1
|
Rossi MA, Péloquin K, Allsop DB, El Amiri S, Bouzayen R, Brassard A, Bergeron S, Rosen NO. Sexual growth and destiny beliefs: Longitudinal associations with dyadic coping among couples seeking medically assisted reproduction. J Sex Med 2023; 20:1241-1251. [PMID: 37632412 PMCID: PMC10545535 DOI: 10.1093/jsxmed/qdad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/27/2023] [Accepted: 06/29/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Medically assisted reproduction is a vulnerable time for couples' sexual health. Believing that sexual challenges can be worked through (i.e., sexual growth beliefs) or that these challenges indicate incompatibility (i.e., sexual destiny beliefs) may be related to dyadic coping-the strategies couples use to cope-with the physical and psychological stressors of medically assisted reproduction. AIM In the current study we aimed to examine the longitudinal associations between typical (i.e., average) levels of sexual growth and destiny beliefs and positive and negative facets of dyadic coping and how greater than typical levels of these constructs predicted each other across time. METHODS Couples (n = 219) seeking medically assisted reproduction were recruited for an online longitudinal, dyadic study. OUTCOMES Couples completed online measures of sexual growth and destiny beliefs and positive and negative dyadic coping at baseline, 6-and 12-months. RESULTS Random intercept cross-lagged panel models demonstrated that at the within-person level, reporting higher sexual growth beliefs at baseline, relative to their average across time points, was associated with lower negative dyadic coping at 6 months. Higher negative dyadic coping at 6 months, relative to their average, was linked to lower sexual growth beliefs at 12-months. When individuals reported higher sexual destiny beliefs at 6-months, relative to their average, they and their partners reported higher negative dyadic coping at 12 -months. At the between-person level, higher overall levels of sexual destiny beliefs were related to higher overall levels of negative dyadic coping. No associations with positive dyadic coping were identified. CLINICAL IMPLICATIONS Couples may benefit from identifying and reducing unhelpful beliefs about sex and negative dyadic coping. STRENGTHS AND LIMITATIONS Strengths of this study include our large, inclusive sample, engagement of community partners, and novel analytical approach to assess change over time. However, following couples in 6-month increments and not using questionnaires specific to medically assisted reproduction may have limited our ability to detect nuanced changes that couples experience during this time. CONCLUSION Lower sexual growth and higher sexual destiny beliefs may promote couples' engagement in less adaptive coping behaviors as they seek medically assisted reproduction.
Collapse
Affiliation(s)
- Meghan A Rossi
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4J1, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montréal, 90 Avenue Vincent d'Indy, Montréal, Québec, H2V 2S9, Canada
| | - David B Allsop
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4J1, Canada
| | - Sawsane El Amiri
- Department of Psychology, Université de Montréal, 90 Avenue Vincent d'Indy, Montréal, Québec, H2V 2S9, Canada
| | - Renda Bouzayen
- Department of Obstetrics and Gynaecology, IWK Health Centre, 5980 University Avenue, Halifax, NS, B3K 6R8, Canada
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Québec, J1K 2R1, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, 90 Avenue Vincent d'Indy, Montréal, Québec, H2V 2S9, Canada
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4J1, Canada
- Department of Obstetrics and Gynaecology, IWK Health Centre, 5980 University Avenue, Halifax, NS, B3K 6R8, Canada
| |
Collapse
|
2
|
Dufton M, Bouzayen R. Complex reciprocal translocations, more complex than initially thought: a case report. F S Rep 2021; 2:487-492. [PMID: 34934992 PMCID: PMC8655409 DOI: 10.1016/j.xfre.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To present a case of a couple who experienced spontaneous abortion after the transfer of a preimplantation genetic testing for structural rearrangement (PGT-SR) normal/balanced embryo. The embryo was later determined to have significant paternally inherited chromosome deletion that was not previously identified as part of a complex translocation. Design Case report. Setting Single infertility practice. Patient(s) A 35-year-old patient with a history of five spontaneous abortions and her 36-years-old partner, a carrier of a balanced reciprocal translocation. Intervention(s) In vitro fertilization with PGT-SR and follow-up genetic testing. Main Outcome Measure(s) Identification of a paternal reciprocal translocation, pregnancy outcome after PGT-SR, and follow-up genetic testing after the spontaneous abortion of a PGT-SR normal/balanced embryo. Result(s) Karyotyping for a couple with a history of recurrent pregnancy loss identified a paternal reciprocal translocation between chromosomes 5 and 17 after G-banding analysis. In vitro fertilization with PGT-SR resulted in one normal/balanced embryo. The couple experienced a 9-week spontaneous abortion of the transfer of the embryo. Testing of product of conception identified a 3.2-Mb deletion on chromosome 17 resulting in the loss of 55 known genes and deemed likely pathogenic. Repeat karyotyping using G-banding and metaphase fluorescence in situ hybridization identified an additional chromosomal translocation, a segment of chromosome 17 translocated to chromosome 6, the same segment of deoxyribonucleic acid absent from the fetus. Conclusion(s) Preimplantation genetic testing for structural rearrangement cases are complex. Genetic testing must be completed with the best available technology by a reliable testing center. We, therefore, recommend that all chromosomal translocations detected by G-banding be further investigated with metaphase fluorescence in situ hybridization. When unexpected results occur in this patient population, testing beyond the standard of care may be required, including advanced molecular testing.
