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Showing 1 - 200 of 370 Journals sorted alphabetically
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 6, SJR: 0.881, h-index: 38)
Adaptation     Hybrid Journal   (Followers: 8, SJR: 0.111, h-index: 4)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.538, h-index: 35)
African Affairs     Hybrid Journal   (Followers: 59, SJR: 1.512, h-index: 46)
Age and Ageing     Hybrid Journal   (Followers: 85, SJR: 1.611, h-index: 107)
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American Entomologist     Full-text available via subscription   (Followers: 6)
American Historical Review     Hybrid Journal   (Followers: 139, SJR: 0.652, h-index: 43)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 40, SJR: 1.441, h-index: 77)
American J. of Epidemiology     Hybrid Journal   (Followers: 171, SJR: 3.047, h-index: 201)
American J. of Hypertension     Hybrid Journal   (Followers: 23, SJR: 1.397, h-index: 111)
American J. of Jurisprudence     Hybrid Journal   (Followers: 17)
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American Law and Economics Review     Hybrid Journal   (Followers: 25, SJR: 0.824, h-index: 23)
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Analysis     Hybrid Journal   (Followers: 23)
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Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 19, SJR: 0.884, h-index: 31)
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Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 26, SJR: 0.96, h-index: 71)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 2, SJR: 0.102, h-index: 20)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
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Biometrika     Hybrid Journal   (Followers: 19, SJR: 2.801, h-index: 90)
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Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.213, h-index: 9)
Biostatistics     Hybrid Journal   (Followers: 16, SJR: 1.955, h-index: 55)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 148, SJR: 2.314, h-index: 133)
BJA Education     Hybrid Journal   (Followers: 64, SJR: 0.272, h-index: 20)
Brain     Hybrid Journal   (Followers: 61, SJR: 6.097, h-index: 264)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 44, SJR: 4.086, h-index: 73)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 4, SJR: 1.771, h-index: 50)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 34, SJR: 1.267, h-index: 38)
British J. of Aesthetics     Hybrid Journal   (Followers: 26, SJR: 0.217, h-index: 18)
British J. of Criminology     Hybrid Journal   (Followers: 527, SJR: 1.373, h-index: 62)
British J. of Social Work     Hybrid Journal   (Followers: 83, SJR: 0.771, h-index: 53)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.391, h-index: 84)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 27)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 3, SJR: 1.474, h-index: 31)
Cambridge J. of Economics     Hybrid Journal   (Followers: 58, SJR: 0.957, h-index: 59)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 11, SJR: 1.067, h-index: 22)
Cambridge Quarterly     Hybrid Journal   (Followers: 11, SJR: 0.1, h-index: 7)
Capital Markets Law J.     Hybrid Journal   (Followers: 1)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.439, h-index: 167)
Cardiovascular Research     Hybrid Journal   (Followers: 12, SJR: 2.897, h-index: 175)
Cerebral Cortex     Hybrid Journal   (Followers: 41, SJR: 4.827, h-index: 192)
CESifo Economic Studies     Hybrid Journal   (Followers: 16, SJR: 0.501, h-index: 19)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.436, h-index: 76)
Children and Schools     Hybrid Journal   (Followers: 6, SJR: 0.211, h-index: 18)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 3)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 21, SJR: 0.737, h-index: 11)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 9, SJR: 1.238, h-index: 15)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 11, SJR: 0.191, h-index: 8)
Classical Receptions J.     Hybrid Journal   (Followers: 24, SJR: 0.1, h-index: 3)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 59, SJR: 4.742, h-index: 261)
Clinical Kidney J.     Open Access   (Followers: 4, SJR: 0.338, h-index: 19)
Community Development J.     Hybrid Journal   (Followers: 24, SJR: 0.47, h-index: 28)
Computer J.     Hybrid Journal   (Followers: 7, SJR: 0.371, h-index: 47)
Conservation Physiology     Open Access   (Followers: 2)
Contemporary Women's Writing     Hybrid Journal   (Followers: 11, SJR: 0.111, h-index: 3)
Contributions to Political Economy     Hybrid Journal   (Followers: 5, SJR: 0.313, h-index: 10)
Critical Values     Full-text available via subscription  
Current Legal Problems     Hybrid Journal   (Followers: 26)
