The burden of infertility in New Zealand: A baseline survey of prevalence and service use.

Background: Studies in southern New Zealand indicate that up to a quarter of women experienced infertility, likely due to delay in childbearing. However, these findings may not be generalisable to the whole population.

Aims: To assess the lifetime prevalence of infertility and evidence for disparities for New Zealand men and women in a nationally representative sample.

Age-related natural fertility outcomes in women over 35 years: a systematic review and individual participant data meta-analysis.

Study Question: What is the rate of natural conception leading to ongoing pregnancy or livebirth over 6-12 months for infertile women of age ≥35 years?

Summary Answer: Natural conception rates were still clinically relevant in women aged 35 years and above and were significantly higher in women with unexplained infertility compared to those with other diagnoses.

What Is Known Already: In recent years, increasing numbers of women have attempted to conceive at a later age, resulting in a commensurate increase in the need for ART. However, there is a lack of data on natural fertility outcomes (i.

The prevalence and potential determinants of dysmenorrhoea and other pelvic pain in women: a prospective study.

Objective: To estimate the prevalence of pelvic pain and model associations with potential demographic, obstetric, gynaecological and psychosocial determinants.

Design, Setting And Sample: A cohort study of women born between 1972 and 1973 in Dunedin, New Zealand, most recently assessed when aged 38 years (95% of survivors retained); 429 women were eligible for analysis.

Methods: Women self-completed reproductive health questionnaires at ages 21, 26, 32 and 38 years, with questions on dysmenorrhoea at ages 13 and 15, and on all pelvic pain at age 38.

Resolution of infertility and number of children: 1386 couples followed for a median of 13 years.

Study Question: How common were children among infertile couples?

Summary Answer: A total of 61.7% of infertile couples presenting for care subsequently had live born children 13.1 years after first being clinically assessed, with a mean of 1.

Ovulation monitoring and fertility knowledge: Their relationship to fertility experience in a cross-sectional study.

Background: Various aspects of fertility knowledge, including the timing of the fertile window, have consistently been found to be poor. Limited evidence also suggests ovulation monitoring to time intercourse could be common. However, there have been no studies that compare these two aspects of fertility and women's fertility/infertility experiences.

Infertility and outcomes for infertile women in Otago and Southland.

Aim: To establish the burden of infertility in women residing in Otago and Southland.

Methods: A survey of women aged 25-50 years residing in Otago and Southland was conducted to determine the proportions that experienced infertility, sought medical help and resolved their infertility, and to assess the determinants of these outcomes.

Results: Of the 1,125 participants, 21.

Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex and the relationship with family formation.

Objective: To estimate the cumulative incidence of infertility for men and women in a population-based sample.

Design: Longitudinal study of a birth cohort.

Setting: Research unit.

Genome sequence of Francisella tularensis subspecies holarctica strain FSC200, isolated from a child with tularemia.

Here we report the complete, accurate 1.89-Mb genome sequence of Francisella tularensis subsp. holarctica strain FSC200, isolated in 1998 in the Swedish municipality Ljusdal, which is in an area where tularemia is highly endemic.

Evolution of Burkholderia pseudomallei in recurrent melioidosis.

Burkholderia pseudomallei, the etiologic agent of human melioidosis, is capable of causing severe acute infection with overwhelming septicemia leading to death. A high rate of recurrent disease occurs in adult patients, most often due to recrudescence of the initial infecting strain. Pathogen persistence and evolution during such relapsing infections are not well understood.

Development of clinical priority access criteria for assisted reproduction and its evaluation on 1386 infertile couples in New Zealand.

Background: In New Zealand ranking patients for elective, publicly funded procedures uses clinical priority access criteria (CPAC). A CPAC to prioritize patients seeking assisted reproductive technology (ART) was developed in 1997 and implemented nationwide in 2000. This study describes the development of the ART CPAC tool and its evaluation on 1386 couples referred to a single tertiary service from 1998 to 2005.

Factors associated with parents' decisions to tell their adult offspring about the offspring's donor conception.

Background: Tensions and anxieties surround secrecy within families in the context of gamete donation and family building. This paper presents the views of parents who had kept their use of donor insemination a secret from their offspring. A sub-set of these parents said that they wished to tell their now-adult offspring, and discussed the questions and issues this secrecy raised to them.

Analysis of the genome of the Escherichia coli O157:H7 2006 spinach-associated outbreak isolate indicates candidate genes that may enhance virulence.

In addition to causing diarrhea, Escherichia coli O157:H7 infection can lead to hemolytic-uremic syndrome (HUS), a severe disease characterized by hemolysis and renal failure. Differences in HUS frequency among E. coli O157:H7 outbreaks have been noted, but our understanding of bacterial factors that promote HUS is incomplete.

