Epigenetics is defined as the study of the heritable phenotype change that is not strictly dependent on DNA sequence. It involves DNA methylation, histone modifications, regulations of non-coding RNAs, and so on. Great epigenetic changes take place during the spermatogenesis and fertilization, so it is very important for us to understand the epigenetic messages. This paper provides an overview of the latest researches on epigenetics of male germ cells, and briefly discusses the possible genetic risks of the assisted reproductive technology (ART).
Epigenesis, Genetic ; Humans ; Male ; Reproductive Techniques, Assisted ; adverse effects ; trends ; Spermatozoa ; cytology ; metabolism

Assisted reproductive technology (ART), developed in the end of last century, has been playing an irreplaceable role in the treatment of male infertility, though it does have its potential risks, including the induction of monozygotic twins, premature delivery, high incidence of birth defects, etc. How to avoid these risks has posed a challenge and demands earnest attention from andrologists. This article summarizes the main potential risks of ART and proposes some tactics concerning patient evaluation, health education and treatment standardization, so as to optimize the outcomes and minimize the risks. Meanwhile, emphasis is placed on the importance of etiological and anti-oxidant strategies in the treatment of male infertility.
Humans ; Infertility, Male ; therapy ; Male ; Reproductive Techniques, Assisted ; adverse effects ; Risk Factors

With the development of assisted reproductive technique (ART), children born following ART now form a sizeable subgroup of the population, so assessment for the safety of ART becomes more urgent than ever before. The health problems about living quality of children conceived by ART mainly focus on perinatal outcome and short-term follow-up study, including multiple pregnancies, low birth weight and prematurity in singleton births, congenital malformations, imprinting disorders, neurodevelopmental outcome, neonatal outcomes, physical and mental health, as well as cancer risks. In this review, we will discuss the health problems of these children, to provide data for further study.
Child ; Health Status ; Humans ; Quality of Life ; Reproductive Techniques, Assisted ; adverse effects

We report 3 cases of successful pregnancies in women with a history of surgeries for gynecological malignancies and postoperative infertility, achieved by in vitro fertilization-embryo transfer (IVF-ET) with controlled ovarian hyperstimulation. All the 3 patients had clinical pregnancies without cancer recurrence. In such cancer survivors with infertility, the ovarian reserve is severely impaired by cancer therapies and assisted reproductive techniques should be the primary option.
Embryo Transfer ; Female ; Fertilization in Vitro ; Gynecologic Surgical Procedures ; adverse effects ; Humans ; Infertility, Female ; therapy ; Neoplasms ; surgery ; Pregnancy ; Reproductive Techniques, Assisted

The number of offspring conceived by assisted reproductive technology (ART) has reached over 5 million. As the primary means for treating infertility, the health of offspring produced by ART has been a long concern. Both procedures of ART and factors underlying infertility can lead to epigenetic changes which can cause certain diseases. This paper has reviewed diseases noted among offspring conceived by ART, which include imprinting disorders, metabolic syndromes and cancers. We also tried to explore the pathogenesis of such diseases from an epigenetic perspective, which may help with evaluation the influence of ART on the offspring and its safety for application.
Epigenesis, Genetic ; Genetic Diseases, Inborn ; genetics ; Genetics, Medical ; Humans ; Infertility ; therapy ; Pedigree ; Reproductive Techniques, Assisted ; adverse effects

INTRODUCTIONAt present, about 1% of newborns are delivered through assisted reproductive technologies (ART) worldwide. This study aimed to evaluate and compare the growth parameters of children born in assisted and natural conception at 5 years of age.

MATERIALS AND METHODSIn a cross-sectional case control study, weight, height and head circumference of 5-year old children were assessed. The case group consisted of term, singleton babies who were products of ART in the Center for Infertility of Shahid Sadoughi University, Yazd, Iran in 2005. The control group consisted of term, fi rst child, singleton and spontaneously conceived 5-year-old children who were referred for vaccination to primary health care center of Shahid Akbari in 2010.

RESULTSFifty-eight girls (47.5%) and 64 boys (52.5%) "with equal numbers in each of the 2 groups" were evaluated. Sex distribution, mean ages of fathers and mothers were not statistically significant different in both groups. Children born after ART tend to have lower birth weight, smaller birth head circumference and lower weight at 5 years of age. Having low birth weight (<2500 g), being underweight and having short stature at the age of 5 were more common in babies born through ART.

CONCLUSIONGrowth retardation is more prevalent in babies born through ART. Thus, growth assessment, parents' knowledge about child physical development, and timely and accurate follow-up of these children are necessary for early detection of any growth disorders.

Body Height ; Body Weight ; Child, Preschool ; Cross-Sectional Studies ; Female ; Growth Charts ; Growth Disorders ; diagnosis ; etiology ; Head ; anatomy & histology ; Humans ; Male ; Reproductive Techniques, Assisted ; adverse effects

