Increased male live-birth rates after blastocyst-stage frozen-thawed embryo transfers compared with cleavage stage: a society for assisted reproductive technologies clinical outcomes reporting system study

BackgroundOvaleap® (follitropin alfa), a recombinant human follicle stimulating hormone, is a biosimilar medicinal product to Gonal-f® and is used for ovarian stimulation. The main objective of this study was to assess the safety and effectiveness of Ovaleap® compared to Gonal-f® in one treatment cycle in routine clinical practice.MethodsSafety of Ovaleap® Follitropin alfa in Infertile women undergoing superovulation for Assisted reproductive technologies (SOFIA) was a prospective cohort study conducted in six European countries. Eligible patients were infertile women undergoing superovulation for assisted reproductive technology, who were administered Ovaleap® or Gonal-f® for ovarian stimulation and were naïve to follicle stimulating hormone treatment. The recruitment ratio was 1:1. The primary endpoint was incidence proportion of ovarian hyperstimulation syndrome (OHSS) and the secondary endpoint was OHSS severity (Grades I, II, III). The effect of risk factors or potential confounders on the odds ratio for OHSS incidence as well as treatment effect on OHSS incidence was explored using univariate logistic regression. Pregnancy and live birth rates were also assessed.ResultsA total of 408 women who were administered Ovaleap® and 409 women who were administered Gonal-f® were eligible for analysis. The incidence proportion of OHSS was 5.1% (95% CI: 3.4, 7.7) in the Ovaleap® cohort and 3.2% (95% CI: 1.9, 5.4) in the Gonal-f® cohort. This difference in OHSS incidence proportion between the two cohorts was not statistically significant neither before (p = 0.159) nor after univariate adjustment for each potential confounder (p > 0.05). The incidence proportion of OHSS severity grades was similar in the two treatment groups (3.4% versus 2.0% for Grade I, 1.2% versus 1.0% for Grade II, and 0.5% versus 0.2% for Grade III, in the Ovaleap® and Gonal-f® cohorts, respectively), without a significant statistical difference (p = 0.865, for each grade). Among patients who had embryo transfer, clinical pregnancy rates were 33% and 31% and live birth rates were 27% and 26%, in the two cohorts, respectively.ConclusionsFindings from the SOFIA study indicate that the incidence proportions of OHSS and OHSS severity, as well as pregnancy and live birth rates, are similar between Ovaleap® and Gonal-f® treatments and corroborate the safety and effectiveness of Ovaleap® as a biosimilar to Gonal-f®.

Download Full-text

Cumulative live birth rates after fresh and vitrified cleavage-stage versus blastocyst-stage embryo transfer in the first treatment cycle

Human Reproduction ◽

10.1093/humrep/dew219 ◽

2016 ◽

Vol 31 (11) ◽

pp. 2442-2449 ◽

Cited By ~ 47

Author(s):

Anick De Vos ◽

Lisbet Van Landuyt ◽

Samuel Santos-Ribeiro ◽

Michel Camus ◽

Hilde Van de Velde ◽

...

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Treatment Cycle ◽

Blastocyst Stage ◽

Stage Versus ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates ◽

Cumulative Live Birth ◽

Stage Embryo

Download Full-text

Increased male live-birth rates after blastocyst-stage frozen-thawed embryo transfers compared with cleavage-stage frozen-thawed embryo transfers: a SART registry study

F&S Reports ◽

10.1016/j.xfre.2021.02.008 ◽

2021 ◽

Author(s):

Barry E. Perlman ◽

Evelyn Minis ◽

Patricia Greenberg ◽

Kavitha Krishnamoorthy ◽

Sara S. Morelli ◽

...

Keyword(s):

Live Birth ◽

Blastocyst Stage ◽

Registry Study ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates

Download Full-text

Impact of Transferring a Poor Quality Embryo Along with a Good Quality Embryo on Pregnancy Outcomes in IVF/ICSI Cycles: a Retrospective Study

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1213-9164 ◽

2020 ◽

Vol 80 (08) ◽

pp. 844-850

Author(s):

Oya Aldemir ◽

Runa Ozelci ◽

Emre Baser ◽

Iskender Kaplanoglu ◽

Serdar Dilbaz ◽

...