Current Zoology     Full-text available via subscription   (SJR: 0.999, h-index: 20)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 11, SJR: 1.068, h-index: 24)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 12)
Diplomatic History     Hybrid Journal   (Followers: 19, SJR: 0.296, h-index: 22)
DNA Research     Open Access   (Followers: 4, SJR: 2.42, h-index: 77)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 3)
Early Music     Hybrid Journal   (Followers: 15, SJR: 0.124, h-index: 11)
Economic Policy     Hybrid Journal   (Followers: 63, SJR: 2.052, h-index: 52)
ELT J.     Hybrid Journal   (Followers: 25, SJR: 1.26, h-index: 23)
English Historical Review     Hybrid Journal   (Followers: 51, SJR: 0.311, h-index: 10)
English: J. of the English Association     Hybrid Journal   (Followers: 13, SJR: 0.144, h-index: 3)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.791, h-index: 66)
Environmental Epigenetics     Open Access   (Followers: 1)
Environmental History     Hybrid Journal   (Followers: 26, SJR: 0.197, h-index: 25)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.201, h-index: 71)
Epidemiologic Reviews     Hybrid Journal   (Followers: 10, SJR: 3.917, h-index: 81)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 16, SJR: 0.1, h-index: 6)
European Heart J.     Hybrid Journal   (Followers: 49, SJR: 6.997, h-index: 227)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 8, SJR: 2.044, h-index: 58)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. Supplements     Hybrid Journal   (Followers: 7, SJR: 0.152, h-index: 31)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 8, SJR: 1.568, h-index: 104)
European J. of Intl. Law     Hybrid Journal   (Followers: 160, SJR: 0.722, h-index: 38)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.09, h-index: 60)
European J. of Public Health     Hybrid Journal   (Followers: 22, SJR: 1.284, h-index: 64)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 11, SJR: 1.549, h-index: 42)
European Review of Economic History     Hybrid Journal   (Followers: 28, SJR: 0.628, h-index: 24)
European Sociological Review     Hybrid Journal   (Followers: 41, SJR: 2.061, h-index: 53)
Evolution, Medicine, and Public Health     Open Access   (Followers: 11)
Family Practice     Hybrid Journal   (Followers: 11, SJR: 1.048, h-index: 77)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 9, SJR: 1.687, h-index: 115)
Fems Microbiology Letters     Hybrid Journal   (Followers: 20, SJR: 1.126, h-index: 118)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 25, SJR: 7.587, h-index: 150)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.213, h-index: 66)
Foreign Policy Analysis     Hybrid Journal   (Followers: 22, SJR: 0.859, h-index: 10)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 0.903, h-index: 44)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.108, h-index: 6)
French History     Hybrid Journal   (Followers: 32, SJR: 0.123, h-index: 10)
French Studies     Hybrid Journal   (Followers: 20, SJR: 0.119, h-index: 7)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.102, h-index: 3)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 10, SJR: 3.22, h-index: 39)
Geophysical J. Intl.     Hybrid Journal   (Followers: 34, SJR: 1.839, h-index: 119)
German History     Hybrid Journal   (Followers: 25, SJR: 0.437, h-index: 13)
GigaScience     Open Access   (Followers: 3)
Global Summitry     Hybrid Journal  
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.692, h-index: 101)
Health and Social Work     Hybrid Journal   (Followers: 49, SJR: 0.505, h-index: 40)
Health Education Research     Hybrid Journal   (Followers: 12, SJR: 0.814, h-index: 80)
Health Policy and Planning     Hybrid Journal   (Followers: 20, SJR: 1.628, h-index: 66)
Health Promotion Intl.     Hybrid Journal   (Followers: 21, SJR: 0.664, h-index: 60)
History Workshop J.     Hybrid Journal   (Followers: 27, SJR: 0.313, h-index: 20)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 24, SJR: 0.115, h-index: 13)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 4.288, h-index: 233)
Human Reproduction     Hybrid Journal   (Followers: 78, SJR: 2.271, h-index: 179)
Human Reproduction Update     Hybrid Journal   (Followers: 17, SJR: 4.678, h-index: 128)
Human Rights Law Review     Hybrid Journal   (Followers: 60, SJR: 0.7, h-index: 21)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 54, SJR: 1.233, h-index: 88)
ICSID Review     Hybrid Journal   (Followers: 10)
ILAR J.     Hybrid Journal   (Followers: 1, SJR: 1.099, h-index: 51)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.329, h-index: 26)
IMA J. of Management Mathematics     Hybrid Journal   (Followers: 2, SJR: 0.351, h-index: 20)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.661, h-index: 28)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 2.032, h-index: 44)
Industrial and Corporate Change     Hybrid Journal   (Followers: 8, SJR: 1.37, h-index: 81)
