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The effect of assisted reproductive technology on postpartum bleeding: hormonal cycle frozen embryo transfer might increase blood loss

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JOURNAL OF ANESTHESIA 2024年第1期38卷 19-28页

作者： Taniguchi, Mizuki Akinaga, Chieko Suzuki, Kota Tarui, Kaori Tamura, Naoaki Shiko, Yuki Kawasaki, Yohei Nakajima, Yoshiki Hamamatsu Univ Dept Anesthesiol & Intens Care Med Sch Med 1-20-1 HandayamaHigashi Ku Hamamatsu 4313192 Japan Adachi Hosp Dept Anesthesiol Kyoto Japan Hamamatsu Univ Dept Obstet & Gynecol Sch Med Hamamatsu Japan Chiba Univ Hosp Clin Res Ctr Chiba Japan

Background Among assisted reproductive technologies, frozen thawed embryo transfer (FET) is associated with increased blood loss at delivery. Anesthesiologists need to be aware of new factors that affect postpartum blood loss. This study investigated whether FET cycles with or without hormonal support affect the amount of postpartum *** We conducted a retrospective cohort study of patients admitted for delivery at a single university hospital between January 2015 and December 2018. Patients were divided into no-assisted reproductive technology (No-ART), hormonal cycle FET (HC-FET) and natural cycle FET (NC-FET) group. The primary outcome was the amount of blood loss after delivery (median [interquartile range]), which was compared among the three groups. Multiple regression analysis was performed to investigate the factors affecting blood *** Between 2015 and 2018, 3187 women delivered neonates. In vaginal delivery, postpartum blood loss in the HC-FET group (1060 [830] g) was significantly greater than in the NC-FET group (650 [485] g, P = 0.001) and in the No-ART group (590 [420] g P < 0.001). Multiple linear regression analysis showed that HC-FET (P < 0.001) was one of the independent factors for the amount of bleeding. In cesarean delivery, the HC-FET group had more blood loss than the No-ART group (910 [676] g vs. 784 [524] g, P = 0.039). However, HC-FET was not an independent factor for postpartum blood *** The HC-FET group had more blood loss than the No-ART group for both vaginal and cesarean deliveries. Furthermore, HC-FET was an independent factor that increased postpartum blood loss in vaginal deliveries.

关键词： assisted reproductive technology Hormonal cycle frozen embryo transfer Postpartum bleeding Blood loss after delivery Postpartum hemorrhage

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Endometriosis-related infertility: severe pain symptoms do not impact assisted reproductive technology outcomes

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HUMAN REPRODUCTION 2024年第2期39卷 346-354页

作者： Maignien, C. Bourdon, M. Parpex, G. Ferreux, L. Patrat, C. Bordonne, C. Marcellin, L. Chapron, C. Santulli, P. Univ Paris Fac Sante Paris France Ctr Hosp Univ CHU Cochin Hop Univ Paris Ctr HUPC AP HP Dept Gynaecol Obstet & Reprod Med 2 123 Blvd Port Royal F-75014 Paris France INSERM U1016 Cochin Inst Dept Dev Reprod & Canc Paris France Ctr Hosp Univ CHU Cochin Hop Univ Paris Ctr HUPC AP HP Dept Reprod Biol Cochin India Ctr Hosp Univ CHU Hotel Dieu Hop Univ Paris Ctr HUPC AP HP Dept Radiol Paris France

