China
Africa
Explore chapters and articles related to this topic
Multiple pregnancy and infertility
Published in Janetta Bensouilah, Pregnancy Loss, 2021
Mary and her husband had been trying to conceive for 3 years, and after undergoing extensive investigations that led to a diagnosis of unexplained infertility, they were advised that IVF would be their best option. They did not feel quite ready to accept that this was the path for them, and as Mary was only 29 years of age, they believed that they could afford to wait a little longer before, as they saw it, ‘giving up’ on their natural fertility. After a further few months Mary duly conceived naturally, only for her immense joy to be crushed when it was discovered that the pregnancy was ectopic. After surgery to remove her left Fallopian tube, Mary was devastated to be told that her remaining tube was damaged to the extent that natural conception was highly unlikely, and that if she underwent IVF, removal of the remaining tube first would be best to avoid the risk of further ectopic pregnancies. Mary’s emotional recovery took many months as she was consumed by distress about what she had lost. Her self-esteem plummeted and she felt an overwhelming sense of failure. She described her feelings as veering between anger and profound grief. Her anger was directed both at herself and her ‘failed’ body, and at her doctor, who had delivered the news in a way that she found cold, uncaring and too matter-of-fact. She grieved both for her lost pregnancy and for her own fertility.
Being a ‘good’ parent: single women reflecting upon ‘selfishness’ and ‘risk’ when pursuing motherhood through sperm donation
Published in Zeynep B. Gürtin, Charlotte Faircloth, Conceiving Contemporary Parenthood, 2020
Multiple interviews were held with the women over a fifteen month period between 2010 and 2012. Two participants were interviewed once, eight participants on two occasions, nine participants on three occasions and four participants were interviewed four times. The number of interviews held depended upon the participants’ own thinking and treatment trajectory, as well as their willingness and time available for interviews. Three of the twenty-three participants did not start fertility treatment during the study period, two decided to stop treatment and six were continuing or considering their options for further treatment when the study period ended. Due to the long and often complex nature of their treatment journey, participants undertook various fertility treatments at various locations, undergoing a combination of intrauterine insemination (IUI), in vitro fertilisation (IVF), or in three cases IVF with donor eggs. Eighteen participants had some or all of their treatment in the UK and six had some or all of their treatment abroad. One participant had her fertility treatment funded by the NHS. However, all other participants were private patients at NHS or private fertility clinics, fully funding their own fertility investigations and treatment.
Assisted Reproductive Technology and Multiple Pregnancy
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Rezan A. Kadir, Zdravka Veleva
Multiple pregnancy is also associated with increased maternal risks and complications during pregnancy, intrapartum and postpartum. These risks are often overlooked and underestimated when counseling women about risks of multiple pregnancy. Mothers carrying twins undergo an exaggerated physiological response to pregnancy. They suffer nausea and vomiting of pregnancy more commonly compared to women with singleton pregnancy, often with severe intensity requiring repeated hospital admissions. They are also more likely to develop hyperemesis gravidarum. There is also an increased risk of ovarian hyperstimulation syndrome after IVF treatment, with more severe symptoms.
A thinner endometrium is associated with lower newborn birth weight during in vitro fertilization–frozen-embryo transfer: a cohort study
Published in Gynecological Endocrinology, 2023
Xiuping Zhang, Lixia Liang, Yuanjing Hu, Zhiping Zhang, Yuanxia Wu, Xueluo Zhang, Xueqing Wu
The development of in vitro fertilization (IVF) technology has been a boon for numerous infertile patients, which contributes to increases in pregnancy and live-birth rates for these patients. Nevertheless, concerns are being raised over the safety of IVF because IVF is associated with an elevated risk of pregnancy and neonatal complications. For instance, Geyter et al. observed that women who conceived with assisted reproductive technology (ART) had a higher risk of premature delivery than naturally conceived women, accompanied by lower mean newborn birth weights. Moreover, their data also revealed that the birth weight was reduced markedly for newborns delivered < 37 weeks after embryo transfer [1]. Additionally, mounting studies have reported that various types of ART alter fetal growth dynamics, which may affect the newborn birth weight [2–4].
Does male fertility-related quality of life differ when undergoing evaluation by reproductive urologist versus reproductive endocrinologist?
Published in Human Fertility, 2023
Rachel Danis, Intira Sriprasert, William Petok, Jesse Stone, Richard Paulson, Mary Samplaski
We found that RU evaluated men who earned lower incomes than those evaluated by a RE (43.1% versus 70.8% of men earned >$100,000, respectively, p = 0.002). These men were also less like to be in couples pursuing IVF (54.0% versus 70.9%, p = 0.03). Taken together these findings relate to financial access to care. The mean cost of IVF in the US is $30,274 (Dupree, 2016; Smith et al., 2011), and patients with household incomes >$150,000/year are more likely to utilise IVF (Smith et al., 2011). Male factor specific data show that 47% of men report financial strain from infertility, and 46% report treatment options limited by cost (Dupree, 2016; Elliott et al., 2016). Despite infertility being defined as a disease by the World Health Organisation and ASRM, private health insurance plans rarely cover treatment for infertility (Dupree et al., 2016; House of Representatives, Congress (2010); Practice Committee of the American Society for Reproductive Medicine, 2020; Zegers-Hochschild et al., 2009). Only 15 states have laws mandating infertility coverage, and only 8/15 have male coverage (Dupree, 2016; Dupree et al., 2016). It is possible that some men will see a RU to optimize male factor issues in order to avoid the need for costly IVF. The stress associated with the male factor and the cost of IVF may have also contributed to the lower FertiQoL scores seen in males evaluated by a RU versus RE.
Follitropin Alpha for assisted reproduction: an analysis based on a non-interventional study in Greece
Published in Current Medical Research and Opinion, 2022
Vassilis Fragoulakis, Andreas Mantis, Nikolaos Christoforidis, Dimitrios Dovas, Spyros Deftereos, Tryfwnas Lainas, Evripidis Mantoudis, Thanos Paraschos, Dimitris Sakellariou, Evangelos Makrakis
Within the regression framework, as expected, the total dose of Gonal-f was the most important factor for the drugs cost per patient. The estimation of mean total cost of IVF therapy per patient in this local setting was in line with the corresponding costs found in other countries. More specifically, the estimated costs per IVF cycle (in 2014 USD) are in the U.S.A at $12,513, UK at $5244, Australia at $5645, Brazil at $3000, Canada at $8500, Germany at $4,418–$4,977, India at $600–$1000 (92). As it can be observed, the estimated costs of IVF vary among different countries36. However, the high cost of IVF is the main obstacle that prevents couples from benefiting from this technology37. This indicates that the IVF procedure in Greece represents one of the least costly and thus an attractive option in Europe for those suffering of infertility38. It must be mentioned at this point, that the clinic cost was based on literature and represents a rough estimation of the actual cost and probably would be slightly changed, if new evidence came into view.