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  • 1.

    【2hr】Editorial

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    机译 社论
    • 作者：W. Ombelet
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第2期
    摘要：
  • 2.

    【2hr】Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium)

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    机译 用供体精子人工授精（AID）：单个国家（比利时）精子库设施的异质性
    摘要：Due to the high inflow of foreign patients seeking cross-border reproductive care in Belgium and the increased number of lesbian couples and single women who call for artificial insemination with donor sperm (AID), Belgian sperm banks nowadays face a shortage in donor sperm. However, since there is no central registration system for sperm donors in Belgium, no figures are currently available supporting this statement. Therefore a study was performed to obtain a detailed overview of the sperm banking facilities in Belgium. Questionnaires were sent to all Belgian centres for assisted reproduction with laboratory facilities (n = 18) to report on their sperm banking methods. The results showed that 82% of the centres rely partially or completely on foreign donor sperm. Moreover, four of the thirteen centres that have their own sperm bank use imported donor sperm in > 95% AID cycles. Our results show that in 63% of the Belgian AID cycles imported Danish donor sperm is being used.Donor recruitment is mainly performed through the centre’s website (61%) or by distributing flyers in the centre (46%) and 9 to 180 potential donors have been recruited per centre in 2013. Eventually, 15 to 50% of these candidate donors were accepted. Different criteria for donor acceptance are handled by the centres: donor age limits range from 18-25 to 36-46 years old, and thresholds for sperm normality differ considerably. We can conclude that a wide variation in methods associated with sperm banking is observed in Belgian centres.
  • 3.

    【2hr】A new scoring model for characterization of adnexal masses based on two-dimensional gray-scale and colour Doppler sonographic features

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    机译 基于二维灰度和彩色多普勒超声特征表征附件质量的新评分模型
    摘要：Objective: To determine the most discriminating two-dimensional gray-scale and colour Doppler sonographic features that allow differentiation between malignant and benign adnexal masses, and to develop a scoring model that would enable more accurate diagnosis with those features.Methods: A cross sectional prospective study was conducted on patients scheduled for surgery due to presence of adnexal masses at Woman’s Health Center, Assiut University, Egypt between October 2012 and October 2013. All patients were evaluated by 2D ultrasound for morphological features of the masses combined with colour Doppler examination of their vessels. The final diagnosis, based on histopathological analysis, was used as a gold standard.Results: One hundred forty-six patients were recruited, 104 with benign masses, 42 with malignant masses. Features that allowed statistically significant discrimination of benignity from malignancy were; volume of mass, type of mass, presence and thickness of septae, presence and length of papillary projections, location of vessels at colour Doppler and colour score. A scoring model was formulated combining these features together; Assiut Scoring Model (ASM). The cut-off level with the highest accuracy in detection of malignancy, was ≥6, had a sensitivity of 93.5% and specificity of 92.2%.Conclusion: Our Scoring Model; a multiparameter scoring using four gray-scale ultrasound and two colour Doppler features, had shown a high sensitivity and specificity for prediction of malignancy in adnexal masses compared with previous scoring systems.
  • 4.

    【2hr】IVM results are comparable and may have advantages over standard IVF

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    机译 IVM结果可比，并且可能优于标准IVF
    摘要：Retrieval of immature oocytes from unstimulated ovaries, followed by in vitro maturation (IVM) was originally proposed in order to avoid side effects of gonadotropin administration. The target is to eliminate or significantly reduce the risk of ovarian hyperstimulation syndrome (OHSS) in patients with polycystic ovary syndrome (PCOS), drug cost and burden on patients. This technology was also suggested in treatment of normo-ovulatory women, fertility preservation or infrequent conditions such as failure of oocytes to mature or repeated development of poor quality embryos. In this study we intended to examine the possibility that IVM results may be comparable to standard IVF. A PubMed database search from 1999-2013 was carried out for publications concerning the indications of IVM and study the possibility that IVM results may be comparable to standard IVF.In vitro maturation of the oocytes procedures obtained up to 35% clinical pregnancy rate in young women, comparable with in vitro fertilization (IVF) in many programs. The obstetric and perinatal outcomes of IVM cycles are comparable with IVF/ICSI cycles.In conclusion IVM may gradually replace IVF in certain cases, as the technique continues to develop and pregnancy rates continue to increase, being a promising and simple alternative approach to standard IVF in various indications.
  • 5.

