D M Saunders

University of Sydney, Sydney, New South Wales, Australia

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Publications (29)138.75 Total impact

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    ABSTRACT: STUDY QUESTION: Is anxiety focused on the pregnancy outcome, known to be particularly salient in women conceiving through assisted reproductive technology (ART), related to difficult infant temperament? SUMMARY ANSWER: While trait anxiety predicts infant temperament, pregnancy-focused anxiety is not associated with more difficult infant temperament. WHAT IS KNOWN ALREADY: A large body of research has provided convincing evidence that fetal exposure to maternal anxiety and stress in pregnancy has adverse consequences for child neurodevelopmental, behavioural and cognitive development, and that pregnancy-specific anxiety (concerns related to the pregnancy outcome and birth) may be of particular significance. Women conceiving through ART are of particular interest in this regard. Research over more than 20 years has consistently demonstrated that while they do not differ from spontaneously conceiving (SC) women with respect to general (state and trait) anxiety, they typically report higher pregnancy-specific anxiety. While research suggests normal behavioural and developmental outcomes for children conceived through ART, there is some evidence of more unsettled infant behaviour during the first post-natal year. STUDY DESIGN, SIZE, DURATION: The longitudinal cohort design followed 562 nulliparous women over a 7-month period, during the third trimester of pregnancy and at 4 months after birth. PARTICIPANTS/MATERIALS, SETTING, METHODS: Approximately equal numbers of nulliparous women conceiving through ART (n = 250) and spontaneously (SC: n = 262) were recruited through ART clinics and nearby hospitals in Melbourne and Sydney, Australia. Participants completed three anxiety measures (state, trait, pregnancy specific) at time 1 in the third trimester of pregnancy and a measure of infant temperament at time 2, 4 months after birth. At time 1, relevant socio-demographic, pregnancy (maternal age, smoking, alcohol, medications, medical complications) information was recorded and at time 2, information regarding childbirth (gestation, infant birthweight, mode of delivery) and post-natal (concurrent mood) variables was recorded and controlled for in analyses. MAIN RESULTS AND THE ROLE OF CHANCE: In the third trimester of pregnancy, women conceiving through ART reported lower state and trait anxiety, but higher pregnancy-focused anxiety than their SC counterparts (all Ps < 0.05). Hierarchical regression analyses including mode of conception, all anxiety variables and relevant covariates indicated that while trait anxiety in pregnancy predicted more difficult infant temperament (P < 0.001), pregnancy specific and state anxiety did not. Mode of conception predicted infant temperament; with ART women reporting less difficult infant temperament (P < 0.001) than their SC counterparts. LIMITATIONS, REASONS FOR CAUTION: The major limitations in the study are the reliance on a self-report measure of infant temperament and the fact that the study did not assess quality of caregiving which may moderate the effect of pregnancy anxiety on infant temperament. WIDER IMPLICATIONS OF THE FINDINGS: This study is the first to our knowledge to prospectively examine the impact of gestational stress (pregnancy anxiety) on infant temperament in women conceiving through ART. Findings confirm existing research indicating that trait anxiety in pregnancy is associated with difficult infant temperament and suggest that pregnancy-specific anxiety (measured in the third trimester) is not implicated. These findings are reassuring for women conceiving through ART whose pregnancies may be characterized by particularly intense concerns about the wellbeing of a long sought after baby. STUDY FUNDING/COMPETING INTEREST(S): The study was funded by a grant from the Australian Research Council (ARC) and in kind and financial contributions from IVF Australia and Melbourne. TRIAL REGISTRATION NUMBER: N/A.
