What Are the Live Birth and Multiple Pregnancy Rates When 1 Versus 2 Low-Quality Blastocysts Are Transferred in a Cryopreserved Cycle? a Retrospective Cohort Study, Stratified for Age, Embryo Quality, and Oocyte Donor Cycles

2020 ◽  
Author(s):  
Suha Arab ◽  
Ahmad Badegiesh ◽  
Sarah Aldhaheri ◽  
Weon-Young Son ◽  
Michael H. Dahan
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Embryo Quality ◽  
Multiple Pregnancy ◽  
Pregnancy Rates ◽  
Oocyte Donor

scholarly journals Pregnancy Outcomes Following the First Frozen Blastocyst Transfer Among Women Aged Less Than 35 Years Old: A Retrospective Cohort Study

2021 ◽  
pp. 1-7
Author(s):  
Le Hoang ◽  
Le Duc Thang ◽  
Nguyen Thi Lien Huong ◽  
Nguyen Minh Thuy ◽  
Vu Thi Mai Anh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Group 2 ◽  
Group 1

Background: Many guidelines have been issued regarding the number of embryos to be transferred after in vitro fertilization (IVF), but patients and clinicians may be reluctant to accept or offer a single embryo transfer due to the expected lower chance of pregnancy or live birth. This study was aimed to provide additional information on cycle outcome according to the number and quality of thawed transferred blastocysts. Methods:A retrospective cohort study was designed to collect the data of 505 patients who performed the first frozen blastocysts transfer at Tam Anh General Hospital from June 2018 to September 2019. One good-quality embryo was transferred for 121 patients (Group 1), two good for 214 patients (Group 2), one good and one poor for 112 patients (Group 3), one good and two poor for 25 patients (Group 4), and one or two poor for 33 patients (Group 5). Results:The pregnancy rate was 71.9%, 74.8%, 69.4%, 84.0%, and 39.4% in Group 1–5, respectively. The multiple pregnancy rate was 36.9%, 16.9%, and 32.0% in Groups 2–4, respectively, higher than Group 1 (4.9%). The live birth rate was 55.6%, 50.9%, and 60.0% in Group 2–4, respectively, but not significantly different from the Group 1 (47.9%). Conclusions:Transferring an additional good or poor embryo, along with a good embryo, does not increase the live birth rate while the incidence of multiple pregnancies rises significantly.

scholarly journals Low dose hCG supplementation in a Gn-RH-agonist trigger protocol is associated with worse pregnancy outcomes: a retrospective cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Maren Shapiro ◽  
Phillip Romanski ◽  
Ann Thomas ◽  
Andrea Lanes ◽  
Elena Yanushpolsky
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Low Dose ◽  
Pregnancy Rates ◽  
Lower Probability ◽  
Luteal Support ◽  
Low Dose Hcg

Abstract Background A number of studies have looked at dual triggers with hCG and GnRH agonist (GnRHa) in varying doses, but the question remains: what is the optimal dose of hCG to minimize ovarian hyperstimulation syndrome (OHSS) and still offer adequate pregnancy rates? The purpose of this study was to compare pregnancy and OHSS rates following dual trigger for oocyte maturation with GnRHa and a low-dose hCG versus hCG alone. A secondary objective was the assess pregnancy outcomes in subsequent frozen cycles for the same population. Methods A total of 963 women < 41 years old, with a BMI 18–40 kg/m2 and an AMH > 2 ng/mL who underwent fresh autologous in vitro fertilization (IVF) with GnRH antagonist protocol at a University-based fertility center were included in this retrospective cohort study. Those who received a low dose dual trigger with hCG (1000u) and GnRHa (2 mg) were compared to those who received hCG alone (10,000u hCG/250-500 μg Ovidrel). Differences in implantation rates, pregnancy, live birth, and OHSS were investigated. Results The dual trigger group was younger (mean 33.6 vs 34.1 years), had a higher AMH (6.3 vs 4.9 ng/mL,) more oocytes retrieved (18.1 vs 14.9) and a higher fertilized oocyte rate (80% vs 77%) compared with the hCG only group. Yet, the dual trigger group had a lower probability of clinical pregnancy (gestational sac, 43.4% vs 52.8%) and live birth (33.4% vs 45.8%), all of which were statistically significant. There were 3 cases of OHSS, all in the hCG-only trigger group. In subsequent frozen cycles, pregnancy rates were comparable between the two groups. Conclusions The dual trigger group had a better prognosis based on age and AMH levels and had better stimulation outcomes, but significantly worse pregnancy outcomes, suggesting the low dose hCG (1000u) in the dual trigger may not have provided adequate luteal support, compared to an hCG-only trigger (10,000u hCG/250-500 μg Ovidrel). Interestingly, the pregnancy rates were comparable in subsequent frozen cycles, further supporting the hypothesis that the issue lies in inadequate luteal phase support, rather than embryo quality. Based on these findings, our program has changed the protocol to 1500u of hCG in a dual trigger.

