Neither male age nor semen parameters influence clinical pregnancy or live birth outcomes from IVF

2018 ◽  
Vol 18 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Uma Mariappen ◽  
Kevin N. Keane ◽  
Peter M. Hinchliffe ◽  
Satvinder S. Dhaliwal ◽  
John L. Yovich
Keyword(s):  
Birth Outcomes ◽  
Live Birth ◽  
Clinical Pregnancy ◽  
Semen Parameters ◽  
Male Age

scholarly journals Cytoplasmic String Between ICM and mTE Is a Positive Predictor of Clinical Pregnancy and Live Birth Outcomes in Elective Frozen-thawed Single Blastocyst Transfer Cycles: a Time-lapse Study

2020 ◽  
Author(s):  
Bing-Xin Ma ◽  
Lei Jin ◽  
Bo Huang
Keyword(s):  
Birth Outcomes ◽  
Live Birth ◽  
Inner Cell Mass ◽  
Cell Mass ◽  
Time Lapse ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Single Blastocyst Transfer ◽  
First Time ◽  
Present Group

Abstract Background: In this study, we aim to investigate whether cytoplasmic string between inner cell mass (ICM) and mural trophectoderm (mTE) is a positive predictor of clinical pregnancy and live birth outcomes.Methods: 1,267 elective frozen-thawed single blastocyst transfer (eSBT) cycles cultured in time-lapse incubation system from January 2018 to May 2019 were involved in the study. Blastocysts were grouped according to the appearance of cytoplasmic strings between ICM and mTE cells, and identified as “Present” and “Absent” groups. In Present group, they were further categorized according to the quantity of cytoplasmic strings between ICM and mTE cells. Clinical pregnancy and live birth outcomes of blastocysts were used to evaluate the effect of cytoplasmic strings between ICM and mTE.Results: The baseline demographic and laboratory features were similar between the Present and Absent groups of cytoplasmic strings between ICM and mTE (P>0.05). According to the time-lapse analysis, cytoplasmic strings between ICM and mTE were more visible among good quality blastocysts. Furthermore, blastocysts with cytoplasmic strings showed a higher clinical pregnancy and live birth rates (P<0.05), and no significant differences were observed in abortion rate and birth weight (P>0.05).Conclusions: Although the previous conclusions of cytoplasmic strings were controversial, the present time-lapse analysis provides the evidence for the first time that cytoplasmic strings between ICM and mTE cells would be a positive predictor of clinical pregnancy and live birth outcomes in elective frozen-thawed single blastocyst transfer cycles.

Male ageing is negatively associated with the chance of live birth in IVF/ICSI cycles for idiopathic infertility

2019 ◽  
Vol 34 (12) ◽  
pp. 2523-2532 ◽  
Author(s):  
F Horta ◽  
B Vollenhoven ◽  
M Healey ◽  
L Busija ◽  
S Catt ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Live Birth ◽  
Oocyte Quality ◽  
Clinical Pregnancy ◽  
Female Age ◽  
Male Age ◽  
Idiopathic Infertility ◽  
Negative Effect ◽  
Male Ageing

