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Sustarsic A, Hadzic V, Meulenberg CJW, Abazovic E, Videmsek M, Burnik Papler T, Paravlic AH. The influence of lifestyle interventions and overweight on infertility: a systematic review, meta-analysis, and meta-regression of randomized controlled trials. Front Med (Lausanne) 2023; 10:1264947. [PMID: 38020109 PMCID: PMC10646477 DOI: 10.3389/fmed.2023.1264947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
This study aimed to investigate the effect of lifestyle intervention (LSI) on diagnosed infertility in overweight and obese women. A systematic review and meta-analysis were conducted. A literature search was performed on the following databases from September 2022 to December 2022: PubMed, Web of Science, and SPORTDiscus. The inclusion criteria were the following: women between 18 and 45 years of age, BMI over 25.0 kg/m2, diagnosed with infertility, a weight loss intervention, and control group part of RCTs. In total, 15 studies were identified and included. The meta-analysis shows a beneficial effect of LSI on reducing weight, waist circumference, and BMI and increasing infertility. A significantly beneficial effect of lifestyle intervention on weight reduction was observed for participants who initially had a higher BMI, while a non-significant effect was observed for individuals with a BMI above 35 kg/m2. The meta-analysis showed a beneficial effect of lifestyle intervention on ovulation incidence and sex hormone-binding globulin. The lifestyle intervention group had 11.23 times more ovulatory incidence than the control group, which in turn increased the ability to conceive. As robust evidence for the effect of lifestyle interventions on infertility in obese and overweight women was found, it is advised to integrate similar interventions into future infertility treatment processes.
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Affiliation(s)
- Ana Sustarsic
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | - Vedran Hadzic
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | | | - Ensar Abazovic
- Faculty of Sport and Physical Education, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Mateja Videmsek
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | - Tanja Burnik Papler
- Division of Gynecology, Department of Human Reproduction, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Armin H. Paravlic
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
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Lizán Tudela C, Cuevas Sáiz I, Abad de Velasco L, Gregori Navarro L, Comellas M, Pérez-Sádaba FJ, Lizán L. The Perspective of Patients and Health Professionals on the Prioritization of Assisted Reproductive Techniques. The PRIOFER Study. Patient Prefer Adherence 2023; 17:2641-2653. [PMID: 37927341 PMCID: PMC10624199 DOI: 10.2147/ppa.s421041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose To determine the perspective of patients and professionals in Assisted Reproduction Units (ARU) on the importance of assisted reproductive techniques (ART) compared to other elective procedures, to highlight the relevance of ART as an elective procedure and the impact of delayed interventions on patients. Design Patients and Methods An observational, descriptive, cross-sectional, online survey-based study was conducted in infertility patients and partners (n=98) and ARU healthcare professionals (n=83). The survey included a best-worst scaling (BWS) experiment and an ad-hoc questionnaire to analyze the pandemic impact on ART management and infertility patients in Spain. In the BWS, each respondent established priorities choosing which patient profile should be rated as the highest and lowest priority profile on a waiting list. To understand the importance that they give to assisted reproduction compared to other procedures, three very common elective procedures involving different patient profiles were selected: cataract surgery, knee arthroplasty, and varicose vein surgery. For each procedure, three hypothetical patient profiles corresponding to three different degrees of severity on a waiting list were designed. Results Patients attributed greater importance to ART profiles (BWS score: patients 0.14 vs professionals -0.05; p<0.01) whereas professionals prioritized cataract surgery (patients 0.06 vs professionals 0.23; p<0.01). Concerning the profile severity, more severe profiles were prioritized in all procedures by both groups. Patients' and professionals' perspectives on the impact of the pandemic were similar, with exceptions: information received for resuming ART; health care provision in crisis situations; and reduction of parenting options. The pandemic affected patients' ability to conceive a child (70.4% of those surveyed), their psychological well-being (75.5%), and partner, social, and work relationships (69.4%). Conclusion Preference studies involving patients and professionals can provide important information to define framework criteria for the management of waiting lists for elective procedures, and to prioritize interventions during pandemic periods. The pandemic impact on infertility patients highlights the relevance of developing measures and strategies to cope with similar future situations in the most appropriate way.
