Infertility therapy-associated multiple pregnancies (births): an ongoing epidemic

Adashi, Eli Y.; Barri, Pedro N.; Berkowitz, Richard L.; Braude, Peter; Bryan, Elizabeth; Carr, J. Walter; Cohen, Jean; Collins, John A.; Devroey, Paul; Frydman, René; Gardner, David K.; Germond, Marc; Gerris, Jan; Gianaroli, Luca; Hamberger, Lars; Howles, Colin M.; Jones, Howard W.; Lunenfeld, Bruno; Pope, A. L.; Reynolds, Meredith A.; Rosenwaks, Zev; Schieve, Laura A.; Serour, Gamal I.; Shenfield, Françoise; Templeton, Allan; Steirteghem, André Van; Veeck, Lucinda L.; Wennerholm, Ulla-Britt

doi:10.1016/s1472-6483(10)62069-x

Cited by 139 publications

(87 citation statements)

References 124 publications

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“…To balance the weakness of these morphological criteria and increase the pregnancy outcome, clinicians have resorted to transferring more than one embryo. Conse-quently, the incidence of multiple pregnancies, perinatal mortality as well as health problems for both the mother and the babies increased considerably [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of human oocyte developmental competence expressed in cumulus cells before ICSI: a preliminary study

Assidi

Montag

Ven

et al. 2010

J Assist Reprod Genet

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Purpose To identify reliable genomic biomarkers expressed in cumulus cells that accurately and non-invasively predict the oocyte developmental competence and reinforce the already used morphological criteria. Methods Eight consenting patients were selected for ovarian stimulation and ICSI procedures. Cumulus-oocyte complexes were transvaginally punctured and individually selected based on both good morphological criteria and high zona pellucida birefringence. Following ICSI, two 3-day embryos per patient were transferred. Pregnancy outcome was recorded and proven implantation was thereafter confirmed. Differential gene expression was assessed using two microarray platforms. Further real-time PCR validation, Ingenuity pathways analysis and intrapatient analysis were performed on 17 selected candidates. Results Seven genes were differentially (p≤0.05) associated to successful pregnancy and implantation. These biomarkers could be used to predict the oocyte developmental competence. Conclusions These genomic markers are a powerful reinforcement of morphological approaches of oocyte selection.Their large-scale validation could increase pregnancy outcome and single embryo transfer efficiency.

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Section: Introductionmentioning

confidence: 99%

Biomarkers of human oocyte developmental competence expressed in cumulus cells before ICSI: a preliminary study

Assidi

Montag

Ven

et al. 2010

J Assist Reprod Genet

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“…The rate of multiple pregnancies (twin, triplet, and higher-order ones) has increased in developed countries, including Japan for several decades (Imaizumi 1998;Kurosawa et al 2012), as a consequence of advanced maternal age and the development of fertility treatments (Adashi et al 2003;Templeton et al 2004). Twin pregnancies, constituting the vast majority of multiple ones, are subject to increased risks of having preterm and low birth weight infants compared with singleton pregnancies (Glinianaia et al 1998;McDonald et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan

Koshida

Ono

Tsuji

et al. 2016

Tohoku J. Exp. Med.

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Multiple pregnancies (twin, triplet, and higher-order pregnancy) are associated with an increased risk of resultant preterm and low birth weight infants. The increase of multiple pregnancies for several decades in Japan has been an important consideration in bed allocation planning for neonatal intensive care unit (NICU). The guideline of the Japan Society of Obstetrics and Gynecology (JSOG) in 2008 recommended that embryo transfer be limited to one. The epidemiological data of Japanese regional multiple pregnancies before the JSOG recommendation are valuable in assessing the perinatal effects after this recommendation. The aim of this study was to investigate regional backgrounds of multiple pregnancies and neonatal outcomes of multiple births including NICU admission before the JSOG recommendation. This is a retrospective population-based study for 20 months (January, 2007 through August, 2008 in Shiga Prefecture, Japan. Sending questionnaires to institutions treating multiple births in Shiga, we extracted relevant data from the responses of respective obstetricians and neonatologists. There were 245 multiple births including 241 twins and 4 triplets. We found more twin deliveries with higher risks such as monochorionic diamniotic twins or preterm twins less than 34 weeks in hospitals including perinatal centers than in primary obstetrics clinics. More than half of multiple-birth infants (57%) required NICU admission, and nearly 20% of NICU beds in Shiga are occupied with multiple-birth infants. Furthermore, half of multiple-birth infants were conceived with medical assistance. We conclude that multiple pregnancies resulting from medically assisted conception could have a significant impact upon the NICU bed occupancy in Japan.

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“…The necessity to decrease the multiple pregnancies incidence in assisted reproduction has become a health, economic and legal issue in many countries [1]. Meanwhile, the approach of transferring a single embryo is still challenging [2], since the identification of embryos with high implantation potential remains difficult.…”

Section: Introductionmentioning

confidence: 99%

The combination of pronuclear and blastocyst morphology: a strong prognostic tool for implantation potential

Braga

Setti

Figueira

et al. 2013

J Assist Reprod Genet

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Purpose To (i) investigate a possible association between different features of pronuclear (PN) morphology and different features of blastocyst morphology, (ii) evaluate the combination of PN and blastocyst morphologies as a predictive factor for ICSI outcomes and (iii) identify possible contributing factors to poor PN morphology. Methods This study included 908 normally fertilised zygotes reaching full blastocyst stage, obtained from 350 patients undergoing ICSI cycles, in which the implantations rates were 0 % or 100 %. The influence of PN morphology on blastocyst morphology and on the rates of pregnancy and miscarriage was investigated. Embryos were graded and split into three groups, taking into consideration both the PN and the blastocyst status. The pregnancy rate was compared among these groups. Results Inner cell mass (ICM) alterations were correlated with the number of nucleolar precursor bodies (NPB), while trophectoderm alterations were correlated with the size of the pronuclei and the distribution of the NPB. The distribution of the NPB had an impact on the chances of pregnancy. A significant difference was observed among the groups regarding the pregnancy rate. The maternal age, number of aspirated follicles and number of retrieved oocytes influenced the incidence of PN defects. Conclusions These findings suggest that a lower oocyte yield may lead to higher-quality PN zygotes. In addition, different PN features may influence further embryo development, especially the quality of the blastocyst. Moreover, the association between PN and blastocyst morphology may be used as a prognostic tool for implantation.

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Infertility therapy-associated multiple pregnancies (births): an ongoing epidemic

Cited by 139 publications

References 124 publications

Biomarkers of human oocyte developmental competence expressed in cumulus cells before ICSI: a preliminary study

Biomarkers of human oocyte developmental competence expressed in cumulus cells before ICSI: a preliminary study

Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan

The combination of pronuclear and blastocyst morphology: a strong prognostic tool for implantation potential

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