Couples with non-obstructive azoospermia are interested in future treatments with artificial gametes

Hendriks, Saskia; Hessel, M.; Mochtar, Monique H.; Meißner, Andreas; Veen, Fulco van der; Repping, Sjoerd; Dancet, Eline

doi:10.1093/humrep/dew095

Cited by 10 publications

(12 citation statements)

References 59 publications

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“…The characteristics of included studies are described in Table 1 . Twelve studies had a DCE design ( Musters et al , 2011 ; van Empel et al , 2011 ; Huppelschoten et al , 2014 ; van den Wijngaard et al , 2014 , 2015 ; Weiss et al , 2017 ; Hendriks et al , 2019 ; Braam et al , 2020 ; Abdulrahim et al , 2021 ; Cornelisse et al , 2022 ; Skedgel et al , 2022 ; Keller et al , 2023 ), one study included both a DCE and a survey ( Hendriks et al , 2016 ), one was designed as CAs study ( Palumbo et al , 2011 ), and six were survey and/or interview studies ( Bayram et al , 2005 ; Steures et al , 2005 ; van Weert et al , 2007 ; Sills et al , 2012 ; Duthie et al , 2017 ; Stormlund et al , 2019 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 20 studies, 11 had been conducted in the Netherlands ( Bayram et al , 2005 ; Steures et al , 2005 ; van Weert et al , 2007 ; Musters et al , 2011 ; van Empel et al , 2011 ; Huppelschoten et al , 2014 ; van den Wijngaard et al , 2014 , 2015 ; Weiss et al , 2017 ; Braam et al , 2020 ; Cornelisse et al , 2022 ), two studies were conducted in both the Netherlands and Belgium ( Hendriks et al , 2016 , 2019 ), two studies were carried out in the USA ( Sills et al , 2012 ; Duthie et al , 2017 ), one in Australia ( Keller et al , 2023 ), one in the UK ( Abdulrahim et al , 2021 ), one in Denmark ( Stormlund et al , 2019 ), and one in Spain ( Palumbo et al , 2011 ). The largest study included multiple countries: the USA, the UK, Denmark, Norway, Sweden, Finland, Spain, and China ( Skedgel et al , 2022 ).…”

Section: Resultsmentioning

confidence: 99%

“…All six survey/interview studies were rated as being at critical risk of bias owing to selection bias, use of unvalidated questionnaires, and not accounting for the lack of independence of the data in the analysis (multiple questions were answered by each participant) ( Bayram et al , 2005 ; Steures et al , 2005 ; van Weert et al , 2007 ; Sills et al , 2012 ; Duthie et al , 2017 ; Stormlund et al , 2019 ). Of the 14 DCE/CA designs, nine had moderate risk of bias ( Palumbo et al , 2011 ; van Empel et al , 2011 ; Huppelschoten et al , 2014 ; van den Wijngaard et al , 2015 ; Hendriks et al , 2016 ; Weiss et al , 2017 ; Braam et al , 2020 ; Abdulrahim et al , 2021 ; Skedgel et al , 2022 ) and four had high risk of bias, for example owing to low participation rates or suboptimal statistical analysis ( Musters et al , 2011 ; van den Wijngaard et al , 2014 ; Hendriks et al , 2019 ; Cornelisse et al , 2022 ). The overall rating of a study was based on the lowest rating in any of the categories.…”

Section: Resultsmentioning

confidence: 99%

“…Effectiveness was reported in 17 studies ( Bayram et al , 2005 ; Steures et al 2005 ; van Weert et al , 2007 ; Musters et al , 2011 ; Palumbo et al , 2011 ; van Empel et al , 2011 ; Huppelschoten et al , 2014 ; van den Wijngaard et al , 2014 ; Hendriks et al , 2016 , 2019 ; Duthie et al , 2017 ; Weiss et al , 2017 ; Stormlund et al , 2019 ; Abdulrahim et al , 2021 ; Cornelisse et al , 2022 ; Skedgel et al , 2022 ; Keller et al , 2023 ). Effectiveness was operationalized by pregnancy rate or chance of pregnancy within a certain time after one treatment cycle and ranged between 2% and 50%.…”

Section: Resultsmentioning

confidence: 99%

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Driving factors in treatment decision-making of patients seeking medical assistance for infertility: a systematic review

