Reproductive biomedicine online

Description

An international journal, produced on web and in paper copy, devoted to biomedical research and ethical issues surrounding human conception and the welfare of the human embryo. The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy. Relevant topics include fertility and infertility, contraception, IVF and assisted reproduction, the preimplantation diagnosis of genetic disease, cloning, embryo stem cells, implantation and organogenesis, miscarriage, genetic disorders afflicting the embryo, and their alleviation, fetal operations and treatments, and the growth of embryos affected by these processes to term. Ethical and political topics arising through the treatment and care of various clinical conditions are presented. Counselling, news from wide sources, interviews with leading scientists and clinicians, replies to patients' queries, a manufacturers' corner, job opportunities, and other matters of relevance to the journal's fields of study will be presented on web, paper or both. Patients will not be counselled about their condition.

  • Impact factor
    2.68
  • 5-year impact
    2.52
  • Cited half-life
    4.80
  • Immediacy index
    0.72
  • Eigenfactor
    0.01
  • Article influence
    0.70
  • Website
    Reproductive BioMedicine Online website
  • Other titles
    Reproductive biomedicine online (Online), RBM online
  • ISSN
    1472-6491
  • OCLC
    52067842
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this prospective cohort study was to determine the time-course in androgen and semen parameters in men after weight loss associated with bariatric surgery. Six men aged 18–40 years, meeting National Institutes of Health bariatric surgery guidelines, were followed between 2005 and 2008. Study visits took place at baseline, then 1, 3, 6 and 12 months after surgery. All men underwent Roux-en-y gastric bypass (RYGB). At each visit, biometric, questionnaire, serum, and urinary specimens and seman analysis were collected. Urinary integrated total testosterone levels increased significantly (P < 0.0001) by 3 months after surgery, and remained elevated throughout the study. Circulating testosterone levels were also higher at 1 and 6 months after surgery, compared with baseline. Serum sex hormone-binding globulin levels were significantly elevated at all time points after surgery (P < 0.01 to P = 0.02). After RYGB surgery, no significant changes occurred in urinary oestrogen metabolites (oestrone 3-glucuronide), serum oestradiol levels, serial semen parameters or male sexual function by questionnaire. A threshold of weight loss is necessary to improve male reproductive function by reversing male hypogonadism, manifested as increased testosterone levels. Further serial semen analyses showed normal ranges for most parameters despite massive weight loss.
    Reproductive biomedicine online 11/2014;
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    ABSTRACT: The aim of this study was to identify whether progesterone measurement on the day after HCG administration has any additional clinical value, over that obtained from progesterone measurement on the day of HCG administration. This was a single-centre, non-interventional retrospective, observational, cohort of a consecutive series of 1457 ovarian stimulation cycles leading to fresh embryo transfer cycles between January 2011 and May 2013. Progesterone was found to rise and increase rapidly by about five-fold over a 24-h period. The result of logistic regression analysis suggests that progesterone measurement around the time of HCG administration is one of the three significant (P < 0.001) variables affecting clinical pregnancy rate. The predictive value of progesterone measurement on the day of HCG administration could be improved by having a further measurement 24-h later. If the progesterone levels on both days were normal, the implantation rate was 36%, but if the progesterone level on both days were high, the implantation rate dropped to 22%. Progesterone measurement should be considered on the day of HCG administration and also the day after HCG administration to provide clinically useful information on whether or not embryos should be frozen and transfer deferred to a subsequent cycle.
    Reproductive biomedicine online 11/2014;
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    ABSTRACT: Until recently, surrogacy was banned in Vietnam for all cases. The government, however, has altered its position on reproductive technology and will soon legalize non-commercial surrogacy among relatives. Motherhood is highly venerated in Vietnamese society and, under this local kinship conception, gestational process is of paramount importance in establishing a connection between the fetus and the woman. The implications of this new government decision for local kinship, motherhood and the individuals concerned will be discussed.
