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Dhont N.,Genk Institute for Fertility Technology
Human Reproduction

The Walking Egg non-profit organisation (npo) was founded in 2010 by scientists and an artist to realise the Arusha Project which strives to implement accessible infertility programmes in resource-poor countries. Right from the start The Walking Egg has opted for a multidisciplinary and global approach towards the problem of infertility and in cooperation with the Special Task Force (STF) on "Developing countries and infertility" of the European Society of Human reproduction and Embryology (ESHRE) and the WHO, it gathers medical, social and economical scientists and experts along with artists to discuss and work together towards its goal. The project aims to raise awareness surrounding childlessness in resource-poor countries and to make infertility care in all its aspects, including assisted reproductive technologies, available and accessible for a much larger part of the population. Source

Ombelet W.,Genk Institute for Fertility Technology
Human Reproduction

According to WHO data more than 180 million couples in developing countries suffer from primary or secondary infertility. The social stigma of childlessness still leads to isolation and abandonment in many developing countries. Differences between the developed and developing world are emerging because of the different availability in infertility care and different socio-cultural value surrounding procreation and childlessness. Although reproductive health education and prevention of infertility are number one priorities, the need for accessible diagnostic procedures and new reproductive technologies (ART) is very high. The success and sustainability of ART in resource-poor settings will depend to a large extend on our ability to optimise these techniques in terms of availability, affordability and effectiveness. Accessible infertility treatment can only be successfully introduced in developing countries if socio-cultural and economic prerequisites are fulfilled and governments can be persuaded to support their introduction. We have to liaise with the relevant authorities to discuss the strengthening of infertility services, at the core of which lies the integration of infertility, contraceptive and maternal health services within public health care structures. After a fascinating period of more than 30 years of IVF, only a small part of the world population benefits from these new technologies. Time has come to give equitable access to effective and safe infertility care in resource-poor countries as well. Source

Ombelet W.,Genk Institute for Fertility Technology
Middle East Fertility Society Journal

It is generally accepted that intrauterine insemination (IUI) with homologous semen should be preferred as a first choice treatment to more invasive and expensive techniques of assisted reproduction in the case of cervical, unexplained and moderate male factor subfertility. Scientific validation of this strategy is difficult because the literature is rather confusing and not conclusive. The rationale for the use of artificial insemination is to increase gamete density at the site of fertilization. Many variables may influence success rates after IUI treatment procedures. It's obvious that some factors will never be solved by methodological adjustments such as female age, duration of infertility etc. However, quite a number of variables can be improved upon using different strategies. In this paper we will make a review of recommendations for daily IUI practice based on evidence-based data. © 2013 Middle East Fertility Society.Production and hosting by Elsevier B. V. All rights reserved. Source

Dhont N.,Ghent University | Luchters S.,Ghent University | Ombelet W.,Genk Institute for Fertility Technology | Gasarabwe A.,Projet Ubuzima | And 2 more authors.
Human Reproduction

Background: This study examines perceptions of infertility causes, treatment-seeking behaviour and factors associated with seeking medical care in an urban infertile population in Rwanda, as well as the response of health providers. Methods: Between November 2007 and May 2009 a hospital based survey was conducted among 312 women and 254 male partners in an infertile relationship. Results: Infertility causes based on a medical diagnosis were mentioned by 24 of women and 17 of men. Male infertility awareness was low in both sexes with 28 of men and 10 of women reporting male-related causes. Seventy-four per cent of women and 22 of men had sought care for their infertility in the past. Seeking treatment in the formal medical sector was associated with higher income, being married and infertility duration of more than 5 years in both sexes. In women, higher education and being nulliparous and in men blaming oneself for the infertility was also associated with seeking formal medical care. Participants reported a wide array of treatments they received in the past, often including ineffective or even harmful interventions. Conclusion: Health authorities should invest in improving information, education and counselling on issues pertaining to causes and treatments of infertility, and in drawing up guidelines for the management of infertility at all levels of health care. © 2010 The Author. Source

Oehninger S.,Eastern Virginia Medical School | Franken D.R.,University of the Free State | Ombelet W.,Genk Institute for Fertility Technology | Ombelet W.,Hasselt University
Fertility and Sterility

Several semen parameters are used to discriminate the fertile male from the subfertile male. The most widely used parameters are sperm concentration, motility, progressive motility, and sperm morphology. Semen analysis is usually applied as described in the World Health Organization manual for semen analysis. In addition to a routine semen analysis, sperm functional tests have been described for many years, which in most cases are regarded as research tools and not part of the routine semen testing in an infertility clinic. In this review we report on the value of four sperm function tests: the sperm penetration assay, the sperm-zona pellucida binding tests, the acrosome reaction, and the hyaluronan binding assay. For each test we describe the current value, the indication for performing the test, how to interpret the results, and its therapeutic implications. Our data show that sperm functional assays are highly predictive of IVF outcome results and have the potential to assist in clinical decision making, especially to avoid the current long-standing treatment with IUI and to direct the patients to intracytoplasmic sperm injection without delay when sperm functional testing fails. We believe that advances in molecular biology techniques will allow us to develop simpler sperm function assays in the near future. This will undoubtedly help clinicians in optimizing male factor infertility diagnosis and treatment. ©2014 by American Society for Reproductive Medicine. Source

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