Collapse
Affiliation(s)
- Megan Dufton
- Atlantic Assisted Reproductive Therapies, Halifax, Novia Scotia, Canada.,Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Renda Bouzayen
- Atlantic Assisted Reproductive Therapies, Halifax, Novia Scotia, Canada.,Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
3
|
Digby AM, Roberts L, Brown MM, Dufton M, Bouzayen R. Predictive ability of a blastocyst grade on reproductive outcomes in elective fresh embryo transfer. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
4
|
Abstract
OBJECTIVE To examine the effect of body mass index on gonadotropin dose requirements for ovarian stimulation, as well as other clinical outcomes in women undergoing in vitro fertilization. METHODS We performed a retrospective cohort study involving 752 women undergoing a total of 951 IVF or IVF-ICSI cycles at a private fertility clinic between January 2007 and May 2011. The 951 treatment cycles were divided into three groups according to the weight of the women involved: normal weight (BMI < 25 kg/m², 461 cycles), overweight (25 ≤ BMI < 30 kg/m², 277 cycles), and obese (BMI ≥ 30 kg/m², 179 cycles). Total gonadotropin dose requirements and clinical IVF cycle outcomes (cycle cancellation, clinical pregnancy, and live birth) were compared between the three BMI groups. We performed multivariable analyses, adjusting for potential confounders such as age at cycle start, day 3 serum FSH level, smoking, presence of polycystic ovary syndrome, and duration of infertility. RESULTS There were no significant differences between the three BMI groups for any of the IVF cycle outcomes measured, including the total FSH dose required for ovarian stimulation. The likelihood of cycle cancellation, clinical pregnancy, and live birth were not significantly different between normal weight, overweight, and obese women. CONCLUSION Obese women did not require significantly higher doses of gonadotropins for ovarian stimulation than normal weight individuals. At our centre, female obesity did not significantly affect the clinical outcomes of IVF treatment. However, given the conflicting results of existing studies, the effect of maternal obesity on IVF outcomes remains unclear.
Collapse
Affiliation(s)
- Alexandra Legge
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS
| | - Renda Bouzayen
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS
| | - Linda Hamilton
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS
| | - David Young
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS
| |
Collapse
|
5
|
|
6
|
Bouzayen R, Eggertson L. [In vitro fertilization: a private matter becomes public]. CMAJ 2009; 181:E71-2. [PMID: 19720691 DOI: 10.1503/cmaj.091408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
7
|
Felberbaum R, Daya S, Fischer R, Thaele M, Auray JP, Duru G, Bouzayen R, Beresniak A, Blechschmidt J. Kosteneffektivität von rekombinantem FSH (r-hFSH) bei assistierten Reproduktionstechniken (ART) in Deutschland - Modellierung im Vergleich zu urinärem FSH (u-hFSH). Geburtshilfe Frauenheilkd 2002. [DOI: 10.1055/s-2002-33008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
8
|
Silverberg K, Daya S, Auray JP, Duru G, Ledger W, Wikland M, Bouzayen R, O'Brien M, Falk B, Beresniak A. Analysis of the cost effectiveness of recombinant versus urinary follicle-stimulating hormone in in vitro fertilization/intracytoplasmic sperm injection programs in the United States. Fertil Steril 2002; 77:107-13. [PMID: 11779599 DOI: 10.1016/s0015-0282(01)02945-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the cost effectiveness of recombinant human FSH (Gonal-F; Serono, Inc., Randolph, MA) and urinary FSH (Fertinex; Serono, Inc.) for ovarian stimulation during IVF with or without intracytoplasmic sperm injection for the treatment of infertility. DESIGN Clinical decision analysis techniques (the Markov model) were used to model the direct medical costs per patient during assisted reproductive technology. MAIN OUTCOME MEASURE(S) Clinical and economic outcomes of two different ovarian stimulation protocols (recombinant human FSH or urinary FSH) during three treatment cycles were considered. RESULT(S) More ongoing pregnancies were achieved, with fewer stimulation cycles, after recombinant human FSH (Gonal-F) than after urinary FSH (Fertinex) (40,665 versus 37,890). In addition, recombinant human FSH was also found to be more cost effective per ongoing pregnancy. From a societal perspective, the mean cost per pregnancy was $40,688 for recombinant human FSH versus $47,096 for urinary FSH. From the insurers' perspective, the mean cost/pregnancy for recombinant human FSH was $28,481 versus $32,967 for urinary FSH. CONCLUSION(S) Recombinant human FSH (Gonal-F) is not only more efficient clinically than urinary FSH (Fertinex), but also more cost effective. This analysis illustrates the point that the economic effectiveness of a drug depends less on its acquisition costs and rather more on the clinical outcomes associated with its use.