    Human Reproduction 02/2013; · 4.67 Impact Factor
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    ABSTRACT: To evaluate whether older first-time mothers (≥37 years) have higher rates of postpartum depression compared with younger first-time mothers, controlling for mode of conception and known risk factors for postpartum depression. Prospective cohort study. Assisted reproductive technology (ART) clinics in two large Australian cities and public and private antenatal clinics and/or classes in the vicinity of ART clinics. Nulliparous women who had conceived spontaneously (n = 295) or through ART (n = 297) in three age-groups: younger, 20 to 30 years (n = 173); middle, 31 to 36 years (n = 214); and older, ≥37 years (n = 189). Semistructured interviews and questionnaires. Major depressive disorder in the first 4 months after birth as assessed by structured diagnostic interview. The study performed 592 complete pregnancy assessments and 541 postpartum assessments. The prevalence of major depressive disorder was 7.9%, at the lower end of community rates. Neither maternal age-group nor mode of conception was statistically significantly related to depression. Older first-time mothers, whether conceiving through ART or spontaneously, do not show increased vulnerability to postnatal depression.
    Fertility and sterility 09/2011; 96(5):1218-24. · 3.97 Impact Factor
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    Eliza C Curnow, John P Ryan, Douglas M Saunders, Eric S Hayes
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    ABSTRACT: To assess the effect of glutathione ethyl ester (GSH-OEt) on the development of macaque metaphase (MI) oocytes as a model for human MI oocyte in vitro maturation (IVM). Prospective cohort study. Nonhuman primate assisted reproductive technology program. Twenty-three Macaca fascicularis females aged 6.5-12.5 years. Ovarian stimulation and maturation of MI oocytes in [1] human tubal fluid (HTF), [2] mCMRL-1066, [3] mCMRL-1066+GSH-OEt 3 mM, or [4] mCMRL-1066+GSH-OEt 5 mM. Oocytes were assessed for maturation after 4-6 hours (early) and 18-20 hours (late) of culture. Mature oocytes were inseminated or subjected to glutathione (GSH) assay. Zygotes were cultured to the blastocyst stage for total differential cell counts. Oocyte maturation rate, GSH content, pronuclear formation and blastocyst development, and cell number were compared between IVM treatment groups and sibling in vivo matured (IVO) MII oocytes. Compared with HTF, mCMRL-1066 supported higher rates of normal fertilization and blastocyst development in early but not late maturing MI-MII oocytes. Five micromoles of GSH-OEt significantly increased blastocyst total cell and inner cell mass cell number in early MI-MII oocytes compared with IVO and IVM controls. GSH-OEt significantly increased oocyte GSH content and fertilization in late maturing oocytes but not blastocyst development. GSH-OEt positively affects the development of early and late maturing IVM oocytes.
    Fertility and sterility 03/2011; 95(4):1235-40. · 3.97 Impact Factor
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    ABSTRACT: It is increasingly common for women in high-income countries to delay childbearing. We aimed to describe the context of pregnancy for first-time mothers of different ages and examine relationships among maternal age at first birth, mode of conception and psychosocial wellbeing in pregnancy. Using stratified sampling, we recruited similar numbers of women conceiving through assisted reproductive technology (ART; n = 297) or spontaneously (n = 295) across three age groups: younger, ≤ 20-30 years; middle, 31-36 years; older, ≥ 37 years. Women participated in a structured interview and completed validated questionnaires assessing socio-economic status, personality, quality of partner relationship, state and trait anxiety, pregnancy-focused (P-F) anxiety and maternal-fetal attachment. Older maternal age was associated with lower depression and anxiety symptoms, lower maternal-fetal attachment (P< 0.05), greater psychological hardiness (resilience) (P< 0.001) and lower ratings of control in the partner relationship (P< 0.05) at a univariate level. ART conception, but not older maternal age, was associated with more P-F anxiety. Although most main effects of age and mode of conception became non-significant after controlling for contextual/reproductive history variables, a significant association between ART conception and more intense fetal attachment emerged (P< 0.05). Women having their first baby when older appear to have some psychological advantages over their younger counterparts; they are more resilient, report their partners as less controlling and report lower symptoms of depression and anxiety during pregnancy. However, women conceiving through ART have a more complex experience of pregnancy, simultaneously experiencing more P-F anxiety and more intense emotional attachment to the fetus.
