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Multiple pregnancy and infertility
Published in Janetta Bensouilah, Pregnancy Loss, 2021
Although the goal of IVF is to maximise the likelihood of a successful pregnancy while minimising the risk of multiple birth, the number of multiples arising from IVF remains a concern. The majority of twin pregnancies following IVF are dizygotic, due to the transfer of more than one embryo, but it is estimated that there is a twofold increase in the incidence of monozygotic twins following IVF. A recent meta-analysis confirmed that there is a 2. 25-fold higher risk following IVF than in natural conception, plus an apparently higher risk with some ART techniques, such as intracytoplasmic sperm injection (ICSI) and blastocyst transfer.11
The effects of IVF on the women involved
Published in Elisabeth Hildt, Dietmar Mieth, In Vitro Fertilisation in the 1990s, 2018
Procedures as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) are often hard to bear for the women and men involved, hard to bear in many respects: physically, psychologically, socially, financially, etc. Why then undergo such procedures? The promoting factor is the very strong desire for a child of one’s own. Reproductive medicine refers to the suffering of infertile people as legitimation to act under certain conditions. But what kind of pain is this? Suffering is a complex concept, an experience on many levels. Is reproductive medicine sufficiently aware of that? Do we take into consideration possible implications of IVF-treatment and provide strategies to cope with them? I am convinced that the medical performance dominates at the expense of psychological and social implications.
Assisted reproduction and embryo research
Published in Marc Stauch, Kay Wheat, Text, Cases and Materials on Medical Law and Ethics, 2018
In its report, the Warnock Committee explained the process of IVF (in vitro fertilisation) in the following terms: Since the early – 1990s a newer variant of IVF has been available, known as intracytoplasmic sperm injection (ICSI): this technique involves injecting a single sperm into the egg and has proven effective in addressing problems of male infertility, including low sperm count and impaired sperm mobility. Today IVF – including ICSI – is increasingly a mainstream treatment: latest HFE Authority figures show that between 1991 and 2015, would-be mothers underwent more than 1 million IVF treatment cycles, resulting in 281,438 live births.12
A retrospective analysis of artificial oocyte activation in patients with low or no fertilisation in intracytoplasmic sperm injection cycles
Published in Journal of Obstetrics and Gynaecology, 2022
Kevin K. W. Lam, Jacki Y. Y. Wong, Tak-Ming Cheung, Raymond H. W. Li, Ernest H. Y. Ng, William S. B. Yeung
Intracytoplasmic sperm injection (ICSI) involves the injection of a single sperm into a mature oocyte and is used to treat infertile couples with severe male infertility or fertilisation problem in conventional in vitro fertilisation (IVF; Palermo et al. 1992). According to the information of the Council on Human Reproductive Technology (2019), there were more than 3600 ICSI cycles performed in 2019, accounting for more than 78% of all oocyte retrieval cycles in Hong Kong . The normal fertilisation rate of ICSI in IVF units ranges from 65−80% (Embryology and Alpha Scientists in Reproductive, 2017). Despite its high efficiency in fertilisation, total fertilisation failure still occurs in 1−3% of ICSI cases (Swain and Pool 2008). Deficiency in oocyte activation is the major cause of fertilisation failure or abnormally low fertilisation after ICSI (Esfandiari et al. 2005). Inappropriate ICSI technique or failure of sperm head de-condensation are not considered as significant causes of fertilisation failure after ICSI (Yanagida et al. 2008).
Ginkgo biloba extract 761 reduces vascular permeability of the ovary and improves the symptom of ovarian hyperstimulation syndrome in a rat model
Published in Gynecological Endocrinology, 2022
Jie Zhang, Jie Huang, Xinhuan He, Ning Li, Yu Miao, Beiqing Li, Xiaoguang Shao, Ningning Wang
Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication of in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) therapy [1]. OHSS is essentially a vascular disorder with clinical symptoms associated with an overall increase in systemic vascular permeability. In cases of OHSS, fluid and serum proteins are constantly lost from the vasculature, leading to ascites and even progression to pleural effusion, thrombosis, and hypovolemic shock [2,3]. Studies in humans and rodents have investigated that vascular endothelial growth factor (VEGF) and its receptors VEGFR seem to play a key role in the pathogenesis of OHSS [4,5]. Moreover, these suggestions are reinforced by the findings that the occurrence of OHSS correlates with the serum concentration of VEGF, and the fact that VEGF content in the follicular fluid is frequently higher in patients with OHSS than that of individuals not affected by such complication [6]. Interestingly, both the clinical pregnancy rate and abortion rate in OHSS patients were significantly higher than those without the syndrome. These observations suggest that early pregnancy processes, such as implantation, trophoblast invasion, and placentation, may also be affected in patients with OHSS [7].
Ginkgo biloba extract 761 reduces vascular permeability of the ovary and improves the symptom of ovarian hyperstimulation syndrome in a rat model
Published in Gynecological Endocrinology, 2022
Jie Zhang, Jie Huang, Xinhuan He, Ning Li, Yu Miao, Beiqing Li, Xiaoguang Shao, Ningning Wang
Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication of In Vitro Fertilization and Intracytoplasmic Sperm Injection (IVF/ICSI) therapy [1]. OHSS is essentially a vascular disorder with clinical symptoms related to an overall increase in systemic vascular permeability. In cases of OHSS, fluid and serum proteins are constantly lost from the vasculature, leading to ascites and even progressing to pleural effusion, thrombosis, and hypovolemic shock [2,3]. Studies in humans and rodents have investigated that vascular endothelial growth factor (VEGF) and its receptors VEGFR seem to play a key role in the pathological process of OHSS [4,5]. Moreover, these suggestions are strengthened by the findings that the occurrence of OHSS correlates with the serum concentration of VEGF, and the fact that VEGF content in the follicular fluid is frequently higher in OHSS patients than that of individuals not affected by such complications [6]. Interestingly, both the clinical pregnancy rate and abortion rate in OHSS patients were significantly higher than those without the syndrome. These observations suggest that early pregnancy processes, such as implantation, trophoblast invasion, and placentation, may also be affected in OHSS patients [7].