262,251 research outputs found
Early loss rates of entire pregnancies after assisted reproduction are lower in twin than in singleton pregnancies.
No full textCase-control studies on plurality dependent spontaneous embryonic loss rates after assisted reproduction found that twin pregnancies have a two to five times lower miscarriage rate of the entire pregnancy compared with singletons
The 2004 Italian legislation on the application of assisted reproductive technology: epilogue.
No full textOBJECTIVE:
To evaluate how the unique Italian fertility regulations (≤3 inseminated oocytes/cycle, transfer of all embryos, prohibition of embryo cryopreservation) affected outcomes of ART.
STUDY DESIGN:
Case-control study from the Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. We compared outcomes of ART patients between five years before (n=1791) and five years after (n=2474) the implementation of the law.
RESULTS:
The mean embryo transfer (ET) rate was 3.1±2.1 and 1.7±1.1 before and after the law. Significantly more ICSI procedures were performed in women above 35 years old during the post-law period. The ET rate was higher before (88.6%) than after (80.5%) the law (OR 1.9, 95% CI 1.6, 2.2) especially in women >37 years undergoing ICSI (88.2 vs. 76.1%; OR 2.3, 95% CI 1.3, 4.2). The clinical pregnancy rates were practically unchanged but the proportion of triplet births significantly decreased after the law (10.3 vs. 4.1%, OR 2.7, 95% CI 1.4, 5.0).
CONCLUSION:
In contrast to interim analyses, we found that the statutory obligation to transfer all available embryos produced from up to three inseminated oocytes reduced the ET rates, especially in older women, and decreased the triplet births rate
Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology
No full textObjective: To evaluate the relationship between assisted reproduction technology (ART) and anxiety symptoms during late pregnancy and early parenthood. Method: Women with ART pregnancies were prospectively compared to their partners and to women with spontaneous pregnancies. The sample of 87 subjects, 48 ART (25 mothers and 23 fathers) and 39 non-ART mothers were given the ASQ-IPAT Anxiety Scale at 30-32 weeks of gestation, and at one week and three months after delivery. Results: The main socio-demographic and obstetrical characteristics were similar between groups. ART women showed higher scores for latent anxiety than non-ART women at three months after birth and showed no difference from ART men in all assessments. Manifest anxiety scores in ART women were higher, compared to non-ART women during the third trimester of pregnancy and one week after birth and were higher in all assessments when compared to ART men. Overall level of anxiety was higher in ART women in all assessments when compared to non-ART women and higher than in ART men during the two postnatal assessments. Conclusion: We confirm the higher level of anxiety that characterizes the pregnancy-birth process in ART pregnancies. In addition, the higher manifest anxiety present before delivery and one week post-partum can be explained by the special nature of these pregnancies. Psychological support should be offered to ART patients because anxiety is an important risk factor for maternal post-partum depression and can lead to negative effects on the neonate and on child emotional and behavioral development. © 2008 by Walter de Gruyter
Psychological vulnerability of singleton children after the "vanishing" of a co-twin following assisted reproduction
No full textWe test the hypothesis that parents who conceived twins by assisted reproduction technology (ART), but experienced loss of one twin, have a different parental-child relationship compared with ART parents following a singleton pregnancy. We used the 1994-2005 ART database of the Centre for Infertility of the Arcispedale Santa Maria Nuova in Reggio Emilia, Italy to identify families of 53 singleton births after the 'vanishing' twin syndrome. The controls comprised 106 families who conceived and delivered singletons, matched for gestational age (>/= 28 /= 32 /= 37 weeks), maternal age (< 35, >/= 35 40 years), child's age (1-3, 4-6, and 7-11 years) and child's gender. We completed 3 tests: a sociodemographic questionnaire, the QUIT - Italian Questionnaires of Temperament - motor scale, and the Child Vulnerability Scale. We found that children in the study had significantly more difficulties at the beginning of nursery school (p = .002) and kindergarten (p = .0005), with more frequent anxiety of separation from the parents (nursery school, p = .009; kindergarten, p = .001). We found a lower mean QUIT motor score for the 7- to 11-year-old children when compared to the general Italian normative values, suggesting that parents perceived their children as having more motor difficulties. In contrast, analysis of the Child Vulnerability Scale showed that significantly more parents (15.1%) from the controls perceived their child as vulnerable compared to those from the study group (3.8%), p = .034. We conclude that despite the perceived motor difficulties and the difficulties in the process of individuation-separation that appear at the beginning of the different educational circumstances, parents of singletons following the 'vanishing' twin syndrome perceive their children as 'invincible', and thus less vulnerable compared to controls
Depressive symptoms during late pregnancy and early parenthood following assisted reproductive technology
No full textObjective: To evaluate the relationship between assisted reproduction technology (ART) and depressive symptoms during late pregnancy and early parenthood. Design: Case-control longitudinal study. Setting: The Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Patient(s): Women who conceived by ART compared with men and compared with women following spontaneous conceptions. Intervention(s): The sample of 87 subjects, 48 ART (25 mothers, 23 fathers; response rate of 30%) and 39 non-ART mothers were evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at 30-32 weeks of gestation, and at 1 week and 3 months after delivery. Main Outcome Measure(s): Mean scores and prevalence of low scores. Result(s): The main sociodemographic and obstetric characteristics were similar between groups. Edinburgh Postnatal Depression Scale scores were higher in ART women compared with non-ART women during all assessments and higher during the third trimester of pregnancy and at 1 week postpartum compared with ART men. The prevalence of depressed subjects was significantly higher in ART women compared with non-ART women during the antenatal assessment. Conclusion(s): Assisted reproductive technology pregnancies are more frequently associated with depressive symptoms that may persist after delivery, suggesting a greater emotional vulnerability of these women. The risk of depression during and following ART pregnancies needs monitoring to avoid adverse effects of postpartum depression on the mother-infant relationship and infant's psychologic development. © 2009 American Society for Reproductive Medicine
The effect of legislation on outcomes of assisted reproduction technology: lessons from the 2004 Italian law.
