Embryo culture using a time-lapse monitoring system improves live birth rates compared with a conventional culture system: a prospective cohort study

2017 ◽  
Vol 21 (4) ◽  
pp. 255-262 ◽  
Author(s):  
Lihong Wu ◽  
Wei Han ◽  
Jiang Wang ◽  
Xiaodong Zhang ◽  
Weiwei Liu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Live Birth ◽  
Embryo Culture ◽  
Prospective Cohort ◽  
Culture System ◽  
Time Lapse ◽  
Live Birth Rates ◽  
Conventional Culture ◽  
System A

scholarly journals The impact of adenomyosis on IVF outcomes: a prospective cohort study

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Chloe Higgins ◽  
Hugo Fernandes ◽  
Fabricio Da Silva Costa ◽  
Wellington P Martins ◽  
Beverley Vollenhoven ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Live Birth ◽  
Prospective Cohort ◽  
Clinical Pregnancy ◽  
Confounding Factors ◽  
Birth Rates ◽  
Ivf Outcomes ◽  
Live Birth Rates ◽  
Detrimental Impact

Abstract STUDY QUESTION Does the presence of adenomyosis in women treated with IVF alter IVF outcomes? SUMMARY ANSWER Adenomyosis does not significantly alter IVF outcomes when adjusted for confounding factors including maternal age and smoking status. WHAT IS KNOWN ALREADY Studies evaluating adenomyosis and its impact on infertility, particularly when focusing on IVF, remain controversial. Many studies report that adenomyosis has a detrimental effect on IVF outcomes, however age is strongly related with both the prevalence of adenomyosis and worse reproductive outcomes. STUDY DESIGN, SIZE, DURATION A prospective cohort study of women undergoing 4002 IVF cycles who had undergone a screening ultrasound assessing features of adenomyosis from 1 January 2016 to 31 March 2018 at a multi-site private fertility clinic. Of these women, 1228 fulfilled the inclusion criteria and commenced an IVF cycle, with a subset of 715 women undergoing an embryo transfer (ET). Women were defined as having adenomyosis if there was sonographic evidence of adenomyosis on ultrasound as per the Morphological Uterus Sonographic Assessment criteria, and were then compared to women without. PARTICIPANTS/MATERIALS, SETTING, METHODS All women at a private multi-site IVF clinic who underwent a standardised ultrasound to identify features of adenomyosis and also commenced an IVF cycle were assessed for their outcomes. These included clinical pregnancy (defined as the presence of a gestational sac on ultrasound at 7 weeks’ gestation), clinical pregnancy loss, number of cancelled cycles, number of useful embryos for transfer or freezing and live birth rates. As a secondary aim, initiated stimulation cycles and those that had an ET were analysed separately to determine when an effect of adenomyosis on IVF might occur: during stimulation or transfer. MAIN RESULTS AND THE ROLE OF CHANCE When adjusting for confounders, women with and without sonographic features of adenomyosis had no significant differences in most of their IVF outcomes including live birth rates. LIMITATIONS, REASONS FOR CAUTION Adenomyosis had a detrimental impact on IVF outcomes prior to adjusting for confounding factors. No allowance was made for the possibility that confounding factors may merely reduce the effect size of adenomyosis on IVF outcomes. Second, despite a power calculation, the study was underpowered as not all fresh cycles led to an ET. WIDER IMPLICATIONS OF THE FINDINGS This is one of the largest studies to evaluate adenomyosis and IVF outcomes, while also importantly adjusting for confounding factors. The results suggest that adenomyosis does not have the detrimental impact on IVF that has previously been suggested, possibly reducing the importance of screening for and treating this entity. STUDY FUNDING/COMPETING INTEREST(S) The study received no external funding. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER ACTRN12617000796381.

scholarly journals Fecundability among Danish women with a history of miscarriage: a prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023996 ◽  
Author(s):  
Cathrine Wildenschild ◽  
Anders H Riis ◽  
Vera Ehrenstein ◽  
Elizabeth E Hatch ◽  
Lauren A Wise ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Live Birth ◽  
Prospective Cohort ◽  
Reproductive History ◽  
Self Report ◽  
Fertility Treatment ◽  
Kaplan Meier ◽  
History Of ◽  
Cumulative Probabilities