Live birth rates of low prognosis patients according to POSEIDON criteria; A retrospective cohort study

2020 ◽  
Vol 49 (7) ◽  
pp. 101817
Author(s):  
Banu Seven ◽  
Cavidan Gulerman ◽  
A. Seval Ozgu-Erdinc ◽  
Nafiye Yilmaz ◽  
Yaprak Engin-Ustun
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Birth Rates ◽  
Live Birth Rates

scholarly journals Uterus Size May Affect Reproductive Outcome in Women with Adenomyosis After Gnrh- Agonist Pretreatment Undergoing Frozen Embryo Transfer Cycles: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wei Xiong ◽  
Ruiyi Tang ◽  
Peng Wu ◽  
Zhengyi Sun ◽  
jingran zhen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Gnrh Agonist ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer

Abstract Background: GnRH-agonist is used to treat adenomyosis, but its efficacy in adenomyosis patients with uterine enlargement undergoing frozen embryo transfer (FET) is unclear. Methods：The retrospective cohort study comprised 112 adenomyosis patients with uterine enlargement undergoing the first FET circle. A long-term GnRH-a pretreatment was administered to 112 patients with uterine enlargement. These patients were divided into two groups according to the therapeutic effect: patients with a normal-size uterus after GnRH-a treatment (GN group) and patients with an enlarged uterus after GnRH-a treatment (GL group). Results：Not all patients can shrink their uterus to a satisfactory level. After receiving GnRH-a pretreatment, the uterus returned to normal size in 77% of patients (GN group), and 23% of patients had a persistently enlarged uterus (GL group). The pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate were significantly higher in the GN group than in the GL group. Controlling for the confounding factors, normal uterus size (odds ratio [OR] 4.50; P=0.03) and low body mass index (OR 3.13; P=0.03) affected the odds of achieving live birth. The cut-off value selected on the ROC curve of uterus volume after GnRH-a treatment for detecting live birth was 144.7Conclusions：GnRH-a pretreatment was associated with the regression of adenomyosis lesions and improved clinical pregnancy outcomes in the adenomyosis patients with uterine enlargement whose lesion are GnRH-a susceptible on FET cycles. However, about a quarter of patients may not be less responsive to GnRH-a and have poorer pregnancy outcomes, especially in overweight women.

scholarly journals Effectiveness of highly purified HMG plus r-FSH vs r-FSH alone vs r-FSH plus r-LH in IVF-ET/ ICSI patients：a retrospective cohort study

2020 ◽  
Author(s):  
Zhong-Kai Wang ◽  
She-ling Wu ◽  
Xiao-Na Yu ◽  
Hong-Wu Qiao ◽  
Hua Lou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Subgroup Analysis ◽  
Retrospective Cohort Study ◽  
Ovulation Induction ◽  
Retrospective Cohort ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Current Standard ◽  
Significant Difference ◽  
Clinical Pregnancy Rates

