Papers by Pasquale Patrizio
Medical Anthropology Quarterly
Journal of Assisted Reproduction and Genetics
Journal of Assisted Reproduction and Genetics
AMA journal of ethics, 2018
Reproductive health services, including infertility care, are important in countries with infrast... more Reproductive health services, including infertility care, are important in countries with infrastructure deficits, such as Lebanon, which now hosts more than one million Syrian refugees. Islamic prohibitions on child adoption and third-party reproductive assistance (donor eggs, sperm, embryos, and surrogacy) mean that most Muslim couples must turn to in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) to overcome their childlessness. Attempts to bring low-cost IVF-ICSI to underserved populations might help infertile couples where no other services are available. However, a low-cost IVF-ICSI protocol for male infertility remains technically challenging and thus may result in two standards of clinical care. Nonetheless, low-cost IVF-ICSI represents a form of reproductive justice in settings with infrastructure deficits and is clearly better than no treatment at all.
Journal of assisted reproduction and genetics, Jan 28, 2018
Many people travel abroad to access fertility treatments. This growing phenomenon is known as cro... more Many people travel abroad to access fertility treatments. This growing phenomenon is known as cross border reproductive care (CBRC) or fertility tourism. Due to its complex nature and implications worldwide, CBRC has become an emerging dilemma deserving more attention on the global healthcare agenda. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed for all relevant full-text articles published in PubMed in English during the past 18 years to explore CBRC phenomenon in the new millennium. Little is known about the accurate magnitude and scope of CBRC around the globe. In this systematic and critical review, we identify three major dimensions of CBRC: legal, economic, and ethical. We analyze each of these dimensions from clinical and practical perspectives. CBRC is a growing reality worldwide with potential benefits and risks. Therefore, it is very crucial to regulate the global...
Journal of assisted reproduction and genetics, Jan 9, 2017
This binational qualitative study of medical egg freezing (MEF) examined women's motivations ... more This binational qualitative study of medical egg freezing (MEF) examined women's motivations and experiences, including their perceived needs for patient-centered care in the midst of fertility- and life-threatening diagnoses. Forty-five women who had undertaken MEF were interviewed in the USA (33 women) and in Israel (12 women) between June 2014 and August 2016. Interviews lasted approximately 1 h and were conducted by two senior medical anthropologists, one in each country. Women were recruited from four American IVF clinics (two academic, two private) and two Israeli clinics (both academic) where MEF is being offered to cancer patients and women with other fertility-threatening medical conditions. Women who undertake MEF view their fertility and future motherhood as important components of their identities and recovery and, thus, are grateful for the opportunity to pursue fertility preservation. However, women who undergo MEF have special needs, given that they tend to be a &...
Journal of Assisted Reproduction and Genetics
Human Reproduction, 1993
One of the limiting factors for the successful treatment of male sterility due to congenital abse... more One of the limiting factors for the successful treatment of male sterility due to congenital absence of the vas deferens (CAVD) is the low (<20%) and extremely unpredictable rate of in-vitro fertilization of their epididymal spermatozoa. The recent demonstration that CAVD is a mild form of ...
Journal of assisted reproduction and genetics, Jan 21, 2016
The Journal of Assisted Reproduction and Genetics introduces the JARG Young Investigator Forum, a... more The Journal of Assisted Reproduction and Genetics introduces the JARG Young Investigator Forum, an in-training initiative aimed to expand opportunities for young investigators. The JARG Young Investigator Forum has three primary goals: first, to increase opportunities for trainees and young investigators to contribute as researchers and writers. Trainees will be invited to publish mini-reviews based on their area of research interest/expertise and will have the opportunity to indicate "in-training" when submitting manuscripts as first author Educational research pertaining to reproductive medicine training will be added to the purview of the journal. Second, the Young Investigator Forum will increase opportunities for trainees to serve as journal reviewers and will provide mentorship throughout the peer review process. Third, trainees will have the unique opportunity to gain editorial experience by serving as a "guest editor" of the Young Investigator Forum, over...