Industrial Law J.     Hybrid Journal   (Followers: 30, SJR: 0.184, h-index: 15)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 8, SJR: 1.911, h-index: 90)
Interacting with Computers     Hybrid Journal   (Followers: 10, SJR: 0.529, h-index: 59)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 5, SJR: 0.743, h-index: 35)
Intl. Affairs     Hybrid Journal   (Followers: 52, SJR: 1.264, h-index: 53)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 28)
Intl. Health     Hybrid Journal   (Followers: 5, SJR: 0.835, h-index: 15)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 1.613, h-index: 111)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 33, SJR: 1.593, h-index: 69)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 60, SJR: 0.613, h-index: 19)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 148, SJR: 4.381, h-index: 145)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 4, SJR: 0.247, h-index: 8)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 29, SJR: 0.307, h-index: 15)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 8, SJR: 0.404, h-index: 18)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.457, h-index: 12)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.69, h-index: 79)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 9, SJR: 0.906, h-index: 33)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 33, SJR: 0.231, h-index: 21)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 13, SJR: 0.833, h-index: 12)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.052, h-index: 42)
Intl. Political Sociology     Hybrid Journal   (Followers: 31, SJR: 1.339, h-index: 19)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 18, SJR: 0.539, h-index: 17)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 7, SJR: 0.998, h-index: 28)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 39, SJR: 2.184, h-index: 68)
Intl. Studies Review     Hybrid Journal   (Followers: 18, SJR: 0.783, h-index: 38)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 1, SJR: 0.155, h-index: 4)
ITNOW     Hybrid Journal   (Followers: 2, SJR: 0.102, h-index: 4)
J. of African Economies     Hybrid Journal   (Followers: 15, SJR: 0.647, h-index: 30)
J. of American History     Hybrid Journal   (Followers: 43, SJR: 0.286, h-index: 34)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 13, SJR: 1.038, h-index: 60)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 13, SJR: 2.157, h-index: 149)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 3, SJR: 0.563, h-index: 43)
J. of Biochemistry     Hybrid Journal   (Followers: 43, SJR: 1.341, h-index: 96)
J. of Chromatographic Science     Hybrid Journal   (Followers: 16, SJR: 0.448, h-index: 42)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.167, h-index: 11)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 35, SJR: 0.442, h-index: 16)
J. of Complex Networks     Hybrid Journal   (Followers: 1, SJR: 1.165, h-index: 5)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 13, SJR: 0.196, h-index: 15)
J. of Consumer Research     Full-text available via subscription   (Followers: 43, SJR: 4.896, h-index: 121)
J. of Crohn's and Colitis     Hybrid Journal   (Followers: 10, SJR: 1.543, h-index: 37)
J. of Cybersecurity     Hybrid Journal   (Followers: 3)
J. of Deaf Studies and Deaf Education     Hybrid Journal   (Followers: 9, SJR: 0.69, h-index: 36)
J. of Design History     Hybrid Journal   (Followers: 16, SJR: 0.166, h-index: 14)
J. of Economic Entomology     Full-text available via subscription   (Followers: 6, SJR: 0.894, h-index: 76)
J. of Economic Geography     Hybrid Journal   (Followers: 39, SJR: 2.909, h-index: 69)
J. of Environmental Law     Hybrid Journal   (Followers: 23, SJR: 0.457, h-index: 20)
J. of European Competition Law & Practice     Hybrid Journal   (Followers: 19)
J. of Experimental Botany     Hybrid Journal   (Followers: 14, SJR: 2.798, h-index: 163)
J. of Financial Econometrics     Hybrid Journal   (Followers: 23, SJR: 1.314, h-index: 27)
J. of Global Security Studies     Hybrid Journal   (Followers: 3)
J. of Heredity     Hybrid Journal   (Followers: 4, SJR: 1.024, h-index: 76)
J. of Hindu Studies     Hybrid Journal   (Followers: 7, SJR: 0.186, h-index: 3)
J. of Hip Preservation Surgery     Open Access  
J. of Human Rights Practice     Hybrid Journal   (Followers: 20, SJR: 0.399, h-index: 10)
J. of Infectious Diseases     Hybrid Journal   (Followers: 39, SJR: 4, h-index: 209)
J. of Insect Science     Open Access   (Followers: 8, SJR: 0.388, h-index: 31)

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Journal Cover ESHRE Monographs
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1477-741X - ISSN (Online) 1477-8378
   Published by Oxford University Press Homepage  [370 journals]
  • Contents Page
    • PubDate: 2008-07-01
      DOI: 10.1093/humrep/den176
  • Introduction
    • Authors: Ombelet W.
