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HIGH PERFORMANCE PRACTICE

How do they do it? Common practices in the top-performing IVF clinics in the USA

While there are variations in how the leading centres perform, a survey of the USA’s 13 consistently top-performing clinics finds a recurrence of common medical and laboratory practices – and some changes since a similar survey ten years ago.

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SURVEILLANCE

A new Atlas of fertility treatment policies in Europe exposes inconsistencies in regulation and funding

A country-by-country review of policies and funding in ART finds that only four of 43 countries surveyed are rated as ‘excellent’ according to a nine-point list of treatment criteria; Fertility Europe and the European Parliamentary Forum for Sexual and Reproductive Rights call for a ‘game-changing’ shift in policies.

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MALE INFERTILITY

The number of genotype-phenotype associations validated in male infertility continues to grow

A new systematic review of the validated monogenic causes of male infertility strengthens the evidence base for emerging gene-disease relationships; the review hopes to encourage more routine genetic testing in clinics and identify gaps in our knowledge of male infertility genetics.

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PCOS

Polycystic ovaries still a matter of contention in the diagnosis of PCOS

Substituting the ultrasound assessment of ovarian morphology with serum AMH measurement to diagnose PCOS according to the three Rotterdam criteria changed the number of women classified as having or not having PCOS – and ‘further blurs the diagnostic margins’.

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MENSTRUAL CYCLE

Irregular menstrual cycles linked to risk of cancer in later life

Irregular and long menstrual cycles in early life have been associated with a statistically significant greater risk of developing certain cancers than regular cycles in a large cohort study. The associations were found strongest for obesity-related cancers.

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WELL-BEING

How are you doing? Campus looks at the well-being of ART children and ART patients

A Campus workshop on the long-term impact of ART on the physical and psycho-social well-being of patients and children conceived through ART was held online in December; updates, from different perspectives, were largely reassuring.

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MISCARRIAGE

NICE supports vaginal progesterone to prevent threatened pregnancy loss

The UK agency has updated its guidance on the management of miscarriage to recommend micronised progesterone for women with a previous miscarriage who bleed in a new early pregnancy - but only after ultrasound confirmation of the intrauterine location of the pregnancy.

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IVM IN PCOS

IVM eliminates risk of OHSS in PCOS fertility treatment, but fails to match live birth rate of IVF

A randomised trial comparing two ‘third-line’ approaches in women with PCOS-related infertility – IVM with no ovarian stimulation and IVF with standard stimulation – found that the former removed the risk of OHSS but at a cost of lower live birth rates.

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REGULATION

ESHRE reaffirms its position on IVF add-ons, but little regulatory consensus on donor anonymity

ESHRE took part in the annual meeting of the UK’s Progress Educational Trust, publisher of the internationally read BioNews (www.bionews.org.uk). The ESHRE-sponsored and presented session was one of four on the meeting’s theme of regulation in fertility.

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MENOPAUSAL AGE

Age at menopause: number of births has only limited effect from interrupted ovulation

A large population study has found that having three childbirths is associated with an older age at menopause – and none with a lower age – but there were no further effects beyond three. The results question the assumption that interrupted ovulation during pregnancy delays menopause.

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