Fertility and sterility
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Fertility and sterility · Feb 2019
Comparative StudyOne hundred mosaic embryos transferred prospectively in a single clinic: exploring when and why they result in healthy pregnancies.
To investigate the parameters of mosaicism and the biological mechanisms leading to healthy pregnancies from mosaic embryo transfers. ⋯ After euploid embryos, mosaic embryos can be considered for transfer, prioritizing those of the single segmental mosaic type. If a patient has mosaic embryos available that were generated at different ages, preference should be given to those made at younger ages. Intrablastocyst karyotype discordance and differential cell proliferation and death might be reasons that embryos classified as mosaic can result in healthy pregnancies and babies.
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Fertility and sterility · Feb 2019
Effect of class III and class IV obesity on oocyte retrieval complications and outcomes.
To assess the effect of class III (body mass index [BMI] 40-49.9 kg/m2) and class IV obesity (BMI ≥ 50 kg/m2) on oocyte retrieval complications and outcomes. ⋯ Serious intraoperative and postoperative complications were uncommon across all BMI groups, though minor complications were more common with class III and class IV obesity. These patients were also more likely to require higher doses of propofol and fentanyl, have longer oocyte retrievals, and require a transabdominal retrieval. Overall, oocyte retrieval can be safely performed as an outpatient procedure in women with class III and class IV obesity.
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Fertility and sterility · Dec 2018
Cardiometabolic risks in polycystic ovary syndrome: long-term population-based follow-up study.
To evaluate the incidence of hypertension, metabolic syndrome, dyslipidemia, and obesity in comparing women with polycystic ovary syndrome (PCOS) and a control group of healthy women. ⋯ In this long-term population-based cohort study, the risk of developing hypertension and the metabolic syndrome in young women with PCOS was higher than in controls, but these risks were diluted in the late reproductive period.
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Fertility and sterility · Aug 2018
ReviewRecommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome.
What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? ⋯ The guideline was primarily funded by the Australian National Health and Medical Research Council of Australia (NHMRC) supported by a partnership with ESHRE and the American Society for Reproductive Medicine. Guideline development group members did not receive payment. Travel expenses were covered by the sponsoring organizations. Disclosures of conflicts of interest were declared at the outset and updated throughout the guideline process, aligned with NHMRC guideline processes. Full details of conflicts declared across the guideline development groups are available at https://www.monash.edu/medicine/sphpm/mchri/pcos/guideline in the Register of disclosures of interest. Of named authors, Dr Costello has declared shares in Virtus Health and past sponsorship from Merck Serono for conference presentations. Prof. Laven declared grants from Ferring, Euroscreen and personal fees from Ferring, Euroscreen, Danone and Titus Healthcare. Prof. Norman has declared a minor shareholder interest in an IVF unit. The remaining authors have no conflicts of interest to declare. The guideline was peer reviewed by special interest groups across our partner and collaborating societies and consumer organizations, was independently assessed against AGREEII criteria and underwent methodological review. This guideline was approved by all members of the guideline development groups and was submitted for final approval by the NHMRC.
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Fertility and sterility · Jun 2018
Observational StudyCumulative live birth rates in more than 3,000 patients with poor ovarian response: a 15-year survey of final in vitro fertilization outcome.
To estimate the cumulative live birth rates (CLBRs) in women with poor ovarian response (POR) diagnosed according to the Bologna criteria. ⋯ For women with POR, the CLBR declined with increasing age. Women with advanced age (≥38 years) achieved a significantly lower CLBR than young poor responders (<35 years). Very low CLBR was associated with women aged >43 years old. Natural cycle IVF is of no benefit for these patients.