      First page: 1
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den159
  • List of participants
    • First page: 2
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den174
  • Documentation of infertility prevalence, treatment access and treatment
           outcomes in developing countries
    • Authors: Nygren K; Zegers-Hochschild F.
      First page: 5
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den218
  • False perceptions and common misunderstandings surrounding the subject of
           infertility in developing countries
    • Authors: Ombelet W.
      First page: 8
      Abstract: AbstractAlthough the consequences of the problem of childlessness are more pronounced in developing countries when compared with Western societies, local health care providers and international organizations pay little attention on this issue. The limited budgets for reproductive health care are mostly restricted to family planning and mother care. The most common misunderstanding is the ‘overpopulation-issue’. It is generally believed that the expected growth of the world population puts a real burden on the issue of infertility treatment in resource-poor countries, although recent UN reports clearly show that in most developing countries the fertility rate is dropping significantly and will fall below the threshold of 2.0 by 2050. It seems that the expected population growth in developing countries in the next decades is rather due to population ageing and not to high fertility rates. Another important issue surrounding infertility in developing countries is the so-called ‘limited resources argument’. Because the problem of childlessness is a major health problem in most developing countries, a re-arrangement of the global reproductive health care budget should be requested from local governments and international organizations taking into account the urgent need for a go-together of more successful family-planning policies and affordable simplified ART methods.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den204
  • Affordable assisted reproductive technologies in developing countries:
           pros and cons
    • Authors: Akande E.
      First page: 12
      Abstract: AbstractInfertility in developing countries is pervasive and a serious concern. In addition to the personal grief and suffering it causes, the inability to have children especially in poor communities can create broader problems, particularly for the woman. Infertility services in developing countries span the spectrum from prevention to treatment. From a societal and public health standpoint, prevention is cost–effective and is considered by many governments and public health care providers to be a priority for service delivery. While prevention remains paramount, taken alone it ignores the plight of infertile couples, including those with non-infectious causes of infertility. Two key arguments are frequently used to challenge the development of new reproductive technologies in developing countries: overpopulation and limited resources. Evidence supports the conclusion that there is a compelling need for infertility treatment beyond prevention. In many instances, assisted reproductive technologies (ART) are the last hope or the only means to achieve a child for couples. In an effort to make much needed ART to developing countries accessible and affordable, developing countries should look to public–private partnerships. Governments have a responsibility to ensure safe and effective services including the control of standards for clinical procedures and the regulation of professional practice.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den147
  • Ethical issues of infertility treatment in developing countries
    • Authors: Pennings G.
      First page: 15
      Abstract: AbstractThe provision of infertility treatment in developing countries is controversial. Reports over the last decades have inculcated in people from Western countries the belief that overpopulation is the major problem of developing countries. This paper will analyse the different arguments advanced for and against providing infertility treatment to resource-poor countries. There are two arguments in favour: reproductive autonomy and the huge burden of infertility in these countries. Pronatalism, which reigns in almost all developing countries, is to a great extent responsible for the devastating effects of infertility. The five arguments against the application of infertility treatment are overpopulation, prioritization of limited resources, prevention rather than cure, justice and equal access and risk of abuse. The importance of a person's reproductive autonomy demands that efforts should be made to enable people to determine how many children to have. This is equally true in developing countries. However, given the enormous difficulties of resource-poor countries to provide even the most basic goods, the contribution by society should be directed mostly at prevention and should depend on a strong cost reduction for assisted reproductive technology.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den142
  • Is affordable and cost-effective assisted reproductive technology in
           low-income countries possible? What should we know to answer the question?
    • Authors: Habbema JF.