    【2hr】Obesity and pregnancy, an epidemiological and intervention study from a psychosocial perspective

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    机译 肥胖与妊娠，从社会心理角度进行的流行病学和干预研究
    • 作者：A. Bogaerts
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第2期
    摘要：Background: Maternal obesity is a growing public health concern in Belgium as well as in other European countries and is now becoming the most common risk factor associated with pregnancy complications with impact on the health of the women and her offspring. At this moment, there is no specific management strategy for obese pregnant women and mothers, focusing on physical health and psychological well-being.Objectives: We aimed (1) to study the influence of socio-demographic and obstetrical correlates on pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in different regions of Flanders, Belgium, (2) to review the literature on the onset and progression of labour in normal weight and obese pregnant women, (3) to compare levels and evolution of anxiety and depressed mood during pregnancy between obese women and normal-weight women, (4) to examine whether a prenatal lifestyle intervention programme, based on principles of motivational interviewing, in obese pregnant women reduces GWG and lowers levels of anxiety and depressed mood during pregnancy, (5) to examine associations between inter-pregnancy weight change from the first to the second pregnancy and the risk for adverse perinatal outcomes during the second pregnancy and finally (6) to study predictors of postpartum weight retention (PPWR) in obese mothers at six months after delivery in order to provide clues for the design of interventions aimed at preventing weight retention related to childbearing.Methods: We performed an epidemiological study, an intervention study during pregnancy with postpartum follow up and a literature review.Results: One in three Flemish women start pregnancy being overweight or obese and this prevalence has slowly been rising since 2009 in the Flanders. We identified women at risk for a high pre-pregnancy BMI and excessive GWG, both being important predictors for increased pregnancy and birth related complications. In a literature review, we showed that the combination of a higher incidence of post-term deliveries and increased inadequate contraction pattern during the first stage of labour in obese women suggests an influence of obesity on myometrial activity. Given the low compliance for adequate GWG in obese women in the general Flemish population and their increased psycho-social vulnerability compared to the normal weight pregnant women, counselling obese pregnant women can lead to a reduced GWG and increased psychological comfort. Stabilizing inter-pregnancy maternal weight for all women is an important target for reducing adverse perinatal outcomes in the subsequent pregnancy. Psychological discomfort during pregnancy does impact on PPWR in obese mothers six months after delivery.Discussion and conclusion: Focusing on weight management in obese women before, during and after a pregnancy has advantages for both the mother and her infant. Theoretical and practice based training modules should be developed and focus on: (1) awareness of techniques for identifying the clearly identified risk groups with a high pre-pregnancy BMI and excessive GWG, (2) the increased perinatal risks, (3) an adapted perinatal management and (4) counselling techniques for an adequate weight management and psychological wellbeing in obese pregnant women. To achieve better care for the future, we must focus on tackling maternal obesity. This means that obese women should be reached before they get pregnant for the first time. Targeting primary and community based care, promotion and education are challenging, but the psychosocial context should be acknowledged.
  • 6.

    【2hr】A successful pregnancy following ‘double rescue’ egg retrieval in a woman with Natural cycle IVF

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    机译 一名“自然周期IVF”妇女在“双重营救”取卵后成功怀孕
    摘要：A case is reported of a patient with critically low anti-mullerian hormone (AMH) having successful ‘rescue’ oocyte retrieval in natural in vitro fertilization (IVF) cycle 24 hours after the initial procedure had resulted in no oocyte being collected. Following administration of 10,000 units human chorionic hormone (hCG) a second retrieval was performed 24 hours after the first, producing one Metaphase-I oocyte. After in vitro maturation (IVM) over 4 hours in oocyte maturation medium, introcytoplasmic sperm injection (ICSI) was performed. A subsequent transfer of a 2-cell embryo proceeded on day 2. A positive hCG was recorded 15 days after embryo transfer (ET), and a viable clinical pregnancy has been confirmed. We believe this is the first reported case of a successful egg collection following a prior failed follicle aspiration in Natural IVF cycle. Factors such as good peri-follicular flow and initial follicular fluid cell content are probably essential before attempting a repeat procedure. This report highlights the importance of rescue IVM when an immature oocyte is collected.
  • 7.