Abstract STUDY QUESTION Is male age associated with the clinical outcomes of IVF/ICSI cycles for idiopathic infertility after adjustment for female age? SUMMARY ANSWER Male ageing is negatively associated with clinical IVF/ICSI outcomes in couples with idiopathic infertility independent of female age. WHAT IS KNOWN ALREADY The effect of male age on the outcomes of infertility treatments is controversial and poorly explored. In contrast, fertility is known to decline significantly with female age beyond the mid-30s, and reduced oocyte quality plays an important role. The negative effect of male age on sperm quality is largely associated with an increasing susceptibility to sperm DNA damage. Although increasing maternal age has been linked with poorer oocyte quality, studies on the effect of male age have disregarded the need to control for female age making it difficult to define clearly the role of male age in infertile couples. STUDY DESIGN, SIZE, DURATION This retrospective cohort study analysed 2425 cycles of couples with idiopathic infertility selected from a total of 24 411 IVF/ICSI cycles performed at Monash IVF in Australia between 1992 and 2017. The primary outcome was live birth and secondary outcomes were clinical pregnancy and miscarriage. PARTICIPANTS/MATERIALS, SETTING, METHODS Couples with primary/secondary infertility who underwent IVF/ICSI cycles with male partners classified as normozoospermic were selected (inclusion criteria). Couples in which the female partner had endometriosis, tubal factors, polycystic ovarian syndrome, ovarian hyperstimulation syndrome, poor responders (≤3 mature oocytes retrieved) and couples with more than 15 cumulus oocyte complexes retrieved or who used cryopreserved gametes were excluded. Binary logistic multilevel modelling was used to identify the effect of male age and female age on clinical outcomes after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: &lt;40, 40–44, 45–49, 50–54, ≥55; female age:&lt;30, 30–34, 35–39, ≥40) predictors. MAIN RESULTS AND THE ROLE OF CHANCE There was a negative effect of male age and female age on live birth as odds ratios (OR) with 95% CI for each additional year of age (OR-male age: 0.96 [0.94–0.98]; OR-female age: 0.90 [0.88–0.93] P &lt; 0.001). Potential interactions with male age such as type of treatment (IVF/ICSI), embryo transfer day (Day 3/Day 5) and female age did not have significant associations with outcomes (P &gt; 0.05). Secondary outcomes showed a significant reduction in the odds of clinical pregnancy (OR-male age: 0.97 [0.96–0.99]; OR-female age: 0.92 [0.89–0.94] P &lt; 0.001) and an increase in the odds of miscarriage with older age: male age (OR: 1.05 [1.01–1.08]; P = 0.002); female age (OR: 1.11 [1.05–1.18]; P &lt; 0.001). Worse outcomes were associated with more cycles (clinical pregnancy-OR: 0.96 [0.93–0.99] P = 0.03; live birth-OR: 0.96 [0.92–0.99] P = 0.023) while more inseminated oocytes were associated with better outcomes (clinical pregnancy-OR: 1.06 [1.03–1.06] P &lt; 0.001; live birth-OR: 1.07 [1.04–1.11] P &lt; 0.001). Analyses for age categories showed a gradual worsening of clinical outcomes with increasing male age, with a significantly worse live birth and clinical pregnancy outcomes in males aged older than 50 years compared to males younger than 40 years (P &lt; 0.05). LIMITATIONS, REASONS FOR CAUTION This study is limited to the information on confounding factors included. The study may also be limited in its generalizability to a wider population due the strict selection criteria. Age as a category could potentially result in residual confounding due to categorizing a continuous variable. WIDER IMPLICATIONS OF THE FINDINGS This study provides information for counselling of couples with idiopathic infertility. STUDY FUNDING/COMPETING INTEREST(S) Funded by the Education Program in Reproduction and Development, Department of Obstetrics and Gynaecology, Monash University. None of the authors has any conflict of interest to report. TRIAL REGISTRATION NUMBER N/A.

scholarly journals Outcomes of Intracytoplasmic Sperm Injection Cycles for Complete Teratozoospermia: A Case-Control Study Using Paired Sibling Oocytes

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Nigel Pereira ◽  
Queenie V. Neri ◽  
Jovana P. Lekovich ◽  
Steven D. Spandorfer ◽  
Gianpiero D. Palermo ◽  
...  
Keyword(s):  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Sperm Morphology ◽  
Male Partner ◽  
Clinical Pregnancy ◽  
Semen Parameters ◽  
Birth Rates ◽  
Spontaneous Miscarriage ◽  
Sibling Oocytes ◽  
Live Birth Rates