    Human Reproduction 03/2011; 26(6):1389-98. · 4.67 Impact Factor
  • E C Curnow, J P Ryan, D M Saunders, E S Hayes
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    ABSTRACT: During oocyte growth chromatin configuration of the germinal vesicle (GV) oocyte undergoes modification in relation to changes in transcriptional activity crucial for conferring meiotic as well as developmental competence on the oocyte. In the macaque oocyte, there are 3 distinct GV states: GV1, noncondensed chromatin; GV2, an intermediate state; and GV3, condensed chromatin. The aim of this study was to test the effects of a prematuration culture (PMC) system, using the phosphodiesterase type 3 inhibitor milrinone (MIL), on the synchronization of GV chromatin to the GV3 stage and assess metaphase II (MII) oocyte reduced glutathione (GSH) content as a measure of cytoplasmic maturation. Reagents were purchased from Sigma (St. Louis, MO, USA) unless stated otherwise. To assess the effect of PMC on GV chromatin status, immature oocytes retrieved from unstimulated ovaries were either fixed (2% paraformaldehyde+0.1% Triton-X100) immediately after follicular aspiration (t=0) or after culture in a humidified atmosphere of 6% CO(2) in air at 37°C for 24h in modified Connaught Medical Research Laboratories medium (mCMRL) supplemented with 10% FCS (Hyclone, Logan, UT, USA) and 12.5μM MIL in the absence (MILNil) or presence of 1.0 IU of FSH (MILFSH). For chromatin assessment, fixed GV oocytes were stained with 5μgmL(-1) of 4',6-diamidino-2-phenylindole (Molecular Probes, Leiden, the Netherlands) and imaged using confocal microscopy. Following PMC, MILFSH oocytes were transferred to fresh mCMRL+FCS supplemented with 1.0 IU of recombinant human FSH and 1.0 IU of hLH and cultured for a further 30h. Control and MILFSH oocytes were denuded of cumulus cells and assessed for maturation. The MII oocytes were prepared for GSH analysis, and total GSH content was determined using a commercial 5,5'-dithio-bis(2-nitrobenzoic acid) (DTNB)-GSH reductase recycling assay kit (North-West Life Science). The MII rates were compared using chi-square. Differences in oocyte GSH content were compared using t-test. Significant differences were determined at P<0.05. There was no significant difference in the proportion of oocytes remaining at the GV stage following 24h of PMC in MILNil or MILFSH (42/44, 96% v. 32/35, 91%, respectively). However, there was a significant reduction in GV1 chromatin (15/49, 31% v. 28/54, 52% and 22/58, 38%) and a significant increase in GV3 chromatin (23/49, 47% v. 14/54, 26% and 16/58, 28%) observed in MILFSH oocytes compared with both MILNil and t=0 oocytes, respectively. The MII rate of MILFSH oocytes following in vitro maturation was significantly higher compared with the MII rate of control in vitro matured oocytes (91/167, 55% v. 83/243, 34%). There was no significant difference in the GSH content of GV oocytes from the time of oocyte collection (t=0) or GV oocytes following PMC in MILFSH (3.69±0.16 and 4.14±0.28 pmol/oocyte, n=39-49 oocytes). The GSH content of control in vitro matured MII oocytes was significantly greater than that of MILFSH-treated MII oocytes (3.13±0.16 v. 2.02±0.04 pmol/oocyte, n=53-54 oocytes). The PMC supported high rates of nuclear maturation, but cytoplasmic maturation, assessed by GSH content, was negatively affected. Further assessment following fertilization and development is required to determine the practical utility of PMC in a primate in vitro maturation setting.
