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1.
Semin Perinatol ; 44(7): 151288, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33317710

RESUMO

The rapid rise of novel coronavirus disease 2019 (COVID-19) cases led the American Society for Reproductive Medicine (ASRM) to recommend immediate cessation of all new fertility treatment cycles on March 17, 2020. Controversial from the start, providers and patients expressed their opposition through online petitions, surveys, and other forums. While the impact of a delay in access to reproductive care is unknown, previous studies are reassuring that a delay in the timespan of months may not affect clinical outcomes. However, dropout from care during this pandemic remains a serious concern. Effective therapies against the virus and a vaccine are not on the immediate horizon. Accepting COVID-19 will likely be a part of our lives for the near future necessitates the modification of fertility protocols to keep patients, providers, and staff as safe as possible. We believe fertility treatment is an urgent, essential service that can be performed safely and responsibly during this pandemic.


Assuntos
Assistência à Saúde , Infertilidade/terapia , Guias de Prática Clínica como Assunto , Técnicas de Reprodução Assistida , Tempo para o Tratamento , Feminino , Humanos , Controle de Infecções , Infertilidade/diagnóstico , Participação dos Interessados , Estados Unidos
2.
Fertil Steril ; 114(6): 1135-1139, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33280718

RESUMO

The COVID-19 pandemic accelerated the adoption of telemedicine internationally. The reproductive clinics that thrived in this tumultuous time had access to fully electronic medical records with user-friendly telehealth platforms and remote support staff for physicians. However, complete transition from in-person visits to telehealth uncovered many opportunities for innovation. At-home semen testing is not yet widely recognized, and patients still require an in-person visit for ultrasounds, procedures, and physical examinations. Although emergency policies and waivers have made it easier for providers to legally practice across state borders and receive payments from insurance companies, they vary from state to state and have not been cemented into law. Finally, clinical training for medical students, residents, and fellows has been affected by decreased clinical and surgical volume. However, trainees have also proven to be the most adaptable, quickly shifting to remote learning practices through social media, online surgical atlases, and wide distribution of "virtual visiting professor" lectures. As countries have eased physical distancing guidelines, patients ultimately benefit from having the option of a telehealth appointment. Although there is still much work to be done to improve telehealth, the COVID-19 pandemic has at least proven that it is a safe method of patient care and teaching.


Assuntos
Medicina Reprodutiva/tendências , Telemedicina/tendências , Assistência à Saúde/métodos , Assistência à Saúde/tendências , Educação Médica , Feminino , Humanos , Infertilidade/diagnóstico , Infertilidade/terapia , Licenciamento em Medicina , Masculino , Gravidez , Técnicas de Reprodução Assistida , Análise do Sêmen , Estudantes de Medicina
4.
Medicine (Baltimore) ; 99(48): e23320, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33235093

RESUMO

Repeated implantation failure (RIF) greatly influences pregnancy rate after assisted reproductive technologies (ART) with elusive causes. Our study aimed to explore coagulation parameters in association with RIF and establish a model to predict the risk of RIF in Chinese women.Coagulation parameters, including prothrombin time (PT), thrombin time (TT), activated partial prothrombin time (APTT), D-dimer (DD), fibrin degradation products (FDP), fibrinogen (FG), and platelet aggregation induced by arachidonic acid (AA) and adenosine diphosphate (ADP) were measured in RIF patients and controls. A logistic regression model was built by using the purposeful selection to select important factors for the prediction of RIF.Between 92 RIF patients and 47 controls, we found a statistically significant difference in all of the coagulation parameters except APTT, FDP and platelet aggregation induced by ADP. The purposeful selection method selected PT (odds ratio [OR] = 0.28, 95% CI: 0.12-0.66, P = .003), APPT (odds ratio [OR] = 0.76, 95% CI: 0.63-0.91, P = .004), TT (odds ratio [OR] = 0.75, 95% CI: 0.53-1.08, P = .124), and platelet aggregation induced by AA (odds ratio [OR] = 1.27, 95% CI: 1.11-1.44, P = .0003) as important predictors of RIF risk. ROC curve analysis indicated that the area under ROC curve (AUC) of the model was 0.85 with an optimal cut-off point of the predicted probability being P = .65, leading to a sensitivity of 0.83 and a specificity 0.75.We found that coagulation parameters including PT, APTT, TT and platelet aggregation induced by AA are predictive of RIF in Chinese women. Our results highlight the potential of anti-coagulation therapies to lower the risk of RIF.