Objective. To investigate the outcomes of intracytoplasmic sperm injection (ICSI) cycles where sibling oocytes from a single donor were split between two recipients based on strict sperm morphology.Methods. Retrospective cohort study. All ICSI cycles had one donor’s oocytes split between two recipients in a 1 : 1 ratio based on strict sperm morphology, that is, one male partner had morphology of 0% and the other had morphology of >1%. Fertilization, positive hCG, clinical pregnancy, spontaneous miscarriage, and live birth rates of the aforementioned groups were compared.Results. The baseline characteristics of the two groups (n=103), including semen parameters of the male partners, were comparable. There was no difference in the fertilization rates when comparing the 0% group to the >1% group (78.7% versus 81.6%;P=0.66). The overall positive hCG, clinical pregnancy, spontaneous miscarriage, and live birth rates for the 0% group were 61.2%, 49.5%, 10.7%, and 38.8%, respectively. The corresponding rates in the >1% group were positive hCG (63.1%), clinical pregnancy (55.3%), spontaneous miscarriage (7.77%), and live birth (46.6%).Conclusions. The fertilization and pregnancy outcomes of ICSI cycles for strict sperm morphology of 0% versus morphology of >1% are equivalent. These results can provide reassurance to couples undergoing ICSI for severe teratospermia.

scholarly journals Cytoplasmic String Between ICM and mTE Is a Positive Predictor of Clinical Pregnancy and Live Birth Outcomes in Elective Frozen-thawed Single Blastocyst Transfer Cycles: A Time-lapse Study

2021 ◽  
Author(s):  
Bingxin Ma ◽  
Lei Jin ◽  
Bo Huang
Keyword(s):  
Birth Outcomes ◽  
Live Birth ◽  
Inner Cell Mass ◽  
Cell Mass ◽  
Time Lapse ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Single Blastocyst Transfer ◽  
First Time ◽  
Present Group

Abstract Background: In this study, we aim to investigate whether cytoplasmic string between inner cell mass (ICM) and mural trophectoderm (mTE) is a positive predictor of clinical pregnancy and live birth outcomes.Methods: 1,267 elective frozen-thawed single blastocyst transfer (eSBT) cycles cultured in time-lapse incubation system from January 2018 to May 2019 were involved in the study. Blastocysts were grouped according to the appearance of cytoplasmic strings between ICM and mTE cells, and identified as “Present” and “Absent” groups. In Present group, they were further categorized according to the quantity of cytoplasmic strings between ICM and mTE cells. Clinical pregnancy and live birth outcomes of blastocysts were used to evaluate the effect of cytoplasmic strings between ICM and mTE.Results: The baseline demographic and laboratory features were similar between the Present and Absent groups of cytoplasmic strings between ICM and mTE (P>0.05). According to the time-lapse analysis, cytoplasmic strings between ICM and mTE were more visible among good quality blastocysts. Furthermore, blastocysts with cytoplasmic strings showed a higher clinical pregnancy and live birth rates (P<0.05), and no significant differences were observed in abortion rate and birth weight (P>0.05).Conclusions: Although the previous conclusions of cytoplasmic strings were controversial, the present time-lapse analysis provides the evidence for the first time that cytoplasmic strings between ICM and mTE cells would be a positive predictor of clinical pregnancy and live birth outcomes in elective frozen-thawed single blastocyst transfer cycles.

scholarly journals Associations between male reproductive characteristics and the outcome of assisted reproductive technology (ART)

2017 ◽  
Vol 37 (3) ◽  
Author(s):  
Zhangshun Liu ◽  
Xiaohong Shi ◽  
Lihong Wang ◽  
Yan Yang ◽  
Qiang Fu ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Sperm Concentration ◽  
Reproductive Technology ◽  
Reproductive Hormones ◽  
Clinical Pregnancy ◽  
Semen Parameters ◽  
Female Age ◽  
Art Outcome