ObjectiveTo examine the association between history of miscarriage and fecundability (the cycle-specific probability of conception).DesignNationwide prospective cohort study using web-based questionnaires.SettingDenmark, 2007–2012.Participants977 women attempting to conceive, not using fertility treatment, and with a reproductive history of only miscarriage or only live birth.Exposure and outcome measuresInformation on previous pregnancy outcomes, including miscarriage, came from self-report or from relevant registries. Participants were followed for up to 12 months or until they reported a pregnancy, stopped trying to conceive or started fertility treatment, whichever came first. We used Kaplan-Meier methods to estimate cumulative probabilities of conception for women whose reproductive history included only miscarriage or only live birth. Using proportional probabilities regression modelling, we computed fecundability ratios (FR) with 95% CI comparing women with a history of only miscarriage with women with a history of only live birth.ResultsAfter adjustment for potential confounders, the cumulative probabilities of conception within 12 cycles of follow-up were 85% (95% CI 81% to 89%) for women with a history of 1 miscarriage, 85% (95% CI 73% to 92%) for women with a history of ≥2 miscarriages and 88% (95% CI 87% to 89%) for women whose reproductive history included only live birth. Adjusted FRs were 0.87 (95% CI 0.71 to 1.07) and 0.65 (95% CI 0.36 to 1.17) for women with a history of 1 and ≥2 miscarriages, respectively.ConclusionsOur results indicate that women with a history of miscarriage may have slightly reduced fecundability compared with women with a history of only live birth. The reduction in fecundability was greater for women with repeated miscarriages, although the estimates were imprecise. Despite a potential delay in conception, women with previous miscarriage may have similar probability of pregnancy by 12 cycles of attempts to women with proven fertility.

O-233 Micronized progesterone plus dydrogesterone versus micronized progesterone alone for luteal phase support in frozen-thawed cycles: a prospective cohort study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
T Ho ◽  
T Pham ◽  
K Le ◽  
T Ly ◽  
H Le ◽  
...  
Keyword(s):  
Cohort Study ◽  
Embryo Transfer ◽  
Live Birth ◽  
Prospective Cohort ◽  
Luteal Phase ◽  
Luteal Phase Support ◽  
Live Birth Rates ◽  
Randomized Controlled ◽  
Vaginal Progesterone ◽  
Micronized Progesterone

Abstract Study question Does the addition of oral dydrogesterone to vaginal progesterone as luteal phase support improve pregnancy outcomes during frozen embryo transfer (FET) cycles compared with vaginal progesterone alone? Summary answer Luteal phase support with oral dydrogesterone added to vaginal progesterone improves live birth rates and reduces miscarriage rates compared with vaginal progesterone alone. What is known already Progesterone is an important hormone that triggers secretory transformation of the endometrium to allow implantation of the embryo. During in vitro fertilization (IVF), exogenous progesterone is administered for luteal phase support. However, there is wide inter-individual variation in absorption of progesterone via the vaginal wall. Oral dydrogesterone is effective and well tolerated when used to provide luteal phase support after fresh embryo transfer. However, there are currently no data on the effectiveness of luteal phase support with the combination of dydrogesterone with vaginal micronized progesterone compared with vaginal micronized progesterone after FET. Study design, size, duration Prospective cohort study conducted at an academic infertility center in Vietnam from 26 June 2019 to 30 March 2020. Participants/materials, setting, methods We studied 1364 women undergoing IVF with FET. The luteal support regimen was either vaginal micronized progesterone 400 mg twice daily plus oral dydrogesterone 10 mg twice daily (second part of the study) or vaginal micronized progesterone 400 mg twice daily (first 4 months of the study). The primary endpoint was live birth after the first FET of the started cycle, with miscarriage <12 weeks as one of the secondary endpoints. Main results and the role of chance The vaginal progesterone + dydrogesterone group and vaginal progesterone groups included 732 and 632 participants, respectively. Live birth rates were 46.3% versus 41.3%, respectively (rate ratio [RR] 1.12, 95% confidence interval [CI] 0.99–1.27, p = 0.06; multivariate analysis RR 1.30 (95% CI 1.01–1.68), p = 0.042), with a statistically significant lower rate of miscarriage at < 12 weeks (3.4% vs 6.6%; RR 0.51, 95% CI 0.32–0.83; p = 0.009). Birth weight of both singletons (2971.0 ± 628.4 vs. 3118.8 ± 559.2 g; p = 0.004) and twins (2175.5 ± 494.8 vs. 2494.2 ± 584.7; p = 0.002) was significantly lower in the progesterone plus dydrogesterone versus progesterone group. Limitations, reasons for caution The study were the open-label design and the non-randomized nature of the sequential administration of study treatments. However, our systematic comparison of the two strategies was able to be performed much more rapidly than a conventional randomized controlled trial. In addition, the single ethnicity population limits external generalizability. Wider implications of the findings Oral dydrogesterone in addition to vaginal progesterone as luteal phase support in FET cycles can reduce the miscarriage rate and improve the live birth rate. Carefully planned prospective cohort studies with limited bias could be used as an alternative to randomized controlled clinical trials to inform clinical practice. Trial registration number NCT03998761

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