During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women < 35 years to 56.5% in women >44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P <0.0001). Exclusion of embryo banking cycles led to inflation of livebirth rates in fresh ART cycles, increasing in size in parallel to advancing female age and utilization of embryo banking, reaching 56.3% in women age >44. The infla- tion of livebirth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater.
Male Drosophila flies secrete seminal-fluid proteins that mediate proper sperm storage and fertilization, and that induce changes in female behavior. Females also produce reproductive-tract secretions, yet their contributions to postmating physiology are poorly understood. Large secretory cells line the female’s spermathecae, a pair of sperm-storage organs. We identified the regulatory regions controlling transcription of two genes exclusively expressed in these spermathecal secretory cells (SSC): Spermathecal endopeptidase 1 (Send1), which is expressed in both unmated and mated females, and Spermathecal endopeptidase 2 (Send2), which is induced by mating. We used these regulatory sequences to perform precise genetic ablations of the SSC at distinct time points relative to mating. We show that the SSC are required for recruiting sperm to the spermathecae, but not for retaining sperm there. The SSC also act at a distance in the reproductive tract, in that their ablation: (1) reduces sperm motility in the female’s other sperm-storage organ, the seminal receptacle; and (2) causes ovoviviparity—the retention and internal development of fertilized eggs. These results establish the reproductive functions of the SSC, shed light on the evolution of livebirth, and open new avenues for studying and manipulating female fertility in insects.
In this study we identify precise estimates of the strength and independence of the factors affecting the odds of IVF success and their association with adverse perinatal outcome. To date, successful prediction of livebirth after assisted conception has been limited, with a recent systematic review  finding that models were limited by their sample size, incorporating fewer than 3,100 cycles or couples and their lack of external validation. The notable exception was the model of Templeton et al., which analysed 36,961 treatment cycles undertaken in the UK between 1991 and 1994 and was validated in a population of 1,253 couples receiving IVF treatment in The Netherlands between 1991 and 1999 [7,23]. Since then, ICSI for male factor infertility has been widely adopted, and consequently we demonstrate that this previously validated model, although showing reasonable discrimination, is poorly calibrated and of limited use in contemporary populations. We have developed a new model, which encompasses a series of new measures including use of donor oocytes, ICSI, cycle number, and whether there had been a previous spontaneous or IVF-related livebirth or fetal loss. Using this novel model we can statistically significantly improve the overall prediction of livebirth as assessed by area under the curve and attain excellent calibration with accurate identification of couples with a poor, moderate, or good prognosis. We also find that maternal characteristics, in particular maternal age, source of the oocyte and cervical causes of infertility are strongly associated with the risk of low birth weight and preterm delivery in singleton live births resulting from IVF. Notably, some of these associations were in the opposite direction to those seen for successful livebirth. Thus, in women who successfully have a singleton livebirth with IVF, the risk of low birth weight is reduced in older compared with younger women and both low birth weight and preterm are reduced when the woman’s own embryo has been used.
In a recent study, Esteves et al. (32) reported a cumulative sperm retrieval success rate (SRR) of 97.9% using percutaneous epididymal sperm aspiration (PESA), in association or not with testicular sperm aspiration (TESA), in men with OA, regardless of the cause of obstruction. PESA alone was able to retrieve sperm in more than 80% of the cases. Reproductive outcomes after ICSI were not affected by the source (epididymis versus testicle) or etiology (congenital, failed vasectomy reversal, post-infectious disease). Successful epididymal sperm retrievals were achieved in all congenital obstructive cases, whereas testicular retrievals were needed in approximately 1/3 of the cases classified in the other etiology groups (vasectomy, post-infectious obstructions). In a meta-analysis involving 756 ICSI cycles using surgically retrieved sperm, Nicopoullos et al. compared the outcomes of ICSI between patients with congenital and acquired OA. The meta-analysis revealed no difference in either clinical pregnancy rate (relative risk [RR]: 1.03; 95% confidence interval [CI]: 0.75-1.31; p = 0.87) or livebirth rate (RR: 1.03; 95% CI: 0.81-1.31; p = 0.80) between patients with congenital and acquired cases of OA. A significantly higher fertilization rate was noted in the acquired group (RR: 0.92; 95% CI: 0.84-1; p = 0.05), while a significantly higher miscarriage rate (MR) was noted in the congenital group (RR: 2.67). The authors concluded that in ICSI cycles for men with OA, the cause of OA appears to influence the outcome, with higher FRs and lower MRs observed in patients with acquired OA. However, tests of heterogeneity were sig- nificant, and it should be noted that the studies included had no power to detect clinically significant differences in the analyzed outcomes (21).