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Affiliation(s)
- César Lizán Tudela
- Department of Paediatrics, Obstetrics and Gynaecology, Hospital Clínico Universitario, Valencia, 46010, Spain
| | - Irene Cuevas Sáiz
- Department of Paediatrics, Obstetrics and Gynaecology, Consorcio Hospital General Universitario de Valencia, Valencia, 46014, Spain
| | - Lorenzo Abad de Velasco
- Department of Paediatrics, Obstetrics and Gynaecology, Consorcio Hospital General Universitario de Valencia, Valencia, 46014, Spain
| | - Laura Gregori Navarro
- Department of Paediatrics, Obstetrics and Gynaecology, Hospital Clínico Universitario, Valencia, 46010, Spain
| | | | | | - Luis Lizán
- Outcomes 10 SLU, Castellón de la Plana, Spain
- Department of Medicine, Jaume I University, Castellón de la Plana, Spain
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Azzahra F, Pangestu M, Lestari SW, Pratama G. Impacts of COVID-19 Pandemic on Three IVF Clinics of Jakarta, Indonesia: A Retrospective Qualitative and Quantitative Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2023; 17:254-258. [PMID: 37577908 PMCID: PMC10439993 DOI: 10.22074/ijfs.2023.562118.1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/11/2023] [Accepted: 04/08/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Corona virus disease-19 (COVID-19) pandemic also led to a reduction or even the suspension of elective health services. These decisions affected in vitro fertilization (IVF) programs worldwide. Therefore, it is essential to map the readiness of IVF clinics in providing safety in this situation and in the future. MATERIALS AND METHODS This is a retrospective qualitative and quantitative research done in 2021 that involved three IVF clinics of Jakarta, Indonesia. Those three clinics were government-owned, private-owned, and educational and training center. The qualitative data of each clinic's readiness towards COVID-19 was obtained from interviews with the clinics staff. The quantitative data were collected from the clinics patients' number and demographic data from 2019-2021 as well as from COVID-19 databases. Both data sets were analysed descriptively and only for the quantitative analysis Stata version 16 was used. RESULTS There were changes in the domiciles and number of patients attending the three clinics. The ratio of patients from Jakarta increased while patients from outside Java Island decreased. There was a drop in annual patient numbers in 2020. However, from June 2020 to December 2021, the number of monthly IVF cycles increased significantly by 3.5 cycles per month (P=0.001). There was no association between IVF patients' attendance numbers and COVID-19 cases (P=0.785). One of the clinics had a negative pressure operating theatre, which made them more confident in treating patients with COVID-19 positive and made them even had higher IVF cycles started than the pre-pandemic period. CONCLUSION Those three clinics are prepared in facing COVID-19, as they complied with government regulations. As the COVID-19 pandemic progressed, the number of patients gradually returned to normal.
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Affiliation(s)
- Fira Azzahra
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Mulyoto Pangestu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | | | - Gita Pratama
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Lisonkova S, Bone JN, Muraca GM, Razaz N, Boutin A, Brandt JS, Bedaiwy MA, Ananth CV, Joseph KS. Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth. Paediatr Perinat Epidemiol 2023; 37:117-127. [PMID: 36038519 PMCID: PMC9539106 DOI: 10.1111/ppe.12925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/29/2022] [Accepted: 08/14/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The initial COVID-19 pandemic response-related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre-pandemic period, have been understudied. OBJECTIVES To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART-conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period. METHODS Population-based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015-2019. RESULTS Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART-conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART-conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non-ART group. Maternal characteristics of women who conceived in the early pandemic versus pre-pandemic period differed and included an increased prevalence of pre-pregnancy obesity class 3 and chronic hypertension. CONCLUSIONS The early pandemic closure of ART clinics resulted in a substantial decline in ART-conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART-conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.
