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1.
Hum Fertil (Camb) ; 26(2): 266-275, 2023 Dec.
Article in English | MEDLINE | ID: mdl-35332836

ABSTRACT

This study aimed to discover whether egg sharing compromises the chance of donors or recipients achieving a live birth. A descriptive cohort study was performed of 4,545 fertility patients and 5,316 stimulation cycles at a London based fertility clinic between 2010 and 2019. There was no significant difference in clinical pregnancy rate (CPR) or live birth rate (LBR) between egg sharers and standard IVF patients or between egg sharing recipients and non-egg sharing recipients. Both egg sharers and their recipients had fewer oocytes and fewer day 3 embryos available for fresh embryo transfer or cryopreservation than standard IVF patients or non-egg sharing recipients. The cumulative LBR were significantly lower amongst egg sharers than standard IVF patients (p < 0.05), and significantly lower amongst egg sharing recipients than non-egg sharing recipients (p < 0.05). This study demonstrates that egg sharing does not compromise the chances of donors or their recipients achieving a live birth. However, participants may occasionally require additional ovarian stimulation cycles to conceive. With government funding for IVF treatment falling, egg sharing provides a practical option to allow more women access to IVF. Egg sharing is currently the most efficient way of maximising the use of the precious resource of human oocytes.


Subject(s)
Fertilization in Vitro , Live Birth , Pregnancy , Humans , Female , Cohort Studies , Embryo Transfer , Pregnancy Rate , Birth Rate , Retrospective Studies
2.
Hum Reprod ; 36(8): 2189-2201, 2021 07 19.
Article in English | MEDLINE | ID: mdl-34227667

ABSTRACT

STUDY QUESTION: What are the knowledge and views of UK-based women towards egg donation (ED) and egg sharing (ES)? SUMMARY ANSWER: Lacking knowledge of the practices of ED and ES could be an influential factor in donor egg shortages, rather than negative perceptions or lack of donor anonymity and financial incentives. WHAT IS KNOWN ALREADY: The increasing age of women trying to conceive has led to donor egg shortages, with ED and ES failing to meet demand. Indeed, in recent years in the UK, ES numbers have fallen. This results in long waiting lists, forcing patients abroad for fertility treatment to take up cross border reproductive care. Previous research suggests a lack of knowledge of ED among members of the general public; however, no study has yet assessed knowledge or views of ES in the general public. STUDY DESIGN, SIZE, DURATION: Six hundred and thirty-five UK-based women over 18 years were voluntarily recruited from social media community groups by convenience sampling. The recruitment period was from February to April 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants completed a previously validated questionnaire regarding female fertility, ED and ES, including knowledge, perceptions and approval of the practices and relevant legislation. This included ranking key benefits and issues regarding egg sharing. The questionnaire was completed using the online Qualtrics survey software. Statistical analysis was conducted using SPSS. MAIN RESULTS AND THE ROLE OF CHANCE: Regarding knowledge of ED and ES, 56.3% and 79.8%, respectively had little or no prior knowledge. Upon explanation, most approved of ED (85.8%) and ES (70.4%). A greater proportion of respondents would donate to a family member/friend (49.75%) than to an anonymous recipient (35.80%). Overall, ES was viewed less favourably than ED, with ethical and practical concerns highlighted. Women aged 18-30 years were significantly more likely to approve of egg donation practice compared to those aged >30 years (P < 0.0001). Those against ES found fears of financial coercion or negative psychological wellbeing the most concerning. About 35.8% and 49.7% would personally consider anonymous and known ED, respectively, whilst 56.7% would consider ES. Those answering in favour of egg sharing were significantly more likely to give higher benefit ratings compared to those against the practice (P < 0.001). Most agreed (55.8%) with and were not deterred to donate (60.1%) by the 'Disclosure of Donor Identity' legislation. Only 31.6% agreed with the compensatory cap; however, 52.7% would not be more motivated to donate by an increased cap. LIMITATIONS, REASONS FOR CAUTION: There were several limitations of the study, including the use of convenience sampling and the voluntary nature of participation opening the study up to sampling and participation bias. Finally, closed questions were predominantly used to allow the generation of quantitative data and statistical analysis. However, this approach prevented opinion justification and qualitative analysis, limiting the depth of conclusions drawn. WIDER IMPLICATIONS OF THE FINDINGS: To our knowledge, this is the first study to survey the general public's knowledge and views of ED/ES using a previously validated questionnaire. The conclusion that lack of knowledge could be contributing to the current donor shortfall in the UK demonstrates that campaigns to inform women of the practices are necessary to alleviate donor oocyte shortages. STUDY FUNDING/COMPETING INTEREST(S): No external funds were used for this study. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: NA.