    Reproduction Fertility and Development 01/2011; 23(1):224-225. · 2.58 Impact Factor
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    E C Curnow, J P Ryan, D M Saunders, E S Hayes
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    ABSTRACT: The inadequacies of oocyte in vitro maturation (IVM) systems for both non-human primates and humans are evidenced by reduced fertilization and poor embryonic development, and may be partly explained by significantly lower glutathione (GSH) contents compared with in vivo matured (IVO) oocytes. As this influence has not been fully explored, this study investigated the effect of the GSH donor, glutathione ethyl ester (GSH-OEt), on the IVM and development of macaque oocytes as a model of human oocyte IVM. Macaque oocytes derived from unstimulated ovaries were cultured in mCMRL-1066 alone or supplemented with 3 or 5 mM GSH-OEt. In vitro matured oocytes were subjected to the GSH assay, fixed for the assessment of spindle morphology or prepared ICSI. Embryo development of zygotes cultured in mHECM-9 was assessed up to Day 9 post-ICSI. RESULTS Supplementation of the maturation medium with GSH-OEt significantly increased oocyte maturation and normal fertilization rates compared with control oocytes, but only 5 mM GSH-OEt significantly increased the oocyte and cumulus cell GSH content. Confocal microscopy revealed significant differences in the spindle morphology between IVO and control in vitro matured metaphase II oocytes. Oocytes matured with 5 mM GSH-OEt exhibited spindle area and spindle pole width similar to that seen in the IVO oocyte. While no significant differences were observed in blastocyst rates, addition of 3 mM GSH-OEt during IVM significantly increased the proportion of embryos developing to the 5-8 cell stage while 5 mM GSH-OEt significantly increased the proportion of morula-stage embryos compared with controls. Supplementation of the IVM medium with GSH-OEt promotes better maturation and normal fertilization of macaque oocytes compared with non-supplemented medium. However, further improvement of the primate oocyte IVM culture system is required to support better blastocyst development of oocytes derived from unstimulated ovaries.
    Human Reproduction 10/2010; 25(10):2465-74. · 4.67 Impact Factor
  • E C Curnow, J P Ryan, D M Saunders, E S Hayes
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    ABSTRACT: Glutathione (GSH) is synthesised during oocyte maturation and represents the oocyte's main non-enzymatic defence against oxidative stress. Inadequate defence against oxidative stress may be related to poor embryo quality and viability. In the present study, bovine oocytes were matured in vitro in the presence of GSH ethyl ester (GSH-OEt), a cell permeable GSH donor, and its effects on subsequent fertilisation and embryo development were assessed. GSH-OEt significantly increased the GSH content of IVM oocytes without affecting fertilisation or Day 3 cleavage rates. Maturation in the presence of GSH-OEt did not significantly increase the blastocyst rate compared with control oocytes. However, 5 mM GSH-OEt treatment resulted in significantly higher blastocyst total cell number. The GSH level of IVM oocytes was significantly decreased in the absence of cumulus cells and when cumulus-oocyte complexes were cultured in the presence of buthionine sulfoximine (BSO), an inhibitor of GSH synthesis. The addition of GSH-OEt to cumulus-denuded or BSO-treated oocytes increased the GSH content of bovine oocytes and restored the rate of normal fertilisation, but not embryo development, to levels seen in control oocytes. Thus, GSH-OEt represents a novel approach for effective in vitro elevation of bovine oocyte GSH and improvement in blastocyst cell number.
    Reproduction Fertility and Development 01/2010; 22(4):597-605. · 2.58 Impact Factor
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    E C Curnow, J P Ryan, D M Saunders, E S Hayes
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    ABSTRACT: Fertilisation and development of IVM non-human primate oocytes is limited compared with that of in vivo-matured (IVO) oocytes. The present study describes the IVM of macaque oocytes with reference to oocyte glutathione (GSH). Timing of maturation, comparison of IVM media and cysteamine (CYS) supplementation as a modulator of GSH were investigated. A significantly greater proportion of oocytes reached MII after 30 h compared with 24 h of IVM. Following insemination, IVM oocytes had a significantly lower incidence of normal fertilisation (i.e. 2PN = two pronuclei and at least one polar body) and a higher rate of abnormal fertilisation (1PN = one pronucleus and at least one polar body) compared with IVO oocytes. Immunofluorescence of 1PN zygotes identified incomplete sperm head decondensation and failure of male pronucleus formation as the principal cause of abnormal fertilisation in IVM oocytes. The IVO oocytes had significantly higher GSH content than IVM oocytes. Cumulus-denuded oocytes had significantly lower GSH following IVM compared with immature oocytes at collection. Cysteamine supplementation of the IVM medium significantly increased the GSH level of cumulus-intact oocytes and reduced the incidence of 1PN formation, but did not improve GSH levels of the denuded oocyte. Suboptimal GSH levels in macaque IVM oocytes may be related to reduced fertilisation outcomes.