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Affiliation(s)
- Sarka Lisonkova
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Jeffrey N. Bone
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
| | - Giulia M. Muraca
- Department of Obstetrics and Gynecology, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonOntarioCanada
- Clinical Epidemiology Division, Department of MedicineSolna, Karolinska InstitutetStockholmSweden
| | - Neda Razaz
- Clinical Epidemiology Division, Department of MedicineSolna, Karolinska InstitutetStockholmSweden
| | - Amelie Boutin
- Department of Pediatrics, Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
- Reproduction, Mother and Youth Health and Population Health and Optimal Health Practices UnitsCHU de Québec‐Université Laval Research CenterQuebec CityQuebecCanada
| | - Justin S. Brandt
- Division of Maternal‐Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive SciencesRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Mohamed A. Bedaiwy
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
| | - Cande V. Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive SciencesRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Cardiovascular Institute of New Jersey and Department of MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthPiscatawayNew JerseyUSA
- Environmental and Occupational Health Sciences InstituteRutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - K. S. Joseph
- Department of Obstetrics and GynaecologyUniversity of British Columbia and the Children's and Women's Hospital and Health Centre of British ColumbiaVancouverBritish ColumbiaCanada
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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Shen X, Xiao T, Han W, Ye H, Zhang Y, Huang G. The bibliometric analysis of studies on intracytoplasmic sperm injection from 2002 to 2021. Front Endocrinol (Lausanne) 2023; 14:1109623. [PMID: 36998479 PMCID: PMC10043366 DOI: 10.3389/fendo.2023.1109623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Infertility is estimated to occur in 1 out of every 4-7 couples. Intracytoplasmic sperm injection (ICSI), a type of assisted reproduction introduced in 1992, has been used across the world for almost all indications of infertility, yielding high pregnancy rates. There is a growing concern worldwide about ICSI since semen quality has declined in recent years, accompanied with the potential risks of this technology. This study aims to analyze the current status and hotspots of ICSI via a bibliometric analysis. METHODS We retrieved publications on ICSI from the Web of Science Core Collection database from 2002 to 2021. CiteSpace was used to summarize knowledge mapping of subject categories, keywords, and co-citation relationships with the strongest citation bursts. VOSviewer was used to explore co-citation and co-occurrence relationships for countries, organizations, references, authors, and keywords. RESULTS A total of 8271 publications were analyzed between 2002 and 2021. The major findings are as follows: the USA, China, Italy, Japan, and Belgium are the top five prolific countries. The Free University of Brussels, University of Copenhagen, University of Valencia, Ghent University, and the University of California San Francisco are the top five contributing organizations. Fertility and Sterility and Human Reproduction are the most productive and cited journals. The hotspot topics are risks of ICSI, oocyte preservation, live birth rate, infertile men, and embryo quality in the past two decades. CONCLUSION This study presents a research overview of ICSI from different perspectives. These findings will contribute to a better understanding of the current status of ICSI research and provide hotspots and trends for future studies.
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Affiliation(s)
- Xiaoli Shen
- Center for Reproductive Medicine, Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University Chongqing, Chongqing, China
| | - Tianbing Xiao
- Department of Urology, People’s Hospital of Fengjie, Chongqing, China
| | - Wei Han
- Center for Reproductive Medicine, Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University Chongqing, Chongqing, China
| | - Hong Ye
- Center for Reproductive Medicine, Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University Chongqing, Chongqing, China
| | - Yuanfeng Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Yuanfeng Zhang, ; Guoning Huang,
| | - Guoning Huang
- Center for Reproductive Medicine, Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University Chongqing, Chongqing, China
- *Correspondence: Yuanfeng Zhang, ; Guoning Huang,