STUDY QUESTION: Do severe endometriosis-related painful symptoms impact ART live birth rates?SUMMARY ANSWER: Severe pain symptoms are not associated with reduced ART live birth rates in endometriosis *** IS KNOWN ALREADY ART: is currently recognized as one of the main therapeutic options to manage endometriosis-related infertility. Presently, no data exist in the literature regarding the association between the core symptom of the disease, e.g. pain and ART reproductive *** DESIGN, SIZE, DURATION: Observational cohort study of 354 endometriosis patients, who underwent ART at a tertiary care university hospital, between October 2014 and October 2021. Diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography and magnetic resonance imaging, and histologically confirmed in women who had a previous history of endometriosis surgery (n = 127, 35.9%).PARTICIPANTS/MATERIALS, SETTING, METHODS: The intensity of painful symptoms related to dysmenorrhea (DM), dyspareunia (DP), noncyclic chronic pelvic pain, gastrointestinal (GI) pain, or lower urinary tract pain was evaluated using a 10-point visual analog scale (VAS), before ART. Severe pain was defined as having a VAS of 7 or higher for at least one symptom. The main outcome measure was the cumulative live birth rate (CLBR) per patient. We analyzed the impact of endometriosis-related painful symptoms on ART live births using univariable and multivariate *** RESULTS AND THE ROLE OF CHANCE: Three hundred and fifty-four endometriosis patients underwent 711 ART cycles. The mean age of the population was 33.8 +/- 3.7 years, and the mean duration of infertility was 3.6 +/- 2.1 years. The distribution of the endometriosis phenotypes was 3.1% superficial endometriosis, 8.2% ovarian endometrioma, and 88.7% deep infiltrating endometriosis. The mean VAS scores for DM, DP, and GI pain symptoms were 6.6 +/- 2.7, 3.4 +/- 3.1, and 3.1 +/- 3.6, respectively. Two hundred and

关键词： assisted reproductive technology endometriosis live birth severe pain symptom

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Hepatitis B virus impacts embryonic development and methylation of maternal genes in assisted reproductive technology patients

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JOURNAL OF assisted REPRODUCTION AND GENETICS 2025年第3期42卷 809-815页

作者： Liu, Xia Dong, Shixiang Ding, Yu Li, Jinjin Wang, Jingyuan Qingdao Univ Affiliated Hosp Dept Reprod Med 59 Haier Rd Qingdao 266000 Peoples R China Qingdao Univ Affiliated Hosp Dept Obstet & Gynecol 16 Jiangsu Rd Qingdao 266061 Peoples R China Qingdao Sixth Peoples Hosp Dept Hepatol 9 Fushun Rd Qingdao 266000 Peoples R China Qingdao Municipal Hosp Dept Reprod 5 Donghaizhong Rd Qingdao 266071 Peoples R China

Purpose: In China, the prevalence of hepatitis B virus (HBV) infection among infertile couples is a significant clinical problem. It is necessary to determine the effect of HBV infection on embryo development. Methods: The 4301 fresh cycles and 5763 frozen embryo transfer (FET) cycles were grouped according to the couple with or without HBV infection. The embryo fertilization rate, cleavage rate, transplantable embryo rate, and rate of high-quality embryos were analysed. The methylation status of maternal antigen that embryos require (MATER), zygote arrest 1 (ZAR1) and growth differentiation factor 9 (GDF9) genes in the peripheral blood of assisted reproductive technology (ART) women was detected by methylation-specific polymerase chain reaction (MSP). Results: The pregnancy rate of the female HBV-positive group was significantly lower than that of the HBV-negative group. The fertilization rate of intracytoplasmic sperm injection (ICSI) cycles in the male HBV-positive group was significantly lower than that of the male HBV-negative group. There were no differences in biochemistry or clinical pregnancy rates among the FET groups. The promoter methylation of GDF9 in HBV-positive ART women was higher than that in HBV-negative ART women, and that of ZAR1 in HBV-positive ART women was lower than that in HBV-negative ART women. Conclusion: It was a detrimental effect of HBV infection on in vitro fertilization (IVF) and ICSI treatment outcomes in women. The HBV infection was associated with the maternal genes promoting methylation.

