scholarly journals ACCESS TO ART CARE AT A UNIVERSITY SATELLITE CLINIC: OUTCOME ANALYSIS OF PREGNANCY RATES, INCLUDING SINGLETON LIVE BIRTH RATES

2020 ◽  
Vol 114 (3) ◽  
pp. e111
Author(s):  
Estefania Santamaria Flores ◽  
John Yeh ◽  
Shaila V. Chauhan
Keyword(s):  
Live Birth ◽  
Pregnancy Rates ◽  
Outcome Analysis ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Singleton Live Birth

A RETROSPECTIVE STUDY EXAMINING PHENTERMINE ON PRECONCEPTION WEIGHT LOSS AND PREGNANCY OUTCOMES

2020 ◽  
Vol 26 (9) ◽  
pp. 990-996
Author(s):  
Julia J. Chang ◽  
Ruth B. Lathi ◽  
Sun H. Kim
Keyword(s):  
Weight Loss ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Weight Change ◽  
Polycystic Ovary ◽  
Academic Medical Center ◽  
Pregnancy Rates ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Objective: Obesity is a well-known risk factor for infertility. However, the use of weight loss medications prior to conception is underutilized. The objectives of our study are to describe weight loss, pregnancy rates, and live birth rates after short-term phentermine use in women with obesity and infertility. Methods: This was a retrospective analysis of 55 women (18 to 45 years old) who were overweight or obese, diagnosed with infertility, and prescribed phentermine for weight loss in an ambulatory endocrinology clinic at a single, tertiary level academic medical center. Main outcome measures were mean percent weight change at 3 months after starting phentermine, and pregnancy, and live birth rates from start of phentermine to June 30, 2017. Results: Median duration of phentermine use was 70 days (Q1, Q3 [33, 129]). Mean ± SD percent weight change at 3 months after starting phentermine was −5.3 ± 4.1% ( P<.001). The pregnancy rate was 60% and the live birth rate was 49%. There was no significant difference in pregnancy rates (52% versus 68%; P = .23) or live birth rates (44% versus 54%; P = .50) in women who lost ≥5% versus <5% of their baseline weight. The number of metabolic comorbidities was negatively associated with the pregnancy rate. Phentermine was generally well-tolerated with no serious adverse events. Conclusion: Phentermine can produce clinically significant weight loss in women with obesity during the preconception period. Higher pregnancy or live birth rates were not observed with a greater degree of weight loss with phentermine. Abbreviations: BMI = body mass index; PCOS = polycystic ovary syndrome

scholarly journals Is Endometrial Scratching Beneficial for Patients Undergoing a Donor-Egg Cycle with or without Previous Implantation Failures? Results of a Post-Hoc Analysis of an RCT

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1167
Author(s):  
Alexandra Izquierdo ◽  
Laura de la Fuente ◽  
Katharina Spies ◽  
David Lora ◽  
Alberto Galindo
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Multiple Pregnancy ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Birth Rates ◽  
Ongoing Pregnancy Rate ◽  
Live Birth Rates ◽  
Egg Donor ◽  
Endometrial Scratching

Endometrial scratching (ES) has been proposed as a useful technique to improve outcomes in in vitro fertilization (IVF) cycles, particularly in patients with previous implantation failures. Our objective was to determine if patients undergoing egg-donor IVF cycles had better live birth rates after ES, according to their previous implantation failures. Secondary outcomes were pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, and multiple pregnancy rate. We analysed the results of 352 patients included in the Endoscratch Trial (NCT03108157). A total of 209 were patients with one or no previous implantation failures (105 with an ES done in the previous cycle, group A1, and 104 without ES, group B1), and 143 were patients with at least two previous failed implantations (71 patients with ES, group A2, and 72 without ES, group B2). We found an improvement in pregnancy rates (62.9% in group A1 vs. 55.8% in group B1 vs. 70.4% in group A2 vs. 76.4% in group B2, p = 0.028) in patients with at least two previous implantation failures, but this difference was not statistically different when we compared clinical pregnancy rates (59.1% vs. 51.0% vs. 64.8% vs. 68.1% in groups A1, B1, A2 and B2, respectively, p = 0.104) and live birth rates (52.4% vs. 43.3% vs. 57.8% vs. 55.6% in groups A1, B1, A2 and B2, respectively, p = 0.218). According to these results, we conclude that there is no evidence to recommend ES in egg-donor IVF cycles, regardless of the number of previous failed cycles.