    Reproduction Fertility and Development 01/2010; 22(6):1032-40. · 2.58 Impact Factor
  • E C Curnow, J Ryan, D Saunders, E S Hayes
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    ABSTRACT: Glutathione (GSH) is the main non-enzymatic defence against oxidative stress and is a critical intracellular component required for oocyte maturation. In the present study, several modulators of intracellular GSH were assessed for their effect on the in vitro maturation (IVM) and intracellular GSH content of bovine metaphase (MII) oocytes. Of the five GSH modulators tested, only the cell-permeable GSH donor glutathione ethyl ester (GSH-OEt) significantly increased the GSH content of IVM MII oocytes in a concentration-dependent manner without adversely affecting oocyte maturation rate. The GSH level in IVM MII oocytes was greatly influenced by the presence or absence of cumulus cells and severely restricted when oocytes were cultured in the presence of buthionine sulfoximine (BSO), an inhibitor of GSH synthesis. The addition of GSH-OEt to cumulus-denuded or BSO-treated oocytes increased the GSH content of bovine MII oocytes. Supplementation of the maturation medium with bovine serum albumin (BSA) or fetal calf serum (FCS) affected the GSH content of IVM MII oocytes, with greater levels attained under BSA culture conditions. The addition of GSH-OEt to the maturation medium increased the GSH content of IVM MII oocytes, irrespective of protein source. Spindle morphology, as assessed by immunocytochemistry and confocal microscopy, displayed distinct alterations in response to changes in oocyte GSH levels. GSH depletion caused by BSO treatment tended to widen spindle poles and significantly increased spindle area. Supplementation of the IVM medium with GSH-OEt increased spindle length, but did not significantly alter spindle area or spindle morphology. GSH-OEt represents a novel oocyte-permeable and cumulus cell-independent approach for effective elevation of mammalian oocyte GSH levels.
    Reproduction Fertility and Development 02/2008; 20(5):579-88. · 2.58 Impact Factor
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    ABSTRACT: Glutathione is the main non-enzymatic defense against oxidative stress and a critical part of oocyte maturation and normal fertilization. Our aim was to test different strategies to manipulate cellular glutathione (GSH) content of bovine in-vitro-matured (IVM) oocytes and study the development of embryos produced from such oocytes. The reducing agents lipoic acid (LA, intracellular) and dihydrolipoic acid (DHLA, extracellular) were compared to the cell-permeable reduced glutathione (GSH) donor glutathione ethyl ester (OET) for their effect on oocyte GSH content, oocyte maturation, and blastocyst development (OET only). Reagents were purchased from Sigma (St. Louis, MO, USA) unless stated otherwise. Cumulus–oocyte complexes (COCs) were aspirated from abattoir-derived ovaries and matured for 24 h in a humidified atmosphere of 6% CO2 at 38.5°C in modified tissue culture medium (mTCM199) supplemented with 2% (LA, DHLA) or 10% (OET) fetal calf serum (FCS; Gibco, Grand Island, NY, USA), 0.1 IU bLH and 0.1 IU bFSH (Sioux Biochemicals, Sioux City, IA, USA). COCs were matured in the presence of either LA (100 µm) or DHLA (100 µm) alone or in combination with L-cystine (CYS; 0.6 mm), CYS alone, or OET at 1, 3, and 5 mm. COCs matured under control and experimental conditions were denuded of cumulus cells (40 IU hyaluronidase) and scored for maturity. GSH content of MII oocytes was determined by colorimetric assay (Northwest