关键词： Hepatitis B virus assisted reproductive technology Embryonic development Intracytoplasmic sperm injection

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Artificial intelligence and assisted reproductive technology: A comprehensive systematic review

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TAIWANESE JOURNAL OF OBSTETRICS & GYNECOLOGY 2025年第1期64卷 11-26页

作者： Wu, Yen-Chen Su, Emily Chia-Yu Hou, Jung-Hsiu Lin, Ching-Jung Lin, Krystal Baysan Chen, Chi-Huang Taipei Med Univ Hosp Dept Obstet & Gynecol Div Reprod Med Taipei Taiwan Taipei Med Univ Grad Inst Biomed Informat Taipei Taiwan Taipei Med Univ Grad Inst Med Sci Coll Med Taipei Taiwan Taipei Med Univ Coll Med Sch Med Dept Obstet & Gynecol Taipei Taiwan Taipei Med Univ Shuang Ho Hosp Dept Obstet & Gynecol Taipei Taiwan

The objective of this review is to evaluate the contributions of Artificial Intelligence (AI) to assisted reproductive Technologies (ART), focusing on its role in enhancing the processes and outcomes of fertility treatments. This study analyzed 48 relevant articles to assess the impact of AI on various aspects of ART, including treatment efficacy, process optimization, and outcome prediction. The effectiveness of different machine learning paradigms-supervised, unsupervised, and reinforcement learning-in improving ART-related procedures was particularly examined. The findings indicate that AI technologies significantly enhance ART processes by refining tasks such as embryo and sperm analysis and facilitating personalized treatment plans based on predictive modeling. Notable improvements were observed in the accuracy of diagnosing and predicting successful outcomes in fertility treatments. AI-driven models provided more precise forecasts of the optimal timing for clinical interventions such as egg retrieval and embryo transfer, which are critical to the success of ART cycles. The integration of AI into ART represents a transformative advancement, substantially improving the precision and efficiency of fertility treatments. The continuous evolution of AI methodologies is likely to further revolutionize this field, enabling more tailored and successful treatment approaches. AI is becoming an indispensable tool in reproductive medicine, enhancing both the effectiveness of treatments and the clinical decision-making process. This review underscores the potential of AI to act as a catalyst for innovative solutions in the optimization of ART. (c) 2024 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://***/licenses/by-nc-nd/4.0/).

关键词： Artificial intelligence assisted reproductive technology Machine learning Embryo selection Treatment outcome prediction

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Intimate partner violence in the context of infertility: voices from women seeking assisted reproductive technology treatment and clinicians' perspectives

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reproductive HEALTH 2024年第1期21卷 164页

作者： Fu, Yu Sun, Xueqi Kayimu, Kailibinuer Chen, Gong Wang, Yuanyuan Yang, Fan Peking Univ Natl Clin Res Ctr Obstetr & Gynecol Dis Ctr Reprod Med Dept Obstet & GynecolHosp 3Minist EducState Key Beijing 100191 Peoples R China Peking Univ Inst Populat Res 5 Yiheyuan Rd Beijing Peoples R China

BackgroundThe interplay between infertility and intimate partner violence (IPV) is a pressing global health issue, yet qualitative evidence on this phenomenon is limited. In order to measure and prevent IPV, it is pivotal to explore and integrate perceptions and experiences from those women with infertility themselves on IPV definition and its phenomenal manifestations in the context of *** study is undertaken as part of a year-long ethnographic research based at a reproductive medicine center in Beijing, China from July 2022 to July 2023. Individual interviews with women attending ART outpatient clinics and with clinicians involved in infertility treatment were conducted. Grounded Theory methodology was used to guide data analysis, which entailed a three-step analytical *** total of 37 women and five clinicians were interviewed. Incomplete conceptualization of IPV and high mental stress among patients were evident. IPV against women with infertility has been shown to be a specific and severe form of IPV. The phenomenal manifestation of IPV in the context of infertility often takes the form of psychological abuse, including stonewalling, threats of divorce, and non-compliance with ART *** study revealed that the burden of fertility disproportionately falls on women, often intensified by the involvement of other family and cultural norms, exacerbating gender inequalities and IPV risks. Findings from this study calls for an immediate and comprehensive response in healthcare practice. IPV screening, health education, and structural interventions should be introduced to prevent and mitigate this issue. The interplay between infertility and intimate partner violence (IPV) is a pressing global health issue, yet qualitative evidence on this phenomenon is limited. Therefore, in order to measure and prevent IPV, and to explore and integrate perceptions and experiences from these women with infertility themselves on IPV de