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Poor Quality ◽

Blastocyst Stage ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates ◽

Good Quality Embryo

Abstract Background The number and the quality of embryos transferred are important predictors of success in in vitro fertilization (IVF) cycles. In the presence of more than one good quality embryo on the transfer day, double-embryo transfer (DET) can be performed with these embryos, but generally, different quality embryos are present in the available transfer cohort. We aimed to investigate the effect of transferring a poor quality embryo along with a good quality embryo on IVF outcomes. Methods In this study, 2298 fresh IVF/intracytoplasmic sperm injection (ICSI) cycles with two good quality embryos (group A), one good and one poor quality embryo (group B), and single good quality embryo (group C) transfers were examined. All groups were divided into two subgroups according to the transfer day as cleavage or blastocyst stage. Clinical pregnancy and live birth rates were the primary outcomes. Results In the cleavage stage transfer subgroups, the clinical pregnancy rates were lower in the single-embryo transfer (SET) subgroup compared with DET subgroups, but the difference was not statistically significant compared with DET with mixed quality embryos. The live birth rates were comparable between the three groups. In the blastocyst transfer subgroups, the clinical pregnancy and live birth rates were significantly higher in DET with two good quality embryos than DET with mixed quality embryos and SET groups. Multiple pregnancy rates were higher in both DET groups in terms of transfer day (p = 0.001). Conclusion DET with mixed quality embryos results with lower clinical pregnancy and live birth rates compared with DET with two good quality embryos at the blastocyst stage. At cleavage stage transfer, there is no difference in live birth rates between the two groups.

Download Full-text

Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. a systematic review and meta-analysis

Fertility and Sterility ◽

10.1016/j.fertnstert.2007.07.1064 ◽

2007 ◽

Vol 88 ◽

pp. S317

Author(s):

E.G. Papanikolaou ◽

E. Kolibianakis ◽

C. Venetis ◽

H. Tournaye ◽

B. Tarlatzis ◽

...

Keyword(s):

Systematic Review ◽

Live Birth ◽

Meta Analysis ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates

Download Full-text

Blastocyst transfer increases cumulative-live-birth-rates and reduces time and cost to livebirth compared with cleavage stage in recipients of donated oocytes. A randomized controlled trial

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2022.01.001 ◽

2022 ◽

Author(s):

E. Clua ◽

I. Rodríguez ◽

G. Arroyo ◽

A. Racca ◽

F. Martínez ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Live Birth ◽

Controlled Trial ◽

Blastocyst Transfer ◽

Cleavage Stage ◽

Birth Rates ◽

Live Birth Rates ◽

Randomized Controlled ◽

Cumulative Live Birth

Download Full-text

P–440 Seven years’ experience using oocyte vitrification/warming from in vitro maturation or controlled ovarian hyperstimulation cycles to preserve fertility for oncologic indications

Human Reproduction ◽

10.1093/humrep/deab130.439 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Y Boumerdassi ◽

B Bennan. Smires ◽

S Sarandi ◽

M Sadoun ◽

L Laup ◽

...

Keyword(s):