Methylobacterium genome sequences: a reference blueprint to investigate microbial metabolism of C1 compounds from natural and industrial sources.

Background: Methylotrophy describes the ability of organisms to grow on reduced organic compounds without carbon-carbon bonds. The genomes of two pink-pigmented facultative methylotrophic bacteria of the Alpha-proteobacterial genus Methylobacterium, the reference species Methylobacterium extorquens strain AM1 and the dichloromethane-degrading strain DM4, were compared.

Methodology/principal Findings: The 6.

Parental information sharing with donor insemination conceived offspring: a follow-up study.

Background: Studies of parental decision making regarding information sharing with offspring conceived as a result of donor insemination are almost all based on a 'one point in time' design. This study reports on parental decision making at two points in time, Time 1 and Time 2, 14 years apart.

Methods: Forty-four of 57 families (77%) who had agreed to take part in a follow-up study were interviewed.

Mapping and sequencing of structural variation from eight human genomes.

Genetic variation among individual humans occurs on many different scales, ranging from gross alterations in the human karyotype to single nucleotide changes. Here we explore variation on an intermediate scale--particularly insertions, deletions and inversions affecting from a few thousand to a few million base pairs. We employed a clone-based method to interrogate this intermediate structural variation in eight individuals of diverse geographic ancestry.

Large-insert genome analysis technology detects structural variation in Pseudomonas aeruginosa clinical strains from cystic fibrosis patients.

Large-insert genome analysis (LIGAN) is a broadly applicable, high-throughput technology designed to characterize genome-scale structural variation. Fosmid paired-end sequences and DNA fingerprints from a query genome are compared to a reference sequence using the Genomic Variation Analysis (GenVal) suite of software tools to pinpoint locations of insertions, deletions, and rearrangements. Fosmids spanning regions that contain new structural variants can then be sequenced.

Closing gaps in the human genome with fosmid resources generated from multiple individuals.

The human genome sequence has been finished to very high standards; however, more than 340 gaps remained when the finished genome was published by the International Human Genome Sequencing Consortium in 2004. Using fosmid resources generated from multiple individuals, we targeted gaps in the euchromatic part of the human genome. Here we report 2,488,842 bp of previously unknown euchromatic sequence, 363,114 bp of which close 26 of 250 euchromatic gaps, or 10%, including two remaining euchromatic gaps on chromosome 19.

The donor, the father, and the imaginary constitution of the family: parents' constructions in the case of donor insemination.

Current international policy trends in the field of medically assisted conception are moving towards increased openness of information regarding the nature of conception where donated gametes are involved. In the case of donor insemination this means that the donor is no longer anonymous, offspring have the right to access information about the donor's identity, and parents are encouraged to tell children the nature of their donor-assisted conception. Until recently, however, the practice of donor insemination has tended to create the conditions for ignoring, or erasing, the existence of the donor as the provider of the gametes.

Comparison of Francisella tularensis genomes reveals evolutionary events associated with the emergence of human pathogenic strains.

Background: Francisella tularensis subspecies tularensis and holarctica are pathogenic to humans, whereas the two other subspecies, novicida and mediasiatica, rarely cause disease. To uncover the factors that allow subspecies tularensis and holarctica to be pathogenic to humans, we compared their genome sequences with the genome sequence of Francisella tularensis subspecies novicida U112, which is nonpathogenic to humans.

Results: Comparison of the genomes of human pathogenic Francisella strains with the genome of U112 identifies genes specific to the human pathogenic strains and reveals pseudogenes that previously were unidentified.

Sample-size calculations for trials that inform individual treatment decisions: a 'true-choice' approach.

Background: Sample size decisions for clinical trials should be taken in such a way as to maximize informed choice by reducing scientific uncertainty about the consequences of an intervention.

Purpose: Recent approaches to trial design have focused on the potential decision impact of the trial when deciding whether the trial should be undertaken, and how large it ought to be. For the most part these approaches are concerned with the impact of trials either on clinical opinion or on collective reimbursement recommendations.

Cost-utility analysis when not everyone wants the treatment: modeling split-choice bias.

Not all clinically eligible patients will necessarily accept a new treatment. Cost-utility analysis recognizes this by multiplying the mean incremental expected utility (EU) by the participation rate to obtain the utility gain per head. However, the mean EU gain over all patients in a defined clinical category is traditionally used as a proxy for the mean EU gain over the subpopulation of acceptors.

Survey of Australasian clinicians' prior beliefs concerning lipiodol flushing as a treatment for infertility: a Bayesian study.

Objective: To evaluate clinicians' beliefs concerning the effectiveness of lipiodol flushing as a treatment for unexplained infertility, and to integrate these prior beliefs with evidence from randomised trials.

Design: Survey.

Setting: Specialists in Australasian in vitro fertilisation (IVF) clinics in 2001.