Post-ovulatory ageing of the human oocyte and embryo failure

Post-ovulatory ageing of the human oocyte and embryo failure

Authors: Allen J. Wilcox, Clarice R. Weinberg, Donna D. Baird, Post-ovulatory ageing of the human oocyte and embryo failure, Human Reproduction, Volume 13, Issue 2, 1 February 1998, Pages 394–397, https://doi.org/10.1093/humrep/13.2.394

Abstract

We carried out a prospective study of 221 healthy women who were attempting pregnancy. During the study, women collected daily urine samples and kept daily records of intercourse.

Ovulation and early pregnancy losses were later identified by immunoassays of urinary human chorionic gonadotrophin and steroid metabolites. We have used these data to examine whether the risk of early pregnancy loss was higher with post-ovulatory ageing of the oocyte. 192 pregnancies were ranked by the probability that the oocyte might have aged before fertilization.

There was a statistically significant increase in the risk of early loss as the likelihood of oocyte ageing increased (P < 0.05). No similar risk was observed for clinical miscarriages. Post-ovulatory ageing of the oocyte prior to fertilization may cause early pregnancy failure in humans as it does in several other mammalian species.

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Fertility Awareness in Women Attending a Fertility Clinic

Fertility Awareness in Women Attending a Fertility Clinic

Authors: Blake D, Smith D, Bargiacchi A, France M, Gudex G. Fertility awareness in women attending a fertility clinic. Aust N Z J Obstet Gynaecol. 1997 Aug;37(3):350-2. doi: 10.1111/j.1479-828x.1997.tb02429.x. PMID: 9325525.

Abstract

Eighty women attending for consultation at a tertiary referral fertility unit over a 3-month period were surveyed for their knowledge of fertility awareness and how they used this information to enhance their chances of conception. It was hypothesized that less than 50% of the subjects had an adequate understanding of when the fertile time occurred in their menstrual cycle. A questionnaire was completed anonymously by each subject and these were scored in 3 categories for fertility awareness by 2 independent Natural Family Planning teachers. Scores ranged from 0 for women who had no concept of fertility awareness, to 6 for women who were highly aware. The results showed that 26% (N = 21) of subjects had a score of 4 or greater which was considered as having an adequate understanding. The hypothesis was accepted, giving reason for concern about the effectiveness of consumer education at all levels of fertility investigation.

PIP: Fertility awareness was assessed in a survey of 80 women presenting over a 3-month period to a tertiary referral unit at the National Women’s Hospital in Auckland, New Zealand, for infertility investigation. It was hypothesized that less than 50% of menstruating women with a history of at least 2 years of infertility have an adequate understanding about the fertile time of their menstrual cycle. 60% of women had been trying to conceive for 2-3 years, 23% for 4-5 years, and 17% for more than 6 years. For 58% of clients, this was their first visit to a fertility clinic. 13% had attended a natural family planning (NFP) clinic previously. On the basis of questionnaire responses, participants were graded from 0 to 2 in each of the following 3 categories: 1) level of fertility symptom awareness (cervical mucus and ovulatory pain), 2) level of understanding of what these symptoms mean, and 3) level of use of this information to enhance conception. Only 21 women (26%) had a final score of 4 or greater–a predetermined cut-off considered indicative of adequate fertility awareness. The largest percentage of women (46%) had scores of 0-1. 80% of women with previous NFP instruction had adequate fertility awareness scores. These finding supported the study hypothesis of a generally poor level of fertility awareness among women presenting for treatment of infertility. Greater utilization of NFP clinics by general practitioners and specialists, as well as incorporation of NFP trained nurses into tertiary referral clinics, are recommended.

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