Eran Horowitz

PGE2 induction of labor for consistent decreased perception of fetal movements at term

Objectives: To determine the effects of labor induction with vaginal prostaglandin E2 (PGE2) on mode of delivery and immediate neonatal outcome in women with consistent decreased perception of fetal movements at term. Methods: The study group consisted of 115 women with consistent perception of decreased fetal movements admitted for induction of labor at term. Findings were compared with those of 510 women with normal spontaneous onset of labor. Women with previous cesarean section (CS) were excluded from both the study and control groups. Results: The rate of CS was higher in the study group (14.8%) than in the control group (9%) (not significant). The rates of low 5‐min Apgar score (≤7) and CS performed for non‐reassuring fetal heart rate were two‐fold higher in the study group than in the control group (2.6% vs. 1.2%, and 6.1% vs. 3.1%, respectively, not significant in both). Conclusion: Induction of labor with PGE2 is successful in approximately 85% of the patients with decreased perception of fetal movements at term and apparently with no serious maternal or fetal complications. However, these pregnancies might be at higher risk of perinatal complications. We suggest that active labor induction may be currently considered as the preferred strategy in these pregnancies. Large prospective randomized studies on maternal and neonatal outcome are needed to clarify this issue.

Zygote intrafallopian transfer among patients with repeated implantation failure

To summarize the experience of a single center with laparoscopic zygote intrafallopian transfer (ZIFT) performed exclusively among patients with high‐order repeated implantation failure (RIF) following in vitro fertilization‐embryo transfer (IVF‐ET).

Mental health of women entering fertility treatment: What role do age and internal resources play?

Drawing on Lazarus and Folkmans (1984) model of stress and coping, the study aimed at (a) examining the associations between the mental health of women entering fertility treatment and their internal resources (hope and two aspects of self-consciousness: reflection and rumination); (b) indicating whether mental health is associated with age (above or below 35), and whether this association is mediated by the internal resources. The sample consisted of 137 women (76 aged 20-34; 61 aged 35-44) at the start of fertility treatment who completed a series of self-report questionnaires. Results indicated that younger women reported higher distress and rumination than older women. Higher hope was associated with greater well-being, and higher rumination was associated with greater distress. Furthermore, hope and rumination were found to mediate the association between age and mental health. These findings highlight the importance of developing age-based interventions for women entering fertility treatment, aimed at strengthening their resilience to effectively cope with the demanding process ahead.

Satisfaction in life among fathers following fertility treatment

Abstract Objective: The study aimed at (a) gaining a better understanding of how fertility history (ART/spontaneous) is associated with life satisfaction among new fathers; and (b) identifying personal and interpersonal risk factors for lower satisfaction in life during the transition to fatherhood. Design: This cross-sectional study comprised 172 Israeli fathers (76 who became fathers following ART and 96 following spontaneous pregnancy), who completed a series of self-report questionnaires 5–18 months after the birth of their first child. Results: No differences were found in life satisfaction between fathers in the two fertility history groups. Regression analysis indicated that younger age and higher economic status, as well as lower attachment anxiety and avoidance and better marital relationship, were associated with a higher level of life satisfaction among new fathers. Conclusion: Although the life satisfaction of new fathers does not appear to be affected by their fertility history, it may be hampered by personal and interpersonal risk factors. These results have practical implications for professionals who come into contact with this population.

Contributors to Women's Perceived Stress at the Start of Assisted Reproductive Technology

Abstract Clinicians are often called upon to treat the stress that accompanies Assisted Reproductive Technology (ART). In this study, we sought to examine the contribution of the internal resources of meaning in life and attachment style and the interpersonal resource of self-disclosure to her mother to a womans level of perceived stress upon commencement of ART. In addition, we examined the association between age and perceived stress. The sample consisted of 180 Israeli women (106 aged 20–34; 74 aged 35–44) who completed a series of self-report questionnaires after their initial meeting with a fertility specialist. Regression analysis indicated that older age, lower attachment anxiety, higher perception of meaning in life, and greater self-disclosure to the mother were related to lower levels of perceived stress. Self-disclosure was also found to mediate the association between avoidant attachment and stress. The study highlights the importance of a woman’s personal and interpersonal resources for reducing the experience of stress in the early stages of ART. The results have practical implications for the development of professional interventions seeking to enhance these resources among women embarking on fertility treatment.