Current opinion in endocrinology, diabetes, and obesity, Jan 20, 2016
To assess the effectiveness and ethical dimensions of oocyte cryopreservation for both medical an... more To assess the effectiveness and ethical dimensions of oocyte cryopreservation for both medical and social indications. As more women are postponing motherhood for a variety of reasons, including lack of partner, for completing career plans and reaching financial stability, they are resorting to oocyte cryopreservation. To make informed choices, women rely on their primary care physicians (PCPs) for initial advice, but PCPs are not always fully prepared to discuss oocyte cryopreservation. Interestingly, there are mixed feelings among obstetricians/gynecologists on whether oocyte cryopreservation should be used for elective reasons, whereas it is fully supported for medical indications. Oocyte vitrification has become an established procedure for safeguarding future reproductive chances for medical reasons, and its use is progressively expanding. There is an urgent need in preparing future PCPs and obstetricians/gynecologists as to how to initiate discussions with their patients about...
Journal of the National Cancer Institute Monographs, 2005
Seminars in Reproductive Medicine, Jul 1, 2010
Older parenthood raises a variety of important factual and ethical questions. None of the questio... more Older parenthood raises a variety of important factual and ethical questions. None of the questions have received sufficient attention despite the rapid expansion in the United States and other nations in the numbers of older parents. We do not know much about the safety, economic, and psychosocial impact of these emerging practices on children or parents. Nor have there been many analytical considerations of the ethical issues raised. We argue in this article that there are reasons for concern when older persons seek to utilize fertility treatments, including the safety of pregnancy for older women, risks posed to children delivered by older mothers, issues around what constitutes safe conditions for having a child relative to the age of parents, and the importance of guaranteeing that someone will serve in the parental role should an older parent or parents become disabled or die. To protect the best interest of children created by technology in new familial circumstances, internationally recognized and enforced standards for fertility clinics to follow ought to be enacted in making decisions about treating older parents seeking infertility services.
Journal of Experimental Clinical Assisted Reproduction, 2009
Background: To compare luteal phase bleeding and pregnancy outcomes in normogonadotropic patients... more Background: To compare luteal phase bleeding and pregnancy outcomes in normogonadotropic patients receiving progesterone vaginal gel (PVG) or intramuscular progesterone (IMP) injections. Methods: In this retrospective cohort study, data from 270 patients (292 cycles) undergoing day-3 fresh embryo transfer were analyzed. PVG, 90 mg daily (170 cycles) or IMP, 50 mg daily (122 cycles) began at egg retrieval. Results: Luteal phase bleeding was significantly more common in the PVG than the IMP group. No significant differences were observed in biochemical pregnancy or spontaneous abortion rates between the two groups. Patients who bled before the pregnancy test had significantly lower total and clinical pregnancy rates than non-bleeders. Total and ongoing pregnancy/delivery rates were higher in the PVG than IMP group, but did not achieve statistical significance. Conclusion: Luteal phase bleeding was more common in the PVG group than the IMP group, but pregnancy was successful in more patients in the PVG group. Luteal phase bleeding is prevented or delayed during IMP treatment, but patients who bled before the pregnancy test, whether using the gel or injected progesterone, had significantly reduced pregnancy rates compared with non-bleeders.