The present study was designed to investigate the relationships between indicators of male body mass index (BMI), age, reproductive hormone levels, semen parameters, and the outcomes of assisted reproductive technology (ART). The clinical data were collected from 636 couples who underwent ART between January, 2013 and December, 2015 at the reproductive center involved in our study. Pearson’s correlation or Spearman rank correlation was applied to establish the relevant correlation coefficients. The correlation between influence factors’ and pregnancy outcomes was analyzed using the Logistic regression model. Analyses were conducted using SPSS software. Male BMI was found to be negatively correlated with testosterone (T) (P<0.05), while follicle-stimulating hormone (FSH) was negatively correlated with semen parameters (P<0.05). Luteinizing hormone (LH) was found to be negatively correlated with total sperm count, normal sperm morphology, and abortion (all P<0.05). Clinical pregnancy was related to sperm concentration and female age (P<0.05), and live birth was found to be associated only with female age (P<0.05). Male BMI was associated with the secretion of reproductive hormones, but had no effect on sperm parameters or ART outcome. A higher male age was also negatively connected with the outcome of clinical pregnancy. Reproductive hormones were not associated with ART outcome. Sperm concentration and female age were important factors influencing ART clinical pregnancy, while the only significant factor influencing live birth was female age. Levels of obesity-related inflammatory indicators (i.e. free fatty acid (FFA), glutathione peroxidase (GSH-Px), human inhibin-B (IHNB), interleukin-1 (IL-1), insulin-like growth factor-1 (IGF-1), and reactive oxygen species (ROS)) also varied with degrees of BMI. The present study provides information on the associations between male reproductive characteristics and the outcome of ART, which may contribute to improved strategies to help couples achieve better pregnancy outcomes.

P–106 The evaluation of dietary score representing the overall effect of men’s diet to semen quality on couple’s fertility

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Mitsunami ◽  
A Salas-Huetos ◽  
L Mínguez-Alarcón ◽  
J Attaman ◽  
J Ford ◽  
...  
Keyword(s):  
Live Birth ◽  
Semen Quality ◽  
Quality Parameters ◽  
Clinical Pregnancy ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Standard Deviation Increase ◽  
Diet Pattern ◽  
Dietary Score

Abstract Study question Is men’s diet associated with assisted reproductive technology (ART) outcomes? Summary answer An empirical dietary score representing the overall effect of men’s diet on semen quality was unrelated to ART outcomes. What is known already Multiple studies have related various aspects of men’s diet to semen quality. Generally, healthier foods, such as fish, vegetables, and fruits, have been related to better semen quality, whereas unhealthy foods, like processed and red meats, have had the opposite relationship. Nevertheless, while bulk semen parameters are important biomarkers of male fertility and a diagnostic cornerstone for male factor infertility, they are imperfect predictors of a couple’s fertility. Study design, size, duration Couples presenting to the Massachusetts General Hospital Fertility Center between April 2007 and April 2018 were invited to participate in the Environment and Reproductive Health (EARTH) study, a prospective cohort study. Men’s diet was assessed with a previously validated food frequency questionnaire. A dietary score reflecting the overall relation of men’s food intake with semen quality parameters was empirically derived using reduced rank regression (RRR). The resulting dietary score was related to ART outcomes. Participants/materials, setting, methods We used information from 349 men (908 semen samples) to derive the empirical diet pattern and data from 231 couples (407 ART cycles). The primary outcome was the probability of live birth per treatment cycle; secondary outcomes were semen quality, and fertilization, implantation, and clinical pregnancy rates. We evaluated the association between the dietary score and these outcomes using logistic generalized linear mixed models to account for repeated cycles while adjusting for confounders. Main results and the role of chance Men had a median baseline age and BMI of 36.8 years and 26.9 kg/m2, respectively. The empirical diet pattern was significantly associated with all semen parameters. One standard deviation increase in the empirical diet pattern was associated with lower volume (–0.10 standard units [95% CI: –0.17 to –0.04]) and to higher sperm total sperm count (0.13 standard units [0.06 to 0.20]), concentration (0.17 standard units [0.10 to 0.24]), total motility (0.14 standard units [0.07 to 0.20]), progressive motility (0.08 standard units [0.01 to 0.15]), and normal morphology (0.18 standard units [0.11 to 0.25]). Couples with men in the lowest quartile of the empirical score were more likely to have a diagnosis of male infertility than couples with men in the highest quartile (49% vs 24%). Despite the association with semen parameters, the empirical diet score was not related to any clinical outcome of infertility treatment with ART. The adjusted probabilities of implantation, clinical pregnancy and live birth in the lowest and highest quartile of the empirical score were 0.62 (0.50–0.73) and 0.55 (0.45–0.66), 0.57 (0.46–0.69) and 0.50 (0.40–0.61), and 0.49 (0.37–0.62) and 0.36 (0.25–0.48), respectively. Analyses excluding couples with a diagnosis of male factor infertility yielded similar results. Limitations, reasons for caution We evaluated the relationship only among couples presenting to a fertility center and therefore it is unclear whether findings can be generalized to couples trying to conceive without ART. Wider implications of the findings: Given ART is a robust intervention including stringent sperm selection procedures, any effect that empirical diet may have on a couple’s chances of conceiving through assisted reproduction is unlikely to reflect the effect of these factors on bulk semen quality parameters. Trial registration number The project was funded by ES009718, ES022955, ES026648, and ES000002 from the National Institute of Environmental Health Sciences, and P30DK46200 from the National Institute of Diabetes and Digestive and Kidney Diseases

