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Displaying publications 21 - 31 of 31 in total

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Fulltext Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol

Noorashikin M, Ong FB, Omar MH, Zainul-Rashid MR, Murad AZ, Shamsir A, et al.

J Assist Reprod Genet, 2008 Jul;25(7):297-303.
PMID: 18654847 DOI: 10.1007/s10815-008-9239-9

Low dose stimulation (LS) is emerging as an alternative regime in assisted reproductive technology (ART). This study aimed to compare the cost-effectiveness of LS to the high dose GnRH antagonist (Atg) regime.

Matched MeSH terms: Reproductive Techniques, Assisted*
Religious scholars' attitudes and views on ethical issues pertaining to pre-implantation genetic diagnosis (PGD) in Malaysia

Olesen A, Nor SN, Amin L

J Bioeth Inq, 2016 Sep;13(3):419-29.
PMID: 27365102 DOI: 10.1007/s11673-016-9724-2

Pre-Implantation Genetic Diagnosis (PGD) represents the first fusion of genomics and assisted reproduction and the first reproductive technology that allows prospective parents to screen and select the genetic characteristics of their potential offspring. However, for some, the idea that we can intervene in the mechanisms of human existence at such a fundamental level can be, at a minimum, worrying and, at most, repugnant. Religious doctrines particularly are likely to collide with the rapidly advancing capability for science to make such interventions. This paper focuses on opinions and arguments of selected religious scholars regarding ethical issues pertaining to PGD. In-depth interviews were conducted with religious scholars from three different religious organizations in the Klang Valley, Malaysia. Findings showed that Christian scholars are very sceptical of the long-term use of PGD because of its possible effect on the value of humanity and the parent-children relationship. This differs from Islamic scholars, who view PGD as God-given knowledge in medical science to further help humans understand medical genetics. For Buddhist scholars, PGD is considered to be new medical technology that can be used to save lives, avoid suffering, and bring happiness to those who need it. Our results suggest that it is important to include the opinions and views of religious scholars when it comes to new medical technologies such as PGD, as their opinions will have a significant impact on people from various faiths, particularly in a multi-religious country like Malaysia where society places high value on marital relationships and on the traditional concepts of family.

Matched MeSH terms: Reproductive Techniques, Assisted/ethics*
A survey of scientists' awareness of and attitudes to the use of human blood products and alternatives in human assisted reproductive technology

Peirce K, Roberts P, Ali J, Coombes J, Matson P

Hum Fertil (Camb), 2018 Sep;21(3):174-182.
PMID: 28589740 DOI: 10.1080/14647273.2017.1334131

Scientists working in assisted reproduction [members of Scientists in Reproductive Technology (SIRT) Australia, and subscribers of the online forums EmbryoMail and Quartec] were invited to complete an online questionnaire on the use of human blood products in assisted reproductive technologies (ART). A total of 260 started the questionnaire, with 208 (80%) completing it. A total of 62% of respondents had worked in human ART ≥8 years and 68% had post-graduate qualifications. The majority (82%) reported using products of animal or human origin, with 75% knowing why protein was added to culture media and 41% not worried by this. Almost half (49%) of respondents were unaware of regulations surrounding the use of human blood products in health care and 70% were unaware of adverse events involving human blood products in human ART. Most respondents (70%) indicated that they were not concerned about infections such as hepatitis, but agents such as prions were a cause for concern (57%). A total of 57% of respondents were unaware of alternatives, but 77% would use a suitable alternative. Using blood products in human ART is surrounded by a lack of awareness, often independent of respondents' qualifications or experience. A better understanding of these products and possible alternatives is required if informed decisions about their suitability are to be made.

Matched MeSH terms: Reproductive Techniques, Assisted/adverse effects*; Reproductive Techniques, Assisted/standards
Predicting successful live birth from single serum hCG measurement in assisted reproductive technology (ART) cycle

Rahilah AS, Murizah MZ

Med J Malaysia, 2023 Jan;78(1):14-19.
PMID: 36715185

INTRODUCTION: Assisted reproductive technology may result in various outcomes, causing a significant stress both physically and emotionally to the patients. This study aims to determine the level of serum human chorionic gonadotrophin (hCG) following embryo transfer in predicting successful live births in in vitro fertilisation (IVF) cycles.
MATERIALS AND METHODS: This is a retrospective analysis of 407 IVF pregnancies in Hospital Sultanah Bahiyah Kedah from 2014 to 2019. Serum hCG was withdrawn on either (i) day 16 post-oocyte retrieval for fresh IVF cycle or (ii) day 16 from the addition of progesterone in frozen embryo cycles. Outcomes of IVF pregnancies were analysed in relation to the level of serum hCG.
RESULTS: The overall median hCG level in singleton live birth was 304.7 IU/L, 547.10 IU/L for multiple live births, and early pregnancy loss level was 77 IU/L. When the ROC graphs were plotted, serum hCG level of 152.85 IU/L predicted singleton livebirth with a sensitivity of 81.3%. Serum hCG of 322.40 IU/L predicted multiple live births with sensitivity of 78.6% and a specificity of 64.3%. In the subgroup analysis comparing prediction hCG level in singleton live birth; the cut-off point in frozen cycle was found to be higher as compared to fresh cycle, 277.05 IU/L vs 117.5 IU/L. Blastocyst pregnancies recorded overall higher predictor hCG level as compared to cleavage state in all the outcomes measured; singleton live birth (372.30 IU/L), early pregnancy loss (107.60 IU/L), and multiple pregnancies (711.40 IU/L).
CONCLUSION: A single reading of serum hCG taken at day 16 post-oocyte retrieval or day 16 from the addition of progesterone in a frozen cycle will help to determine the outcomes of IVF pregnancies and direct the physicians during counselling sessions and plan for further follow-up of the patients.