Subject(s)
Insemination, Artificial, Heterologous , Medical Tourism , Attitude , Female , Humans , Motivation , Oocyte Donation , United Kingdom
3.
Andrology ; 8(3): 594-601, 2020 05.
Article in English | MEDLINE | ID: mdl-31755657

ABSTRACT

BACKGROUND: The paternal role in embryogenesis is much more than providing a haploid genome. The spermatozoa have crucial roles related to embryogenesis' epigenetic regulation, fusion of gametes, and cleavage, which may influence intracytoplasmic sperm injection outcomes. OBJECTIVES: To study whether paternal age, length of ejaculatory abstinence and semen parameters influence the outcomes of intracytoplasmic sperm injection in the oocyte recipients from egg-sharing donation cycles. MATERIALS AND METHODS: This historical cohort study involved 427 oocyte recipient intracytoplasmic sperm injection cycles, from 321 patients undergoing egg-sharing donation cycles from January 2015 to May 2017, in a private in vitro fertilization center. Electronic medical records of donors and recipients intracytoplasmic sperm injection cycles were reviewed. The impact of male age, length of ejaculatory abstinence, and semen parameters on recipients' intracytoplasmic sperm injection outcomes were investigated using general mixed models. Implantation, pregnancy, and live birth rates were the primary outcome measures. RESULTS: Paternal age negatively affected fertilization, day 3 top-quality embryos, day 3 normal embryo cleavage speed, blastocyst formation, high-quality blastocysts, and implantation, and was correlated with diminished pregnancy and live birth rates. Length of ejaculatory abstinence negatively influenced the rates of day 3 top-quality embryos, normal embryo development on day 3, blastocyst development, and implantation. Sperm count positively affected the rates of fertilization, blastocyst development, and implantation. The percentage of progressive sperm motility positively affected day 3 normal embryo development rate and implantation rate. Total motile sperm count positively affected blastocyst development rate and implantation rate. DISCUSSION AND CONCLUSION: Additional tracking of the influence of male characteristics on intracytoplasmic sperm injection outcomes should be stimulated. Paternal age is not manageable, but reducing length of ejaculatory abstinence could be an alternative approach to improve the outcomes of intracytoplasmic sperm injection.


Subject(s)
Ejaculation , Fertility , Fertilization , Paternal Age , Sperm Injections, Intracytoplasmic , Adult , Cohort Studies , Female , Humans , Male , Middle Aged , Pregnancy , Pregnancy Rate , Semen
4.
Eur J Obstet Gynecol Reprod Biol ; 236: 98-104, 2019 May.
Article in English | MEDLINE | ID: mdl-30901631

ABSTRACT

OBJECTIVE: This study aims to determine the healthcare professionals knowledge and opinions of egg sharing and does this potentially effect egg sharing numbers in the UK? STUDY DESIGN: 304 healthcare professionals undertook a large, in-depth survey about various topics related to egg sharing. This included ranking key benefits and issues related to egg sharing. Statistical analysis was performed using SPSS. RESULTS: 63.1% of respondents had little or no knowledge of egg sharing, although the majority supported the scheme once a short description was provided. Although attitudes towards egg sharing were positive, there was more support for voluntary donation. The issues surrounding egg sharing of most concern were the psychological well-being of the egg sharer if her own treatment is unsuccessful and the concern that giving away half her eggs reduces IVF success rates. Only 16.5% of respondents had previously referred a patient for egg sharing, with the majority citing lack of knowledge for the reason they hadn't referred. CONCLUSIONS: Egg sharing allows women to receive free or subsidised IVF in exchange for donating half their oocytes collected to a recipient. Although egg sharing was intended to solve the current donor oocyte shortage, egg sharing numbers have fallen over recent years. Education of healthcare professionals about the egg sharing programme and the research that supports it could improve their perceptions of egg sharing, increasing referral rates and egg sharing numbers.