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Abigail A, Marisa B, Victoria L, Megha T, Lorna K, Kathleen B, Zain AS. Rates of COVID-19 infection among in vitro fertilization patients undergoing treatment at a university reproductive health center. J Assist Reprod Genet 2022; 39:2163-2168. [PMID: 35881271 PMCID: PMC9314538 DOI: 10.1007/s10815-022-02581-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) caused an unprecedented challenge for in-vitro fertilization (IVF) patients. The incidence of COVID-19 infection among this population is a fundamental knowledge gap. OBJECTIVE The purpose of this study was to determine the rate of COVID-19 infection among IVF patients compared to other gynecologic surgery patients. MATERIALS AND METHODS This retrospective study evaluated the incidence of COVID-19 infection among patients undergoing IVF, female fertility-related surgeries (FRS) and other gynecologic surgeries at a single academic institution in Los Angeles, California. All patients underwent routine COVID-19 polymerase chain reaction (PCR) screening prior to treatment. RESULT A total of 2742 patients underwent asymptomatic COVID-19 screening before a surgical procedure or IVF between March 1, 2020, and April 5, 2021. The rate of COVID-19 infection among patients who underwent preoperative testing for a non-fertility-related gynecologic procedure was 1.74% (28/1612). In comparison, the positive test results for those who underwent either FRS or IVF were 0.56% (1/180) and 0.34% (1/290), respectively, representing 6.70% (2/30) of positive tests for the whole cohort. The infertility patients had a significantly lower positivity rate compared to the other gynecologic patients during preoperative COVID-19 testing (0.43% vs 1.74%, p = 0.03). CONCLUSION(S) Our study demonstrated that there was a significantly lower incidence of COVID-19 infections in infertility patients undergoing IVF or FRS compared to other gynecologic surgery patients. Future studies should evaluate the cost-effectiveness of routine screening in both the gynecology and infertility patient population, especially in the setting of different variant surges and vaccination rates.
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Affiliation(s)
- Armstrong Abigail
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA
| | - Berger Marisa
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Lee Victoria
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Tandel Megha
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Kwan Lorna
- Department of Urology, University of California Los Angeles, Los Angeles, CA, USA
| | - Brennan Kathleen
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA
| | - Al-Safi Zain
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA
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Horsey K, Gibson G, Lamanna G, Priddle H, Linara-Demakakou E, Nair S, Arian-Schad M, Thackare H, Rimington M, Macklon N, Ahuja K. First clinical report of 179 surrogacy cases in the UK: implications for policy and practice. Reprod Biomed Online 2022; 45:831-838. [PMID: 35907684 DOI: 10.1016/j.rbmo.2022.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
RESEARCH QUESTION What implications for policy and practice can be derived from outcomes and trends observed across 8 years of a surrogacy programme in two UK-regulated IVF centres (London, Cardiff)? DESIGN Retrospective cohort study analysing surrogacy treatments undertaken between 2014 and September 2021. RESULTS Surrogacy continues to rise in popularity in the UK despite the inability of those supporting safe and professional practice to advertise to recruit surrogates. In two IVF centres regulated by the Human Fertilisation and Embryology Authority (HFEA), both the number of surrogacy treatments and the proportion of those undertaken on behalf of same-sex male intended parents increased year on year in the period studied. From a cohort of 108 surrogates, 71 babies were born to 61 surrogates (with five pregnancies ongoing) by February 2022. No statistically significant difference in live birth rates (LBR) was observed between the heterosexual couples and same-sex male couples. Sample sizes of single and transgender intended parents were too small (n < 5) to compare. The use of vitrified oocytes in surrogacy treatments has increased year on year, while fresh oocyte use has declined since peaking in 2019. There was no significant difference in LBR between fresh and vitrified oocyte usage across the cohort. CONCLUSIONS The number of surrogacy treatments steadily increased, with clear evidence that the proportion of same-sex male couples accessing surrogacy is a major contributor to this growth. Vitrified/warmed oocyte use now outstrips the use of fresh oocytes in the surrogacy treatment cycles studied here. The results represent a strong basis for supporting the liberalization of regulatory reform expected to be introduced in the UK later in 2022.
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Affiliation(s)
- Kirsty Horsey
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Grace Gibson
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Giuseppina Lamanna
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Helen Priddle
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | | | - Shailaja Nair
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Mimi Arian-Schad
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Hemlata Thackare
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Michael Rimington
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Nicholas Macklon
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK
| | - Kamal Ahuja
- London Women's Clinic, London Egg Bank, 113-115 Harley Street, London W1G 6AP, UK.
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