Despite having the same methods as the studies included, two studies were excluded: the first because it was a pilot project that was subsequently published in full and included in this study and the second because the statistics on a table were inaccurate. To evaluate the coverage of studies, the publication sample size was compared with the number of live births in the region in the study period using data from the LiveBirth Information System (SINASC) of the Brazilian Ministry of Health. (11)
2.3. Nascimento vivo - E a com pleta expulsao ou extra�ao do concepto que, independentemente do tempo da gesta�ao, depois de separado do orga nismo materno, respira ou mostra al gum sinal de vida, como : batimentos cardiacos, pulsa;ao do cordao umbili cal, ou movImento de musculo volun tario, tenha ou nao sldo secclonado 0 cordio. Todo 0 produto assim nascido, deve ser considerado nascimeno vivo (InternatIonal recomendatlons ou defi nitions of livebIrth and fetal deah. PSH. Publication n.O 3 9, National Office of Vital Statistics, 1960).
This study utilized a historical co- hort design to assess the impact of the Women’s Centre of Jamaica Founda- tion (WCJF) Programme for Adoles- cent Mothers on the prevalence of con- traceptive use among their target population of adolescent mothers aged 16 years and under who experienced a first livebirth in 1994 as a result of their first pregnancy. This study was conducted in 1998 and utilized the fol- lowing data sources: vital records, Women’s Centre program records, and self-reports from a survey. Abstraction of data from vital records and WCJF records provided a source of verifica- tion of key variables from the survey.
Using computational tools, Cenepi construct- ed new epidemiological information systems that were based on municipalities. Thus, epidemio- logically-based systems, such as the LiveBirth Information System (SINASC) and the Notifiable Health Problems Information System (SINAN), were created and the Mortality Information Sys- tem (SIM) was also improved. Through agree- ments with universities and other public insti- tutions, training was provided for health profes- sionals from all over the country. The content of the courses was related to the field of surveillance, such as epidemiology focused on health services; the use of software for epidemiological analysis; the implementation and management of new epi- demiological information systems within the SES and SMS; epidemiological surveillance; and the analysis of health situations.
Data collection occurred through the book of records used in the hospital delivery room, created based on the Certificate of LiveBirth, called by the in- stitution the “Book of Nursery.” It is emphasized that for data collection it was used a structured form com- posed of sociodemographic variables (maternal age, education level, marital status and current occupa- tion) and obstetric (parity, number of prenatal visits, gestational age and type of delivery).
The first component (identification of infant deaths) aims to capture – via the responsible area at the Municipal Health Department – all deaths registered through Death Certificates (DC), at health facilities, at the Services of Death Investigation (SDI), at the Forensic Medicine Institute (FMI) and in registry offices. After that, the eligible deaths that occurred in Recife are selected (excluding congenital malformations). Each of these deaths is directed to the IMS team, who is responsible for locating the respective Certificate of LiveBirth (CLB) in the database of the Information System on Live Births (Sinasc). Considering the mother's residence address,
Introduction: The aim of this study was to assess the epidemiological characteristics of Trypanosoma cruzi-infected mothers and the livebirth conditions of neonates. Methods: A serological survey with IgG-speciic tests was conducted using dried blood samples from newborn infants in the State of Minas Gerais. T. cruzi infection was conirmed in mothers through positive serology in two different tests, and infected mothers were required to have their infants serologically tested after the age of 6 months. The birth conditions of the neonates were obtained from the System of Information on Live Births database. Results: The study included 407 children born to T. cruzi-infected mothers and 407 children born to uninfected mothers. The average age of seropositive mothers was 32 years (CI95% 31.3-32.6), which was greater than the average age of seronegative mothers - 25 years (CI95% 24.8-25.2). The mothers’ level of education was higher among uninfected mothers (41% had 8 or more years of education, versus 22% between the infected mothers). Vaginal delivery was more frequent among infected mothers. There was no evidence of inter-group differences with respect to the child’s sex, gestational age, birth weight or Appearance, pulse, grimace, activity and respiration (APGAR) scores at 1 and 5 minutes. Conclusions: The level of education and the greater number of previous pregnancies and cases of vaginal delivery relect the lower socioeconomical conditions of the infected mothers. In the absence of vertical transmission, neonates had similar health status irrespective of the infection status of their mothers.
The data were gathered by consulting the register of births that happened during the studied period, followed by identification of records, verification of the DNV copy and of the copy or note of the birth certificate. The date of each livebirth and the mother’s name, which were in the birth registration books, were the variables used for identification and selection of medical records for consultation. The information on the birth certificate was obtained 15 days after the delivery day, because this is the deadline for drafting the document in registry offices of maternity hospitals. The query was based on two actions, each directed to a source of research: (i) checking the copy of the archived document, with the medical record; and/or (ii) identifying the birth registration, by consulting the civil registry office in the maternity hospital.