关键词： Intimate partner violence Domestic violence Infertility assisted reproductive technology Qualitative

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Association between being large for gestational age and cardiovascular metabolic health in children conceived from assisted reproductive technology: a prospective cohort study

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BMC MEDICINE 2024年第1期22卷 1页

作者： Zhang, Yiyuan Dai, Kexin Chen, Xiaojing Cui, Linlin Chen, Zi-Jiang Shandong Univ Inst Women Children & Reprod Hlth Cheeloo Coll Med Jinan 250012 Shandong Peoples R China Shandong Univ Hosp 2 Inst Women Children & Reprod Hlth Cheeloo Coll Med Jinan 250012 Shandong Peoples R China Shandong Univ State Key Lab Reprod Med & Offspring Hlth Jinan 250012 Shandong Peoples R China Shandong Univ Natl Res Ctr Assisted Reprod Technol & Reprod Gene Jinan 250012 Shandong Peoples R China Shandong Univ Key Lab Reprod Endocrinol Minist Educ Jinan 250012 Shandong Peoples R China Shandong Technol Innovat Ctr Reprod Hlth Jinan 250012 Shandong Peoples R China Shandong Prov Clin Res Ctr Reprod Hlth Jinan 250012 Shandong Peoples R China Shandong First Med Univ Shandong Prov Hosp Shandong Key Lab Reprod Med Jinan 250012 Peoples R China Chinese Acad Med Sci 2021RU001 Res Unit Gametogenesis & Hlth ART Offspring Jinan 250012 Shandong Peoples R China Shanghai Jiao Tong Univ Ren Ji Hosp Sch Med Dept Reprod Med Shanghai Peoples R China Shanghai Key Lab Assisted Reprod & Reprod Genet Shanghai Peoples R China

Background To the best of our knowledge, no study has investigated the potential joint effect of large for gestational age (LGA) and assisted reproductive technology (ART) on the long-term health of *** This was a prospective cohort study that recruited children whose parents had received ART treatment in the Center for reproductive Medicine, Shandong Provincial Hospital, affiliated to Shandong University, between January 2006 and December 2017. Linear mixed model was used to compare the main outcomes. The mediation model was used to evaluate the intermediary effect of body mass index (BMI).Results 4138 (29.5%) children born LGA and 9910 (70.5%) children born appropriate for gestational age (AGA) were included in the present study. The offspring ranged from 0.4 to 9.9 years. LGAs conceived through ART were shown to have higher BMI, blood pressure, fasting blood glucose, fasting insulin, and homeostatic model assessment of insulin resistance values, even after controlling for all covariates. The odds of overweight and insulin resistance are also higher in LGA subjects. After adjusting for all covariates, LGAs conceived through ART had BMI and BMI z-scores that were 0.48 kg/m2 and 0.34 units greater than those of AGAs, respectively. The effect of LGA on BMI was identified as early as infancy and remained consistently significant throughout *** Compared to AGA, LGA children conceived from ART were associated with increased cardiovascular-metabolic events, which appeared as early as infancy and with no recovery by pre-puberty.