      First page: 21
      Abstract: AbstractDecision making on infertility treatment in low-income countries (LIC) assumes answers to quite a few questions: how should the infertility problem be defined? How often does infertility occur? What is the burden-of-disease of infertility? What is the income in LIC, and what can be spend on health care? How cheap should IVF be in order to be accessible to a considerable part of the population? With what alternative health interventions should infertility treatment be compared? How cost-effective should IVF be in order to compete with those other interventions? These questions will be discussed. The emphasis is on the situation in Sub-Saharan Africa (SSA). It is concluded that a place for ART in a health care package is not straightforward. Many of the questions are not or only partially answered. Moreover, cheap and effective ART has yet to be developed and tested. From the limited evidence available for each of the questions, it could be calculated that an IVF cycle should cost between 50 and 75 dollar in order to be a candidate for the inclusion in a health package in SSA. This estimate can easily change considerably when in the future the calculations will be based on thorough research. Thus, a targeted research programme for answering the open questions, especially on quality-of-life implications of infertility in different societies, is the preferred option for facilitating the future evaluation of ART in LIC.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den203
  • Involuntary childlessness: a neglected problem in poor-resource areas
    • Authors: Van Balen FF.
      First page: 25
      Abstract: AbstractChildlessness is analysed on the individual, the national and the international level. On the individual level five categories of consequences are described: grief and sadness; social isolation and stigma; restricted rights; religious effects and economic aspects. The first category concerns individual feelings and the others are socio-cultural effects in broad-sense. In developing countries childlessness has consequences on individual and socio-cultural level. In the West consequences are mostly restricted to individual feelings. In poor-resource areas there are limited possibilities for modern biomedical treatment. Traditional medicine, with its easy access and cultural acceptation, is a serious ‘competitor’. On the national level there are few incentives and possibilities for development of adequate infertility treatment. Though local and national authorities might be sensitive to the problem, allocation of funds is mostly determined by international agencies, which consider other issues more important. On the international level Western perceptions about the urgency of health issues are still dominant. In the Western world there is little interest and understanding in the problem of ‘barrenness among plenty’ because a focus on population growth reduction and on other problems. Also, the perception of childlessness as an individual problem, makes it difficult to change this attitude. Possibilities for change are discussed.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den141
  • Infertility-related reproductive health knowledge and help-seeking
           behaviour in African countries
    • Authors: Dyer SJ.
      First page: 29
      Abstract: AbstractData from African countries indicate that men and women attribute infertility to traditional beliefs about health and disease as well as to biomedical causes, although appropriate knowledge of the latter is frequently lacking. Infertility is a dreaded condition and as a result help-seeking is often intense and persistent. Most of the help-seeking is undertaken by women and both traditional and modern biomedical health services are accessed. There are, however, many barriers to effective and affordable biomedical infertility care, many of which are related to poor resources and lack of infrastructure, and as a result the need for infertility treatment is often unmet. Advances in the quality of care require greater commitment to the problem of infertility in African countries, the provision of health education as an integral part of infertility management, the integration of infertility services into reproductive health care programmes and defining the role of assisted reproductive technologies in low resource settings. At the same time the importance of traditional health services in infertility management should be recognized.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den148
  • Medical and socio-cultural aspects of infertility in the Middle East
    • Authors: Serour GI.
      First page: 34
      Abstract: AbstractThe Middle East (ME), an area rich in history and tradition with >300 million population, includes 18 heterogeneous countries concerning resources, income per capita, available healthcare services, population density, growth rate, birth rate, total fertility rate and life expectancy. There is a high prevalence of infertility in the ME because of post-partum infection, unsafe abortion, iatrogenic tubal and pelvic infertility, tuberculosis, schistosomiasis and high incidence of male factor infertility. It is argued that in the ME, the solution to the problem of infertility is its prevention, and population control should take precedence over infertility treatment. However, for a successful family planning program and adoption of small family norms, couples should be reassured that they will be helped to achieve pregnancy should they decide so. Prevention and treatment of infertility are of particular significance in ME because a woman social status, her dignity and self-esteem are closely related to her ability to have children. Also there is gender suffering of infertility in the ME. One of the stumbling blocks to acceptance of assisted reproductive technology (ART) as a line of treatment of infertility was the unacceptability to the main religious groups of the involvement of a third party in the act of procreation. Practices of ART in the ME have many common features and little differences. A mechanism had to be found to provide low-cost ART to the needy.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den143
  • Assisted reproductive technology in Latin America: an example of regional
           cooperation and development
    • Authors: Zegers-Hochschild F; Schwarze J, Galdames V.
