Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy. m.castori@operapadrepio.it.
Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, Rome, Italy; UOC Genetica Medica, Fondazione Policlinico Universitario A. Gemelli, Rome Italy. pietrosmile@yahoo.com.
Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy. l.dagruma@operapadrepio.it.
Surgical Department, Unit of Urology, Poliambulanza Foundation, Brescia, Italy. farshid.kalantaryrad@poliambulanza.it.
UOSD Fetal and Perinatal Pathology, Department of Translational Research, Laboratory Medicine, Diagnostics and Services, IRCCS Giannina Gaslini Institute, Genoa, Italy. eziofulcheri@gaslini.org.
Department of Vascular Rehabilitation, San Giovanni Battista Hospital, Rome, Italy. s.michelini@acismom.it.
Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy. a.notarangelo@operapadrepio.it.
MAGI'S LAB. stefano.paolacci@assomagi.org.
General Director, IRCCS Giannina Gaslini Institute, Genoa, Italy. paolopetralia@gaslini.org.
Department of Mother and Child Health, Unit of Obstetrics and Gynecology, Poliambulanza Foundation, Brescia, Italy. daniela.piccinelli@poliambulanza.it.
Department of Obstetrics and Gynecology, University Campus Bio Medico, Rome, Italy. f.plotti@unicampus.it.
Director, San Giovanni Battista Hospital, Rome, Italy. p.scanzano@acismom.it.
Department of Obstetrics and Gynecology, University Campus Bio Medico, Rome, Italy. C.Terranova@unicampus.it.
Surgical Department, Unit of Urology, Poliambulanza Foundation, Brescia, Italy. gerolamotonini@libero.it.
Infertility affects \~20% of the couples in the world. Assisted reproductive technologies (ARTs) are currently the most common treatment option for infertility. Nevertheless, ARTs may be associated with complications for mothers and/or offspring. Natural procreative technology (NaProTechnology) is a natural treatment which minimizes these risks by seeking to identify the causes of infertility to enable better treatments. This narrative review summarizes the complications related to ARTs and clarifies how the NaProTechnology approach can help ARTs to achieve better results or be used in alternative to ARTs.
Methods
Data in the literature indicate that NaProTechnology is a natural approach for treating infertility.
Results
The percentage of live births obtained by NaProTechnology is similar to that of ARTs.
Conclusions
An extensive search for the genetic defects causing infertility or subfertility through genetic testing can help both ARTs and NaProTechnology to achieve successful pregnancies. By discovering the underlying causes of infertility, genetic tests enable better family counseling, like the implications of transmitting risk- and disease-alleles to future generations.
IVF complications NaProTECHNOLOGY implementation, assisted reproductive technology complications, ART maternal risks, multiple pregnancy IVF risk, ovarian hyperstimulation syndrome, natural procreative technology alternative, IVF neonatal outcomes, ART long-term health effects, NaPro vs IVF outcomes, reproductive technology safety comparison
PMID 33170179 33170179 DOI 10.23750/abm.v91i13-S.10525 10.23750/abm.v91i13-S.10525 Kiani et al. 2020, Kiani 2020
Cite this article
Kiani, A. K., Paolacci, S., Scanzano, P., Michelini, S., Capodicasa, N., D'Agruma, L., Notarangelo, A., Tonini, G., Piccinelli, D., Farshid, K. R., Petralia, P., Fulcheri, E., Chiurazzi, P., Terranova, C., Plotti, F., Angioli, R., Castori, M., & Bertelli, M. (2020). Complications related to in vitro reproductive techniques support the implementation of natural procreative technologies. Acta bio-medica : Atenei Parmensis, 91(13-S), e2020018. https://doi.org/10.23750/abm.v91i13-S.10525
Kiani AK, Paolacci S, Scanzano P, Michelini S, Capodicasa N, D'Agruma L, et al. Complications related to in vitro reproductive techniques support the implementation of natural procreative technologies. Acta Biomed. 2020;91(13-S):e2020018. doi:10.23750/abm.v91i13-S.10525
Kiani, Aysha Karim, et al. "Complications related to in vitro reproductive techniques support the implementation of natural procreative technologies." Acta bio-medica : Atenei Parmensis, vol. 91, no. 13-S, 2020, pp. e2020018.