Cancer Survivors ◽

Clinical Outcomes ◽

Live Birth ◽

In Vitro Maturation ◽

Controlled Ovarian Hyperstimulation ◽

Ovarian Hyperstimulation ◽

Birth Rates ◽

Oocyte Vitrification ◽

Live Birth Rates

Abstract Study question Do oocytes vitrified following in vitro maturation (IVM) or controlled ovarian hyperstimulation (COH) for oncologic fertility preservation (FP), lead to similar biological/clinical outcomes after thawing? Summary answer IVM is a valid option when chemotherapy is urgent or COH is contraindicated. We report the second live-birth worldwide after IVM in a cancer patient. What is known already FP aims at maintaining in cancer survivors, the possibility of childbearing using their own gametes. Currently, oocyte vitrification after COH remains the gold standard but IVM has recently emerged as an option for young women seeking FP, when COH is contraindicated or when cancer therapy is urgent. However, the actual competence of oocyte vitrified after IVM in cancer patients is not established. To date, only one live birth has been reported following frozen/warmed oocytes from an IVM cycle and no data is available comparing biological/clinical outcomes of warmed oocytes resulting either from IVM or COH cycles in cancer survivors. Study design, size, duration This retrospective cohort study from a single IVF unit aimed to analyze outcomes of all oocyte warming cycles in 38 cancer survivors having undergone oocyte vitrification for FP after COH or IVM. All of them had oocyte retrieval before administration of gonadotoxic treatment and returned after being cured for assisted reproduction treatments with their oncologist agreement, between January 2014 and December 2020. Participants/materials, setting, methods Thirty-eight oocytes warming cycles followed by ICSI respectively from 18 COH and 22 IVM cycles were analyzed. Survival, degeneration following ICSI, fertilization, top-quality and good-quality embryos, defined at day–2 respectively as 4 and 3–5 adequate-sized blastomeres, without multinucleation and containing <20% of cytoplasmic fragments, implantation, biochemical (hCG>100 UI/mL), clinical (intrauterine sac with fetal heart beat) and live birth rates were compared between IVM and COH cycles using appropriate statistical tests. Significance was set at 5%. Main results and the role of chance The indications for FP were breast cancer (n = 32), hematologic malignancies (n = 3), BRCA1 mutation (n = 2), borderline ovarian tumor (n = 1). The mean age and antral follicle count (AFC) at the time of FP was similar in both groups. The number of cryopreserved oocytes was significantly lower in the IVM group (5.7 ± 9.1) when compared with the COH group (11.4 ± 3.3; p = 0.009). Oocyte survival rates were similar in IVM (70 ± 24%) and COH groups (73 ± 28%). Although not significant, we reported a trend to better results in the COH group when compared with those of IVM group in terms of degeneration rate following ICSI (6 ± 10% vs. 14 ± 20%; p = 0.16), fertilization (72 ± 35% vs. 54 ± 27%; p = 0.08), day 2 top-quality (38 ± 32% vs. 21 ± 31%; p = 0.15) and good-quality embryo (46 ± 30% vs. 25 ± 30%; p = 0.06), implantation (18 ± 35% vs. 14 ± 36%; p = 0.79), biochemical (28 (5/18) vs. 14% (3/22); p = 0.26), clinical (22% (4/18) vs. 9% (2/22); p = 0.24), live birth rates (22% (4/18) vs. 5% (1/22); p = 0.06). Limitations, reasons for caution Caution is needed when interpreting these retrospective data obtained from a limited number of frozen-thawed cycles. Statistical power to compare IVF outcomes after COH and IVM is limited by the few women who return for oocyte reutilization. Wider implications of the findings: The present investigation is the largest evaluating the IVM-oocyte frozen-thawed cycles in a oncologic population. It suggests that a higher oocyte yield may be necessary in IVM, since fertilization/embryo-quality rates seem lower. Success rates and limiting factors of oocyte vitrification in this context is needed for providing proper oncofertility counseling. Trial registration number Not applicable

Download Full-text

P–013 Sperm freezing does not affect live birth rates: results from 6,594 cycles in normozoospermic patients

Human Reproduction ◽

10.1093/humrep/deab130.012 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

M Torra ◽

M Tutusaus ◽

D Garcia ◽

R Vassena ◽

A Rodríguez

Keyword(s):