Assuntos
Perda do Embrião/sangue , Perda do Embrião/epidemiologia , Técnicas de Reprodução Assistida/estatística & dados numéricos , Adulto , Coagulação Sanguínea , Testes de Coagulação Sanguínea , China/epidemiologia , Feminino , Humanos , Estudos Retrospectivos
5.
Medicine (Baltimore) ; 99(48): e23348, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33235102

RESUMO

Ovarian endometriosis cyst (OEC) is caused by the growth of ectopic endometrium into the ovarian cortex, leading to disrupted ovarian cortical structures and infertility. Large OECs are usually surgically removed, and assisted reproductive technology (ART) is required for future pregnancy. The oocyte reserve and development of patients with small non-surgical OECs are unknown. In this study, we compared mitochondrial abnormality, ATPase and IF1 mRNA expression levels, and OXPHO complex proteins between OEC vs control mural granulosa cells (mGCs).OEC mGCs show fewer mitochondria per cell, a higher proportion of aberrant morphology, lower ATPase mRNA levels, higher IF1 mRNA levels, and impaired expression of 3 of the 5 critical proteins involved in the OXPHOS complex, compared with control mGCs. Cell-free mitochondrial DNA (cfmtDNA) levels are higher in the follicular fluid of patients with OEC and were inversely associated with the expression of mtDNA in mGCs and cumulus granulosa cells (cGCs).Taken together, this study indicates that small non-surgical OECs lead to poor quality of oocytes and subsequent embryos during ART compared with control, which was accompanied by mGC mitochondrial dysfunction. mGC and cGC mtDNA and FF cfmtDNA might serve as efficient biomarkers for the non-invasive prediction of pregnancy outcomes in patients with OEC undergoing ART.


Assuntos
Ácidos Nucleicos Livres/metabolismo , Endometriose/epidemiologia , Líquido Folicular/metabolismo , Cistos Ovarianos/epidemiologia , Técnicas de Reprodução Assistida , Adenosina Trifosfatases/sangue , Adulto , Biomarcadores , Estudos de Casos e Controles , Feminino , Células da Granulosa/metabolismo , Humanos , Oócitos/metabolismo , Fosforilação Oxidativa , Proteínas/análise
6.
J Ovarian Res ; 13(1): 140, 2020 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-33246480

RESUMO

Currently, the world is in the seventh month of the COVID-19 pandemic. Globally, infections with novel SARS-CoV-2 virus are continuously rising with mounting numbers of deaths. International and local public health responses, almost in synchrony, imposed restrictions to minimize spread of the virus, overload of health system capacity, and deficit of personal protective equipment (PPE). Although in most cases the symptoms are mild or absent, SARS-CoV-2 infection can lead to serious acute respiratory disease and multisystem failure. The research community responded to this new disease with a high level of transparency and data sharing; with the aim to better understand the origin, pathophysiology, epidemiology and clinical manifestations. The ultimate goal of this research is to develop vaccines for prevention, mitigation strategies, as well as potential therapeutics.The aim of this review is to summarize current knowledge regarding the novel SARS CoV-2, including its pathophysiology and epidemiology, as well as, what is known about the potential impact of COVID-19 on reproduction, fertility care, pregnancy and neonatal outcome. This summary also evaluates the effects of this pandemic on reproductive care and research, from Canadian perspective, and discusses future implications.In summary, reported data on pregnant women is limited, suggesting that COVID-19 symptoms and severity of the disease during pregnancy are similar to those in non-pregnant women, with pregnancy outcomes closely related to severity of maternal disease. Evidence of SARS-CoV-2 effects on gametes is limited. Human reproduction societies have issued guidelines for practice during COVID-19 pandemic that include implementation of mitigation practices and infection control protocols in fertility care units. In Canada, imposed restrictions at the beginning of the pandemic were successful in containing spread of the infection, allowing for eventual resumption of assisted reproductive treatments under new guidelines for practice. Canada dedicated funds to support COVID-19 research including a surveillance study to monitor outcomes of COVID-19 during pregnancy and assisted reproduction. Continuous evaluation of new evidence must be in place to carefully adjust recommendations on patient management during assisted reproductive technologies (ART) and in pregnancy.


