The relationship between in vitro fertilization and naturally occurring antibodies: evidence for increased production of antiphospholipid autoantibodies

Abstract BackgroundThe outcome of in vitro fertilization-embryo transfer is often determined according to follicles and estradiol levels following gonadotropin stimulation. However, there is no accurate indicator to predict pregnancy outcome, and it has not been determined how to choose subsequent drugs and dosage based on the ovarian response. This study aimed to make timely adjustments to follow-up medication to improve clinical outcomes based on the potential value of estradiol growth rate. MethodsSerum estradiol levels were measured on the day of gonadotrophin treatment (Gn0), four days later (Gn4), seven days later (Gn7), and on the trigger day (HCG). The ratio was used to determine the increase in estradiol levels. According to the ratio of estradiol increase, the patients were divided into four groups: group A1 (Gn4/Gn0≤6.44), group A2 (6.44˂Gn4/Gn0≤10.62), group A3 (10.62˂Gn4/Gn0 ≤21.33), and group A4 (Gn4/Gn0>21.33); group B1 (Gn7/Gn4≤2.39), group B2 (2.39˂Gn7/Gn4≤3.03), group B3 (3.03˂Gn7/Gn4≤3.84), and group B4 (Gn7/Gn4>3.84). We analyzed and compared the relationship between data in each group and pregnancy outcome. ResultsIn the statistical analysis, the estradiol levels of Gn4 (P = 0.029, P = 0.042), Gn7 (P< 0.001, P = 0.001), and HCG (P< 0.001, P = 0.002), as well as the ratios of Gn4/Gn0 (P = 0.004, P = 0.006), Gn7/Gn4 (P = 0.001, P = 0.002), and HCG/Gn0 (P< 0.001, P< 0.001) both had clinical guiding significance, and the lower one significantly reduced the pregnancy rate. The outcomes were positively linked to groups A (P = 0.040, P = 0.041) and B (P = 0.015, P = 0.017). The logistical regression analysis revealed that group A1 (OR = 0.440 [0.223–0.865]; P = 0.017, OR = 0.368 [0.169–0.804]; P = 0.012) and B1 (OR = 0.261 [0.126–0.541]; P< 0.001, OR = 0.299 [0.142–0.629]; P = 0.001) had opposite influence on outcomes. ConclusionMaintaining a serum estradiol increase ratio at least above 2.39 on Gn7/Gn4 may result in a higher pregnancy rate. When estradiol growth is not ideal, gonadotrophin dosage should be adjusted appropriately to ensure the desired outcome.

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MicroRNA Expression Profiles Analysis in Sperm Reveals hsa-mir-191 is an Auspicious Omen of in Vitro Fertilization

10.21203/rs.2.12439/v5 ◽

2019 ◽

Author(s):

Hua Xu ◽

Xin Wang ◽

Zhikai Wang ◽

Jianhui Li ◽

Zhiming Xu ◽

...

Keyword(s):

In Vitro Fertilization ◽

Embryonic Development ◽

Roc Curve ◽

Small Rnas ◽

Expression Profiles ◽

High Quality ◽

Vitro Fertilization ◽

The Relationship ◽

Early Human

Abstract Background: MicroRNAs (miRNAs) are a class of noncoding small RNAs that play important roles in many physiological processes by regulating gene expression. Previous studies have shown that the expression levels of total miRNAs increase during mouse embryonic development, and some miRNAs control the regulatory network in development progression. However, few studies have focused on the effects of miRNAs on early human embryonic development. The relationship between miRNAs and early human embryogenesis is still unknown. Results:In this study, RNA-seq data collected from sperm samples from 102 patients with a normal sperm index but treated with assisted reproductive technology (ART) were analyzed for the relationships between differentially expressed small RNAs and the fertilization rate (FR), blastocyst rate and high-quality embryo rate (HQER). The sperm samples with high hsa-mir-191 expression had a higher FR, effective embryo rate (EER) and HQER. hsa-mir-191 was used as a single indicator to predict the HQER. The receiver operating characteristic (ROC) curve had an area under the ROC curve (AUC) of 0.686. We also found that hsa-mir-191 expression is correlated with an abnormal sperm rate (cor = 0.29, p< 0.01). We also evaluated the relationship between hsa-mir-34c and early human embryo development in these 102 sperm samples and obtained negative results. Conclusions: These findings suggest that high hsa-mir-191-5p expression in sperm is associated with early human embryonic quality and that hsa-mir-191-5p could be used as a potential marker to screen high-quality sperm to improve the success rates of in vitro fertilization (IVF).