Collapse
|
9
|
Daya S, Ledger W, Auray JP, Duru G, Silverberg K, Wikland M, Bouzayen R, Howles CM, Beresniak A. Cost-effectiveness modelling of recombinant FSH versus urinary FSH in assisted reproduction techniques in the UK. Hum Reprod 2001; 16:2563-9. [PMID: 11726575 DOI: 10.1093/humrep/16.12.2563] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to undertake an economic evaluation to compare the cost-effectiveness of recombinant (r)FSH with urinary (u)FSH for attaining clinical pregnancy with assisted reproduction. METHODS Mathematical modelling was utilized incorporating a Markovian decision framework and a Monte Carlo simulation. Statistical representations of recurrent events over time were incorporated into a decision analysis involving fresh and frozen cycles in any sequence (after the first fresh embryo transfer cycle) over three successive assisted reproduction attempts. The mean values of transition probabilities were derived from randomized controlled clinical trials and published reports. The distributions of these transition probabilities were agreed upon by a panel of experts. Cost data for procedures and drugs were derived and validated according to the perspectives of the National Health Service and private clinics in the UK. RESULTS The study involved 5000 Monte-Carlo simulations of treatment on a Markov cohort of 100 000 patients. The total number of pregnancies attained was significantly higher in the rFSH (40 575) compared with the uFSH (37 358) group. The cost per successful pregnancy was significantly lower for rFSH (5906 pounds sterling) compared with uFSH (6060 pounds sterling) and overall, fewer cycles of treatment were required with rFSH to achieve an ongoing pregnancy. The incremental cost-effectiveness ratio is 4148 pounds sterling for each additional clinical pregnancy with rFSH. CONCLUSIONS In addition to the increased effectiveness of rFSH in ART, this study demonstrated that it is more cost-effective and more efficient than uFSH in attaining an ongoing pregnancy.
Collapse
Affiliation(s)
- S Daya
- Department of Obstetrics and Gynecology, McMaster University, Hamilton Ontario, Canada.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
OBJECTIVE To determine the reproductive outcome of women who undergo laparoscopic tubal anastomosis. DESIGN Observational prospective study. SETTING University-affiliated infertility medical center. PATIENT(S) One hundred two patients seeking reversal of tubal sterilization. INTERVENTION(S) Laparoscopic tubal anastomosis was performed with a one-suture technique. MAIN OUTCOME MEASURE(S) Pregnancy rate. RESULT(S) There were 69 isthmic-isthmic, 16 isthmic-ampullary, 12 cornual-isthmic, and 5 ampullary-ampullary anastomoses. The mean operative time was 71.35 minutes. Eight patients had bilateral tubal obstruction on postoperative hysterosalpingography. Sixty-nine patients (70%) conceived. Sixty-four (65.3%) had ongoing intrauterine pregnancies, 15 (21.7%) had spontaneous abortions, and 5 (7.2%) had ectopic pregnancies. CONCLUSION(S) This study demonstrates that laparoscopic tubal anastomosis can be done safely and successfully on an outpatient basis, reducing costs and postoperative morbidity while accelerating the patient's return to normal activities.
Collapse
Affiliation(s)
- F Bissonnette
- Department of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Québec, Canada.
| | | | | |
Collapse
|
11
|
Abstract
Since the widespread use of transvaginal ultrasound to diagnose polycystic ovary syndrome (PCOS), a cardinal feature has been shown to be the presence of a bright, highly echogenic stroma. This is usually assessed subjectively. The objective of this study was to determine whether ovarian stromal echogenicity when measured objectively actually differed between women with polycystic ovaries and those with normal ovaries. A total of 67 women underwent a detailed ultrasound assessment before considering assisted conception treatment. Ovarian morphology was assessed and total ovarian volume, stromal volume, peak stromal blood flow velocity and mean stromal echogenicity were measured. The stromal index (ratio of mean stromal echogenicity to mean echogenicity of the entire ovary) and total stromal echogenicity were also calculated. Ovarian volume, stromal volume, and stromal peak blood flow velocity were all significantly higher in ovaries from women with PCOS. There was no difference in the mean stromal echogenicity, although the stromal index was significantly greater in women with polycystic ovaries. The apparent subjective increase in stromal echogenicity in women with polycystic ovaries, as exemplified by the greater stromal index, is due to a combination of the increased volume of ovarian stroma and the significantly lower mean echogenicity of the entire ovary in these women.