Assuntos
/fisiopatologia , Reprodução/fisiologia , Técnicas de Reprodução Assistida , /genética , /genética , Canadá/epidemiologia , Feminino , Humanos , Pandemias , Gravidez , Resultado da Gravidez , /patogenicidade
8.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(5): 439-442, 2020 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-33047570

RESUMO

Water is an important component in liquid medical device products for human assisted reproductive technology. Water traits, conductivity, microbial limits, total organic carbon, easy oxides, heavy metal content, bacterial endotoxin and other indicators have an important impact on sperm, egg and embryo development in vitro, so for such products, the quality of water control is extremely important. The production water for producing such products is generally prepared by MilliQ purification system. In this research, we used four different types of water to fabricate the IVF liquids. It included deionized reverse osmosis water, ultra purified water and ultra purified water without endotoxin or nucleic acid, and compared with tap water. The in vitro rat embryo test system was used to study the embryotoxicity of this four different culture liquid production waters. From the result, the group of the super purified water without endotoxin and nucleic acid has the best result of the embryo formation rate, the number of total cell number and the inner cell number. This study proved the importance of removing endotoxin and nucleic acid from the water used for the preparation of the liquid products for assisted reproduction, and provided the basis for the selection of water quality for the liquid products for assisted reproduction.


Assuntos
Desenvolvimento Embrionário , Contaminação de Equipamentos , Fertilização In Vitro , Técnicas de Reprodução Assistida , Água , Animais , Fertilização In Vitro/instrumentação , Humanos , Ratos , Pesquisa , Tecnologia
9.
PLoS One ; 15(10): e0240936, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33075059

RESUMO

The fate of the ICM in humans is still unknown, due to the ethical difficulties surrounding experimentation in this field. In this study we have explored the existing time-lapse recording data of embryos in the early stages of development, taking advantage of the large refractile bodies (RBs) within blastomeres as cellular markers. Our study found that the cellular composition of the ICM in humans is largely determined at the time of the fourth division and blastomeres which cleave first to fourth, during the fourth division from 8 cells to 16 cells, have the potential to be incorporated in the ICM.


Assuntos
Massa Celular Interna do Blastocisto/fisiologia , Blastômeros/fisiologia , Imagem com Lapso de Tempo/métodos , Divisão Celular , Desenvolvimento Embrionário , Feminino , Humanos , Gravidez , Técnicas de Reprodução Assistida , Estudos Retrospectivos , Gravação em Vídeo
10.
Cochrane Database Syst Rev ; 9: CD007421, 2020 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-32876946