Life Science Specialties, LLC, Vancouver, WA, USA). Oocytes matured in OET were inseminated with frozen/thawed bull sperm (2 × 106 mL-1), cultured to the blastocyst stage (COOK bovine medium, COOK Australia, Brisbane, Queensland, Australia), and subjected to differential cell count (propidium iodide/Hoechst). GSH levels (mean ± SEM) and developmental data (percentage) are expressed for n = 18–73 oocytes or embryos and were analyzed by ANOVA or chi-square test (significance, P ≤ 0.05). LA alone failed to increase oocyte GSH content over 2% FCS control levels (6.98 ± 0.22 pmol/oocyte v. 5.26 ± 0.4 pmol/oocyte). DHLA alone significantly increased oocyte GSH content (9.64 ± 0.8 pmol/oocyte) compared to both LA and controls (10% FCS; 4.78 ± 0.36 pmol/oocyte). CYS alone (10.18 ± 0.58 pmol/oocyte) or in combination with LA (10.84 ± 0.37 pmol/oocyte) or DHLA (9.75 ± 0.66 pmol/oocyte) significantly increased GSH compared to controls. GSH content of MII oocytes matured in 5 mm OET (8.35 ± 0.35 pmol/oocyte) was significantly higher compared to control (5.07 ± 0.32 pmol/oocyte), 1 mm (4.21 ± 0.18 pmol/oocyte), and 3 mm (7.12 ± 0.35 pmol/oocyte) OET treatments. Maturation rates of oocytes were significantly reduced in 2% FCS (51.1–72%) compared to 10% FCS (90.5%). OET treatment (1–5 mm) did not significantly alter maturation rate compared to control (75–89.8%). Blastocyst development of IVM oocytes treated with 1 mm OET (22.5%) was significantly lower compared to 3 mm (42.3%) and 5 mm (41.1%) OET but not to control (33.6%). Blastocysts from IVM oocytes treated with 5 mm OET had significantly higher cell counts compared to controls (126 ± 6.4 cells v. 100.8 ± 5.2 cells). Bovine IVM is a valuable model for testing the efficacy of various strategies to increase oocyte cellular GSH. Both strategies improve oocyte GSH levels, and an increase in blastocyst cell number occurred with GSH donor treatment (5 mm OET).
    Reproduction Fertility and Development - REPROD FERT DEVELOP. 01/2008; 20(1).
  • Reproduction Fertility and Development - REPROD FERT DEVELOP. 01/2008; 20(5).
  • Catherine A McMahon, Douglas M Saunders
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    ABSTRACT: To survey clients with stored frozen embryos regarding intention to donate embryos to other couples and attitudes toward conditional donation. Anonymous postal questionnaire. A private IVF clinic in Sydney, Australia. Clients with embryos stored for 3 or more years. Patients completed a survey regarding attitudes to embryo donation and conditional embryo donation. Spontaneous written comments were also analyzed. Intentions regarding embryos, attitudes toward conditional donation, extent to which conditional donation would influence decision-making. Of the clients surveyed, 99 women (35%) and 66 men (23%) responded. Only 4% indicated it was likely they would donate to other couples; 48% thought donors should be able to specify characteristics of recipients; and 41% indicated they would be more likely to donate if donation was conditional. A sense of ownership and responsibility for the well-being of the offspring underpinned reluctance to donate. Perceived control over the caretaking environment was seen as an advantage of conditional donation. Concerns were also raised about the need for donors to relinquish control and the potential for discrimination. An empirical understanding of the views of infertility patients regarding stored embryos is critical to informing public discourse, policy debates, and clinical practice as well as counseling, policy, and protocols on embryo donation.