OBJECTIVES: To explore the association between assisted reproductive technology (ART) and birth weight discordance in twins (BWDT). METHODS: A retrospective analysis was conducted on twin infants born between January 2011 and December 2020 at the Third Affiliated Hospital of Guangzhou Medical University, with complete basic birth data. The impact of ART on the occurrence of BWDT was identified by the multivariate logistic regression analysis. RESULTS: A total of 3 974 pairs of twins were included, with 1 431 conceived naturally and 2 543 through ART. Neonates in the ART group had higher birth weights than those in the naturally conceived group (P<0.001). The incidence of BWDT was lower in the ART group compared to the naturally conceived group (16.17% vs 21.09%, P<0.001). The multivariate logistic regression analysis, adjusting for confounding factors such as maternal age, parity, pre-pregnancy body mass index, gestational diabetes, hypothyroidism, gestational age, and chorionic properties, showed no significant difference in the risk of BWDT between the ART and naturally conceived groups (P>0.05). CONCLUSIONS ART is not associated with the risk of BWDT.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Birth Weight ; Pregnancy Outcome ; Infant, Premature ; Infant, Low Birth Weight ; Pregnancy, Multiple ; Premature Birth/epidemiology* ; Retrospective Studies ; Population Surveillance ; Reproductive Techniques, Assisted/adverse effects* ; Pregnancy Complications

ObjectiveTo investigate the pregnancy outcomes of assisted reproductive technology (ART) with cryopreserved donor sperm and the safety of the offspring thus conceived.

METHODSThe Human Sperm Bank of CITIC Xiangya Hospital provided cryopreserved donor semen to 31 reproductive centers in China between January 2006 and December 2012, with which 50247 ART cycles were accomplished. We compared the rates of birth defects and spontaneous abortion of intracervical insemination (ICI), intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI).

RESULTSA total of 39 047 ART cycles were performed by artificial insemination with cryopreserved donor sperm, including 36 674 cycles of ICI and 2 372 cycles of IUI. Among the 8 612 clinical pregnancies achieved by ICI, there were 917 cases of spontaneous abortion (at <28 gestational wk) (10.6%) and 6133 live births, with 43 cases of birth defect (0.70%). Of the 547 clinical pregnancies achieved by IUI, there were 41 cases of spontaneous abortion (7.5%) and 426 live births, with 2 cases of birth defect (0.47%). Totally, 11 200 cycles of IVF and ICSI were accomplished with cryopreserved donor sperm. Of the 5 860 clinical pregnancies achieved by IVF, there were 456 cases of spontaneous abortion (7.8%) and 5089 live births, with 55 cases of birth defect (1.08%). Among the 350 clinical pregnancies achieved by ICSI, there were 30 cases of spontaneous abortion (8.6%) and 229 live births, with 3 cases of birth defect (1.31%). The birth defect rate of ART with cryopreserved donor sperm was significantly lower than that published by the Chinese Ministry of Health (0.86% vs 1.53%,P<0.01).

CONCLUSIONSThe safety of the offspring conceived by ART with cryopreserved donor sperm is controllable.

Abortion, Spontaneous ; epidemiology ; China ; Congenital Abnormalities ; epidemiology ; Cryopreservation ; Female ; Fertilization in Vitro ; Humans ; Insemination, Artificial ; Male ; Pregnancy ; Pregnancy Outcome ; Reproductive Techniques, Assisted ; adverse effects ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; cytology ; Tissue Donors

BACKGROUNDThe association between the previous history of endometriosis and obstetric outcomes is still ambiguous. This study aimed to evaluate the effects of previous history of operatively diagnosed endometriosis on pregnancy outcomes.

METHODSA total of 98 primiparous women who had been diagnosed with endometriosis by previous laparoscopic surgery were included in this retrospective cohort study. Pregnancy outcomes were compared between these women (study group) who had a live birth and 300 women without endometriosis (control group) who had a live birth. In the study group, the pregnancy outcomes of 74 women who conceived naturally (no assisted reproductive technology [ART] subgroup) were simultaneously compared with 24 women who conceived by ART (ART subgroup).

RESULTSMiscarriage was observed in 23 of 98 women with endometriosis (23.5%). There were 75 women who had a live birth after laparoscopic diagnosis of endometriosis in the study group eventually. On multivariate analysis, the postpartum hemorrhage rate increased significantly in the study group when compared with the control group (adjusted odds ratio: 2.265, 95% confidence interval: 1.062, 4.872; P = 0.034). There was an upward tendency of developing other pregnancy-related complications, such as preterm birth, placental abruption, placenta previa, cesarean section, fetal distress/anemia, and others in the study group than in the control group. However, the differences showed no statistical significance. Within the study group, the occurrence rate of postpartum hemorrhage and preterm birth was both higher in the ART subgroup than in the no ART subgroup. The differences both had statistical significance (44.4% vs. 17.5%, P = 0.024 and 27.8% vs. 1.8%, P = 0.010, respectively). At the same time, median (interquartile range) for gestational age at delivery in the ART subgroup was significantly shorter than that in the no ART subgroup (38 weeks [36-39 weeks] vs. 39 weeks [38-40 weeks]; P = 0.005).

CONCLUSIONSEndometriosis may affect obstetric outcomes. Women with endometriosis have a higher risk of postpartum hemorrhage. Women with endometriosis who conceived by ART may have a higher risk of postpartum hemorrhage and preterm birth than those conceived naturally.

Abortion, Spontaneous ; epidemiology ; etiology ; Adult ; Cesarean Section ; statistics & numerical data ; Endometriosis ; complications ; epidemiology ; Female ; Gestational Age ; Humans ; Live Birth ; epidemiology ; Placenta Previa ; epidemiology ; etiology ; Postpartum Hemorrhage ; epidemiology ; etiology ; Pregnancy ; Pregnancy Complications ; epidemiology ; etiology ; physiopathology ; Pregnancy Outcome ; Premature Birth ; epidemiology ; etiology ; Reproductive Techniques, Assisted ; adverse effects ; Retrospective Studies ; Risk Factors