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Kovacs G.T.,Monash IVF | Morgan G.,Roy Morgan Research Center Pty Ltd. | Levine M.,Roy Morgan Research Center Pty Ltd. | McCrann J.,Roy Morgan Research Center Pty Ltd.
Australian and New Zealand Journal of Obstetrics and Gynaecology | Year: 2012

Fifteen Australia-wide interview surveys between July 1981 and February 2011 on the community's attitudes to in vitro fertilisation (IVF) were carried out as part of regular Morgan polls. Each survey involved between 650 and 1000 respondents in urban and rural locations. The proportion of respondents who 'approved' or 'disapproved' of various aspects of IVF treatment were determined. Support for IVF to help infertile married couples increased from 77% in 1981 to 91% in 2011. Approval for IVF procedures being supported by Medicare funding rose from 70% in 1981 to 79% in 2000 and was unchanged in 2011. There has also been a marked increase in the support for single women and lesbians using donor sperm. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Source

Coughlan C.,Jessop Wing | Ledger W.,Royal Hospital for Women | Wang Q.,Sun Yat Sen University | Liu F.,Women and Children Hospital of Guangdong Province | And 6 more authors.
Reproductive BioMedicine Online | Year: 2014

Recurrent implantation failure refers to failure to achieve a clinical pregnancy after transfer of at least four good-quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years. The failure to implant may be a consequence of embryo or uterine factors. Thorough investigations should be carried out to ascertain whether there is any underlying cause of the condition. Ovarian function should be assessed by measurement of antral follicle count, FSH and anti-Müllerian hormone. Increased sperm DNA fragmentation may be a contributory cause. Various uterine pathology including fibroids, endometrial polyps, congenital anomalies and intrauterine adhesions should be excluded by ultrasonography and hysteroscopy. Hydrosalpinges are a recognized cause of implantation failure and should be excluded by hysterosalpingogram; if necessary, laparoscopy should be performed to confirm or refute the diagnosis. Treatment offered should be evidence based, aimed at improving embryo quality or endometrial receptivity. Gamete donation or surrogacy may be necessary if there is no realistic chance of success with further IVF attempts. Recurrent implantation failure is an important cause of repeated IVF failure. It is estimated that approximately 10% of women seeking IVF treatment will experience this particular problem. It is a distressing condition for patients and frustrating for clinicians and scientists. In this review, we have discussed the definition and management of the possible underlying causes of recurrent implantation failure. Source

Kovacs G.T.,Monash IVF | Wise S.,Policy Research and Innovation Unit Central Office | Finch S.,University of Melbourne
Human Reproduction | Year: 2013

Study Question How do families with children conceived using donor sperm operate as the children grow up? Summary Answer Families with children aged 5-13 years conceived through anonymous donor sperm function well, when compared with other family types with children of the same developmental stage. What is Known AlreadyPrevious studies on family relationships after donor sperm conception have been reassuring. However, these studies have suffered from Method ological Limitations due to small sample sizes, respondent biases and absence of appropriate controls. Study Design , Size, DurationThis study was an observational study comparing 79 'donor insemination' (DI) families with 987 'couple' families, 364 'single mother' and 112 'step-father' families as part of the Australian Institute of Family Studies Children and Family Life (CFL) study. CFL involved the collection of data on family functioning and child wellbeing from all resident parents through a Family and Child Questionnaire for the 'primary' parent (FACQ-P1) and a Family Relationship Questionnaire (FRQ-P2) for the 'other' parent. Participants/Materials, Setting , Method SAll questionnaires were coded with the identity known only to the researchers. The outcomes studied included parent psychological adjustment, family functioning, couple relationship, parenting and parent-child relationship. Family types were compared, separately for mothers' and fathers' reports. The results presented are the estimated means for each family type based on the final model for each outcome: post hoc comparisons between family types are reported with 95% confidence limits. Main Results and the Role of Chance With all of the outcomes considered, there was not one result where the DI families showed poorer functioning on average than the comparison groups. Limitations , Reason for CautionThe final sample size of DI families is 79 with an excellent response rate of nearly 80%. However, there remains some scope for response bias. Wider Implications of the FindingsThis study further reassures us that families conceived with anonymous donor sperm do not function any differently from other family types. Study Funding/Competing Interest SThe study was partly funded by a research grant from the Fertility Society of Australia, and the profits from a Serono Symposium on Polycystic Ovaries. There are no competing interests. © 2012 The Author. Source

