scholarly journals Live births after oocyte in vitro maturation with a prematuration step in women with polycystic ovary syndrome

2020 ◽  
Vol 37 (2) ◽  
pp. 347-357 ◽  
Author(s):  
Lan N. Vuong ◽  
Anh H. Le ◽  
Vu N. A. Ho ◽  
Toan D. Pham ◽  
Flor Sanchez ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
In Vitro Maturation ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Developmental Competence ◽  
Vitro Fertilization ◽  
Live Births

Abstract Purpose Standard oocyte in vitro maturation (IVM) usually results in lower pregnancy rates than in vitro fertilization (IVF). IVM preceded by a prematuration step improves the acquisition of oocyte developmental competence and can enhance embryo quality (EQ). This study evaluated the effectiveness of a biphasic culture system incorporating prematuration and IVM steps (CAPA-IVM) versus standard IVM in women with polycystic ovarian morphology (PCOM). Methods Eighty women (age < 38 years, ≥ 25 follicles of 2–9 mm in both ovaries, no major uterine abnormalities) were randomized to undergo CAPA-IVM (n = 40) or standard IVM (n = 40). CAPA-IVM uses two steps: a 24-h prematuration step with C-type natriuretic peptide-supplemented medium, then 30 h of culture in IVM media supplemented with follicle-stimulating hormone and amphiregulin. Standard IVM was performed using routine protocols. Results A significantly higher proportion of oocytes reached metaphase II at 30 h after CAPA-IVM versus standard IVM (63.6 vs 49.0; p < 0.001) and the number of good quality embryos per cumulus-oocyte complex tended to be higher (18.9 vs 12.7; p = 0.11). Clinical pregnancy rate per embryo transfer was 63.2% in the CAPA-IVM versus 38.5% in the standard IVM group (p = 0.04). Live birth rate per embryo transfer was not statistically different between the CAPA-IVM and standard IVM groups (50.0 vs 33.3% [p = 0.17]). No malformations were reported and birth weight was similar in the two treatment groups. Conclusions Use of the CAPA-IVM system significantly improved maturation and clinical pregnancy rates versus standard IVM in patients with PCOM. Furthermore, live births after CAPA-IVM are reported for the first time.

scholarly journals Comparative Study Between Mock Embryo Transfer Prior To The Treatment Cycle and Real Embryo Transfer In In Vitro Fertilization

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Hilma Putri Lubis
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Treatment Cycle ◽  
Uterine Cavity ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Clinical Pregnancy Rates

<p><strong>Introduction</strong><strong></strong></p><p>A trial or mock embryo transfer (ET) may influence pregnancy rates and it performed prior to ET allows the clinician to assess the uterine cavity and the utero-cervical angle. The aim of this study is to compare the consistency of the type of ET in mock ET with real ET.</p><p><strong>Material &amp; Methods</strong></p><p>A retrospective comparative analysis of  patients who underwent in vitro fertilization or ICSI cycle from January 2014 to December 2014 in Halim Fertility Center was done. The type of transfer was divided into two groups: ‘easy’ or ‘difficult’. An easy ET was defined as a transfer that occurred without the use of manipulation or other instrumentation and difficult ET was considered when additional instrumentation was required.</p><p><strong>Results</strong></p><p>From the study, 103 patients who underwent Mock-ET, we  found 58 patients (56.3%) with easy ET and 45 patients (43.7%) with difficult ET, which with hard catheter ET in 17 patients (16.5%), with osfander assistance in 20 patients (19.4%) and with stylet in 8 patients (7,8%). 58 patients with Easy Mock ET group were entirely easy real ET (100%) and 45 patients with difficult Mock ET group also entirely were difficult real ET (100%). The Statistical analysis shows no significant difference between the mock ET and real ET groups (p&gt;0,05). In easy real ET, clinical pregnancy rates were 32.8% and in difficult real ET, clinical pregnancy rates were 26.7% with no significant difference between the  groups (p&gt;0,05).</p><p><strong>Conclusion:</strong></p><p>Mock ET prior to the treatment cycle is consistent with real ET.</p>

scholarly journals The Place of In Vitro Maturation in PCO/PCOS

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Shital Julania ◽  
Melanie L. Walls ◽  
Roger Hart
Keyword(s):  
In Vitro Fertilization ◽  
In Vitro Maturation ◽  
Culture Media ◽  
Polycystic Ovary ◽  
Pregnancy Rates ◽  
Ovary Syndrome ◽  
Successful Pregnancy ◽  
Vitro Fertilization ◽  
In Pregnancy

