring a timely ART application.
- MeSH
- asistovaná reprodukce statistika a číselné údaje MeSH
- dospělí MeSH
- lidé MeSH
- porodnost MeSH
- reprodukční chování statistika a číselné údaje MeSH
- věk matky MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Evropa MeSH