A Study on the Prediction of Reproductive Outcomes in Frozen Embryo Transfer Cycles by Calculating the Volume of Uterine Junctional Zone with Three-Dimensional Ultrasound

Abstract Purpose To prospectively study the inﬂuence of the volume of the uterine junctional zone (JZ) as a novel predictor of reproductive outcomes in frozen embryo transfer cycles. Methods Among the first 30 patients, intra- and interobserver repeatability was evaluated and expressed as a coefficient of repeatability. The same classification system was used to evaluate the JZ of 142 infertility patients undergoing in vitro fertilization (IVF). Ultrasonography was performed on the day before transplantation. The three-dimensional (3D) volume images were then analyzed to obtain the volume of the endometrium (EV), the average thickness of the JZ on the coronal plane, and the volume of the JZ (JZV). The JZV was then divided by the EV. These parameters were compared with the outcomes of clinical pregnancy. Results The 3D image showed that the JZ achieved a good intra- and interobserver consistency (k = 0.862, k = 0.694). The total pregnancy rate was 47%. There was a highly significant difference between pregnant and non-pregnant women with respect to age (p < 0.001), JZV (p = 0.003), and JZV/EV (p < 0.001) on the day before transplantation. Age and JZV/EV were independent factors for predicting the success of IVF transplantation (p = 0.010, p = 0.016). The area under the ROC curve of JZV/EV in predicting clinical pregnancy was 0.688, the cut-off value was 0.54, the sensitivity was 83.8%, and the specificity was 50.0%. Conclusion Age and JZV/EV are independent factors for predicting the success of frozen embryo transfer cycles in IVF. A smaller JZV/EV was more beneficial for clinical pregnancy.

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Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00784-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Alessio Paffoni ◽

Marco Reschini ◽

Valerio Pisaturo ◽

Cristina Guarneri ◽

Simone Palini ◽

...

Keyword(s):

In Vitro Fertilization ◽

Pregnancy Rate ◽

Embryo Transfer ◽

Implantation Rate ◽

Clinical Pregnancy ◽

Frozen Embryo Transfer ◽

Fertilization Failure ◽

Vitro Fertilization ◽

Rescue Icsi

Abstract Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

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Comparative Study Between Mock Embryo Transfer Prior To The Treatment Cycle and Real Embryo Transfer In In Vitro Fertilization

KnE Medicine ◽

10.18502/kme.v1i1.538 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Hilma Putri Lubis

Keyword(s):

In Vitro Fertilization ◽

Embryo Transfer ◽

Treatment Cycle ◽

Uterine Cavity ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Vitro Fertilization ◽

Significant Difference ◽

Clinical Pregnancy Rates

IntroductionA trial or mock embryo transfer (ET) may influence pregnancy rates and it performed prior to ET allows the clinician to assess the uterine cavity and the utero-cervical angle. The aim of this study is to compare the consistency of the type of ET in mock ET with real ET.Material & MethodsA retrospective comparative analysis of patients who underwent in vitro fertilization or ICSI cycle from January 2014 to December 2014 in Halim Fertility Center was done. The type of transfer was divided into two groups: ‘easy’ or ‘difficult’. An easy ET was defined as a transfer that occurred without the use of manipulation or other instrumentation and difficult ET was considered when additional instrumentation was required.ResultsFrom the study, 103 patients who underwent Mock-ET, we found 58 patients (56.3%) with easy ET and 45 patients (43.7%) with difficult ET, which with hard catheter ET in 17 patients (16.5%), with osfander assistance in 20 patients (19.4%) and with stylet in 8 patients (7,8%). 58 patients with Easy Mock ET group were entirely easy real ET (100%) and 45 patients with difficult Mock ET group also entirely were difficult real ET (100%). The Statistical analysis shows no significant difference between the mock ET and real ET groups (p>0,05). In easy real ET, clinical pregnancy rates were 32.8% and in difficult real ET, clinical pregnancy rates were 26.7% with no significant difference between the groups (p>0,05).Conclusion:Mock ET prior to the treatment cycle is consistent with real ET.

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The correlation between serum Ca-125 level and clinical pregnancy in in vitro fertilization (IVF): A meta-analysis

10.21203/rs.2.18753/v1 ◽

2019 ◽

Author(s):

Xin-Lei Wang ◽

Zhuo Li ◽

Han Zhang ◽

Ce Shi ◽

Tong Tong ◽

...

Keyword(s):

In Vitro Fertilization ◽

Embryo Transfer ◽

Meta Analysis ◽

Clinical Pregnancy ◽

Ca 125 ◽

Vitro Fertilization ◽

Time Period ◽

Central Register ◽

Significant Difference

Abstract Background Several studies had investigated the role of serum Ca-125 in clinical pregnancy of patients undergoing in vitro fertilization (IVF); however, their conclusions had been inconsistent. This study aimed to evaluate the correlation between serum Ca-125 level and clinical pregnancy in IVF.Methods We systematically review the studies in the databases of Mediline OvidSP, EMBASE OvidSP and Cochrane (CENTRAL Central Register of Controlled Trials). Studies on the correlation between serum Ca-125 level and clinical pregnancy in patients underging IVF with or without Intracytoplasmic sperm injection (ICSI) were considered. The pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) was used in the analysis.Results Seven studies involving 558 patients were included. The meta-analysis showed that there was no significant difference in the serum Ca-125 level before embryo transfer (ET) between clinical pregnant group and nonpregnant group (SMD 0.72; 95% CI [0.01, 1.43], P = 0.05, I 2 = 88%), and the same conclusion was also reached in patients without endometriosis (SMD 0.31; 95% CI [-0.53, 1.16], P = 0.47, I 2 = 89%); However, after embryo transfer, the result showed that the Ca-125 level has a small but significantly increase in the clinical pregnant group than in the nonpregnant group (SMD 0.39; 95% CI [0.09, 0.69], P = 0.01, I 2 = 0%).Conclusions Berore ET, there was no significant correlation between serum Ca-125 level and clinical pregnancy in IVF; After ET, the Ca-125 level has a small but significantly increase in the clinical pregnant group than in the nonpregnant group, and it might reflect a successful interaction between the embryo and the endometrium in that time period.