Matched MeSH terms: Reproductive Techniques, Assisted
A mother with variant Turner syndrome and two daughters with trisomy X: a case report

Ramachandram S, Keng WT, Ariffin R, Ganesan V

J Genet, 2013;92(2):313-6.
PMID: 23970090
Matched MeSH terms: Reproductive Techniques, Assisted
'Intracytoplasmic sperm injection (ICSI) paradox' and 'andrological ignorance': AI in the era of fourth industrial revolution to navigate the blind spots

Sengupta P, Dutta S, Jegasothy R, Slama P, Cho CL, Roychoudhury S

Reprod Biol Endocrinol, 2024 Feb 13;22(1):22.
PMID: 38350931 DOI: 10.1186/s12958-024-01193-y

The quandary known as the Intracytoplasmic Sperm Injection (ICSI) paradox is found at the juncture of Assisted Reproductive Technology (ART) and 'andrological ignorance' - a term coined to denote the undervalued treatment and comprehension of male infertility. The prevalent use of ICSI as a solution for severe male infertility, despite its potential to propagate genetically defective sperm, consequently posing a threat to progeny health, illuminates this paradox. We posit that the meteoric rise in Industrial Revolution 4.0 (IR 4.0) and Artificial Intelligence (AI) technologies holds the potential for a transformative shift in addressing male infertility, specifically by mitigating the limitations engendered by 'andrological ignorance.' We advocate for the urgent need to transcend andrological ignorance, envisaging AI as a cornerstone in the precise diagnosis and treatment of the root causes of male infertility. This approach also incorporates the identification of potential genetic defects in descendants, the establishment of knowledge platforms dedicated to male reproductive health, and the optimization of therapeutic outcomes. Our hypothesis suggests that the assimilation of AI could streamline ICSI implementation, leading to an overall enhancement in the realm of male fertility treatments. However, it is essential to conduct further investigations to substantiate the efficacy of AI applications in a clinical setting. This article emphasizes the significance of harnessing AI technologies to optimize patient outcomes in the fast-paced domain of reproductive medicine, thereby fostering the well-being of upcoming generations.

Matched MeSH terms: Reproductive Techniques, Assisted
Sunni Islamic perspectives on lab-grown sperm and eggs derived from stem cells - in vitro gametogenesis (IVG)

Serour G, Ghaly M, Saifuddeen SM, Anwar A, Isa NM, Chin AHB

New Bioeth, 2023 Jun;29(2):108-120.
PMID: 36427532 DOI: 10.1080/20502877.2022.2142094

An exciting development in the field of assisted reproductive technologies is In Vitro Gametogenesis (IVG) that enables production of functional gametes from stem cells in the laboratory. Currently, development of this technology is still at an early stage and has demonstrated to work only in rodents. Upon critically examining the ethical dimensions of various possible IVG applications in human fertility treatment from a Sunni Islamic perspective, together with benefit-harm (maslahah-mafsadah) assessment; it is concluded that utilization of IVG, once its efficacy and safety are guaranteed, could be permissible by strictly adhering to Islamic ethical principles related to marriage, biological/genetic relatedness, sexual intercourse, and moral status of the embryo/fetus versus that of the gamete. As a result, IVG will be acceptable for treating primary infertility, age-related infertility, and preventing genetic diseases. However, it will be unacceptable for application in posthumous reproduction, donor gametes, genetic enhancement, and procreation in same-sex couples.

Matched MeSH terms: Reproductive Techniques, Assisted
Fulltext Comparison of Treatment Outcomes among Sibling Oocytes Using Different Culture Systems-Conventional IVF versus INVOcell Device-And Evaluation of INVOcell User Satisfaction: The INVOcIVF Study

Yang Mohsin WS, Abdullah Chue NS, Abdul Hamid F, Abu MA, Othman S, Mat Jin N, et al.