Subject(s)
Attitude of Health Personnel , Oocyte Donation/psychology , Adult , Aged , Female , Fertilization in Vitro/economics , Humans , Male , Middle Aged , Oocyte Donation/economics , Oocyte Donation/ethics , Referral and Consultation/statistics & numerical data , Surveys and Questionnaires , United Kingdom , Young Adult
5.
Rev. AMRIGS ; 59(1): 55-59, jan.-mar. 2015.
Article in Portuguese | LILACS | ID: biblio-846824

ABSTRACT

Este artigo analisa os aspectos jurídicos e bioéticos da prática médica da doação compartilhada de óvulos no contexto da Reprodução Assistida no Brasil. Trata-se de uma prática criada pela classe médica para auxiliar na obtenção de gametas femininos e beneficiar as pacientes que buscam alcançar a gravidez com assistência profissional (AU)


This paper examines the legal and bioethical aspects of medical practice of shared egg donation in the context of Assisted Reproduction in Brazil. This is a practice created by physicians to aid in obtaining female gametes and benefit patients seeking to achieve pregnancy with professional assistance (AU)


Subject(s)
Humans , Female , Pregnancy , Oocyte Donation/legislation & jurisprudence , Oocyte Donation/ethics , Ovum/transplantation , Fertilization in Vitro/legislation & jurisprudence , Fertilization in Vitro/ethics , Cooperative Behavior , Bioethical Issues , Contracts , Infertility/economics , Infertility/therapy
6.
J Hum Reprod Sci ; 6(4): 235-40, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24672161

ABSTRACT

Assisted reproductive technology (ART) has grown by leaps and bounds in the last few years. India has one of the highest growths in the ART centers and the number of ART cycles performed every year. Very soon India will be the leader in the world of ART in terms of a number of cycles. With the advances of technology and availability of techniques even in tier II and tier III cities our country, the results still vary dramatically. There is no standardization of protocols and reporting is very inadequate. Furthermore, there are only ART guidelines and no law still exists. Our first and the biggest challenge is to document the tremendous work being done in India and on the basis of analysis of this work, a proper registry can be made and guidance given to all on standardization and improvement. This is the 8(th) edition of National ART Registry of India being presented and analyzed.

7.
West Indian med. j ; 61(4): 460-462, July 2012.
Article in English | LILACS | ID: lil-672935

ABSTRACT

In vitro fertilization (IVF) provides hope for many couples who believed that they could not have children. This paper tracks the development of IVF treatment at The University of the West Indies (UWI), Mona, from its genesis in 2000. It highlights changes over the years in the population seeking IVF at UWI, Mona, and describes clinical services offered to clients, comparing success rates of services internationally. It also reports on seminal research emerging out of UWI, Mona, in the field of assisted reproductive health. The Hugh Wynter Fertility Management Unit (HWFMU), UWI, Mona, leads the way in shaping how society views those challenged with infertility and in its use of assisted reproductive technologies that improve the quality of life for many locally, within the Caribbean and the Diaspora.


La fertilización in vitro (FIV) ofrece esperanza a muchas parejas que una vez creyeran no poder tener hijos. Este trabajo sigue el desarrollo del tratamiento de FIV en la Universidad de West Indies (UWI), Mona, a partir de su génesis en 2000. El mismo resalta los cambios durante los años en la población en busca de FIV en UWI, Mona, y describe los servicios clínicos ofrecidos a los clientes, al tiempo que compara las tasas de éxito a nivel internacional. También reporta acerca de la investigación seminal proveniente de UWI, Mona, en el campo de la salud reproductora asistida. La Unidad de Tratamiento de la Infertilidad Hugo Wynter UTIHEW), UWI, Mona, liderea el camino en cuanto a formar cómo la sociedad ha de ver a aquellos que enfrentan problemas de infertilidad, así como en relación con el uso de las tecnologías de reproducción asistida que mejoran localmente la calidad de vida de muchas personas en el Caribe y en la Diáspora.


Subject(s)
Humans , Fertilization in Vitro , Counseling , Jamaica , Program Development , Universities
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