    【2hr】Association of Childless Couples Of Ghana (ACCOG)

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    机译 加纳无子女夫妇协会（ACCOG）
    • 作者：N. Yaw Osei
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第2期
    摘要：The Association of Childless Couples of Ghana (ACCOG) is a Ghanaian non-faith based Non-Governmental Organization. ACCOG provides a platform for childless couples to find options for accessible infertility care. It provides counselling and other support services to childless couples to enable them to cope with their situation.
  • 8.

    【2hr】Can we define maternal age as a genetic disease?

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    机译 我们可以将产妇年龄定义为遗传病吗？
    • 作者：M. Wilding
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第2期
    摘要：>Maternal age is strongly associated with a decrease in the probability of achieving pregnancy and the birth of a healthy child. Among current theories of the mechanism of this decrease is the hypothesis that a progressive degeneration of the respiratory capacity of mitochondria in eggs of women of advanced age leads to an energy deficit and consequent secondary effects on the oocyte and developing embryo. Mitochondria are uniquely inherited through the female germ line and these organelles contain DNA sequences that are independent from the genome. It is therefore possible that offspring born to females of advanced age inherit suboptimal mitochondria and that these persist throughout the life of the new being. This could in turn lead to long-term consequences for the offspring of females of advanced age such as a reduced potential lifespan in relation to the age of the mother at conception. In this review and hypothesis, we discuss the evidence relating to this theory and suggest that on this basis the maternal age effect could be classified as an inheritable genetic disease.
  • 9.

    【2hr】Editorial

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    机译 社论
    摘要：
  • 10.

    【2hr】IVF Treatment and Single Embryo Transfer

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    机译 试管婴儿治疗和单个胚胎移植
    • 作者：A. Templeton
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第1期
    摘要：
  • 11.

    【2hr】The first 3,000 Non-Invasive Prenatal Tests (NIPT) with the Harmony test in Belgium and the Netherlands

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    机译 比利时和荷兰进行的首批3,000次非侵入性产前检查（NIPT）与和谐测试
    摘要：As the classical first trimester Down syndrome screening (FTS, combination test) has a false-negative rate of 20-25% and > 95% of the abnormal FTS results are false-positive, we evaluated the new Non-Invasive Prenatal Test (NIPT) in Belgium and the Netherlands.The study population consisted of 3000 consecutive pregnancies in Belgium and the Netherlands in which NIPT was performed using the Harmony test. In 57 (1.9%) of the 3000 pregnancies an abnormal NIPT result was found. This included 51 fetuses with trisomy 21, 4 fetuses with trisomy 18 and 2 fetuses with trisomy 13. In 47 of the 57 the NIPT result was confirmed by genetic testing of material obtained by amniocentesis or chorionic biopsy, and no false-positive results were recorded. The false-negative rate as determined on more than 2000 women that had delivered at the time of reporting was low, and so far only 2 false-negative results were reported (one trisomy 18 and one trisomy 21). The failure rate where no NIPT result could be obtained after repeated sampling was 0.90%.In this large clinical series, NIPT using the Harmony test proves to be a very reliable prenatal test to detect fetal trisomies 21, 18 and 13 in maternal blood in Belgium and the Netherlands.
  • 12.

    【2hr】Obstetric outcomes and congenital abnormalities in infants conceived with oocytes matured in vitro

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    机译 体外成熟的卵母细胞婴儿的产科结果和先天性异常
    摘要：
  • 13.