P–737 Effect of dietary patterns on clinical pregnancy and live birth outcomes in men and women receiving assisted reproductive technologies: a systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Kellow ◽  
J LeCerf
Keyword(s):  
Cohort Studies ◽  
Mediterranean Diet ◽  
Birth Outcomes ◽  
Live Birth ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Men And Women

Abstract Study question Is there a relationship between dietary patterns and clinical pregnancy or live birth outcomes in men and women of reproductive age undergoing assisted reproductive technologies (ART)? Summary answer While the Mediterranean and pro-fertility diets show potential to improve fertility outcomes, the association between dietary patterns and ART success is currently inconsistent. What is known already The nutritional status of reproductive-aged couples can have a significant impact on fertility. While the consumption of individual foods and nutrients are known to influence reproductive success, the effect of dietary patterns on clinical pregnancy and live birth outcomes in people using assisted reproductive technologies (ART) is currently unknown. Study design, size, duration Six electronic databases were systematically searched for original research published in English between January 1978 and December 2020 reporting on the effect of pre-defined dietary patterns on either clinical pregnancy and/or live birth rates following invitro fertilisation or intracytoplasmic sperm injection in men and women aged 18–49 years. Screening of all retrieved articles was performed independently by two review authors. Eligible studies underwent quality assessment and qualitative and quantitative synthesis using random-effects model meta-analyses. Participants/materials, setting, methods Studies eligible for inclusion in this systematic review were cross-sectional, cohort, clinical trial, and randomised controlled trial study designs. Eligible participants were both males and females, aged 18–49 years, who were undergoing invitro fertilisation or intracytoplasmic sperm injection. Studies were excluded if their primary analysis assessed consumption of individual foods, food groups, vitamins, or minerals, rather than dietary patterns. Studies measuring proxy estimates of fertility status such as sperm quality or quantity were not included. Main results and the role of chance Twelve studies (11 prospective cohort studies, 1 randomised controlled trial) reporting on 3144 participants (92% female) were included in the review. Six studies were of positive methodological quality, and six were of neutral quality. Eleven studies used validated food frequency questionnaires to quantify dietary pattern adherence. In individual studies, three dietary patterns (Mediterranean diet, pro-fertility diet, Iranian traditional medicine diet) were associated with increased likelihood of achieving a clinical pregnancy, while two dietary patterns (pro-fertility diet, Mediterranean diet) were associated with increased probability of live birth. Meta-analyses of five Mediterranean diet cohort studies showed no association between dietary pattern and clinical pregnancy (OR 1.3; 95% CI: 0.73- 1.72, P = 0.59), and meta-analysis of three Mediterranean diet cohort studies found no relationship between dietary pattern and live birth (OR 1.51; 95% CI: 0.83–2.76, P = 0.18). Limitations, reasons for caution Males were under-represented in the included studies, and half of the studies were of neutral methodological quality. All studies completed dietary assessments at baseline only, however dietary assessments should ideally be undertaken at regular intervals throughout the duration of cohort studies, in the event that dietary patterns change over time. Wider implications of the findings: Further research utilising higher quality nutrition research methodologies is required to better understand the association between dietary patterns and fertility outcomes during assisted reproductive technologies. Trial registration number Not applicable