关键词： Large for gestational age Cardiovascular metabolic health Obesity assisted reproductive technology

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Associations between exposure to phthalates and liver function among women undergoing assisted reproductive technology

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ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2024年 108卷 104463-104463页

作者： Wang, Yi Yin, Li Du, Yao-Yao Liao, Hong-Mei Li, Juan Yao, Wen Yuan, Xiao-Qiong Guo, Qing-Chun Deng, Tao -Ran Guo, Na Zhang, Min Zeng, Qiang Li, Chong Li, Yu Feng Huazhong Univ Sci & Technol Tongji Hosp Tongji Med Coll Reprod Med Ctr 1095 Jiefang Ave Wuhan 430030 Hubei Peoples R China Gen Hosp Cent Theater Command Wuhan Hubei Peoples R China Zhengzhou Univ Affiliated Hosp 3 Reprod Ctr Zhengzhou Peoples R China Huazhong Univ Sci & Technol Tongji Med Coll Sch Publ Hlth Dept Occupat & Environm Hlth Wuhan Hubei Peoples R China Shanghai Jiao Tong Univ Sch Med Sch Publ Hlth Dept Environm Hlth Shanghai Peoples R China

Phthalates can induce hepatotoxicity in animal studies. We aimed to assess the associations of individual and mixture of urinary phthalate metabolites with serum liver function indicators among 764 women undergoing assisted reproductive technology (ART). In linear models, we observed inverse correlations between urinary mono-benzyl phthalate and serum total protein (TP) as well as globulin (beta=-0.27 and -0.23, respectively, P<0.05). Additionally, negative associations were identified between mono-isobutyl phthalate and mono-butyl phthalate (MBP) and aspartate aminotransferase-to-alanine transaminase ratio (AST/ALT) (P<0.05). MBP and the sum of all phthalate metabolites (& sum;***.m) were positively associated with bilirubin, with beta ranging from 0.14 to 0.47. Most phthalate metabolites were also positively related to gamma-glutamyl transferase (GGT) (all P<0.05). In Bayesian kernel machine regression models, phthalate mixture was positively associated with bilirubin and GGT, whereas inversely associated with AST/ALT and TP. Our results suggest that phthalate exposure may impair liver function among women undergoing ART.

关键词： assisted reproductive technology Liver function Mixture analysis Phthalate Bilirubin Gamma-glutamyl transferase

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Impact of Systemic Lupus Erythematosus on Conception: Insights into Infertility, Fertility Preservation, assisted reproductive technology, and Pregnancy Outcomes

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SEMINARS IN reproductive MEDICINE 2024年第3期42卷 209-227页

作者： Moyer, Amanda Edens, Cuoghi Univ Chicago Med Sect Rheumatol Chicago IL 60637 USA Univ Chicago Med Sect Pediat Rheumatol Chicago IL 60637 USA Stanford Med Dept Med Div Immunol & Rheumatol Stanford CA USA Stanford Med Dept Pediat Div Allergy Immunol & Rheumatol Stanford CA USA

Many individuals with systemic lupus erythematosus (SLE) face significant challenges manifesting their family planning goals due to numerous factors, including disease-related complications, treatment-induced effects, immunological factors, self-imposed limitations, and the socioeconomic impacts of having a chronic disease. Instances of unexplained infertility are also prevalent. Encouragingly, advancements in treatment modalities, risk factor management, specialized training within the medical community, and enhanced patient/provider education have contributed to an increase in successful pregnancies among SLE patients, fostering a safer, more promising reproductive landscape. However, despite advances, individuals with SLE continue to struggle with the complexities of family building. This review explores infertility and pregnancy outcomes in SLE, fertility preservation, the role of assisted reproductive technology, and considerations for tailoring these approaches to SLE patients.

关键词： infertility systemic lupus erythematosus pregnancy assisted reproductive technology surrogacy

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A Qualitative Study on the Experience of assisted reproductive technology in Women with Dyspareunia

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INTERNATIONAL JOURNAL OF WOMENS HEALTH 2024年 16卷 543-553页

作者： Wei, Qun Wang, Zilian He, Yu Hong, Xia Shen, Xuling Zhang, Songying Zhejiang Univ Sir Run Run Shaw Hosp Coll Med Reprod Med Ctr Hangzhou Zhejiang Peoples R China