    【2hr】Inflammatory response in maternal serum during preterm labour

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    机译 早产期间孕妇血清中的炎症反应
    • 作者：I. Tency
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第1期
    摘要：Preterm birth (PTB), defined as a delivery before 37 weeks of gestation, is the leading cause of perinatal morbidity and mortality worldwide. Diagnosis of preterm labour as well as accurate prediction of PTB is notoriously difficult. Preterm birth is initiated by multiple mechanisms including infection or inflammation which is the only pathological process for which a firm causal link with PTB has been established. Intrauterine infection evokes an immune response that involves the release of cytokines and chemokines, prostaglandins and matrix-degrading enzymes. These substances trigger uterine contractions, membrane rupture and cervical ripening. Most intra-uterine infections are chronic and subclinical in nature and consequently hard to diagnose before labour or rupture of the membranes. The best studied site of infection is amniotic fluid, but this requires an invasive procedure. A non-invasive approach seems to be more relevant to clinical practice. However, few studies have investigated the maternal inflammatory response during preterm labour. Therefore, the overall objective of this study was to determine several inflammatory markers in maternal serum from pregnant women in labour (either term or preterm) vs. non-labouring controls.We completed a nested case control study in which singleton pregnancies were recruited at Ghent University Hospital and divided into groups according to gestational age and labour status. Multiple proteins were evaluated in maternal serum using enzyme-linked or multiplex bead immunoassays including soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), matrix metalloproteinases (MMP)-9 and MMP-3, tissue inhibitor of metalloproteinases (TIMP)-1, TIMP-2, TIMP-3 and TIMP-4 and a panel of 30 cytokines, chemokines and growth factors.
  • 14.

    【2hr】Outpatient Management of Severe Ovarian Hyperstimulation Syndrome (OHSS) with Placement of Pigtail Catheter

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    机译 放置尾纤导管的严重卵巢过度刺激综合征（OHSS）的门诊管理
    摘要：Objective: To evaluate the efficacy and safety of outpatient management of severe ovarian hyperstimulation syndrome (OHSS) requiring placement of a pigtail catheter.Methods: retrospective analysis of thirty-three consecutive patients who underwent in-vitro fertilization (2003-2009) and developed severe/critical OHSS requiring placement of a pigtail catheter. Patients who were managed on outpatient basis were monitored by frequent office visits, daily phone calls, and received IV normal saline for hydration when required.Results: In 3 patients (9.1%) OHSS started early, requiring placement of a pigtail catheter 4.3 + 0.6 days after retrieval. In 30 patients (90.9%) OHSS started late (14 ± 4 days after retrieval). The mean amount of ascitic fluid drained immediately after placement of the catheter was 2085 ± 1018 cc. The pigtail catheter was removed after 7.8 ± 5.3 days. Of the 31 patients who had embryo transfer (two had total freeze), 84% conceived. Twenty-nine patients (88%) were managed on outpatient basis without any complications. Four patients required hospital admission for 1-7 days (3.0 ± 2.7). One patient with severe OHSS was admitted for work up for chest pain. Three patients with critical OHSS with severe pleural effusion requiring thoracentesis were admitted for supportive measures.Conclusion: The placement of a pigtail catheter resulted in safe and effective outpatient management for the majority of patients with severe OHSS.
  • 15.

    【2hr】Complete congenital foetal heart block: a case report

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    机译 完全性先天性胎儿心脏传导阻滞：一例报告
    摘要：Congenital heart block (CHB) is the most severe manifestation of neonatal lupus which can develop into a lethal atrioventricular (AV) block. Complete congenital foetal heart block related to maternal anti-Ro/SSA autoantibodies typically develops between 20 and 24 weeks of gestation. CHB with a structurally normal heart is frequently associated with maternal autoantibodies to Ro/SSA and La/SSB. We are presenting a case of foetal complete CHB with high maternal Ro/SSA and La/SSB titre with favourable outcome.
  • 16.