Sperm can be obtained by microepididy- mal sperm aspiration (MESA), percutaneous sperm aspiration (PESA), and testicular sperm extraction (TESE), from patients with congenital absence of the vas deferens (CBAVD). The authors of the vi- deo on PESA as a method for sperm retrieval in obstructive azoospermia nicely demonstrate this technique in men with CBAVD. These patients have an abnormal epididymis from this condition making the retrieval more challenging (1). In their case series of 32 men with CBAVD, success rate at obtaining motile sperm by PESA was 96.8%, with a livebirth rate of 34.4% per attempt. The short-term outcome of resulting offspring was
location. Thus, in fi ve years, there was great data improvement. The frequency of BDs in the livebirth cohort was 0.8%, according to the SINASC. Results from this study are in agreement with the predominance of musculoskeletal system defects, followed by the central nervous system, as found in the cities of Rio de Janeiro, Vitória and Vale do Paraíba Paulista, in Brazil, and in the city of Caracas, in Venezuela. These results are similar to those found in the United States and in Europe. 3,13,18 The prevalence of BDs
and chance. The present study adjusted for differences in individual risks that were not under practitioners’ control in each hospital of birth and the statistical techniques used reduced misinterpretation due to random ﬂ uctuations in the results. The study has the advantage of including all live births in the city over the study period, thus avoiding differences in accuracy of ascertainment and completeness of registration of livebirth infants between hospitals. However, it lacked a more precise assessment of gestational risk as well as a better measure of illness severity at birth than birth weight alone, which is known to predict mortality risk less accurately than well-known score systems in the literature. 4,17 Therefore, residual confounding cannot
Given the facts, we suggest a review in the form of the Certificate of LiveBirth to include the register of HC and other anthropometric measurements that are already conducted but do not have a field to be recorded in the current model of the form. Another important measure would be the development of a surveillance model for all congenital anomalies that included, among other actions, the improvement on case definitions, the creation of a list with priority anomalies for epidemiological investigation, as well as the training and tools of the necessary resources. Furthermore, some coordinated actions between the surveillance services and health care need to be strengthened, in order to prevent new cases and for health promotion, and also for the children with microcephaly and their families follow up.
infertile couples (11). The men had idiopathic oligozoospermia (5-15 million/mL) and persis- tently elevated SDF (DFI>30% by SCD) despi- te taking oral antioxidant therapy. The women were aged <40 years and had no apparent fer- tility issues. The main outcome measures were clinical pregnancy rate (CPR), livebirth rate (LBR), and miscarriage rate, and the study was powered (80%) to detect a 30% difference in LBR between the groups with a significance level of 5%. The clinical characteristics of the couples subjected to ICSI using testicular versus ejacu- lated sperm were not statistically different. In this study, we found that LBR was significantly higher (P=0.007) in the Testi-ICSI group (46.7%) than in the Ejac-ICSI group (26.4%). Moreover, miscarriage rates were lower in couples who used testicular versus ejaculated sperm for ICSI (10% vs. 34.3%, P=0.012). The relative risk of achieving a livebirth by Testi-ICSI was incre- ased by 76% (RR 1.76, 95% CI 1.15-2.70). This means that the number needed to treat by Testi- -ICSI compared with Ejac-ICSI to achieve one additional livebirth was 4.9 (95% CI 2.8-16.8), thus suggesting that one out of five oocytes pi- ck-ups can be avoided if testicular sperm is used in preference over ejaculated sperm.
The objective of the present study was to evaluate the completeness and agreement between data obtained from the LiveBirth Information System (SINASC) and hospital records for high neonatal risk situations. Using RecLink III software, a probabilistic data linkage was carried out using databases from a Public Health Neonatal Intensive Care Unit and SINASC (years 2005-2006), which made possible the analysis of data from 170 live births with very low birth weight (between 500g and 1,499g), present at both databases. Variables evaluated were: maternal age, number of antenatal care vi- sits, delivery type, sex, birth weight, Apgar score at 1 st and 5 th minutes and gestational
All births with birth weight < 1,000 g were preterm, prevalence > 90.0% in infants between 1,000 g and 1,800 g. From 3,000 g and upwards, the prevalence of preterm births was low. As in many studies, the numbers of births in each 100 g group were small, there is considerable variation between the studies, but the mean curves follow the expected pattern. The relatively low rates of preva- lence observed in Jundiaí and Itajaí are probably due to the fact that these studies included samples of pregnant women who probably had lower risk pregnancies. Comparing the curve based on the primary data and the SINASC results suggests that the SINASC underesti- mates the prevalence of premature births in Brazil. The situation appears to have changed for the better in 2011 compared with the previous decade. This is possibly due to the fact that gestational age began to be collected in exact weeks, and not grouped into categories. Even in 2011, many maternity wards used the previous version of the Statement of LiveBirth, which is being gradually replaced by the updated version. A more exact evaluation of the impact of the change in the document may be able to be carried out from 2012 onwards. The differences between the SINASC data and the primary data occur mainly up to 3,000 g. Above this weight, they are lower and not signiicant.
Compared to controls, cases were more likely to have higher BMI, an earlier age at menarche, a later age at first livebirth, a later age at menopause, a history of benign breast disease and a family history of breast cancer, and were less likely to be physically active (Table 1). All of the above variables were considered potential confounders and adjusted for in subsequent analyses. No significant differences were found between cases and controls in socio-demographic fac- tors, including marital status, educational level, occupation, and household income, or in re- productive factors, including nulliparous, number of live births, months of breast feeding, menopausal status, and use of an oral contraceptive.