Collapse
Affiliation(s)
- W M Buckett
- Department of Obstetrics and Gynecology, McGill University, Royal Victoria Hospital, Montréal, Québec, Canada
| | | | | | | | | |
Collapse
|
12
|
Abstract
OBJECTIVE To determine the long-term results of laparoscopic fenestration and coagulation of ovarian endometriomas and to compare them with the results of ovarian cystectomy performed by either laparotomy or laparoscopy. DESIGN Case-control study. SETTING Two university-affiliated hospitals. PATIENT(S) One hundred fifty-six premenopausal women with ovarian endometriomas of at least 3 cm in diameter (stage 3 and 4 endometriosis, revised American Fertility Society classification). INTERVENTION(S) Laparoscopic ovarian fenestration and coagulation (group 1, 80 patients); laparoscopic ovarian cystectomy (group 2, 23 patients); and ovarian cystectomy by laparotomy and microsurgical technique (group 3, 53 patients). MAIN OUTCOME MEASURE(S) Operative findings, recurrence rate, and cumulative clinical pregnancy rate (PR) over a 36-month follow-up period. RESULT(S) The mean (+/-SD) time to first pregnancy was significantly shorter in group 1 (1.4+/-0.2 years) than in group 2 (2.2+/-0.5 years) or group 3 (2.4+/-0.5 years). The difference between the cumulative clinical PR between the three groups was not statistically significant after 36 months of follow-up. The difference in the recurrence rate among groups 1, 2, and 3 was not statistically significant. CONCLUSION(S) Laparoscopic ovarian fenestration and coagulation of endometriomas leads to faster conception than ovarian cystectomy by laparotomy. Laparoscopic ovarian fenestration and coagulation of endometriomas is associated with cumulative clinical PRs and recurrence rates over 36 months that are similar to those associated with ovarian cystectomy.
Collapse
Affiliation(s)
- R Hemmings
- McGill University and Centre Hospitalier de l'Université de Montréal, Quebec, Canada
| | | | | |
Collapse
|
13
|
Lachapelle MH, Bouzayen R, Langlais J, Jarvi K, Bourque J, Miron P. Effect of lysoplatelet-activating factor on human sperm fertilizing ability**Supported by a grant from the Institut de Médecine de la Reproduction de Montreal, Montréal, Quebec, Canada. Fertil Steril 1993. [DOI: 10.1016/s0015-0282(16)55873-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Lachapelle MH, Bouzayen R, Langlais J, Jarvi K, Bourque J, Miron P. Effect of lysoplatelet-activating factor on human sperm fertilizing ability. Fertil Steril 1993; 59:863-8. [PMID: 8458509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate the penetration rates in the hamster zona-free oocyte sperm penetration assay (SPA) after exposure of spermatozoa to lysoplatelet-activating factor (LPAF) and lysophosphatidyl choline (LPC). DESIGN Washed human spermatozoa were exposed to 100 microM of LPAF or LPC, followed by the assessment of their fertilizing ability using the SPA. The percentage of penetration, the sperm binding in the SPA, the percentage of motile spermatozoa, and the acrosome reaction rates were quantified. SETTING Private research and university laboratories. PATIENTS, PARTICIPANTS Fresh and frozen semen samples from fertile donors with proven fertility were used as well as fresh semen from infertile patients attending a fertility clinic. All the infertile patients had abnormal semen analysis. INTERVENTIONS Human spermatozoa were incubated for 90 minutes in the presence or absence of LPAF or LPC at 100 microM with 0.3% albumin in Ham's F-10 (GIBCO, Dorval, Quebec, Canada), and their fertilizing ability was evaluated using the SPA. The effect of these lysophospholipids on the percentage of acrosome reaction was evaluated with a fluorescent microscopy technique. RESULTS The penetration rates of the SPA in male factor increased significantly from 3% +/- 6% with controls to 19% +/- 9% and 34% +/- 22% after incubation with LPC and LPAF, respectively. Sperm-oocyte binding was not significantly increased in this group. Sperm penetration assay penetration rates were also increased in fertile cryopreserved spermatozoa with LPC and LPAF. In this group, the acrosome reaction was significantly increased from 2% +/- 1% in controls to 10% +/- 6% and 8% +/- 3% after incubation with LPC and LPAF, respectively. CONCLUSION Lysoplatelet-activating factor and LPC independently increased the penetration rate of spermatozoa and the percentage of acrosome reaction. Lysophosphatidylcholine and LPAF may be beneficial in the treatment of spermatozoa with male factor infertility and may increase fertilization rates in IVF.
Collapse
Affiliation(s)
- M H Lachapelle
- Institut de Médecine de la Reproduction de Montreal, Hopital Maisonneuve-Rosemont, Université de Montréal Quebec, Canada
| | | | | | | | | | | |
Collapse
|