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MicroRNA Expression Profiles Analysis in Sperm Reveals hsa-mir-191 is an Auspicious Omen of in Vitro Fertilization

10.21203/rs.2.12439/v2 ◽

2019 ◽

Author(s):

Hua Xu ◽

Xin Wang ◽

Zhikai Wang ◽

Jianhui Li ◽

Zhiming Xu ◽

...

Keyword(s):

In Vitro Fertilization ◽

Embryonic Development ◽

Roc Curve ◽

Small Rnas ◽

Small Rna Sequencing ◽

High Quality ◽

Vitro Fertilization ◽

The Relationship ◽

Early Human

Abstract Background : MicroRNAs (miRNAs) are a class of noncoding small RNAs that play important roles in many physiological processes by regulating gene expression. Previous studies have shown that the expression levels of total miRNAs increase during mouse embryonic development, and some miRNAs control the regulatory network in development progression. However, few studies have focused on the effects of miRNAs on early human embryonic development. The relationship between miRNAs and early human embryogenesis is still unknown. Results: In this study, sperm samples from 102 patients with a normal sperm index but treated with assisted reproductive technology (ART) were collected for small RNA sequencing, and the relationships between differentially expressed small RNAs and the fertilization rate (FR), blastocyst rate and high-quality embryo rate (HQER) were analyzed. The sperm samples with high hsa-mir-191 expression had a higher FR, effective embryo rate (EER) and HQER. hsa-mir-191 was used as a single indicator to predict the HQER. The receiver operating characteristic (ROC) curve had an area under the ROC curve (AUC) of 0.686. We also found that hsa-mir-191 expression is correlated with an abnormal sperm rate (cor = 0.29, p < 0.01). We also evaluated the relationship between hsa-mir-34c and early human embryo development in these 102 sperm samples and obtained negative results. Conclusions: These findings suggest that high hsa-mir-191-5p expression is associated with improved early human embryonic development and that hsa-mir-191-5p could be used as a potential marker to screen high-quality sperm to improve the success rates of in vitro fertilization (IVF).

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Higher gestational weight gain and lower serum estradiol levels on the day of human chorionic gonadotropin administration are associated with increased risk of preeclampsia after in vitro fertilization

10.21203/rs.2.21456/v1 ◽

2020 ◽

Author(s):

Yu-Chen Chen ◽

Yun-Ju Lai ◽

Yu-Ting Su ◽

Ni-Chin Tsai ◽

Kuo-Chung Lan

Keyword(s):

Weight Gain ◽

In Vitro Fertilization ◽

Gestational Weight Gain ◽

Chorionic Gonadotropin ◽

Serum Estradiol ◽

Vitro Fertilization ◽

Gestational Weight ◽

Relationship Of ◽

The Relationship

Abstract Background Very few previous studies have examined the effect of endocrine parameters during ART on preeclampsia. Moreover, there is little known about the relationship of steroid hormone levels on development of the placenta. The purpose of this study is to assess the association of preeclampsia with serum estradiol (E2) and progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration during controlled ovarian hyperstimulation (COH) for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods This was a hospital-based cohort study using clinical data from the Kaohsiung Chang Gung Memorial Hospital Obstetric and Neonatal Database (KCGMHOND) from Jan 1, 2001 to December 1, 2018. Eligible women underwent at least one autologous IVF/ICSI cycle and had a live-born infant with a gestational age (GA) of more than 20 weeks. Results A total of 622 women who had live births after fresh IVF/ICSI-ET during the study period met our inclusion criteria. Twenty-eight women (4.5%) met the diagnostic criteria for preeclampsia. However, women in the preeclampsia group had a significantly higher body mass index (22 vs. 24, p =0.05), body weight at delivery (70.0 vs. 80.5 kg, p <0.001) and gestational weight gain (13.0 vs. 19.6 kg, p =0.002) and had lower use of ICSI (29.9% vs. 10.7%, p =0.021). Logistic regression analysis of the relationship of patient and treatment characteristics with preeclampsia. The crude ORs indicated that young female age >34, not using ICSI, E2 peak <1200 pg/mL and gestational weight gain >20 kg were associated with preeclampsia. After adjustment for confounding, the only factors that remained significant were E2 peak <1200 pg/mL (aOR = 4.634, 95% CI = 1.061 to 20.222), and gestational weight gain >20 kg (aOR: 13.601, 95% CI: 3.784, 48.880). Conclusions For women receiving IVF/ICSI, lower estradiol hormone levels on the day of hCG administration and higher pregnancy weight gain are related with subsequent preeclampsia.

