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INFERTILITY PREVALENCE

Prevalence of infertility judged higher than previous estimates, though studies vary greatly

A new WHO-funded meta-analysis of global and regional infertility prevalence finds high overall lifetime and 12-month rates (17.5% and 12.6%), but acknowledges huge variation in the methodology of contributing studies; a ‘consistent definition’ is needed to improve the management of infertility.

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PREGNANCY INTERVAL

Registry study challenges recommended six-month pregnancy interval after miscarriage or abortion

A new registry study suggests that conceiving within six months of a miscarriage or induced abortion is not associated with any increased risks of adverse pregnancy outcomes. The results are consistent for an interpregnancy interval as short as three months, and ‘do not support’ WHO recommendations.

The EU’s tissue and cell directives will shortly be superseded by a new single legislationread

TISSUE & CELL LEGISLATION

The EU’s tissue and cell directives will shortly be superseded by a new single legislation; ESHRE outlines the ‘key considerations’

The European Commission has published its proposed legislation for substances of human origin (SoHO) and is presently in a consultation phase. ESHRE, in a hybrid meeting for MEPs in November, reviewed the proposal’s implications for assisted reproduction from both the institutional and patient perspective. ESHRE secures large EU data collection grant.

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PCOS

Large population study reaffirms link between PCOS and metabolic complications of pregnancy

A cross-linkage analysis of more than 90,000 deliveries has found that women with a history of PCOS were at a higher risk of gestational diabetes, pre-eclampsia and Caesarean section than those without PCOS; extra monitoring is advised for PCOS pregnancies.

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RECURRENT PREGANCY LOSS

Campus: Managing implantation failure

Following a Campus meeting in December Focus on Reproduction spoke to the co-ordinator of ESHRE’s SIG Implantation and Early Pregnancy, Professor Henriette Svarre Nielsen from the University of Copenhagen, about managing patients with recurrent pregnancy loss – some with as many as ten miscarriages - and its associations with endometriosis and the vaginal/endometrial microenvironment.

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CHROMOSOMAL MOSAICISM

New ESHRE recommendations steer a path through the complexities of managing embryonic mosaicism

A survey of how centres manage chromosomal mosaicism in their PGT patients was the basis for new ESHRE recommendations. There remain many knowns and unknowns, but the new publication offers recommendations on how to manage the detection of chromosomal mosaicism, validation of techniques, risk assessment, reporting, embryo transfer policies, prenatal testing and genetic counselling.

Counsellingread

COUNSELLING

Psychological interventions in infertility associated with small reductions in distress and modest effects on conception

New meta-analysis finds huge number of studies assessing a variety of approaches for emotional and psychological support in infertility, but studies of poor methodological quality and great heterogeneity.

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CANNABIS IN PREGNANCY

Cannabis use in pregnancy raises risk of adverse maternal and infant outcomes

A large cohort study from Canada has found that around 2% of pregnant women used cannabis during the study period and that this use was particularly associated with a greater infant risk of preterm birth, low birth weight and small-for-gestational age.

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SPERM COUNT

The decline in sperm count has become steeper since 2000

A follow-up to the 2017 meta-analysis of Levine et al finds that sperm count is declining at an accelerated pace (now at 2.64% per year) and throughout all parts of world; male fertility described as a ‘major public health problem’.

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CAMPUS: MALE INFERTILITY

Many more questions than answers at male reproductive health Campus meeting

A far-reaching Campus meeting in support of the Male Reproductive Health Initiative exposed gaps in the diagnosis and treatment of male infertility and highlighted basic needs for research. Men’s reproductive medicine, said the WHO, is ‘important but neglected’.

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