P–087 Paternal age clinical effect on cumulative live birth rates (CLBR) per inseminated oocyte, embryo transfer and embryo transferred in autologous IVF-ICSI cycles of infertile males

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A NAVARR. GOMEZ-LECHON ◽  
R Rivera-Egea ◽  
I Hervas ◽  
M Gi. Julia ◽  
N Garrido
Keyword(s):  
Reproductive Success ◽  
Male Infertility ◽  
Embryo Transfer ◽  
Live Birth ◽  
Age Groups ◽  
Paternal Age ◽  
Semen Parameters ◽  
Reproductive Outcomes ◽  
Male Age ◽  
The Impact

Abstract Study question Is reproductive success measured as CLBR per inseminated oocyte, per embryo transfer and per embryo transferred affected by paternal age in autologous IVF-ICSI cycles? Summary answer The number of embryo transfers and embryos transferred until live birth, but not the number of inseminated oocytes, were significantly different among the age groups. What is known already In recent years, there has been an increase of the average paternal age at which the first child is conceived. Therefore, there is a growing interest on the study of the impact of male age on the reproductive outcomes in assisted reproduction cycles (ART). Several studies have shown negative effects of advanced paternal age on semen parameters, embryo aneuploidy, miscarriage, male infertility,.... However, other studies have found no association between them. Hence, the impact of paternal age on reproductive outcomes still remains uncertain, leading to a need of more research on this topic, which this study tries to address. Study design, size, duration This retrospective observational multicentric cohort study has included autologous IVF-ICSI treatments (n = 6295) performed to couples with etiology of male infertility (non-normozoospermic) in Spain IVIRMA clinics between January 2008 and March 2020 using patients’ own sperm sample. Paternal age ranged from 20 to 75 years. The study population was categorized in 5 groups following the criterion of homogenizing the number of observations between groups: 20–34 (A), 34–37 (B), 37–39 (C), 39–42 (D) and 42–75 (E) years. Participants/materials, setting, methods Considering that male age could be a factor affecting reproductive outcomes, we evaluated men with different age that performed an autologous IVF-ICSI treatment with their own semen, etiology of male infertility and known age. Data was exported in order to obtain the clinical database and Kaplan-Meier was used for data analysis. P &lt; 0.05 was considered statistically significant. We measured reproductive success by CLBR per embryo transfer, per embryo transferred and per inseminated oocytes until live birth. Main results and the role of chance This study considered approximately 2976 patients and 4385 embryo transfers. The CLBR per inseminated oocyte showed no significant difference between the study groups: A (6.43%, 48.24%, 81.38%), B (5.74%, 52.14%, 82.87%), C (6.14%, 49.83%, 83.69%), D (5.89%, 53.60%, 81.16%) and E (6.61%, 47, 52%, 77.85%) for 4, 13 and 21/22 inseminated oocytes, respectively. In terms of CLBR per embryo transfer, the results obtained for each of the age groups were: A (31.81%, 71.89%, 87.63%), B (28.89%, 67.87%, 82.63%), C (27.10%, 68.87%, 88.17%), D (23.45%, 64.63%, 100.00%) and E (22.88%, 55.48%, 63.31%) for 1, 4 and 7 embryo transfers, respectively. There were statistically significant differences in the CLBR per embryo transfer between the studied age groups (p &lt; 0.0001). CLBR per embryo transferred for each age group was as follows: A (10.85%, 60.53%, 80.88%), B (9.34%, 59.75%, 78.23%), C (11.89%, 57.63%, 74.97%), D (10.25%, 52.71%, 77.76%) and E (11.71%, 51.50%, 71.51%) for 1, 4 and 7 embryos transferred, respectively. As in the case before, there were statistically significant differences in the CLBR per embryo transferred between the age groups (p &lt; 0.05). The findings presented highlight that the increase in paternal age could be affecting the reproductive outcomes in IVF-ICSI cycles using autologous oocytes. Limitations, reasons for caution The retrospective nature of this study leads to biases derived from the clinical practice and to the presence of missing data (limiting sample size). Moreover, this study considered autologous cycles, therefore the results were not adjusted for female factors. Wider implications of the findings: Our study showed that reproductive outcomes measured by CLBR per embryo transfer and embryo transferred until live birth were significantly different between the paternal age groups in autologous IVF-ICSI cycles of infertile males. Hence, paternal age could be affecting reproductive outcomes and it should be considered for improving infertility counselling. Trial registration number NA