von Estorff,

Mochtar,

Lehmann

et al. 2024

Human Reproduction Update

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BACKGROUND ART differs in effectiveness, side-effects, administration, and costs. To improve the decision-making process, we need to understand what factors patients consider to be most important. OBJECTIVE AND RATIONALE We conducted this systematic review to assess which aspects of ART treatment (effectiveness, safety, burden, costs, patient-centeredness, and genetic parenthood) are most important in the decision-making of patients with an unfulfilled wish to have a child. SEARCH METHODS We searched studies indexed in Embase, PubMed, PsycINFO, and CINAHL prior to November 2023. Discrete choice experiments (DCEs), surveys, interviews, and conjoint analyses (CAs) about ART were included. Studies were included if they described two or more of the following attributes: effectiveness, safety, burden, costs, patient-centeredness, and genetic parenthood. Participants were men and women with an unfulfilled wish to have a child. From each DCE/CA study, we extracted the beta-coefficients and calculated the relative importance of treatment attributes or, in case of survey studies, extracted results. We assessed the risk of bias using the rating developed by the Grading of Recommendations Assessment, Development and Evaluation working group. Attributes were classified into effectiveness, safety, burden, costs, patient-centeredness, genetic parenthood, and others. OUTCOMES The search identified 938 studies of which 20 were included: 13 DCEs, three survey studies, three interview studies, and one conjoint analysis, with a total of 12 452 patients. Per study, 47–100% of the participants were women. Studies were assessed as having moderate to high risk of bias (critical: six studies, serious: four studies, moderate: nine studies, low: one study). The main limitation was the heterogeneity in the questionnaires and methodology utilized. Studies varied in the number and types of assessed attributes. Patients’ treatment decision-making was mostly driven by effectiveness, followed by safety, burden, costs, and patient-centeredness. Effectiveness was rated as the first or second most important factor in 10 of the 12 DCE studies (83%) and the relative importance of effectiveness varied between 17% and 63%, with a median of 34% (moderate certainty of evidence). Of eight studies evaluating safety, five studies valued safety as the first or second most important factor (63%), and the relative importance ranged from 8% to 35% (median 23%) (moderate certainty of evidence). Cost was rated as first or second most important in five of 10 studies, and the importance relative to the other attributes varied between 5% and 47% (median 23%) (moderate certainty of evidence). Burden was rated as first or second by three of 10 studies (30%) and the relative importance varied between 1% and 43% (median 13%) (low certainty of evidence). Patient-centeredness was second most important in one of five studies (20%) and had a relative importance between 7% and 24% (median 14%) (low certainty of evidence). Results suggest that patients are prepared to trade-off some effectiveness for more safety, or less burden and patient-centeredness. When safety was evaluated, the safety of the child was considered more important than the mother’s safety. Greater burden (cycle cancellations, number of injections, number of hospital visits, time) was more likely to be accepted by patients if they gained effectiveness, safety, or lower costs. Concerning patient-centeredness, information provision and physician attitude were considered most important, followed by involvement in decision-making, and treatment continuity by the same medical professional. Non-genetic parenthood did not have a clear impact on decision-making. WIDER IMPLICATIONS The findings of this review can be used in future preference studies and can help healthcare professionals in guiding patients’ decision-making and enable a more patient-centered approach.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Driving factors in treatment decision-making of patients seeking medical assistance for infertility: a systematic review

von Estorff,

Mochtar,

Lehmann

et al. 2024

Human Reproduction Update

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“…Men with NOA must undergo surgical sperm retrieval and intracytoplasmic sperm injection in order to father biological children, and the live birth rate is ~25% [ 32 ]. Artificial intelligence and predictive modelling may aid in increasing the sperm retrieval rate in men with NOA [ 33 ].…”

Section: Future Perspectives In Azoospermiamentioning

confidence: 99%

Current updates and future perspectives in the evaluation of azoospermia: A systematic review

Punjani

Kang

Lamb³

2021

Arab Journal of Urology

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Objectives: To provide a summary of the current evaluation of azoospermia and insights into future perspectives in the evaluation and counselling of men with azoospermia. Methods: A search of PubMed, Cochrane Reviews and Web of Science databases was performed for full-text English-language articles published between 1943 and 2020 focussing on 'future perspectives', 'azoospermia' and 'evaluation'. Results: Azoospermia represents a severe form of male infertility characterised by sperm production so impaired that there are no sperm present in the ejaculate. The current evaluation of azoospermia focusses on patient history and physical examination with selected adjunctive laboratory investigations including serum hormones, a karyotype and screening for Y chromosome microdeletions. Future diagnostics are focussed on identifying the underlying genetic aetiologies for azoospermia, as well as a greater emphasis on screening for systemic illness that men with severe infertility may be predisposed to develop. Conclusion:Azoospermia represents an extreme form of male infertility, and evaluation relies heavily on history and physical examination, as genetic evaluations for these individuals remain limited. Future evaluation will focus on next-generation sequencing and more rigorous evaluation for possible co-existing and future risk of systemic disease.

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Balancing Ethical Pros and Cons of Stem Cell Derived Gametes

2017

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In this review we aim to provide an overview of the most important ethical pros and cons of stem cell derived gametes (SCD-gametes), as a contribution to the debate about reproductive tissue engineering. Derivation of gametes from stem cells holds promising applications both for research and for clinical use in assisted reproduction. We explore the ethical issues connected to gametes derived from embryonic stem cells (both patient specific and non-patient specific) as well as those related to gametes derived from induced pluripotent stem cells. The technology of SCD-gametes raises moral concerns of how reproductive autonomy relates to issues of embryo destruction, safety, access, and applications beyond clinical infertility.

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Couples with non-obstructive azoospermia are interested in future treatments with artificial gametes

Abstract: The authors report no financial or other conflict of interest relevant to the subject of this article.

Cited by 10 publications

References 59 publications

Driving factors in treatment decision-making of patients seeking medical assistance for infertility: a systematic review

Driving factors in treatment decision-making of patients seeking medical assistance for infertility: a systematic review

Current updates and future perspectives in the evaluation of azoospermia: A systematic review

Balancing Ethical Pros and Cons of Stem Cell Derived Gametes

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