No full textOBJECTIVE:
To evaluate the effect of the 2004 Italian regulations (insemination of <or=3 oocytes/cycle, transfer of all embryos, prohibition of embryo cryopreservation) on outcomes of assisted reproduction treatment (ART).
DESIGN:
Case-control study.
SETTING:
The Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
PATIENT(S):
Women undergoing ART for the first time.
INTERVENTION(S):
Comparing outcomes of ART between 2 years before (n = 900) and after (n = 936) the law's implementation (March 10, 2004).
MAIN OUTCOME MEASURE(S):
Rates of fertilization, pregnancy, "take-home baby," and multiple pregnancies.
RESULT(S):
During the pre-law period, statistically significantly more patients reached embryo transfer (odds ratio 1.9; 95% CI, 1.5, 2.5), and embryo transfer rate per cycle was statistically significantly higher (3.1 +/- 1.7 vs. 2.2 +/- 0.7), but the overall transfer of good embryos was lower (OR 0.6; 95% CI, 0.5, 0.8). The pregnancy rates per aspiration cycle were similar between the periods, but the pregnancy rate per embryo transfer and birth rate with at least one liveborn baby per embryo transfer were statistically significantly lower in the pre-law period (OR 0.7; 95% CI, 0.5, 0.9). The multiple births rate was not different between the two periods.
CONCLUSION(S):
In contrast to prior pessimistic expectations, the obligation to transfer all available embryos produced from <or=3 inseminated oocytes neither reduced success rates of ART nor increased the multiple births rate
Psychosocial support for infertile couples during assisted reproductive technology treatment.
No full textOBJECTIVE:
To evaluate the psychosocial support perceived by couples during assisted reproductive technology (ART) treatments.
DESIGN:
Prospective follow-up of patients undergoing ART.
SETTING:
Department of Obstetrics and Gynecology, S. Maria Nuova Hospital, Reggio Emilia, Italy.
PATIENT(S):
Eighty-three women and 83 men admitted for ART.
INTERVENTION(S):
Patients completed a sociodemographic questionnaire and the Multidimensional Scale of Perceived Social Support at the beginning of ovarian stimulation, upon oocyte pick-up, and 1 month after ET.
MAIN OUTCOME MEASURE(S):
Perception of psychosocial support.
RESULT(S):
Men, compared with women, consistently reported poorer perception of psychosocial support, especially from friends and significant others; family support showed no difference. Women showed a decrease in perceived support, especially from friends, in cases of failure. Both reported less support from significant others if they had previously already undergone ART treatments.
CONCLUSION(S):
Men might feel excluded from the treatment because of the greater attention to women, leading to feelings of isolation from friends and partners. Women suffer particularly in cases of failure that reconfirms the trauma of infertility. These psychological risk factors underline the usefulness of psychological support for these couples, especially in cases of prolonged infertility
Psychosocial support for infertile couples during assisted reproductive technology treatment
No full textObjective
To evaluate the psychosocial support perceived by couples during assisted reproductive technology (ART) treatments.
Design
Prospective follow-up of patients undergoing ART.
Setting
Department of Obstetrics and Gynecology, S. Maria Nuova Hospital, Reggio Emilia, Italy.
Patient(s)
Eighty-three women and 83 men admitted for ART.
Intervention(s)
Patients completed a sociodemographic questionnaire and the Multidimensional Scale of Perceived Social Support at the beginning of ovarian stimulation, upon oocyte pick-up, and 1 month after ET.
Main Outcome Measure(s)
Perception of psychosocial support.
Result(s)
Men, compared with women, consistently reported poorer perception of psychosocial support, especially from friends and significant others; family support showed no difference. Women showed a decrease in perceived support, especially from friends, in cases of failure. Both reported less support from significant others if they had previously already undergone ART treatments.
Conclusion(s)
Men might feel excluded from the treatment because of the greater attention to women, leading to feelings of isolation from friends and partners. Women suffer particularly in cases of failure that reconfirms the trauma of infertility. These psychological risk factors underline the usefulness of psychological support for these couples, especially in cases of prolonged infertility
Spontaneous embryonic loss following in vitro fertilization: incidence and effect on outcomes.
No full textOBJECTIVES:
The purpose of this study was to determine the early spontaneous loss rate in multiple pregnancies following assisted reproductive technology (ART).
STUDY DESIGN:
Analysis of pregnancies following ART as related to the initial number of embryos and maternal age was performed.
RESULTS:
At least one spontaneous loss was observed in 47.0% (95% CI 29.8-64.9) of quadruplets, 59.3% (95% CI 48.2-69.8) of triplets, and 35.2% (95% CI 29.6-41.2) of twins. The increased loss rates in mothers > or =35 years was related to early twin pregnancies, but not to early triplet and quadruplet gestations. We could not find an effect of the starting number of embryos on either gestational age or birth weight characteristics.
CONCLUSION:
Our observations did not identify a clear relation between early spontaneous loss of multiple gestations and either initial number of embryos or maternal age. Other factors might be involved in the outcome of ART multiple pregnancies
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