    Reproductive biomedicine online 11/2014;
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    ABSTRACT: The efficiency of a new vitrification technique using embryos obtained after abnormal fertilization was assesed. A total of 100 embryos were vitrified, 48 with the automatic dehydrated carrier (ADC) technique and 52 with cryotop. The survival rates in ADC and cryotop groups were similar (85.4% versus 92.3%). The loss rates of 10.4% for the ADC group and 1.9% for the cryotop group were not significantly different. The intact rate was significantly lower in the ADC group (26.8% versus 64.6%; P = 0.001). After 48 h of culture, blastocyst formation rates in the ADC and cryotop groups were 14.6% and 25.0%, respectively, which were not significantly different. In conclusion, the practicability of ADC vitrification was demonstrated. The study has some limitations, which necessitates further work.
    Reproductive biomedicine online 11/2014;
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    ABSTRACT: • A novel hysteroscopic technique for metroplasty, the “Hysteroscopic Outpatient Metroplasty to Expand Dysmorphic Uteri (HOME-DU technique)” was evaluated• The study was conducted on 30 infertile women with dysmorphic uterus (T-shaped and tubular-shaped/infantilis uteri) - as diagnosed by office hysteroscopy and three-dimensional trans-vaginal ultrasound - who underwent the HOME-DU technique• Our data seem to support the safety and efficacy of such outpatient technique in order to improve the volume and shape of dysmorphic uteri• The improvement of the uterine cavity volume and morphology may offer new approaches in increasing reproductive outcomes
    Reproductive biomedicine online 11/2014;
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    ABSTRACT: The use of dehydroepiandrosterone (DHEA) may improve ovarian stimulation outcomes in women of advanced reproductive age and could reduce embryo aneuploidy. In this prospective study, 48 women diagnosed with poor ovarian response received DHEA supplementation for at least 12 weeks. These women were compared with a group of poor responders (n = 113) who did not receive supplementation. During the study period, patients taking day 2 FSH and oestradiol were measured monthly before and after treatment. Stimulation characteristics, stimulation outcome and clinical outcome (clinical pregnancy and live birth rates) were reported. Evaluation of anti-Müllerian hormone (AMH) was carried out before initiation of treatment and immediately before the subsequent stimulation. Supplementation with DHEA for at least 12 weeks resulted in a modest, but statistically significant, increase in AMH levels and decrease in baseline FSH (P < 0.001 and P = 0.007, respectively). Administration of DHEA had no effect on any of the stimulation parameters nor was there any difference in clinical pregnancy rates and live birth rates between the two groups. Supplementation with DHEA significantly affects women with poor prognosis undergoing ovarian stimulation for IVF. Patients should be counselled about the uncertain effectivenessm, potential side-effects and cost of this treatment.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: In this study, the hypothesis that embryo development during routine IVF procedures is determined by pre-ovulatory follicular fluid composition was tested. Follicular fluid from women with obesity (‘obese’) and a ‘positive’ or ‘negative’ IVF outcome was added during the in-vitro maturation of bovine oocytes. ‘Negative’ and ‘obese’ follicular fluid reduced bovine embryo development, compared with the laboratory control embryo development (P < 0.05 or P < 0.1). The addition of follicular fluid also altered bovine blastocyst gene expression. Also, LDHA and PPARGC1B gene expression differed between follicular fluid groups. Data suggest that pre-ovulatory follicular fluid can potentially affect oocyte developmental competence and embryo quality. Furthermore, the bovine model may be used as a screening tool.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: Abortion legislation remains a contentious topic in the UK, which receives much attention from politicians, clinicians and professional bodies alike. In this study, the perspectives of general practitioners and obstetrics and gynaecology clinicians on the Abortion Act 1967 was explored. To this end, a short electronic questionnaire was distributed to all 211 GP and obstetrics and gynaecology clinicians affiliated with the University of Cambridge School of Clinical Medicine. Of the 100 anonymous responses collected, a significant majority felt that abortion law in Northern Ireland should be changed in line with the rest of the UK. The respondents' votes, however, were either opposed to or divided over any other changes to the Abortion Act, including altering the 24 week time limit, clarifying the legal definition of fetal abnormalities, introducing abortion purely on the woman's request, and modifying the requirement for two clinicians to approve any request for abortion. These perspectives were not entirely aligned with the recommendations of the Royal College of Obstetricians and Gynaecologists and the House of Commons Science and Technology Committee, or with current medical evidence and demographic data.