      First page: 42
      Abstract: AbstractBACKGROUNDSince 1990, the Latin American Registry of Assisted Reproduction covers more than 80% of the assisted reproductive technology (ART) cycles performed regionally.METHODS130 centers enter their data online, and after collection, it is analyzed and published regionally.RESULTSThis paper analyses trends in ART procedures initiated between 1990 and 2004, and babies born up to 2005. Overall, the data include 150,000 embryo transfer (ET) cycles, 33,500 deliveries and the birth of 44,978 babies. The yearly increment in initiated cycles is below other regions of the world. The economic, religious and social factors explaining this limited access to ART are discussed. Major trends include: an increase in the age of female partner undergoing treatments; a marked shift towards an increase in the use of ICSI; and a steady increase in the delivery rates per ET reaching 24.6% in IVF/ICSI cycles, and 30.7% in OD cycles. Despite a slight decrease in the mean number of ET (2.9), almost half of all births are either twins or triplets.CONCLUSIONSOur region is confronted with two main issues: limited access to those who can afford it; and a high number of embryos transferred resulting in almost 50% of babies born from multiple births.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den151
  • Infertility in African countries: challenges created by the HIV epidemic
    • Authors: Dyer SJ.
      First page: 48
      Abstract: AbstractHIV infection and infertility are two common reproductive health disorders in Africa. From the perspective of infertility-related reproductive health care, the HIV epidemic has created several challenges which include reduction of fecundity, depletion of scarce health resources, creation of barriers to infertility treatment and increased suffering. Infertility in turn is a risk factor for HIV acquisition and a possible force in the spread of the HIV epidemic. Recognition of the reproductive health needs and desires of HIV-infected infertile men and women is a prerequisite for addressing these challenges. Subsequent strategies comprise the development of treatment guidelines for low-resource environments and a greater integration of HIV and sexual and reproductive health services. Where resources for infertility treatment are not available, the consequences must be critically assessed.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den157
  • Modern endoscopic-based exploration of the female reproductive tract: a
           model for developing countries?
    • Authors: Campo R; Molinas C.
      First page: 54
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den162
  • African experience with training courses on sperm examination
    • Authors: Franken DR; Aneck-Hahn NN.
      First page: 60
      Abstract: AbstractIn conjunction with the World Health Organization’s Department of Health and Research, the Department of Obstetrics and University of Stellenbosch, South Africa presented since 1997 hands-on semenology workshops for 87 health care workers from 16 Sub-Sahara African countries. The programme consists of a five-day workshop, during which participants underwent a pre-training test after which they received intensive hands-on training on sperm concentration, motility, vitality and sperm morphology. Following the workshop, all the participants were enrolled in a continuous quality control programme for sperm morphology. The morphology reading skills of 53 workshop participants that enrolled for the external quality control programme were analysed and classified over an extended period. The reading skills were monitored using 36 slides (18 sets over 48 months). Three participants (5.7%) had a poor standard of reading, 6 participants (11.3%) had a marginal standard of reading and 45 participants had an acceptable reading standard (83%). An external quality control programme can be highly successful, on condition that it is presented continuously with a 3–4 month interval between tests. Our results underline the importance of hands-on training and moreover the crucial role that follow up external quality control programmes plays in the maintenance of a technicians reading skills. This observation can be validated for all semen parameters.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den140
  • Intrauterine insemination (IUI) as a first-line treatment in developing
           countries and methodological aspects that might influence IUI success
    • Authors: Ombelet W; Campo R, Bosmans E, et al.
      First page: 64
      Abstract: AbstractIt is generally accepted that intrauterine insemination (IUI) should be preferred to more invasive and expensive techniques of assisted reproduction and be offered as a first-choice treatment in cases of unexplained and moderate male factor subfertility. Scientific validation of this strategy is rather difficult because literature is rather confusing and not conclusive. IUI is proven easier to perform, less invasive and less expensive than other methods of assisted reproduction. Effectivity has been documented in controlled studies under the condition that the inseminating motile count exceeds more than 1 million motile spermatozoa. Risks are minimal, provided the multiple gestation incidence can be reduced to an acceptable level and provided at least one tube is patent. Therefore, in developing countries, reflection on the implementation and use of IUI as a first-line treatment for most cases of non-tubal infertility seems mandatory. The costs are minimal, training is easy, quality control possible and severe complications are almost non-existing. In cases of unexplained infertility or combined male subfertility and ovulatory dysfunction, correction and/or ovarian stimulation with clomiphene citrate (CC) is probably the best strategy from a cost–benefit point of view unless CC-resistancy has been proven in which the use of low-dose gonadotrophins is necessary.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den165
  • Assisted reproductive technologies: how to minimize the risks and
           complications in developing countries?