RESUMO

BACKGROUND: This is an update of a Cochrane Review first published in the Cochrane Library (2010, Issue 7). To increase the success rate of assisted reproductive technologies (ARTs), adherence compounds such as hyaluronic acid (HA) have been introduced into subfertility management. Adherence compounds are added to the embryo transfer medium to increase the likelihood of embryo implantation, with the potential for higher clinical pregnancy and live birth rates. OBJECTIVES: To determine whether adding adherence compounds to embryo transfer media could improve pregnancy outcomes, including improving live birth and decreasing miscarriage, in women undergoing assisted reproduction. SEARCH METHODS: We searched the Cochrane Gynaecology and Fertility Group Trials Register, CENTRAL, MEDLINE, Embase, and PsycINFO electronic databases on 7 January 2020 for randomised controlled trials that examined the effects of adherence compounds in embryo transfer media on pregnancy outcomes. Furthermore, we communicated with experts in the field, searched trials registries, checked reference lists of relevant studies, and conference abstracts were handsearched. SELECTION CRITERIA: Only truly randomised controlled trials comparing embryo transfer media containing functional concentrations of adherence compounds to media with no or low adherence compound concentrations were included. DATA COLLECTION AND ANALYSIS: Two review authors selected trials for inclusion according to the above criteria, after which the same two review authors independently extracted data for subsequent analysis. Statistical analysis was performed according to the guidelines developed by Cochrane. We combined data to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). We assessed statistical heterogeneity using the I² statistic. We used GRADE methods to assess the overall quality of evidence for the main comparisons. MAIN RESULTS: We analysed 26 studies with a total of 6704 participants. Overall, the certainty of evidence was low to moderate: the main limitations were imprecision and/or heterogeneity. Compared to embryos transferred in media containing no or low (0.125 mg/mL) HA, the addition of functional (0.5 mg/mL) HA concentrations to the transfer media probably increases the live birth rate (RR 1.21, 95% CI 1.1 to 1.31; 10 RCTs, N = 4066; I² = 33%; moderate-quality evidence). This suggests that if the chance of live birth following no HA addition in media is assumed to be 33%, the chance following HA addition would be between 37% and 44%. The addition of HA may slightly decrease miscarriage rates (RR 0.82, 95% CI 0.67 to 1.00; 7 RCTs, N = 3091; I² = 66%; low-quality evidence). Nevertheless, when only studies with low risk of bias were included in the analysis, there was no conclusive evidence of a difference in miscarriage rates (RR 0.96, 95% CI 0.75 to 1.23; N = 2219; I² = 36%). Adding HA to transfer media probably results in an increase in both clinical pregnancy (RR 1.16, 95% CI 1.09 to 1.23; 17 studies, N = 5247; I² = 40%; moderate-quality evidence) and multiple pregnancy rates (RR 1.45, 95% CI 1.24 to 1.70; 7 studies, N = 3337; I² = 36%; moderate-quality evidence). We are uncertain of the effect of HA added to transfer media on the rate of total adverse events (RR 0.86, 95% CI 0.40 to 1.84; 3 studies, N = 1487; I² = 0%; low-quality evidence). AUTHORS' CONCLUSIONS: Moderate-quality evidence shows improved clinical pregnancy and live birth rates with the addition of HA as an adherence compound in embryo transfer media in ART. Low-quality evidence suggests that adding HA may slightly decrease miscarriage rates, but when only studies at low risk of bias were included in the analysis, the results were inconclusive. HA had no clear effect on the rate of total adverse events. The increase in multiple pregnancy rates may be due to combining an adherence compound and transferring more than one embryo. Further studies of adherence compounds with single embryo transfer need to be undertaken.


Assuntos
Meios de Cultura/química , Implantação do Embrião/efeitos dos fármacos , Adesivo Tecidual de Fibrina/farmacologia , Ácido Hialurônico/farmacologia , Técnicas de Reprodução Assistida , Adesivos Teciduais/farmacologia , Aborto Espontâneo/epidemiologia , Adulto , Implantação do Embrião/fisiologia , Feminino , Humanos , Nascimento Vivo/epidemiologia , Gravidez , Gravidez Múltipla/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Eur J Obstet Gynecol Reprod Biol ; 253: 148-153, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32866858

RESUMO

OBJECTIVE(S): to evaluate the impact of the COVID-19 pandemic on infertile couples' emotions, anxiety and future plans. STUDY DESIGN: An observational study was perfomed by Italian ART centers and online forums. In this study, infertile couples candidate to ART and whose treatment was blocked due to the COVID-19 lockdown were enrolled through an online survey. The psychological impact of COVID-19 was measured by Impact of Event Scale-Revised (IES-R) and by a short form of the Spielberger State-Trait Anxiety Inventory (STAI); Self-perceived anxiety related either to pregnancy safety and to economic crisis measured by VAS scale. RESULTS: 627 patients completed the survey. The COVID-19 lock-down had a moderate/severe psychological impact on infertile patients (mean IES-R score 36.4 ± 16.6). The mean STAI score was 49.8 ± 15.3, with an overall incidence of STAI > 36 of 71 %. The mean VAS scale for anxiety perception was 45.3 ± 15.3. Women were more emotionally distressed, anxious and depressed than men (36.8 ± 16.4 vs 31.0 ± 18.4 for IES-R, respectively; p = 0.03). Notwithstanding the uncertainty about pregnancy safety, 64.6 % of respondents chose to maintain their reproductive programme. Economic crisis induced 11.5 % of the surveyed patients to give up their ART program. Respondents who had at least one relative affected by COVID-19 had a significantly higher IES-R score and anxiety VAS, but not higher STAI scores, than patients belonging to unaffected families. CONCLUSION(S): COVID-19 pandemic itself and the recommendation to stop ART program generated higher distress levels in infertile couples. The psychological impact of COVID-19 pandemic in infertility patients should not be underestimated, and a specific psychological support should be planned.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Infertilidade/psicologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/psicologia , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Emoções , Feminino , Nível de Saúde , Humanos , Itália/epidemiologia , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/psicologia , Complicações Infecciosas na Gravidez/virologia , Técnicas de Reprodução Assistida/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
15.
Hum Reprod ; 35(12): 2774-2783, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32877507