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Luaran Transfer Embrio Simpan Beku pada Pasien Endometriosis Pasca Operasi dan Non Endometriosis yang Menjalani IVF di Klinik Permata Hati RSUP Dr. Sardjito

Jurnal Kesehatan Reproduksi ◽

10.22146/jkr.56940 ◽

2020 ◽

Vol 7 (2) ◽

pp. 108

Author(s):

Rina Fatmawati ◽

Shofwal Widad ◽

Agung Dewanto

Keyword(s):

In Vitro Fertilization ◽

Success Rate ◽

Embryo Transfer ◽

Pregnancy Outcomes ◽

Clinical Pregnancy ◽

Frozen Embryo Transfer ◽

Research Subjects ◽

Vitro Fertilization ◽

Biochemical Pregnancy

Background: Endometriosis is a chronic condition that is influenced by the hormone estrogen which affects women of childbearing age, and is associated with pelvic pain and infertility. In Vitro Fertilization (IVF) is currently the most efficient assisted reproductive technology and its high success rate is often done for infertility therapy in women associated with endometriosisObjective: The aim of this study is to determine whether postoperative endometriosis affected pregnancy outcomes in patients underwent frozen embryo transfer in IVF / ICSI programs.Method: This Research is done with a retrospective cohort design. The data was taken from medical records, research subjects who met the inclusion and exclusion criteria. The research data was collected, processed and analyzed using SPSS 23. Univariate, bivariate and multivariate data analysis was carried out to determine the effect between variablesResult: There were 458 research subjects in this study. Endometriosis patients were 119 subjects (26%). 57 subjects were categorized as minimum-mild endometriosis (47.9%) and moderate-severe subjects as many as 62 subjects (52.1%). The biochemical pregnancy rate (36.31%) and clinical pregnancy (29.4%) in patients with endometriosis was slightly higher than in non-endometriosis. But statistically it did not affect success rate of achieving biochemical (p = 0.428; RR 0.89; 95% CI: 0.71-1.24) and clinical pregnancy (p = 0.535; RR 0.883; 95% CI: 0.63- 1.22). The rate of miscarriage in postoperative endometriosis patients was higher than non-endometriosis patients (88.6% vs 80.7%) but was not statistically significant (p = 0.294; RR 1.69; 95% CI: 0.61-4.67) . Biochemical and clinical pregnancies were significantly affected by age, infertility, endometrial thickness, embryo age and embryo quality. The incidence of miscarriage was affected by the ovarian stimulation protocol.Conclusion: Endometriosis post operative statistically has no effect on pregnancy outcomes in the IVF / ICSI cycle with frozen embryo transfer compared with another cause of infertility .Keywords:Endometriosis, In Vitro Fertilization, Clinical pregnancy, biochemical pregnancy, miscarriage

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Estimating the causal effect of embryo transfer day on clinical in vitro fertilization outcomes using propensity score matching

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04013-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Han-Chih Hsieh ◽

Chun-I Lee ◽

En-Yu Lai ◽

Jia-Ying Su ◽

Yi-Ting Huang ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Live Birth ◽

Implantation Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Vitro Fertilization ◽

Significant Difference ◽

Day 5 Transfer

Abstract Background For women undergoing in vitro fertilization (IVF), the clinical benefit of embryo transfer at the blastocyst stage (Day 5) versus cleavage stage (Day 3) remains controversial. The purpose of this study is to compare the implantation rate, clinical pregnancy rate and odds of live birth of Day 3 and Day 5 embryo transfer, and more importantly, to address the issue that patients were chosen to receive either transfer protocol due to their underlying clinical characteristics, i.e., confounding by indication. Methods We conducted a retrospective cohort study of 9,090 IVF cycles collected by Lee Women’s Hospital in Taichung, Taiwan from 1998 to 2014. We utilized the method of propensity score matching to mimic a randomized controlled trial (RCT) where each patient with Day 5 transfer was matched by another patient with Day 3 transfer with respect to other clinical characteristics. Implantation rate, clinical pregnancy rate, and odds of live birth were compared for women underwent Day 5 transfer and Day 3 transfer to estimate the causal effects. We further investigated the causal effects in subgroups by stratifying age and anti-Mullerian hormone (AMH). Results Our analyses uncovered an evidence of a significant difference in implantation rate (p=0.04) favoring Day 5 transfer, and showed that Day 3 and Day 5 transfers made no difference in both odds of live birth (p=0.27) and clinical pregnancy rate (p=0.11). With the increase of gestational age, the trend toward non-significance of embryo transfer day in our result appeared to be consistent for subgroups stratified by age and AMH, while all analyses stratified by age and AMH were not statistically significant. Conclusions We conclude that for women without strong indications for Day 3 or Day 5 transfer, there is a small significant difference in implantation rate in favor of Day 5 transfer. However, the two protocols have indistinguishable outcomes on odds of live birth and clinical pregnancy rate.

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