    • Authors: De Sutter P; Gerris J, Dhont M.
      First page: 73
      Abstract: AbstractIn 2% of assisted reproductive techniques (ART) cycles complications occur. Some are preventable, some are not. In this paper, we will discuss risks and complications of the standard ‘Western’ approach in ART today and point to some measures to be taken when implementing ART in developing countries, where resources and access to medical care may be limited. Ovarian hyperstimulation syndrome (OHSS, and its thrombo-embolic complications) is responsible for the majority of cycle-related complications, followed by bleeding and infection at oocyte retrieval. ART pregnancies are complicated by first-trimester bleeding more often than spontaneous pregnancies, they are more often ectopic, but the major complication is the very high incidence of multiple pregnancies, when more than one embryo is transferred. OHSS can be prevented by screening patients at risk and by using mild or no stimulation. Simple measures can minimize the risks of bleeding or infection. Obviously single embryo transfer is the only way to avoid multiple pregnancies, which have a highly increased risk for severe maternal and neonatal morbidity and mortality (mainly due to prematurity). Special attention should be given to pre-existing pathologies. Risk minimization of ART in developing countries is not only mandatory from an economical but also an ethical point of view.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den160
  • Affordable ART services in Africa: synthesis and adaptation of laboratory
    • Authors: Huyser C.
      First page: 77
      Abstract: AbstractThe aim of this paper is to provide information, opinions and suggestions on affordable laboratory-orientated fertility screening and treatment. Resource management to provide such services in developing countries, basic and advanced assisted reproductive services and assisted reproduction treatment (ART) of patients with sexually transmitted infections are addressed. Alternative viewpoints and parallel thinking should be encouraged to synthesize and adapt first-world ART guidelines and recommendations into safe and workable directives for developing regions. Affordable African ART programmes, devoid of commercialism, can provide essential sexual health screening services en route to safe fertility services for human immunodeficiency virus type-1 (HIV-1) serodiscordant couples (male HIV-positive), who wish to have their own biological child.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den139
  • INVO: a simple, low cost effective assisted reproductive technology
    • Authors: Frydman RR; Ranoux CC.
      First page: 85
      Abstract: AbstractINVO procedure is a simple and effective infertility treatment that uses a new device, the INVOcell. INVO can be performed in a physician's office or in a satellite facility of an IVF center. The INVO procedure consists of fertilization of oocyte(s) and early embryo development in the INVOcell placed into the maternal vaginal cavity for incubation. The vaginal cavity replaces the complex in vitro fertilization (IVF) laboratory. This study presents the specially designed device, INVOcell that has received CE Certification. INVOcell overcomes the disadvantages of the previously used prototype and makes the procedure simpler and reproducible. INVO is a proven procedure that has demonstrated comparable results to conventional IVF when comparative studies were performed. Over 800 cycles have been published worldwide that showed a clinical pregnancy rate of 19.6%. The INVO technology can be performed in an office setting with minor capital equipment. INVO is a simple low-cost procedure that can be available almost everywhere. INVO allows the treatment of a new population of infertile couples who could not benefit from IVF due to cost and availability. The participation of the patient in the process of fertilization and early embryo development is a psychological benefit that creates a high level of acceptance of INVO.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den163
  • Four years of IVF/ICSI experience in Kampala (Uganda)
    • Authors: Platteau PP; Desmet BB, Odoma GG, et al.
      First page: 90
      Abstract: AbstractWe all know that starting and running an ART clinic is not so easy as some people might perceive from outside. Doing the same thing in the middle of Africa is even more challenging as some evidences in the Western world are not so obvious in this part of the world. We started our clinic in Kampala in 2004. The clinic was a converted apartment from a four flat building. In the beginning, we had difficulties with importing drugs, culture media and consumables; we had the feeling everybody was against us. We overcame multiple power failures, night intruders and a 20% masturbation failure, but once the first IVF/ICSI babies were born, people started to believe in the project. At present, ∼250 IVF/ICSI cycles a year are done in batches, we have a successful embryo freezing programme, offer IUI/ICSI for sero discordant HIV couples and have the first babies after IVF, ICSI, testicular biopsy, embryo freezing, oocyte donation and surrogacy in Central Africa. The results are comparable to the ones in the Western world.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den161
  • Affordable ART and the Third World: difficulties to overcome
    • Authors: Cooke ID; Gianaroli LL, Hovatta OO, et al.