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O-107 Searching for the optimal number of oocytes to reach a life birth following in vitro fertilization: a systematic review with meta-analysis

Human Reproduction ◽

10.1093/humrep/deab126.011 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

N Sermondade ◽

C Sonigo ◽

M Pasquier ◽

N Yata-Ahdad ◽

E Fraison ◽

...

Keyword(s):

In Vitro Fertilization ◽

Live Birth ◽

Birth Rate ◽

Meta Analysis ◽

Live Birth Rate ◽

Cumulative Live Birth Rate ◽

Continuous Increase ◽

Vitro Fertilization ◽

The Relationship

Abstract Study question To investigate the relationship between the number of oocytes and both the live birth rate after fresh embryo transfer and the cumulative live birth rate. Summary answer Above a 15-oocyte threshold, live birth rate (LBR) following fresh transfer plateaus, whereas a continuous increase in cumulative live birth rate (CLBR) is observed. What is known already Several lines of evidence indicate that number of oocytes represents a key point for in vitro fertilization (IVF) success. However, consensus is lacking regarding the optimal number of oocytes for expecting a live birth. This is a key question because it might impact the way practitioners initiate and adjust COS regimens. Study design, size, duration A systematic review and meta-analysis was performed. MEDLINE, EMBASE, and Cochrane Library were searched for studies published between January 01, 2004, and August 31, 2019 using the search terms: “(intracytoplasmic sperm injection or icsi or ivf or in vitro fertilization or fertility preservation)” and “(oocyte and number)” and “(live birth)”. Participants/materials, setting, methods Two independent reviewers carried out study selection, quality assessment using the adapted Newcastle-Ottawa Quality Assessment Scales, bias assessment using ROBIN-1 tools, and data extraction according to Cochrane methods. Independent analyses were performed according to the outcome (LBR and CLBR). The mean-weighted threshold of optimal oocyte number was estimated from documented thresholds, followed by a one-stage meta-analysis on articles with documented or estimable relative risks. Main results and the role of chance After reviewing 843 records, 64 full-text articles were assessed for eligibility. A total of 36 studies were available for quantitative syntheses. Twenty-one and 18 studies were included in the meta-analyses evaluating the relationship between the number of retrieved oocytes and LBR or CLBR, respectively. Given the limited number of investigations considering mature oocytes, association between the number of metaphase II oocytes and IVF outcomes could not be investigated. Concerning LBR, 7 (35.0%) studies reported a plateau effect, corresponding to a weighted mean of 14.4 oocytes. The pooled dose-response association between the number of oocytes and LBR showed a non-linear relationship, with a plateau beyond 15 oocytes. For CLBR, 4 (19.0%) studies showed a plateau effect, corresponding to a weighted mean of 19.3 oocytes. The meta-analysis of the relationship between the number of oocytes and CLBR found a non-linear relationship, with a continuous increase in CLBR, including for high oocyte yields. Limitations, reasons for caution Statistical models show a high degree of deviance, especially for high numbers of oocytes. Further investigations are needed to assess the generalization of those results to frozen mature oocytes, especially in a fertility preservation context, and to evaluate the impact of female age. Wider implications of the findings Above a 15-oocyte threshold, LBR following fresh transfer plateaus, suggesting that the freeze-all strategy should probably be performed. In contrast, the continuous increase in CLBR suggests that high numbers of oocytes could be offered to improve the chances of cumulative live births, after evaluating the benefit–risk balance. Trial registration number Not applicable

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