Objective: This study aims to investigate the phenomenon of sexual intercourse-related fear among women utilizing assisted reproductive technology due to dyspareunia. The primary objective is to offer insights that can inform the development of targeted nursing interventions. Methods: Employing a purposive sampling approach, a cohort of 23 female patients experiencing dyspareunia and undergoing July 2022 and December 2022, were selected as participants for this research. Semi-structured, in-depth interviews were conducted to gather qualitative data. The Colaizzi 7-step analysis method was subsequently applied to scrutinize the interview transcripts and identify emergent themes. Results: The analysis yielded five prominent themes: psychological disturbances, incongruent cognitive perceptions, anticipations regarding conception, insufficient adaptive responses, and sexual expectations. Conclusion: It is imperative for medical practitioners to demonstrate reverence for patients' sexual beliefs and conditions, attune to their apprehensions, and offer efficacious emotional support. Tailored and multifaceted sexual health knowledge should be dispensed based on patients' individual requirements and their envisioned sexual experiences, thereby fostering spousal and familial harmony. By prioritizing patients' sexual well-being, cultivating a compassionate medical milieu, and augmenting the quality of assisted reproductive services, comprehensive improvements can be achieved.

关键词： dyspareunia female assisted reproductive technology qualitative research

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Pregnancy following assisted reproductive technology in morbidly obese patients: assessment of feto-maternal outcomes

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JOURNAL OF assisted REPRODUCTION AND GENETICS 2024年第4期41卷 903-914页

作者： Song, Bonnie B. Mandelbaum, Rachel S. Anderson, Zachary S. Masjedi, Aaron D. Harris, Chelsey A. Violette, Caroline J. Ouzounian, Joseph G. Matsuo, Koji Paulson, Richard J. Univ Southern Calif Dept Obstet & Gynecol Div Gynecol Oncol 2020 Zonal AveIRD520 Los Angeles CA 90033 USA Univ Southern Calif Dept Obstet & Gynecol Div Reprod Endocrinol & Infertil Los Angeles CA USA Univ Southern Calif Dept Obstet & Gynecol Div Maternal Fetal Med Los Angeles CA USA Univ Southern Calif Norris Comprehens Canc Ctr Los Angeles CA 90033 USA

Purpose To examine feto-maternal characteristics and outcomes of morbidly obese pregnant patients who conceived with assisted reproductive technology (ART). Methods This cross-sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. Study population was 48,365 patients with ART pregnancy from January 2012 to September 2015, including non-obesity (n = 45,125, 93.3%), class I-II obesity (n = 2445, 5.1%), and class III obesity (n = 795, 1.6%). Severe maternal morbidity at delivery per the Centers for Disease and Control Prevention definition was assessed with multivariable binary logistic regression model. Results Patients in the class III obesity group were more likely to have a hypertensive disorder (adjusted-odds ratio (aOR) 3.03, 95% confidence interval (CI) 2.61-3.52), diabetes mellitus (aOR 3.08, 95%CI 2.64-3.60), large for gestational age neonate (aOR 3.57, 95%CI 2.77-4.60), and intrauterine fetal demise (aOR 2.03, 95%CI 1.05-3.94) compared to those in the non-obesity group. Increased risks of hypertensive disease (aOR 1.35, 95%CI 1.14-1.60) and diabetes mellitus (aOR 1.39, 95%CI 1.17-1.66) in the class III obesity group remained robust even compared to the class I-II obesity group. After controlling for priori selected clinical, pregnancy, and delivery factors, patients with class III obesity were 70% more likely to have severe maternal morbidity at delivery compared to non-obese patients (8.2% vs 4.4%, aOR 1.70, 95%CI 1.30-2.22) whereas those with class I-II obesity were not (4.1% vs 4.4%, aOR 0.87, 95%CI 0.70-1.08). Conclusions The results of this national-level analysis in the United States suggested that morbidly obese pregnant patients conceived with ART have increased risks of adverse fetal and maternal outcomes.

关键词： Pregnancy assisted reproductive technology Morbid obesity Intrauterine fetal demise Severe maternal morbidity

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