Minimal stimulation is as effective as classical stimulation in a single embryo transfer program in Turkey

Ozornek, H.; Özay, A.; Oztel, Z.; Atasever, Ebru; Turan, Ezgi; Ergin, E.

doi:10.1016/j.fertnstert.2013.07.1149

Cited by 1 publication

(2 citation statements)

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“…Minimal stimulation compared to conventional stimulation was assessed in Turkey (upper MIC) and showed that minimal stimulation resulted in similar clinical pregnancy rates while being more cost effective ( Özörnek et al , 2013 ). A study comparing two minimal stimulation protocols in normal responders with tubal factor infertility reported improved outcomes with clomiphene citrate as compared to letrozole, and concluded that such stimulation is feasible in the Indian context ( Nagulapally et al , 2012 ).…”

Section: Resultsmentioning

confidence: 99%

“…We found 14 studies focusing on efficacy, feasibility and acceptability of more affordable ART options, of which two provided indirect evidence (moderate risk of bias) as they were conducted as pilot studies in high-income countries ( Ombelet et al , 2014 ; Van Blerkom et al , 2014 ). Of the remaining 12 studies, five could be accessed as a (conference) abstract only ( Eluga et al , 2010 ; Nagulapally et al , 2012 ; Özörnek et al , 2013 ; Shah Nawaz and Azhar, 2014 ; De Beer et al , 2016 ), three were scored as at critical risk of bias ( Gnoth et al , 2013 ; Khan et al , 2013 ; Lucena et al , 2013 ), two at serious risk ( Aleyamma et al , 2011 ; Orhue et al , 2012 ) and two at moderate risk of bias ( Mukherjee et al , 2012 ; Navarro-Carbonell et al , 2012 ).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

IVF and other ART in low- and middle-income countries: a systematic landscape analysis

Chiware

Vermeulen

Blondeel

et al. 2020

Human Reproduction Update

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BACKGROUND Infertility affects 48.5 million couples worldwide with a prevalence estimated at 3.5–16.7% in low- and middle-income countries (LMIC), and as high as 30–40% in Sub-Saharan Africa. ART services are not accessible to the majority of these infertile couples due to the high cost of treatments in addition to cultural, religious and legal barriers. Infertility and childlessness, particularly in LMIC, have devastating consequences, which has resulted in considerable interest in developing affordable IVF procedures. However, there is a paucity of evidence on the safety, efficiency and ability to replicate techniques under different field conditions, and how to integrate more affordable ART options into existing infrastructures. OBJECTIVE AND RATIONALE This review was performed to investigate the current availability of IVF in LMIC and which other ART options are under development. This work will unfold the landscape of available and potential ART services in LMIC and is a key element in positioning infertility more broadly in the Global Public Health Agenda. SEARCH METHODS A systematic literature search was performed of articles and gray literature on IVF and other ART options in LMIC published between January 2010 and January 2020. We selected studies on IVF and other ART treatments for infertile couples of reproductive age (18–44 years) from LMIC. The review was limited to articles published after 2010, based on the recent evolution in the field of ART practices in LMIC over the last decade. Citations from high-income countries, including data prior to 2010 and focusing on specialized ART procedures, were excluded. The literature search included PubMed, Popline, CINHAL, EMBASE and Global Index Medicus. No restrictions were applied with regard to study design or language. Two reviewers independently screened the titles and abstracts, and extracted data. A search for gray literature was performed using the ‘Google’ search engine and specific databases (worldcat.org, greylit.org). In addition, the reference lists of included studies were assessed. OUTCOMES The search of the electronic databases yielded 3769 citations. After review of the titles and abstracts, 283 studies were included. The full texts were reviewed and a further 199 articles were excluded. The gray literature search yielded 586 citations, most of which were excluded after screening the title, and the remaining documents were excluded after full-text assessment due to duplicate entries, not from LMIC, not relevant or no access to the full document. Eighty-four citations were included as part of the review and separated into regions. The majority of the studies were observational and qualitative studies. In general, ART services are available and described in several LMIC, ranging from advanced techniques in China to basic introduction of IVF in some African countries. Efforts to provide affordable ART treatments are described in feasibility studies and efficacy studies; however, most citations were of low to very low quality. We found no studies from LMIC reporting the implementation of low-cost ART that is effective, accessible and affordable to most of those in need of the services. WIDER IMPLICATIONS The World Health Organization is in a unique position to provide much needed guidance for infertility management in LMIC. This review provides insight into the landscape of ART in LMIC in various regions worldwide, which will guide efforts to improve the availability, quality, accessibility and acceptability of biomedical infertility care, including ART in these countries.

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Section: Resultsmentioning

confidence: 99%