Tarlatzis B.C.,Aristotle University of Thessaloniki | Griesinger G.,University of Lubeck | Leader A.,University of Ottawa | Rombauts L.,Monash IVF | And 2 more authors.
Reproductive BioMedicine Online | Year: 2012

Corifollitropin alfa is a novel recombinant gonadotrophin with sustained follicle-stimulating activity. A single injection can replace seven daily injections of recombinant follicle-stimulating hormone (rFSH) during the first week of ovarian stimulation. All cases of ovarian hyperstimulation syndrome (OHSS) with corifollitropin alfa intervention in a gonadotrophin-releasing hormone antagonist protocol have been assessed in three large trials: Engage, Ensure and Trust. Overall, 1705 patients received corifollitropin alfa and 5.6% experienced mild, moderate or severe OHSS. In the randomized controlled trials, Engage and Ensure, the pooled incidence of OHSS with corifollitropin alfa was 6.9% (71/1023 patients) compared with 6.0% (53/880 patients) in the rFSH group. Adjusted for trial, the odds ratio for OHSS was 1.18 (95% CI 0.81-1.71) indicating that the risk of OHSS for corifollitropin alfa was similar to that for rFSH. The incidence of mild, moderate and severe OHSS was 3.0%, 2.2% and 1.8%, respectively, with corifollitropin alfa, with 1.9% requiring hospitalization, and 3.5%, 1.3% and 1.3%, respectively, in the rFSH arms, with 0.9% requiring hospitalization. Despite a higher ovarian response with corifollitropin alfa compared with rFSH for the first 7 days of ovarian stimulation, the incidence of OHSS was similar. Corifollitropin alfa is a new agent used in ovarian stimulation treatment for IVF fertilization. One injection of corifollitropin alfa can replace seven injections of recombinant FSH (rFSH). In three studies of corifollitropin alfa treatment, we assessed all cases of ovarian hyperstimulation syndrome (OHSS), a potentially serious complication of ovarian stimulation treatment. Overall, 5.6% of the patients (95/1701) experienced OHSS. Two of the trials compared corifollitropin alfa versus rFSH. Because OHSS is relatively rare, we pooled the results of these trials to give a more reliable estimate of the incidence of OHSS. In the pooled analysis, 6.9% (71/1023) of patients receiving corifollitropin alfa had signs or symptoms of OHSS, compared with 6.0% in the rFSH group (53/880). The risk of OHSS with corifollitropin alfa treatment was similar to the risk of OHSS in patients who received rFSH: the incidence of mild, moderate and severe OHSS was 3.0%, 2.2% and 1.8%, respectively, in patients in the corifollitropin alfa treatment groups, with 1.9% requiring hospitalisation, and 3.5%, 1.3% and 1.3%, respectively, in patients in the rFSH treatment groups, with 0.9% requiring hospitalization. Although the ovaries respond more to corifollitropin alfa than to rFSH for the first 7 days of ovarian stimulation, neither treatment regimen was significantly more likely to cause OHSS. © 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. Source

Hope N.,Monash IVF | Rombauts L.,Monash IVF
Fertility and Sterility | Year: 2010

Objective: To assess whether provision of an educational DVD was more effective in increasing the uptake of elective single embryo transfers (eSET) than an educational brochure in an IVF population. Design: Randomized controlled trial. Setting: Private IVF clinic. Patient(s): One hundred thirty-one couples starting their first cycle of IVF were randomized to receive either an educational DVD or brochure. Intervention(s): Sixty-four couples received the DVD and 67 couples received the brochure. Both provided identical factual information on outcomes and risks of twin pregnancies. The DVD also included two short interviews with mothers of twins. Main Outcome Measure(s): Preference for eSET after the intervention. Result(s): There were no significant differences in fertility history or demographics. After the interventions, both groups demonstrated significantly improved knowledge. Patients in the DVD group were significantly more likely to prefer eSET compared with patients who read the brochure (82.6% vs. 66.7%). Conclusion(s): Patients exposed to the educational DVD were significantly more likely to prefer eSET. Provision of an educational DVD, such as the one used in the present study, may provide an affordable and more effective means of delivering health risk information. © 2010 American Society for Reproductive Medicine. Source

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