Abstract Objective: To evaluate the effectiveness of highly purified human menopausal gonadotropins (hp-HMG) plus recombinant follicle stimulating hormone (r-FSH) vs r-FSH vs r-FSH plus recombinant luteinizing hormone （r-LH） in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) patients。Design :Retrospective cohort studyMethods:This was a retrospective study. Among a total number of 3568 patients who had undergone IVF/ICSI applications, 409 eligible patients were included.Total units of follitropin alpha preparations used in ovulation induction, total number of meiois-2 phase oocytes, total number of used oocytes in ICSI cycle, fertilization rate and clinical pregnancy rates of both groups were analyzed. In this retrospective cohort study, women undergoing IVF/ICSI Gonadotropin releasing hormone (GnRH) antagonist cycles downregulation. 409 patients were included in the study. Among them One group followed the current standard protocol of no LH or hp-HMG supplementation given(n=64). The other had LH supplementation in the form of r -LH (Luveris; Merck Serono, Switzerland) (n=221), Another group had hp-HMG supplementation in the form of hp-HMG (Menopur , Ferring,Germany)(n=121).In the Subgroup analysis were decided by AFC ,7 < AFC〈20 or AFC>20 of the three group.Result: Mean duration of stimulation and was longer in the group of patients treated with hp-HMG plus rFSH compared to the group of patients treated with r-FSH and the group of r-LH plus r-FSH (13.24 days and 12.72days and12.21days, respectively; P<0.05). The amount of GN does for patients treated withhp-HMG plus rFSH compared to the group of patients treated with r-FSH plus r-LH and the group of r-FSH alone respectively (P<0.05). Clinical pregnancy rates were 76.6% and 60.9% and 62.9% （P<0.05）in the groups of patients treated with hp-hMG plus rFSH, r-FSH plus r-LH,r-FSHalonerespectively. What’s morea greater live birth rate was noted in the hp-hMG plus r-FSH group, there was statistically significant difference between the three groups (P>0.05).in the subgroup analysis when AFC>20 hp-HMG plus rFSH group have more lower ovarian hyperstimulation syndrome （OHSS） than r-FSH plus r-LH and rFSH alone,respectively.Clonclusion:The higher oocyte yield with r-FSH does not result in higher quality embryos.hp-HMG or r-LH supplementation is an option for improving IVF outcome in patients ovulation induction with r-FSH during GnRH agonist down-regulation. Particularly, hp-HMG is recommended as it may have a beneficial action on implantation in selected group especially AFC more than 20patients.

scholarly journals Pregnancy outcomes in women with Budd-Chiari syndrome or portal vein thrombosis - A multicentre retrospective cohort study

2021 ◽  
Author(s):  
Hanke Wiegers ◽  
Eva N. Hamulyák ◽  
Stefanie E. Damhuis ◽  
Jack R. Duuren ◽  
Sarwa Darwish Murad ◽  
...  
Keyword(s):  
Cohort Study ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Budd Chiari Syndrome ◽  
Live Births ◽  
Vein Thrombosis ◽  
Chiari Syndrome

Objective: to evaluate current practice and outcomes of pregnancy in women previously diagnosed with Budd-Chiari syndrome and/or portal vein thrombosis, with and without concomitant portal hypertension. Design and setting: multicentre retrospective cohort study between 2008-2021 Population: Women who conceived in the predefined period after the diagnosis of Budd-Chiari syndrome and/or portal vein thrombosis Methods and main outcome measures: We collected data on diagnosis and clinical features. The primary outcomes were maternal mortality and live birth rate. Secondary outcomes included maternal, neonatal and obstetric complications. Results: Forty-five women (12 Budd-Chiari syndrome, 33 portal vein thrombosis; 76 pregnancies) were included. Underlying prothrombotic disorders were present in 23 of 45 women (51%). Thirty-eight women (84%) received low-molecular-weight heparin during pregnancy. Of 45 first pregnancies, 11 (24%) ended in pregnancy loss and 34 (76%) resulted in live birth of which 27 at term age (79% of live births and 60% of pregnancies). No maternal deaths were observed, one woman developed pulmonary embolism during pregnancy and two women (4%) had variceal bleeding requiring intervention. Conclusions: The high number of term live births (79%) and lower than expected risk of pregnancy-related maternal and neonatal morbidity in our cohort suggest that Budd-Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contra-indication for pregnancy. Individualized, nuanced counselling and a multidisciplinary pregnancy surveillance approach are essential in this patient population.

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