In vitro maturation (IVM) of human oocytes is an emerging treatment option for women with polycystic ovary/polycystic ovary syndrome (PCO/PCOS) in addition to the standard in vitro fertilization (IVF) treatment. There has been significant improvements in pregnancy rates with IVM over the last two decades. This article reviews the place of IVM for women with PCO/PCOS, placing an emphasis on the predictors of successful pregnancy, optimization of culture media, IVM protocols, pregnancy rates, and neonatal outcomes following IVM treatment.

scholarly journals Follicular output rate tends to improve clinical pregnancy outcomes in patients with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer treatment

2019 ◽  
Vol 47 (10) ◽  
pp. 5146-5154
Author(s):  
Xiaoqing Tan ◽  
Yu Wen ◽  
Huixiao Chen ◽  
Ling Zhang ◽  
Bin Wang ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Polycystic Ovary ◽  
Controlled Ovarian Hyperstimulation ◽  
Clinical Pregnancy ◽  
Ovarian Hyperstimulation ◽  
Output Rate ◽  
Vitro Fertilization

Objective This study aimed to examine the relationship between the follicular output rate (FORT) and clinical outcomes in patients with polycystic ovarian syndrome (PCOS). Methods A total of 841 patients with PCOS undergoing in vitro fertilization-embryo transfer (IVF-ET) were divided into three groups according to their FORT (low, middle, and high). Controlled ovarian hyperstimulation and clinical outcomes were compared retrospectively. Results Serum estradiol levels on the day of human chorionic gonadotropin (3780.5, 3599.9, and 3375.7 pg/mL) and the number of retrieved oocytes (17.5, 16.1, and 14.8) decreased from the high to low FORT groups. Pre-ovulatory follicle counts were significantly higher in the high FORT group than in the middle and low FORT groups. The number of retrieved oocytes, high-quality embryo rate, and clinical pregnancy rate decreased from the high to low FORT groups. The incidence of moderate and severe ovarian hyperstimulation syndrome (OHSS) in the middle FORT group was significantly lower than that in the high and low FORT groups. Conclusions FORT may be used to predict clinical outcomes of IVF/intracytoplasmic sperm injection-embryo transfer in patients with PCOS. Efforts should be made to prevent OHSS in patients with PCOS and a high or low FORT in controlled ovarian hyperstimulation cycles.

scholarly journals Clinical Pregnancy after Elimination of Embryo Fragments Before Fresh Cleavage-Stage Embryo Transfer

2020 ◽  
Author(s):  
Luis H. Sordia-Hernandez ◽  
Felipe A. Morales-Martinez ◽  
Lorna M. Frazer-Moreira ◽  
Lilith Villarreal-Pineda ◽  
María Ofelia Sordia-Piñeyro ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Poor Quality ◽  
Abortion Rate ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Cleavage Stage ◽  
Fresh Embryo Transfer ◽  
Vitro Fertilization ◽  
Stage Embryo

Objective: To determine if the elimination of fragments in cleavage-stage embryos, before fresh transfer, improves pregnancy rates in in vitro fertilization cycles. Materials and methods: This is a Prospective observational case-control study carried out at a University Reproductive Center. We included Twenty-six infertile patients divided into two groups. Group one: 13 patients with embryos classified as grade B and C (embryos with fragments) according to the Hill classification, and Group two: 13 patients with grade A embryos (embryos with no fragments). Embryo Defragmentation was performed in embryos of group one 65 to 68 hours after conventional fertilization. Fresh embryo transfer was made after two hours post fragments removal. Reproductive results were evaluated and compared between both groups. Results: The total number of clinical pregnancies was nine. In group one there were 5 (38.5 %); in group two, there were 4 (30.8%). The difference was not statistically significant (p = 0.68). Two abortions were reported in the study, both in group one; were fragment elimination was performed. This represents an abortion rate of 40% in patients who got pregnant in this group. These patients had twice the probability of suffering an abortion (OR 2.1; 95% CI 1.4-3.37). Ongoing pregnancies were similar in both groups. Conclusion: Removal of fragments in freshly transferred day three embryos could be an alternative to increase clinical pregnancy and ongoing pregnancy rates in patients who have only poor-quality embryos. Despite the relationship with a higher abortion rate, this strategy could represent a real alternative for this type of patient.

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