RESUMO

STUDY QUESTION: What are the perceptions of infertility patients and the factors correlating with their psychological distress, following suspension of fertility treatments during the Corona Virus Disease-19 (COVID-19) pandemic? SUMMARY ANSWER: Most patients preferred to resume treatment given the chance regardless of background characteristics; higher self-mastery and greater perceived social support were associated with lower distress, while feeling helpless was associated with higher distress. WHAT IS KNOWN ALREADY: Infertility diagnosis and treatment frequently result in significant psychological distress. Recently published data have shown that clinic closure during the COVID-19 pandemic was associated with a sharp increase in the prevalence of anxiety and depression among infertile patients undergoing IVF and was perceived as an uncontrollable and stressful event. Personal resources play an important protective role in times of crisis, helping reduce levels of distress. STUDY DESIGN, SIZE, DURATION: This cross-sectional questionnaire study included patients whose fertility treatment was suspended following the COVID-19 pandemic, in a tertiary hospital. The survey was delivered to 297 patients within 12 days at the beginning of April 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS: The self-administered questionnaire included items addressing: (i) patients' demographic characteristics, (ii) anxiety related to COVID-19 infection risk and level of social support, (iii) patients' perceptions of the new guidelines and description of subsequently related emotions and (iv) two validated scales assessing levels of emotional distress and self-mastery. Multivariate analysis was conducted to assess factors alleviating or increasing emotional distress during the COVID-19 pandemic. MAIN RESULTS AND THE ROLE OF CHANCE: There were 168 patients who completed the survey, giving a response rate of 57%. Study variables in the regression model explained 38.9% of the variance in psychological distress experienced by patients during treatment suspension. None of the background characteristics (e.g. age, marital status, parity, economic level or duration of treatments) had a significant contribution. Feeling helpless following the suspension of treatments was associated with higher distress (P < 0.01). Higher self-mastery and greater perceived social support were associated with lower distress (P < 0.01). Despite the ministry of health's decision, 72% of patients wished to resume treatment at the time of survey. LIMITATIONS, REASONS FOR CAUTION: This was a cross-sectional study, thus information about patients' characteristics prior to the COVID-19 pandemic was not available. The length and implications of this pandemic are unknown. Therefore, the ability to draw conclusions about the psychological consequences of the crisis is limited at this point of time. WIDER IMPLICATIONS OF THE FINDINGS: Personal resources play an important protective role in times of crisis, helping to reduce levels of distress. Study findings suggest that attention should be paid to strengthening and empowering patients' personal resources together with directly confronting and containing feelings of helplessness. In line with the European Society for Human Reproduction and Embryology (ESHRE) guidelines, especially at this time of high levels of distress, it is imperative to offer emotional support to reduce stress and concerns. Furthermore, as the pandemic is stabilizing, resumption of treatment should be considered as soon as appropriate according to local conditions. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the IVF unit of the Shamir Medical Center. All authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
/psicologia , Fertilidade , Infertilidade/diagnóstico , Infertilidade/psicologia , Adulto , Ansiedade , Atitude Frente a Saúde , /diagnóstico , Estudos Transversais , Depressão/psicologia , Feminino , Fertilização In Vitro/efeitos adversos , Humanos , Infertilidade/complicações , Pessoa de Meia-Idade , Pandemias , Gravidez , Técnicas de Reprodução Assistida/psicologia , Risco , Apoio Social , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
16.
J Assist Reprod Genet ; 37(11): 2663-2668, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32939662

RESUMO

The COVID-19 pandemic has fueled numerous debates in the field of assisted reproductive technology (ART) as the effect of SARS-CoV-2 on pregnancy and infancy is still considered uncharted territory. Various theses and recommendations on what optimal practice is have emerged, as evidenced by surveys, webinars, and recent publications. ART specialists are faced with dilemmas in light of the lack of concrete scientific evidence required to pave the way towards future safe practice. Meanwhile, infertile couples were similarly left in limbo unable to exercise their reproductive autonomy unlike fertile couples-where achieving a pregnancy via natural conception is a matter of decision. ART treatment being classified as non-essential has only recently re-started, facing new challenges while enabling pregnancy at a time of uncertainty. This article highlights matters of bioethical nature to be considered in the ART world at the time of COVID-19 while presenting an all-inclusive critique of the current status. When pursuing pregnancy through IVF treatment during the pandemic, distancing and caution have the lead role in an effort to defend the health of the intended parents and future children. To promote patient autonomy along with our ethical, moral, and legal duty towards our patients, emphasis should be given on ascertaining shared decision-making, and ensuring that an appropriate all-inclusive informed consent is signed prior to initiating any IVF treatment.