Live Birth ◽

Study Groups ◽

Oocyte Donation ◽

Blastocyst Stage ◽

Reproductive Outcomes ◽

Sperm Cryopreservation ◽

Birth Rates ◽

Live Birth Rates ◽

Cryopreserved Sperm ◽

Fresh Semen

Abstract Study question Does sperm cryopreservation influence the reproductive outcomes of normozoospermic patients undergoing elective ICSI? Summary answer After controlling for confounders, the use of cryopreserved semen from normozoospermic patients does not affect pregnancy and live birth rates after ICSI. What is known already Sperm cryopreservation with slow freezing is a common practice in ART. While frozen-thawed semen typically presents reduced motility and vitality, its use for ICSI is generally considered adequate in terms of reproductive outcomes. Nevertheless, most studies comparing reproductive outcomes between fresh versus cryopreserved sperm include patients with oligo- and/or asthenozoospermia, where the altered quality of the sample can partially mask the full effect of freezing/thawing. The objective of this study is to ascertain whether ICSI using fresh or cryopreserved semen from normozoospermic patients results in similar fertilization rates and reproductive outcomes. Study design, size, duration Retrospective cohort of 6,594 couples undergoing their first elective ICSI cycle between January 2011 and December 2019, using normozoospermic partner semen (fresh or cryopreserved). All cycles involved a fresh embryo transfer, either at cleavage or blastocyst stage. Cycles were divided in 4 groups: fresh semen with partner’s oocytes (FSPO, n = 1.878), cryopreserved semen with partner’s oocytes (CSPO, n = 142), fresh semen with donor oocytes (FSDO, n = 2.413), and cryopreserved semen with donor oocytes (CSDO, n = 2.161). Participants/materials, setting, methods A slow freezing protocol using GM501 SpermStore medium (Gynemed, Lensahn) was used for all sperm cryopreservation. Sperm washing, capacitation, and selection prior to ICSI were performed equally for fresh and frozen-thawed samples, using pellet swim-up in IVF® medium (Vitrolife, Göteborg). Fertilization rate (FR), pregnancy (biochemical, clinical, and ongoing) and live birth (LB) rates were compared among study groups using Pearson’s Chi square and Student’s t-test. A p-value <0.05 was considered statistically significant. Main results and the role of chance Male and female age, sperm concentration and motility after ejaculation, and number of oocytes inseminated were similar between study groups compared (FSPO vs. CSPO, FSDO vs. CSDO). As expected, oocyte donation cycles resulted in higher LB rate than cycles in which partner’s oocytes were used (30.04% vs 18.17%, p < 0.001). In cycles using partner’s oocytes, no significant differences were observed between fresh and cryopreserved sperm in FR, pregnancy and LB rates (p > 0.05 for all outcomes). However, in oocyte donation, the mean FR after ICSI using cryopreserved semen (73.6 ± 19.6) was lower than the FR obtained with fresh semen (75.1 ± 19.2), p = 0.010. Similarly, in oocyte donation cycles, the biochemical pregnancy rate was significantly lower when using cryopreserved semen (48.5% in CSDO vs. 52.3% in FSDO, p = 0.009), while clinical, ongoing pregnancy and LB rates were similar between both semen status (p > 0.05). In oocyte donation, a subgroup analysis including only the ICSI cycles with embryo transfer at blastocyst stage (n = 1.187 for FSDO, n = 337 for CSDO) confirmed that the LB rate was comparable between fresh and cryopreserved semen groups (34.7% vs 35.6% respectively, p = 0.76), without significant differences in pregnancy rates neither (p > 0.05 for all outcomes). Limitations, reasons for caution Caution should be exerted when extrapolating these results to different protocols for sperm cryopreservation and selection, or to IVM and classical IVF cycles, which were excluded from analysis. Due to the retrospective nature of the study, some uncontrolled for variables may affect the results. Wider implications of the findings: Sperm cryopreservation does not affect pregnancy and live birth rates in normozoospermic patients, although it may lower slightly fertilization rates. In line with previous studies including patients with an apparent male factor detected after routine semen analysis, sperm cryopreservation is a safe and convenient technique. Trial registration number Not applicable

Download Full-text