    【2hr】The tWE lab Simplified IVF Procedure: First Births after freezing/thawing

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    机译 tWE实验室简化的IVF程序：冷冻/解冻后的头胎
    摘要：Background: Infertility care is one of the most neglected health care issues in developing countries (DC), affecting more than 50 million couples. The social stigma of childlessness still leads to isolation and abandonment. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in DC. Consequently most cases of infertility are only treatable by using assisted reproductive technologies which are either unavailable or too costly. Lowering the laboratory costs associated with IVF is a crucial step to make IVF affordable for a larger part of the world population. We recently developed and described a new simplified method of IVF culturing, called the tWE lab method. Our initial results in fresh IVF cycles showed that IVF methodology can be significantly simplified and result in successful outcomes at levels that compare favourably to those obtained in high resource programs.Case-reports: We report three pregnancies and four live births as a result of transferring five cryo/thawing embryos which were developed after using the simplified tWE lab system. The two singleton babies delivered vaginally, for the twin pregnancy a caesarean section was performed. All babies were healthy, the perinatal outcome was uneventful in all cases.Conclusion: We provide proof-of-principle evidence that transferring cryopreserved/thawed embryos obtained with our tWE lab simplified culture system can lead to successful pregnancies and healthy live births.
  • 17.

    【2hr】Helping Women with their Fertility should be part of the Agenda for Gender Equality

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    机译 帮助妇女生育，应成为两性平等议程的一部分
    • 作者：G. Nargund
    • 刊名：Facts, Views Vision in ObGyn
    • 2014年第1期
    摘要：
  • 18.

    【2hr】Editorial

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    机译 社论
    • 作者：W. Ombelet
    • 刊名：Facts, Views Vision in ObGyn
    • 2013年第4期
    摘要：
  • 19.

    【2hr】A novel radiographic technique to asses grafts in the female pelvis: a comparison of the Inside-Out and the Outside-In transobturator mid urethral sling positioning

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    机译 评估女性骨盆中移植物的一种新颖的射线照相技术：“ Inside-Out”和“ Outside-In”经闭孔中尿道吊带定位的比较
    摘要：The three-dimensional configuration of mid-urethral sling tapes is difficult to demonstrate in traditional anatomical dissections or imaging studies. The aim of this study was to test the utility of a novel technique using mesh tapes to assess spatial differences between the in-out and out-in transobturator mid-urethral slings. Two independent surgeons performed their usual transobturator mid-urethral sling placement on 10 fresh thawed cadavers, alternating sides in the consecutive cadavers. Tantalum wires threaded through the polypropylene-tapes rendered them radio-opaque. Following placement, CT scans were obtained to generate 3-D and MIPS images for analysis. Results showed that the mean angle formed by the in-out sling measured 122º (95%CI: 107º-136º); versus 144º (95%CI: 131º-151º) for the out-in sling (p = 0.02). The paired differences between the tapes’ inner angles were significantly different; with a mean difference of 20º (median 19.0º), (p = 0.008). There was no significant correlation between either approach and BMI or angle of the pubic arch. The images revealed that the tapes lie as a band posterior/dorsal to the urethra rather than inferior. In conclusion: marking mesh with Tantalum wire, in combination with 3-D and MIPS CT-scan reconstruction images, provided a unique method to visualize the entire sling trajectory. The clinical implications of the more horizontal positioning after the out-in approach remain to be determined.
  • 20.

    【2hr】Donor-conceived children looking for their sperm donor: what do they want to know?

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    机译 寻找供体的孩子寻找他们的精子供体：他们想知道什么？
    摘要：Objective: This paper aims to gain in-depth understanding of why some donor-conceived offspring want to know the identity of their sperm donor.Methods: Step-by-step inductive thematic analysis was performed on first-hand quotes from donor-conceived offspring selected from a wide range of sources (including empirical studies and donor conception networks, registries and support groups).Results: We found that at least 7 different objectives can underlie the wish to know one’s donor: to avoid medical risks and consanguineous relationships; to connect with one’s roots; to complete one’s life (hi-)story; to understand where one’s traits come from; to discover or assess one’s defining characteristics and capabilities; to rectify a wrong-doing, and to map out one’s ancestral history.Conclusion: The analysis shows that there is great variance among identity-seekers in the weight they attribute to wanting to know their donor. It is also clear that they have very different assumptions about the role and importance of genetics in terms of establishing ‘who they are’ or ‘can become’, including deterministic misconceptions. Rather than treat all donor-conceived offspring’s needs as of equal concern, this analysis should help distinguish between and assess the relevance of the various motivations.
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