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Fertility
About: Fertility is a research topic. Over the lifetime, 29988 publications have been published within this topic receiving 681106 citations.
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TL;DR: An alternative viewpoint is posited: that teenage childbearing in a highly developed industrial country such as the United States is a social response to disadvantage, and that the excessive infant mortality associated with it is a consequence of the same disadvantage rather than of early fertility per se.
Abstract: In the United States, further reducing the incidence of infant mortality remains a highly desirable goal. Particularly acute is the need to reduce black infant mortality, which is approximately twice the rate for whites. 1 Because one feature of black American fertility patterns is a high rate of teenage childbearing, some have suggested that early fertility plays an important role in high rates of black infant mortality. Correspondingly, one policy view is that efforts to prevent teenage childbearing will also reduce infant mortality. The logic underpinning this policy approach is based on a common interpretation of the observed association between teenage childbearing and excessive infant mortality, namely, that early fertility is inherently detrimental to child survival. This article reconsiders that assumption and posits an alternative viewpoint: that teenage childbearing in a highly developed industrial country such as the United States is a social response to disadvantage, and that the excessive infant mortality associated with it is a consequence of the same disadvantage rather than of early fertility per se. Teenage motherhood in the United States occurs almost exclusively among socioeconomically disadvantaged populations, in which women at any age may be exposed to environmental factors that elevate infant mortality (Geronimus, 1986a). If environmentally induced risk factors are the primary explanation of the association between early fertility and excess infant mortality, then policy initiatives focusing directly on altering the childbearing behavior of teenagers will not reduce infant mortality. Furthermore, if environmental influences are more important than inherent biological factors, then fundamental questions arise regarding the possibility of extrapolating from US experience to countries, particularly less developed ones, with different population parameters and environmental considerations.
190 citations
TL;DR: Prenatal stress may influence the balance of adrenal and gonadal hormones during a critical stage of fetal hypothalamic differentiation, thereby producing a variety of reproductive dysfunctions in adulthood.
Abstract: Female rats subjected to prenatal stress later experienced fewer conceptions, more spontaneous abortions and vaginal hemorrhaging, longer pregnancies, and fewer viable young than nonstressed rats. The offspring of the prenatally stressed rats were lighter in weight and less likely to survive the neonatal period. Prenatal stress may influence the balance of adrenal and gonadal hormones during a critical stage of fetal hypothalamic differentiation, thereby producing a variety of reproductive dysfunctions in adulthood.
190 citations
TL;DR: Multivariate correlated time-to-event analyses show that larger testis volume, previous treatment with gonadotropins, and no previous androgen use each independently predicts faster induction of spermatogenesis and unassisted pregnancy.
Abstract: Background: The induction of spermatogenesis and fertility with gonadotropin therapy in gonadotropin-deficient men varies in rate and extent. Understanding the predictors of response would inform clinical practice but requires multivariate analyses in sufficiently large clinical cohorts that are suitably detailed and frequently assessed. Design, Setting, and Participants: A total of 75 men, with 72 desiring fertility, was treated at two academic andrology centers for a total of 116 courses of therapy from 1981–2008. Outcomes: Semen analysis and testicular examination were performed every 3 months. Results: A total of 38 men became fathers, including five through assisted reproduction. The median time to achieve first sperm was 7.1 months [95% confidence interval (CI) 6.3–10.1]) and for conception was 28.2 months (95% CI 21.6–38.5). The median sperm concentration at conception for unassisted pregnancies was 8.0 m/ml (95% CI 0.2–59.5). Multivariate correlated time-to-event analyses show that larger testis v...
190 citations
TL;DR: This article examined fertility trends in Ethiopia for evidence of short and long-term responses to famine, political events, and economic decline, finding evidence of significant short-term declines in conception probabilities during years of famine and major political and economic upheaval.
Abstract: We examine recent fertility trends in Ethiopia for evidence of short- and long-term responses to famine, political events, and economic decline. We use retrospective data on children ever born from the 1990 National Family and Fertility Survey to estimate trends in annual marital conception probabilities, controlling for women’s demographic and socioeconomic characteristics. The results of our analysis provide evidence of significant short-term declines in conception probabilities during years of famine and major political and economic upheaval. In the longer term, marital fertility in both urban and rural areas declined in the 1980s after increasing moderately in the 1970s.
189 citations
TL;DR: The age-related decline in female fertility may be reversed in couples electing to use donated oocytes from a younger woman, and women of advanced reproductive age may conceive, carry, and give birth to infants with success rates similar to those of their younger counterparts using assisted reproductive methods.
Abstract: Objective. —To evaluate the effect of age on pregnancy success rates in functionally agonadal women undergoing oocyte donation. Design. —A prospective study of 100 consecutive patients using oocyte donation for the treatment of infertility. Patients. —Women aged 40 years and above requesting oocyte donation (N=104) were required to undergo medical, reproductive, and psychological screening. Suitable candidates (n=65) were matched with an oocyte donor whose cycle was synchronized with that of the potential recipient, prior to the donor's undertaking ovarian hyperstimulation and transvaginal ultrasound—directed follicle aspiration. Outcomes were compared with those of two groups undergoing therapy at the same time: (1) women below 40 years of age undergoing oocyte donation for premature ovarian failure (n=35) and (2) women 40 years of age and above undergoing standard in vitro fertilization and embryo transfer using their own oocytes (n=57). Main Outcome Measures. —Embryo implantation and pregnancy rates. Setting. —The in vitro fertilization program of the University of Southern California and the California Medical Center, Los Angeles. Results. —Improved outcomes were observed with regard to fertilization rates in vitro, number of embryos transferred, embryo implantation rate, clinical pregnancy rates, and ongoing or successfully completed pregnancy rates when women undergoing oocyte donation regardless of age were compared with women 40 years of age and above using their own oocytes. No age-related decline in fertility was demonstrable when oocyte donation was used, with a mean age of 44.3±3.1 years for those successfully conceiving (range, 40 to 52 years). Perinatal outcomes (n=27) were generally uncomplicated, with a mean gestational age at delivery of 38.4±2.1 weeks (range, 34 to 42 weeks), although multiple births occurred in 24.1% of cases. Conclusions. —The age-related decline in female fertility may be reversed in couples electing to use donated oocytes from a younger woman, and women of advanced reproductive age may conceive, carry, and give birth to infants with success rates similar to those of their younger counterparts using assisted reproductive methods. ( JAMA . 1992;268:1275-1279)
189 citations