scholarly journals Comparative effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG HP) in assisted reproductive technology (ART) treatments: a non-interventional study in Germany

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Klaus F. Bühler ◽  
Robert Fischer ◽  
Patrice Verpillat ◽  
Arthur Allignol ◽  
Sandra Guedes ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Follicle Stimulating Hormone ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Human Menopausal Gonadotropin ◽  
Ongoing Pregnancy ◽  
Complete Cycle ◽  
Significant Difference

Abstract Background This study compared the effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa; GONAL-f®) with urinary highly purified human menopausal gonadotropin (hMG HP; Menogon HP®), during assisted reproductive technology (ART) treatments in Germany. Methods Data were collected from 71 German fertility centres between 01 January 2007 and 31 December 2012, for women undergoing a first stimulation cycle of ART treatment with r-hFSH-alfa or hMG HP. Primary outcomes were live birth, ongoing pregnancy and clinical pregnancy, based on cumulative data (fresh and frozen-thawed embryo transfers), analysed per patient (pP), per complete cycle (pCC) and per first complete cycle (pFC). Secondary outcomes were pregnancy loss (analysed per clinical pregnancy), cancelled cycles (analysed pCC), total drug usage per oocyte retrieved and time-to-live birth (TTLB; per calendar week and per cycle). Results Twenty-eight thousand six hundred forty-one women initiated a first treatment cycle (r-hFSH-alfa: 17,725 [61.9%]; hMG HP: 10,916 [38.1%]). After adjustment for confounding variables, treatment with r-hFSH-alfa versus hMG HP was associated with a significantly higher probability of live birth (hazard ratio [HR]-pP [95% confidence interval (CI)]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; relative risk [RR]-pFC [95% CI]: 1.09 [1.05, 1.15], ongoing pregnancy (HR-pP [95% CI]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; RR-pFC [95% CI]: 1.10 [1.05, 1.15]) and clinical pregnancy (HR-pP [95% CI]: 1.10 [1.05, 1.14]; HR-pCC [95% CI]: 1.14 [1.10, 1.19]; RR-pFC [95% CI]: 1.10 [1.06, 1.14]). Women treated with r-hFSH-alfa versus hMG HP had no statistically significant difference in pregnancy loss (HR [95% CI]: 1.07 [0.98, 1.17], were less likely to have a cycle cancellation (HR [95% CI]: 0.91 [0.84, 0.99]) and had no statistically significant difference in TTLB when measured in weeks (HR [95% CI]: 1.02 [0.97, 1.07]; p = 0.548); however, r-hFSH-alfa was associated with a significantly shorter TTLB when measured in cycles versus hMG HP (HR [95% CI]: 1.07 [1.02, 1.13]; p = 0.003). There was an average of 47% less drug used per oocyte retrieved with r-hFSH-alfa versus hMG HP. Conclusions This large (> 28,000 women), real-world study demonstrated significantly higher rates of cumulative live birth, cumulative ongoing pregnancy and cumulative clinical pregnancy with r-hFSH-alfa versus hMG HP.

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