Int J Environ Res Public Health, 2022 Sep 29;19(19).
PMID: 36231691 DOI: 10.3390/ijerph191912391

INVOcell is considered an alternative to conventional IVF proposed for intravaginal embryo culture; however, implementation is still low because evidence is scanty regarding its outcome and, most importantly, the device's user satisfaction. Thus, we aim to compare the embryo outcome of sibling oocytes following INVOcell culture with conventional IVF (cIVF) by assessing its clinical outcome (fertilization, blastulation rate, and good embryo quality) and the user satisfaction evaluation based on a local validation questionnaire. A prospective study was done at a university-setting hospital for 12 months (July 2021-2022). The oocytes collected were divided into INVOcell and cIVF groups equally. Inclusion criteria included <40 years old and body mass index (BMI) < 30 kg/m2. The pre- and post-satisfaction questionnaires were assessed. In total, 23 women were included following standard controlled ovarian stimulation (COS). The mean age was 32.9, and the mean BMI was 24.9 kg/m2. Most of them suffered from tubal factors. A total of 252 oocytes were collected and incubated accordingly (cIVF; 138, INVOcell; 114). The blastulation rate was superior in the INVOcell group (p = 0.16); otherwise, the fertilization rate and good embryo quality were not significantly different between both methods (p > 0.05). Overall, women were satisfied with the INVOcell device as they were adequately advised, follow-up was scheduled, and the lowest score was obtained for all side effects of the device. Although both methods produce similar fertilization rates and good-quality embryos, the blastulation rates were better in the INVOcell group. Functionally, it is a user-friendly device and tolerable. Therefore, INVOcell can be used as an alternative method for reproductive treatment in carefully selected patients without jeopardizing the IVF outcomes.

Matched MeSH terms: Reproductive Techniques, Assisted
Fulltext Iatrogenic (‘clinician-induced’) damage incurred by human sperm during infertility treatment: postgraduate research and collaborative developments between the universities of Malaya and Oxford

Yelumalai, S., Jones, C., Coward, K.

JUMMEC, 2013;16(2):1-6.
MyJurnal

Assisted Reproductive Technology (ART) is a suite of laboratory techniques designed to rescue infertile phenotypes. While ART has led to the birth of 5 million ART babies worldwide, success rates rarely exceed 40%. One potential factor for this could be iatrogenic (‘clinician-induced’) damage to critical sperm proteins, such as phospholipase C zeta (PLCζ) and protamine, which are fundamental for oocyte activation and sperm DNA integrity, respectively. This report describes how we have begun to investigate the adverse effects of ART techniques upon these key sperm proteins. We also describe the pathway taken by Miss Suseela Yelumalai to acquire a scholarship from the Malaysian Government and her postgraduate experience at the University of Oxford. We introduce the facilities and learning opportunities available at the Institute of Reproductive Sciences (IRS) which houses Dr Kevin Coward’s research laboratory, and finally, highlight the potential for collaborative development between the Universities of Oxford and Malaya.

Matched MeSH terms: Reproductive Techniques, Assisted
Fulltext Repeated Evaluations of Testes and Semen Characteristics in Two Binturongs (Arctictis binturong)

Zainuddin ZZ, Sipangkui S, Farqhan Kelana M, Chee YK, Tarmizi MRM, Comizzoli P

Front Vet Sci, 2021;8:658573.
PMID: 33778042 DOI: 10.3389/fvets.2021.658573

The binturong is a medium size carnivore belonging to the Viverrid family that lives in dense forests of South-East Asia. In addition to the protection of this vulnerable species in its natural habitat (in situ), conservation breeding efforts (ex situ) aim at maintaining a good genetic diversity while increasing the number of individuals to reinforce wild populations. Both approaches require a solid understanding of binturong's basic biology. However, there is still a lack of precise information about reproduction. The objective of this brief research report was to analyze testicular sizes and semen characteristics at different times of the year to better understand the reproductive physiology and inform future conservation efforts. A secondary objective was to describe sperm cryotolerance for the first time in that species. Examinations of testes and semen collections were conducted on two adult males. While testicular measurements were relatively constant across multiple examinations, semen characteristics (volume, viability, sperm concentrations, sperm motility) varied between samples. However, incidence of sperm morphological abnormalities was consistently high. Sperm cryotolerance appeared to be poor but further studies are warranted. The present dataset will be useful for future research on binturong reproduction and for the development of assisted reproductive techniques and biobanking of germplasms in that species.

Matched MeSH terms: Reproductive Techniques, Assisted
A pilot study to determine whether progestogen supplementation using dydrogesterone during the first trimester will reduce the incidence of gestational hypertension in primigravidae

Zainul Rashid MR, Lim JF, Nawawi NH, Luqman M, Zolkeplai MF, Rangkuty HS, et al.

Gynecol Endocrinol, 2014 Mar;30(3):217-20.
PMID: 24552449 DOI: 10.3109/09513590.2013.860960

Gestational hypertension (GH) remains one of the main causes of high maternal and perinatal morbidity and mortality worldwide with the highest incidence among primigravidae of about 10%-15%. However, it was noted that the incidence of GH in primigravidae who conceived following assisted reproductive technique (ART) or intrauterine insemination (IUI) supplemented with dydrogesterone during the first trimester was low.

Study site: Obstetrics and Gynecology
Department, Pusat Perubatan Universiti Kebangsaan Malaysia PPUKM

Matched MeSH terms: Reproductive Techniques, Assisted