    Fertility and sterility 12/2007; 91(1):140-7. · 3.97 Impact Factor
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    ABSTRACT: The trend to older maternal age at first birth is well established in Western countries and biological risk factors, particularly declining fertility, are well documented. Less is known, however, about the psychosocial well-being of older first time parents. This study explores differences in psychosocial adjustment during pregnancy in older (maternal age >or= 38 years) and younger (maternal age < 35 years) couples after assisted reproductive technology (ART) conception. Questionnaire data were collected from a consecutive cohort of pregnant nulliparous women and their partners recruited over a 12-month period from ART clinics in Sydney, Australia. There were more similarities than differences when comparing older and younger couples. Older couples took longer to conceive and were more likely to use donor eggs. Older pregnant women scored higher on a measure of psychological hardiness/resilience and reported a lower identification with motherhood compared with younger pregnant women. Older men differed only in reporting a less satisfying social orientation during pregnancy (lower satisfaction with sex life, relationship with partner and social life). Findings do not indicate problematic adjustment during pregnancy in older couples, but differences found need further investigation using larger samples and prospective designs.
    Human Reproduction 04/2007; 22(4):1168-74. · 4.67 Impact Factor
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    Obstetrical and Gynecological Survey 03/2004; 59(4):242-243. · 2.51 Impact Factor
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    ABSTRACT: Concerns about possible adverse outcomes for children conceived using ICSI were highlighted in 1998 when 1-year-old ICSI children were found to be at increased risk (relative risk = 9.2) of delayed mental development compared with children conceived naturally or using IVF. As the findings were biologically plausible, it was considered important to reassess child development when a more accurate measure of long-term cognitive ability could be obtained. The mental development of 97 ICSI, 80 IVF and 110 naturally conceived (NC) children at 5 years of age was assessed using intelligence quotients (IQ) obtained from the Wechsler Preschool and Primary Scales of Intelligence. The mean full-scale IQ was 110 +/- 18 for ICSI, 111 +/- 13 for IVF and 114 +/- 13 for NC children (P = 0.21, non-significant). ICSI children were not at increased risk for delayed (full-scale IQ <85) cognitive development (ICSI 5.2%, IVF 2.5%, NC 0.9%; P = 0.18, non-significant). The only significant independent predictor of below-average full-scale IQ on multivariate analysis was lower maternal education level. These findings suggest that the genetic influence of parental cognitive ability is more important than the mode of conception in determining the long-term intellectual ability of children conceived using ICSI.
    Human Reproduction 11/2003; 18(10):2067-72. · 4.67 Impact Factor
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    ABSTRACT: The recent derivation of embryonic stem cell lines from human blastocysts and related implications for regenerative medicine has intensified a longstanding debate about the use of human embryos for research purposes. However, studies have shown that few couples with stored embryos opt to donate them for research. Herein, the attitudes and concerns of potential embryo donors to donation of surplus embryos for medical research were examined. From a total of 509 couples who had stored frozen embryos and who had received a questionnaire about embryo donations for medical research, 152 women (30%) and 123 male partners (24%) responded. Embryos had been stored for a mean of 2.25 years (range 3 months to 12 years). Some 10% of respondents indicated it probable, and 34% possible, that they would donate their surplus embryos for research in the future. Women respondents whose embryos had been stored longer, and those committed to the practice of a religion, were more worried about their embryos. Respondents positively disposed to donation commented on their desire not to waste embryos, a desire to help infertile couples, and/or to advance scientific knowledge. Those with negative views commented on the embryo as a potential child and expressed concerns about a perceived lack of control over the type of research to be carried out. Findings indicate a need for tailored education and counselling about embryo donation for medical research.
    Human Reproduction 05/2003; 18(4):871-7. · 4.67 Impact Factor
  • Fertility and Sterility 09/2002; 78. · 4.17 Impact Factor
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    ABSTRACT: Infant attachment and mother-child interaction were evaluated for 65 primiparous women and their singleton infants conceived through in vitro fertilisation (IVF) and a control group of 61 women and their infants conceived naturally. The sample was enrolled during pregnancy as part of a longitudinal study. At 12 months postpartum, security of infant attachment was assessed using the Strange Situation procedure, and mother-child interaction was assessed in a free play context using the Emotional Availability Scales. IVF children demonstrated predominantly secure attachment relationships with their mothers (64.6% IVF, 55.9% controls), and there were no significant between-group differences in the proportion of IVF compared to control group children classified in any of the secure or insecure attachment groups. Furthermore, there were no significant group differences on maternal (sensitivity, structuring, hostility) or child (responsivity, involving) dimensions of interaction during play. The majority of IVF mothers (86%) were sensitive and their infants responsive (91%). Contrary to expectation, mother's ratings of greater anticipated infant difficultness assessed during pregnancy and higher ratings of infant temperament and behaviour difficulty assessed at 4 and 12 months postpartum were associated with secure attachment relationships and more optimal mother-child interaction in both the IVF and control groups.