      First page: 93
      Abstract: AbstractA coherent strategy is required, donors to cover the costs of a business plan and personnel to provide advice and training and the country must be chosen. An urban environment is preferred with a local link, ideally a University Department with an existing ART programme and a willingness to be involved. Premises, a clinician and an embryologist must be identified, appropriate training arranged and excellent communication systems put in place. Apart from arranging equipment and servicing supplies, management systems and transparent data collection processes must be established. The protocol and local variations have to be agreed. The clinic needs to be related to the local health system, referral patterns must be created and screening processes set up to develop a waiting list of suitable patients. The nature of prior treatments must be defined. At some point, there needs to be a visit of an agreed scientific adviser with or without a donor representative. The number of patients treated in an initial cohort and review details should be determined. A longer term programme, the creation of a local professional network and clear relations with the state health system need to be explored. Any of these stages may constitute difficulties to be overcome.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den145
  • Infertility in developing countries: funding the project
    • Authors: Sallam HN.
      First page: 97
      Abstract: AbstractAssisting developing countries in establishing infertility services is not a uniform exercise and depends on the stage of development of each country. Three levels of assistance are suggested: providing basic (level 1), advanced (level 2) or tertiary referral infertility services (level 3). At each of these levels, four activities are needed: equipping the clinics, training the staff, educating the public and running the services. Basic (level 1) clinics can be equipped by international donors, whereas level 2 and 3 clinics can be funded through a partnership between an international scientific body (WHO, ESHRE, etc.) and an international bank (World Bank, African Development Bank, etc.). Training of the medical and paramedical staff should be the responsibility of the non-profit organizations (NPOs) preferably in regional training centers. An awareness campaign is necessary to educate the public and inform them of the range of treatment available in their community and can also be funded by NPOs. Finally, the running cost of the services including the staff salaries, the cost of the investigations and medication should be the responsibility of the local government, although in many countries, this has to come from out of pocket payments.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den144
  • Reproductive research in non-human primates at Institute of Primate
           Research in Nairobi, Kenya (WHO Collaborating Center): a platform for the
           development of clinical infertility services?
    • Authors: D'Hooghe TM; Nyachieo A, Chai DC, et al.
      First page: 102
      Abstract: AbstractThe Institute of Primate Research (IPR; is a WHO collaborating center for research in reproductive biology, infectious diseases and ecology/conservation. It includes a fully equipped surgical complex, >5000 square feet of laboratory space, a quarantaine facility, library, conference room, administrative offices, etc. More than 500 primates can be housed at IPR, mainly baboons. Reproductive research at IPR is applied to endometriosis, assisted reproduction, prevention of heterosexual transmission of HIV and includes the investigation of immunocontraceptives and placental retroviruses. Reproductive research capacities of IPR include: videolaparoscopic surgical equipment, surgical experience, endometrial biopsies and uterine flushes, ovarian stimulation, laparoscopic oocyte aspiration, hormonal analyses in baboon blood and urine, sperm assessment, in vitro culture and reproductive immunological investigations. During the last years, simultaneously with the development of baboon IVF, there have been contacts with several Kenyan gynecologists at the level of KEMRI (Kenya Medical Research Institute), KOGS (Kenyan Obstetrical and Gynecological Society), Kenyatta National Hospital and Aga Khan Hospital in Nairobi to develop clinical infertility services including low-budget high-quality IVF in Nairobi. The logic behind this initiative is that the Kenyans trained in non-human primate embryology, and IVF would be natural partners to develop human IVF in Kenya.
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den164
  • Patients' voice
    • Authors: Namusisi R.
      First page: 108
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den171
  • IVF in developing countries: an artist's view
    • Authors: Vanmechelen K.
      First page: 110
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den146
  • Message from the French Ministry of Foreign Affairs
    • Authors: Kouchner B.
      First page: 112
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den138
  • Message from the government of Uganda
    • Authors: Sajjabi A.
      First page: 113
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den173
  • Message from the European Commission: the role of the developed countries,
           a political issue
    • Authors: Languille S.
      First page: 115
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den149
  • Recommendations Arusha-meeting 2007
    • First page: 117
      PubDate: 2008-07-01
      DOI: 10.1093/humrep/den225
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