BackgroundThe transfer of multiple embryos after in vitro fertilization (IVF) increases the risk of twins and higher-order births. Multiple births are associated with significant health risks and maternal and neonatal complications, as well as physical, emotional, and financial stresses that can strain families and increase the incidence of depression and anxiety disorders in parents. Elective single embryo transfer (eSET) is among the most effective methods to reduce the risk of multiple births with IVF.Main bodyCurrent societal guidelines recommend eSET for patients <35 years of age with a good prognosis, yet even this approach is not widely applied. Many patients and clinicians have been reluctant to adopt eSET due to studies reporting higher live birth rates with the transfer of two or more embryos rather than eSET. Additional barriers to eSET include risk of treatment dropout after embryo transfer failure, patient preference for twins, a lack of knowledge about the risks and complications associated with multiple births, and the high costs of multiple IVF cycles. This review provides a comprehensive summary of strategies to increase the rate of eSET, including personalized counseling, access to educational information regarding the risks of multiple pregnancies and births, financial incentives, and tools to help predict the chances of IVF success. The use of comprehensive chromosomal screening to improve embryo selection has been shown to improve eSET outcomes and may increase acceptance of eSET.ConclusionseSET is an effective method for reducing multiple pregnancies resulting from IVF. Although several factors may impede the adoption of eSET, there are a number of strategies and tools that may encourage the more widespread adoption of eSET in clinical practice.
Background: International and market forces are key drivers of deforestation and forest degradation, with transnational and market-based solutions in land-use and forest governance often missing economic, distributive, and environmental targets. Methods: This paper tackles both the framing and effectiveness of transnational initiatives affecting forest lands and peoples in the Global South, and the quality of relationships between institutions in the Global North and the Global South. Through more equitable research partnerships, this paper draws lessons from case studies in Indonesia (legality verification system in different forest property regimes), the Democratic Republic of the Congo (lifting of a moratorium on new logging concession), and Brazil (FSC in the Amazon region and the Amazon Fund). Results: International partnerships have privileged market-based instruments and commodity exchange between Global South and Global North countries, and the benefits of such mechanisms are unevenly distributed. Complementary and alternative policy instruments are discussed for each geography. Conclusions: Glocalizing land-use and forest governance implies in advancing equitable research partnerships between institutions in the Global South and Global North, and strengthening a community of practice for critical enquiry and engagement in partnerships for sustainable development. Land-use, climate and forest governance mechanisms must redress power dynamics, and partnership models, and commit to improving well-being and sustainable livelihood outcomes.
The magnetic levitation platform consists of polymethyl methacrylate (PMMA), permanent neodymium magnets and aluminum-coated mirrors. 3-mm-thick PMMA components were cut with a laser cutter. A microchannel is placed between two permanent neodymium magnets (NdFeB) with same poles facing each other (1). We applied magnetic levitation principles to profile and sort cells from TESE samples, as a function of their unique levitation profiles. A tissue biopsy sample is suspended in a paramagnetic medium and introduced to the magnetic levitation platform. Tissue sample is levitated, sorted and flowed along the capillary, until they reached their equilibrium height within the system. Levitation heights were imaged an analyzed by in-house developed image analysis software. RESULTS: We have shown that sperm and RBCs in TESE samples have a uniquely different levitation and density signatures. Thus, sperm cells can be sorted and purified using the magnetic levitation system. CONCLUSIONS: Our preliminary results demonstrate that this simple, inexpensive and easy-to-use technology could revolutionize sperm isolation post TESE/TESA by significantly improving the simplicity, efficiency and yield of usable sperm after for ICSITESE/TESA.
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