Personal Growth of New Fathers following Assisted Reproductive Technology or Spontaneous Pregnancy

SYNOPSIS Objective: The study aimed at comparing personal growth between fathers whose infants were conceived with the aid of assisted reproductive technology (ART) and those whose infants were conceived spontaneously and to examine associations with personal resources. Design: We examined associations between personal growth on the one hand and optimism, positive and negative emotions, and parenting stress on the other, among fathers whose infants were conceived with the aid of ART and those whose infants were conceived spontaneously. One hundred and seventy-two Israeli first-time fathers (76 following ART and 96 following spontaneous pregnancies) whose infants were 5–18 months old completed a series of self-report questionnaires. Results: No difference was found in personal growth between the two research groups. For all men, lower economic status, older age of the child, higher optimism, higher positive and negative emotions, and parenting stress were all associated with greater growth. Conclusions: Although a certain level of stress and negative affect is a prerequisite for personal growth, it is made possible by positive resources, such as optimism and positive emotions. In addition, the manner in which the pregnancy was achieved appears to have no long-term consequences for men’s experience of personal growth in the transition to fatherhood. Professionals should relate to the present needs and emotional states of new fathers rather than their fertility history.

Endometrial nerve fibre density in patients undergoing IVF: a pilot study

The presence of nerve fibres in the functional layer of the endometrium has been strongly associated with endometriosis. Presence of nerve fibres in the endometrium of women undergoing IVF has not been previously assessed. This prospective pilot study assessed the presence of nerve fibres in endometrium of women undergoing IVF due to various causes and examined the correlation between the presence of nerve fibres and IVF success. A total of 32 IVF patients underwent endometrial biopsy during days 21-23 of the menstrual cycle. Nerve fibres were identified by immunohistochemical staining. Correlations between the presence and density of nerve fibres and aetiology of infertility and IVF success were measured. Nerve fibres were identified in the endometrium of 10/31 (32.3%) women with a satisfactory biopsy. Presence of nerve fibres was not correlated with cause of infertility. Clinical pregnancy was achieved in 12/32 (37.5%) patients, without correlation to presence of nerve fibres in the endometrium. Nerve fibres were identified in a substantial percentage of women undergoing IVF, possibly reflecting underdiagnosis of endometriosis in this population. The presence of nerve fibres does not appear to interfere with implantation. The significance of nerve fibres in the endometrium of IVF patients warrants further research. The presence of nerve fibres in the functional layer of the endometrium has been strongly associated with endometriosis. The presence of nerve fibres in the endometrium of women undergoing IVF has not been previously assessed. Our aim was to assess the presence of nerve fibres in endometrium of women with various causes of infertility undergoing IVF and to examine the association between the presence of nerve fibres in the endometrium and IVF success. In a prospective study, 32 IVF patients underwent endometrial biopsy during days 21-23 of the menstrual cycle. Nerve fibres were identified by immunohistochemical staining. Associations between the presence and density of nerve fibres and the aetiology of infertility and IVF success were measured. Nerve fibres were identified in the endometrium of 10/31 (32.3%) women with a satisfactory biopsy. No association was found between the presence of nerve fibres and the cause of infertility. Clinical pregnancy was achieved in 12/32 (37.5%) patients, without association with the presence of nerve fibres in the endometrium. Nerve fibres can be identified in a substantial percentage of women undergoing IVF, possibly reflecting underdiagnosis of endometriosis in this population. Their presence does not interfere with embryo implantation. The significance of nerve fibres in the endometrium of IVF patients warrants further research.