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: Isolation of human follicles is based on digestion of the tissue by combinations of enzymes. Follicle vitality and morphology are often based on the analysis of pooled follicles of different maturation stages. Information is therefore lacking on the effect of the isolation protocol to individual follicles of different maturation stages. A study was conducted using five protocols combining different enzymes and varying concentrations. Isolated follicles were classified according to their maturation stages, counted and characterized for vitality, morphology, early apoptosis and organization of transzonal projections. No statistical differences were found between the protocols when outcome parameters were analysed on a pool of follicles regardless of their maturation status. Differences were observed in quality when the follicles were analysed separately according to their maturation status. Combining morphologic characteristics and vitality, both Liberase DH and Liberase TM combined with collagenase IV were better at isolating high-quality primordial follicles, compared with collagenase IV. No statistical difference between the isolation protocols was found for primary follicles. If only high-quality isolated secondary follicles are needed, collagenase IV is found to be most advantageous. Follicles of different maturation stages react differently when enzymatic isolation protocols are compared.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: The effects of childhood cancer therapy on ovarian reserve tests and on pubertal development within 5 years were compared with a control group. The study group was composed of 41 patients who underwent chemotherapy during pre-menarche (subgroup A; n = 15) and after menarche (subgroup B; n = 26); the control group was composed of 44 patients admitted with non-cancer related diseases (in total n = 85). Mean total ovarian volume and total antral follicle counts on ultrasound examination were significantly lower in the study group compared with the control group (3.5 ± 2.3 versus 5.2 ± 2.4 ml; P = 0.001; and 3.4 ± 3.3 versus 8.6 ± 3.5; P < 0.001, respectively). Mean FSH level was significantly higher in the control group (13.5 ± 16.2 versus 7.3 ± 2.7 mIU/ml; P = 0.017). Anti-Müllerian hormone levels in subgroup A were significantly higher than in subgroup B (1.8 ± 0.1 versus 1.5 ± 0.08 pg/dl; P = 0.034). In conclusion ovarian volume, antral follicle count and FSH can be used for evaluating the harmful effect of cancer chemotherapy on ovarian follicles. Post-menarche, Anti-Müllerian values reveal that ovarian follicles are more sensitive to the devastating effects of cytotoxic treatment.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: Preimplantation genetic diagnosis (PGD) for human leukocyte antigen (HLA) typing is an established procedure for conceiving a child who may donate cord blood or haematopoietic stem cells for transplantation to save an ill sibling. Haematopoietic stem cell transplantation (HSCT) from related matched donors improves overall survival compared with unrelated or non-matched donors. As IVF for PGD–HLA is unavailable for 70% of patients, it is a relevant clinical option. Recent success of HSCT after PGD–HLA, and excellent health and family support of the children born, suggests that debate over this kind of ‘designer baby’ and ‘gift of life’ should subside. Discussions about IVF for PGD–HLA should be held with families when a related matched-donor is unavailable, when HSCT can wait at least 9–12 months, within weeks of diagnosis irrespective of prognosis, and when the mother is of reproductive age. Related half-matched egg donors may also be considered. National and international collaborations should be established, and couples choosing this modality should be referred to experienced IVF and PGD centres. Clinical guidelines will improve physician and patient awareness of IVF for PGD-HLA and its role in advancing the clinical care of children in need of HSCT.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: 5'URR SNPs 1179G > A, -725C>G/T and -486A>C showed increase risk for idiopathic recurrent miscarriages.•Lower HLA-G mRNA level was seen for -1179G>A and -725C>G/T SNPs in idiopathic recurrent miscarriage cases compared with controls.•14bp Insertion allele showed susceptibility for idiopathic recurrent miscarriages.•5'URR SNPs -1306G>A, -1179G>A, -633G>A and -486A>C are in strong linkage disequilibrium with 14bp I/D.•5'URR SNPs along with 14bp I/D construct nine unique haplotype in North Indian.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: We studied the HRG C633T SNP in women with unexplained infertility undergoing IVF.•The HRG C633T SNP influences: 1) The number of oocytes retrieved and fertilized. 2) The proportion not undergoing embryo transfer due only obtaining poor quality embryos unfit for transfer.