Assuntos
Acesso aos Serviços de Saúde , Técnicas de Reprodução Assistida , Infecções por Coronavirus , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral
18.
Medicine (Baltimore) ; 99(37): e22009, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925733

RESUMO

BACKGROUND: Human assisted reproductive technology (ART) has become an important part of infertility treatments throughout the world, including IVF, ICSI, embryo culture, and embryo cryopreservation. In China and East Asia, Chinese herbal medicine (CHM) has been used to treat various diseases and improves the success chance of live birth among infertile couples undergoing ART treatment. The aim of this study is to assess the effect and safety of Chinese herbal medicine among women undergoing ART. METHODS: Cochrane Library, MEDLINE, EMBASE, CNKI, VIP, CBM and WANGFANG will be searched. All randomized controlled trials will be included if they recruited participants undergoing ART for assessing the effect and safety of Chinese herbal medicine. Primary outcomes will be live birth. Two authors will independently scan all the potential articles, extract the data and assess the risk of bias using Cochrane tool of risk of bias. Based on the guideline of Cochrane Collaboration, all analysis will be performed by RevMan 5.3 software. Dichotomous variables will be expressed as RR with 95% CIs and continuous variables will be reported as MD with 95% CIs. If possible, a fixed or random effects models will be conducted and the confidence of cumulative evidence will be assess using GRADE. RESULTS: This study will be to assess the effect and safety of Chinese herbal medicine among women undergoing ART. CONCLUSIONS: This study will assess the effect and safety of Chinese herbal medicine among women undergoing ART and move forward to help inform clinical decisions.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Infertilidade/terapia , Metanálise como Assunto , Técnicas de Reprodução Assistida , Revisões Sistemáticas como Assunto , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Humanos , Nascimento Vivo , Gravidez
19.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(3): 96-105, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-190826

RESUMO

La pandemia por el nuevo virus SARS-CoV-2 ha provocado un proceso de adaptación a la nueva situación por parte de toda de la sociedad y, con ello, los centros de reproducción asistida. Tras la fase aguda de la crisis sanitaria, en la que se redujo de forma drástica la actividad, se han reanudado los ciclos, guiados por las recomendaciones de las sociedades científicas. En este artículo revisamos toda la información publicada respecto al virus y el sistema reproductivo, señalando la presencia de enzima convertidora de angiotensina tipo ii(angiotensin-converting enzyme 2, ACE2) en el sistema reproductivo femenino y masculino, a nivel testicular, ovárico, endometrial y a nivel embrionario. Además, realizamos un análisis comparativo entre las recomendaciones de las sociedades científicas en cuanto al cribado de la infección, las normas de funcionamiento y las medidas generales de laboratorio


The pandemic caused by the new SARS-CoV-2 virus has led to a process of adaptation to the new situation by society as a whole and, therefore, by assisted reproduction centres. After the acute phase of the health crisis, when activity was drastically reduced, cycles have resumed, guided by the recommendations of scientific societies. In this article, a review is presented of all the published information regarding the virus and the reproductive system, pointing out the presence of angiotensin-converting enzyme 2 (ACE2) in the female and male reproductive system, at the testicular, ovarian, endometrial and embryonic levels. In addition, a comparative analysis is carried out between the recommendations of the scientific societies regarding the screening of infection, performance standards, and general laboratory measurements


Assuntos
Humanos , Pandemias , Técnicas Reprodutivas , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Fertilidade , Técnicas de Reprodução Assistida/normas , Fertilização In Vitro , Inseminação Artificial , Infecções por Coronavirus/fisiopatologia , Medicina Reprodutiva/organização & administração , Serviços de Saúde Reprodutiva/normas
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