O-181 4D ultrasound guided embryo transfers statistically improve live birth rates - A randomised controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
L Nancarrow ◽  
N Tempest ◽  
A Drakeley ◽  
R Hombury ◽  
K Ford ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Live Birth ◽  
Controlled Trial ◽  
Uterine Cavity ◽  
Pregnancy Rates ◽  
Ultrasound Guided ◽  
Birth Rates ◽  
Live Birth Rates ◽  
4D Ultrasound ◽  
Randomised Controlled

Abstract Study question Does the use of 4D ultrasound to guide embryo transfers improve live birth rates in comparison to the clinical touch technique? Summary answer 4D ultrasound guided embryo transfers (4DUS) result in significantly higher live birth rates (LBR) in comparison to those performed using the clinical touch technique (CTT)(41%vs28%). What is known already A previous Cochrane review showed ultrasound guided embryo transfers (ET) improve pregnancy outcomes in comparison to CTT; however there was a large degree of heterogeneity between the studies and the largest study in the review showed no difference between ultrasound guidance and CTT. A further study demonstrated no difference in ongoing pregnancy rates between 2D vs 3D ultrasound guided embryo transfers, however this study did not use LBR as an endpoint and did not report on procedure duration/difficultly, both of which are known to impact ET success rates. Study design, size, duration This was a prospective, open labelled randomised controlled trial comparing superiority between two techniques for ET (4DUS vs CTT). A total of 320 (n = 160/group) patients were recruited using computer generated randomisation that were centrally distributed in consecutive sealed opaque envelopes between July 2018 to December 2019. Main outcomes were clinical pregnancy rate (CPR) and LBR. Following the procedure, participants completed a survey based on their comfort and satisfaction. Participants/materials, setting, methods Inclusion criteria included single blastocyst transfer and a normal uterine cavity. Participants were recruited and randomized on the day of ET. Those allocated to the CTT group, had their embryo transferred without ultrasound, depositing the embryo 6cm from the external os. Those in the 4DUS group had their ET using transvaginal 4D ultrasonography and had their embryos deposited at the maximal implantation point (MIP). Main results and the role of chance Results were available from a total of 295 women (8% attrition rate, CTT n = 153; 4DUS n = 142)). No demographic differences between the two groups (CTT and 4DUS) were noted including age (p = 0.05), BMI (p = 0.29), duration of infertility (p = 0.94), type of infertility (p = 0.68) or embryo quality (p = 0.89). All the 4DUS and 95% of the CTT group were performed by the same practitioner. The 4DUS resulted in significantly higher CPR (50% vs 36% p = 0.015, OR 1.78 (1.12-2.84)) and LBR (41%vs 28%, p = 0.021, OR 1.77 (1.09-2.87)). There were no statistically significant differences between miscarriage (p = 0.494), pregnancy of unknown location (p = 0.141) or ectopic pregnancy rates (p = 0.958) between the two groups. The 4DUS process took significantly longer time compared with the CTT procedure (15.7 vs 10.2 minutes respectively, p &lt; 0.01). The results of the survey showed no statistical difference between patient comfort (p = 0.17) or satisfaction (p = 0.08) between the groups however there were significantly more positive comments in the 4DUS (p &lt; 0.01). In the 4DUS group there was no difference in mean endometrial thickness (P = 0.186) or endometrial volume (p = 0.836) between pregnant and non-pregnant patients. Limitations, reasons for caution Due to the nature of this trial we were unable to blind the participants due to the obvious differences between the methods. Wallace catheters were used for the CTT and Kitazato catheters for the 4DUS, whilst a methodological weakness; previous meta-analysis has not shown any difference between different soft catheters. Wider implications of the findings LBRs, when utilizing 4DUS, are significantly higher than the current UK average (41%vs22-23%) and significantly higher than CTT. 4DUS allows for superior imaging of the uterine cavity, tailoring the embryo deposition point specifically to the patient. Further RCTs are required to confirm that 4DUS is the superior technique for ET. Trial registration number ISRCTN79955797 ,IRAS 202857