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: Infertility outcomes can be influenced by many factors. Although a number of treatments are offered, deciding which one to use first is a controversial topic. Although IVF may have superior efficacy in achieving a live birth with a reasonable safety profile, the availability of cheaper and less invasive treatments preclude its absolute use. For this reason, certain patient groups with ‘good-prognosis’ infertility are traditionally treated with less invasive treatments first. ‘Good-prognosis’ infertility may include unexplained infertility, mild male factor infertility, stage I or II endometriosis, unilateral tubal blockage and diminished ovarian reserve. Here, evidence behind the use of IVF as a first-line treatment is compared with its use as a last-resort option in women with ‘good-prognosis’ infertility.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: Conception of a child using cryopreserved sperm from a deceased man is generally considered ethically sound provided explicit consent for its use has been made, thereby protecting the man's autonomy. When death is sudden (trauma, unexpected illness), explicit consent is not possible, thereby preventing posthumous sperm procurement (PSP) and conception according to current European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine guidelines. Here, we argue that autonomy of a deceased person should not be considered the paramount ethical concern, but rather consideration of the welfare of the living (widow and prospective child) should be the primary focus. Posthumous conception can bring significant advantages to the widow and her resulting child, with most men supporting such practice. We suggest that a deceased man can benefit from posthumous conception (continuation of his ‘bloodline’, allowing his widow's wishes for a child to be satisfied), and has a moral duty to allow his widow access to his sperm, if she so wishes, unless he clearly indicated that he did not want children when alive. We outline the arguments favouring presumed consent over implied or proxy consent, plus practical considerations for recording men's wishes to opt-out of posthumous conception.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: In this prospective randomized study, the effect of daily gonadotrophin-releasing hormone agonist (GnRHa) in the luteal phase on IVF and intracytoplasmic sperm injection (ICSI) outcomes was assessed. Women (n = 446) were counselled for IVF–ICSI, and randomized on the day of embryo transfer to group 1 (daily 0.1 mg subcutaneous GnRHa until day of beta-HCG) (n = 224) and group 2 (stopped GnRHa on day of HCG injection) (n = 222). Both groups received daily vaginal progesterone suppositories. Primary outcome was clinical pregnancy rate. Secondary outcome was ongoing pregnancy rate beyond 20 weeks. Mean age, oestradiol on day of HCG, number of oocytes retrieved, number of embryos transferred, and clinical and ongoing pregnancy rates were 28.9 ± 4.5 years, 2401 ± 746 pg/mL; 13.5 ± 6.0 oocytes; 2.6 ± 0.6 embryos, and 36.2% and 30.4% consecutively in group 1 compared with 29.7 ± 4.7 years, 2483 ± 867 pg/mL, 13.7 ± 5.5 oocytes, 2.7 ± 0.6 embryos, 30.6% pregnancy rate, and 25.7% ongoing pregnancy rate in group 2. No significant difference was found between the groups. Subcutaneous GnRHa during the luteal phase of long GnRHa protocol cycles does not increase clinical or ongoing pregnancy rates after IVF–ICSI.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: Infertility rates vary with different definitions and study designs.•Incidence of infertility was obtained from a prospective follow-up study.•Couples who used coal as cooking fuel were more likely to have impaired fecundity.•Higher BMI and long-term health problems in women tended to reduce the fecundity.•Men who had married at later ages were more likely to have delayed pregnancies.
    Reproductive biomedicine online 10/2014;
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    ABSTRACT: A number of physiological events, such as sperm hyperactivation, chemotaxis towards the egg, capacitation and acrosome reaction, are triggered by activation of sperm ion channels in response to a diverse range of chemical cues. Cation channel of sperm (CatSper), a sperm-specific ion channel, is unique in orchestrating the events for fertilization, and seems to be exclusively evolved for sperm function and male fertility. CatSper acts as a polymodal, chemosensory calcium channel and plays a vital role in the regulation of sperm hyperactivation. CatSper knockout models and application of patch clamp recordings have shown that it is indispensable for male fertility, and mutations and deletions in CatSper gene(s) may lead to infertility. In fact, mutations in CatSper1 and 2 have been identified in infertile individuals; however, CatSper3 and 4 have not been explored. Restricted localization and expression of CatSper in sperm offer an added advantage to developing gamete-based safe non-hormonal contraceptives. This review concisely covers identification, structure, function, and mechanism of action of CatSper channels. The functional importance of this complex ion channel in sperm motility and male fertility is highlighted for further research on male fertility, infertility, and contraception.
    Reproductive biomedicine online 10/2014;