    Journal of Child Psychology and Psychiatry 12/2000; 41(8):1015-23. · 5.42 Impact Factor
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    ABSTRACT: Infant attachment and mother-child interaction were evaluated for 65 primiparous women and their singleton infants conceived through in vitro fertilisation (IVF) and a control group of 61 women and their infants conceived naturally. The sample was enrolled during pregnancy as part of a longitudinal study. At 12 months postpartum, security of infant attachment was assessed using the Strange Situation procedure, and mother-child interaction was assessed in a free play context using the Emotional Availability Scales. IVF children demonstrated predominantly secure attachment relationships with their mothers (64.6% IVF, 55.9% controls), and there were no significant between-group differences in the proportion of IVF compared to control group children classified in any of the secure or insecure attachment groups. Furthermore, there were no significant group differences on maternal (sensitivity, structuring, hostility) or child (responsivity, involving) dimensions of interaction during play. The majority of IVF mothers (86%) were sensitive and their infants responsive (91%). Contrary to expectation, mother's ratings of greater anticipated infant difficultness assessed during pregnancy and higher ratings of infant temperament and behaviour difficulty assessed at 4 and 12 months postpartum were associated with secure attachment relationships and more optimal mother-child interaction in both the IVF and control groups.
    Journal of Child Psychology and Psychiatry 10/2000; 41(8):1015 - 1023. · 5.42 Impact Factor
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    ABSTRACT: OBJECTIVE: To examine the psychosocial and parenthood-specific adjustment and attitudes to parenting at 1 year postpartum of IVF parents. DESIGN: Prospective, controlled study. SETTING: Volunteers in a teaching hospital environment. PATIENT(s): Sixty-five primiparous women with singleton IVF pregnancies and their partners, and a control group of 61 similarly aged primiparous women with no history of infertility and their partners. INTERVENTION(s): Completion of questionnaires and interviews. MAIN OUTCOME MEASURE(s): Parent reports of general and parenthood-specific adjustment and attitudes to parenting. RESULT(s): The IVF mothers tended to report lower self-esteem and less parenting competence than control mothers. Although there were no group differences on protectiveness, IVF mothers saw their children as significantly more vulnerable and "special" compared with controls. The IVF fathers reported significantly lower self-esteem and marital satisfaction, although not less competence in parenting. Both IVF mothers and fathers did not differ from control parents on other measures of general adjustment (mood) or those more specific to parenthood (e.g., attachment to the child and attitudes to child rearing). CONCLUSION(s): The IVF parents' adjustment to parenthood is similar to naturally conceiving comparison families. Nonetheless, there are minor IVF differences that reflect heightened child-focused concern and less confidence in parenting for mothers, less satisfaction with the marriage for the fathers, and vulnerable self-esteem for both parents.
    Fertility and Sterility 04/2000; 73(3):565-74. · 4.17 Impact Factor

Publication Stats

856 Citations
138.75 Total Impact Points

Institutions

  • 1998–2013
    • University of Sydney
      • Discipline in Obstetrics and Gynaecology
      Sydney, New South Wales, Australia
  • 2011
    • University of Washington Seattle
      Seattle, Washington, United States
  • 2008–2010
    • Wisconsin National Primate Research Center
      Madison, Wisconsin, United States
  • 1997–2007
    • Macquarie University
      • Department of Psychology
      Sydney, New South Wales, Australia
  • 1992–2002
    • Royal North Shore Hospital
      Sydney, New South Wales, Australia