P–079 A spontaneous LH peak before triggering for intrauterine insemination with donor sperm (IUI-D) is associated to lower live birth rates

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Blazquez ◽  
D Garcia ◽  
P Calvillo ◽  
R Vassena ◽  
A Rodriguez
Keyword(s):  
Live Birth ◽  
Intrauterine Insemination ◽  
Study Groups ◽  
Pregnancy Rates ◽  
P Value ◽  
Birth Rates ◽  
Donor Sperm ◽  
Live Birth Rates ◽  
Common Clinical Practice ◽  
Definition Of

Abstract Study question Are live birth rates after IUI with donor sperm (IUI-D) and controlled ovarian stimulation comparable between women with a spontaneous LH peak vs those without? Summary answer Biochemical, clinical, ongoing pregnancy rates and live birth rates were higher among women without an LH peak. What is known already It is common clinical practice to trigger ovulation in IUI cycles once specific criteria are met; if a natural LH surge appears, adjusting the IUI timing may become necessary. Pregnancy rates seem to be slightly better when IUI is scheduled in relation to the presence or absence of an LH peak in non-stimulated cycles. In IUI with stimulated cycles, however, there is no consensus in the medical literature regarding the best moment to program the IUI, due to different inclusion criteria, different IUI timing and definition of LH peak among studies. Study design, size, duration Retrospective cohort study of 9,657 IUI-D cycles performed between 2012 and 2019 in one fertility center. IUI-D without LH peak (n = 6,679) versus IUI-D with LH peak (n = 2,978) were compared. Differences in pregnancy outcomes between study groups were evaluated using a Pearson’s Chi2 test. A p &lt; 0.05 was considered statistically significant. Participants/materials, setting, methods The definition used to define an LH peak is &gt; 10UI/L in the last follicular control. In cases without an LH peak, when at least one dominant follicle reached 17mm, ovulation was triggered with human chorionic gonadotropin in the following 24h, and IUI-D was performed 38h after triggering. In cases with an LH peak, ovulation was triggered the 6h following the detection, and IUI-D was also performed 38h later. Main results and the role of chance The women BMI and age were comparable between groups, with a mean±SD of 35.2±4.8 years old, and 24.3±4.7 for BMI. Other characteristics such as number of previous inseminations, type of stimulation drug, initial dose, total dose, stimulation length and number of follicles &gt; 16mm in the last follicular control were also comparable. As expected, the LH level at the last follicular control was different between groups, with a mean of 5.1UI/L in the no-LH peak and 21.4IU/L in the LH peak group. The group without an LH peak had higher biochemical, clinical, ongoing and live birth rates compared to the group with LH peak: 27.7% vs. 20.7%; 19.5% vs. 15.5%; 17.7% vs. 13.7%; 16.3% vs. 12.6%, respectively (p-value&lt;0.001). Limitations, reasons for caution The main limitation of the study is its retrospective nature. Also, a definition of LH peak based in absolute values was used; a definition based in relative values may lead to different results. Wider implications of the findings: A definition of LH peak based on absolute numbers is imprecise, and the cut-off of 10UI/L does not allow a good scheduling for IUI. A LH peak based on relative values could improve the detection of patients starting ovulation and the accuracy in programming IUI. Trial registration number Not applicable

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