Does IVF worsen pelvic pain in women with endometriosis? Nearly half of women with endometriosis reported perceived worsening of pelvic pain after IVF. Prior studies generally suggested no IVF-related pain worsening, but few assessed delayed flares or longer-term trajectories. International cross-sectional study based on an online survey conducted between September 2024 and April 2025 including 546 respondents. PARTICIPANTS/MATERIALS Women aged ≥18 years with surgically or imaging-confirmed endometriosis and at least one completed IVF cycle. A 25-item questionnaire captured demographics, reproductive history, comorbidities, and patient-reported pain trajectories before, during, and after IVF. The primary outcome was perceived worsening of pelvic pain after IVF (patient-reported outcome measure; PROM). Secondary outcomes were worsening of dysmenorrhoea and dyspareunia. Group comparisons and exploratory multivariable logistic regressions were performed. Predictor analyses were exploratory. MAIN Among 546 respondents, 48.9% reported worsening pelvic pain after IVF, 49.1% reported worsening dysmenorrhoea, and 35.5% worsening dyspareunia. Current pain scores were significantly higher in women reporting worsening versus no worsening (all P < 0.001). In multivariable analyses, immediate post-cycle pain flare emerged as the strongest and most consistent predictor across all pain outcomes, independently associated with worsening of pelvic pain (adjusted odds ratio [aOR] 5.91, 95% CI 3.88-9.14), dysmenorrhoea (aOR 4.03, 95% CI 2.08-8.05), and dyspareunia (aOR 3.17, 95% CI 2.07-4.90) (all P < 0.001). For the primary outcome, reporting oocyte retrieval as the most painful IVF step (aOR 0.53, 95% CI 0.31-0.88; P = 0.016) and achieving a live birth after IVF (aOR 0.63, 95% CI 0.42-0.92; P = 0.020) were independently associated with lower odds of pelvic pain worsening. In secondary outcome models, live birth was associated with lower odds of dysmenorrhoea worsening, while bladder pain syndrome/interstitial cystitis independently predicted worsening of dyspareunia. A formal response rate could not be calculated due to open online dissemination without a known denominator. LIMITATIONS Self-reported, retrospective data are prone to recall and selection bias, and the cross-sectional design precludes causal inference. Recruitment via associations and social media without a denominator limits generalizability, absence of baseline pain scores impedes assessment of change, and incomplete capture of peri-IVF hormonal regimens may confound results. IVF may not be pain-neutral in endometriosis. Monitoring pain trajectories at key IVF milestones may help identify women at risk of long-term exacerbation. Prospective studies should test whether early monitoring combined with tailored interventions-optimized analgesia, psychological support, or adapted stimulation protocols-can mitigate chronic pain trajectories throughout the IVF journey and ultimately improve quality of life. No specific funding; authors declare no conflicts of interest. N/A.
Agence de la biomédecine, 2024·Agence de la biomédecine - AMP Vigilance
Rapport annuel d'AMP Vigilance 2023 de l'Agence de la biomédecine. 2023 ART vigilance report from the French Agence de la biomédecine. AMP Vigilance is the mandatory adverse-event surveillance system covering serious adverse events and reactions related to assisted reproduction practice in France. Reports cycle counts, vigilance signals, and incident classifications across French ART centers.
Natural Procreative Technology (NaProTechnology) is a system of management of infertility and other reproductive health issues which requires the application of a woman’s observation and record of key events throughout her menstrual cycle. The study assessed the knowledge, awareness, and perception of NaProTechnology as well as the effect of an educational intervention among pharmacy undergraduate students at University of Nigeria, Nsukka. It was a cross-sectional, questionnaire-based study. The ethical approval was obtained from the research ethics committee of the Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka. At baseline, the knowledge, awareness and perception of the students were assessed. Followed by the administration of an educational video on NaProTechnology. Then a post intervention survey was done to assess the effect of the educational intervention. Key finding: s
There were 410 and 350 students in the preand post-intervention surveys respectively with relatively equal number of males and females. Majority were between 18 and 29 years old. Less than 5% were married while the highest proportion of the respondents were from 300 level The knowledge, awareness, and positive perception of NaProTechnology among the pharmacy students prior to intervention were poor but improved markedly post intervention (P < 0.001).
A video intervention was effective in improving the short-term knowledge, awareness and positive perception of NaProTechnology among pharmacy students. Key message: s
What is already known on this topic?
Natural Procreative Technology (NaProTechnology) is a system of management of infertility based on the observation and record of fertility biomarkers by a woman. What this study add: s?
The level of knowledge, awareness, and positive perception of NaProTechnology among the pharmacy undergraduates students were poor prior to a video intervention but improved markedly afterwards
How this study might affect research, practice or policy?
This study would lead to the public health system approach of informing, educating and communicating NaProTechnology to pharmacy students to achieve long-term effects by using well-designed courses and curriculum implementation.
Agence de la biomédecine, 2023·Agence de la biomédecine - AMP Vigilance
Rapport annuel d'AMP Vigilance 2022 de l'Agence de la biomédecine. 2022 ART adverse-event surveillance report from the French Agence de la biomédecine, covering serious adverse events and reactions in assisted reproduction during 2022.