Fertility and Sterility, 2001
To determine whether mutations in the pro-hAKAP82 gene and the resulting pro-hAKAP82 and hAKAP82 ... more To determine whether mutations in the pro-hAKAP82 gene and the resulting pro-hAKAP82 and hAKAP82 proteins were associated with the infertility seen in a patient with stump tail sperm. Case report. Academic research and teaching environment, tertiary care hospital. A single, infertile Caucasian male diagnosed with essentially 100% stump tail sperm. None. Electrophoresis, silver staining, and immunoblotting of patient and control sperm proteins; RII (type II regulatory subunit of protein kinase-A) overlay assay of patient and control sperm proteins, partial DNA sequence analysis of patient&#39;s pro-hAKAP82 gene; indirect immunofluorescence and immunogold electron microscopy of patient and control sperm. No significant abnormalities in the size or amount of pro-hAKAP82 and hAKAP82 or in the ability of these proteins to bind the regulatory subunit of protein kinase-A were identified in the patient&#39;s sperm. Partial sequence analysis of the patient&#39;s pro-hAKAP82 gene was identical to the published normal sequence. Indirect immunofluorescence and immunoelectron microscopy of sperm localized pro-hAKAP82/hAKAP82 to the sperm flagellum and demonstrated that the proteins were present in a disorganized, amorphous region, which apparently represented the fibrous sheath. These results suggest that, although pro-hAKAP82 and hAKAP82 localize to the correct structural component of the flagellum and are not directly responsible for the stump tail phenotype, they are unable to assemble normally into the fibrous sheath. Although this study did not identify abnormalities in the pro-hAKAP82 gene or its resulting proteins in a patient with stump tail sperm, several regions of the gene and protein remain to be examined.
Fertility and Sterility, Mar 1, 2011
Objective: To compare the impact of mandated IVF insurance coverage on ET practices and resulting... more Objective: To compare the impact of mandated IVF insurance coverage on ET practices and resulting multiple pregnancy rates. Design: Retrospective analysis of all fresh, nondonor IVF cycles performed in the United States in 2006. Setting: United States. Patient(s): A total of 91,753 fresh, nondonor IVF cycles in the United States. Intervention(s): None. Main Outcome Measure(s): Pregnancy rate, live-birth rate, embryos transferred, multiple pregnancy rate. Result(s): Overall, nonmandated states had a significantly higher pregnancy rate (38.8% vs. 35%) and live-birth rate (32.2% vs. 29.1%) than mandated states. Nonmandated states also had a significantly higher twin rate (28.1% vs. 26%) and triplet rate (3.9% vs. 3.4%). The average number of embryos transferred was also significantly higher in nonmandated states (2.6 vs. 2.2). These findings were more pronounced in the <35 and 35-37 age groups. Conclusion(s): In the last 8 years, despite a reduction in the average number of embryos transferred and multiple pregnancy rates, there is a continued association between mandated IVF coverage, the transfer of fewer embryos, and lower rates of multiple pregnancies and births, particularly in the younger age groups.
Reproductive Biomedicine Online, 2007
Fert Steril, 2007
Ò , Ferring) G1.3 media. Assessment for maturity was done 24 hours later. Student's t-test for tw... more Ò , Ferring) G1.3 media. Assessment for maturity was done 24 hours later. Student's t-test for two samples and Chi-square test were used for statistical analyses. RESULTS: The data for the two groups is shown in the table below. The number of oocytes survived and the percent survival were statistically different between the two groups with the survival being greater using the Vit method as compared to the SF method. The number and percent of oocytes that matured by IVM was also higher in the Vit group. However, this difference did not reach statistical significance.
Placenta, Jan 10, 2008
In the last several decades, both the growing number of reproductive age cancer survivors, and th... more In the last several decades, both the growing number of reproductive age cancer survivors, and the trend of women from western countries delaying child-bearing to a later age have been markedly increasing. The confluence of these two epidemiologic trends has led to the need for better and more widely available strategies for fertility preservation. In this paper, we will first review both the established and experimental methodologies which can be utilized for either the preservation or postponement of female fertility. These options currently include embryo and oocyte cryopreservation, cortical and whole ovary cryopreservation, ovarian transplantation, ovarian transposition, and gonadotropin releasing hormone agonist protection. As laboratory and surgical techniques for oocyte and ovary cryopreservation continue to improve, modalities now considered experimental will become part of routine practice for reproductive medicine specialists.
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Papers by Pasquale Patrizio