scholarly journals Multiple pregnancy rate in patients undergoing treatment with clomifene citrate for WHO group II ovulatory disorders: a systematic review

2021 ◽  
pp. 1-10
Author(s):  
Heather Garthwaite ◽  
Jane Stewart ◽  
Scott Wilkes
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  

Abstract Background Some studies have stated that intrauterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the pregnancy rate, while others suggest that IUI in the natural cycle (NC) should be the first line of treatment. It remains unclear whether it is necessary to use COS at the same time when IUI is applied to treat isolated male factor infertility. Thus, we aimed to investigate efficacy of IUI with COS for isolated male factor infertility. Methods A total of 601 IUI cycles from 307 couples who sought medical care for isolated male factor infertility between January 2010 and February 2020 were divided into two groups: NC-IUI and COS-IUI. The COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (one follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The IUI outcomes, including clinical pregnancy, live birth, spontaneous abortion, ectopic pregnancy, and multiple pregnancy rates were compared. Results The clinical pregnancy, live birth, spontaneous abortion, and ectopic pregnancy rates were comparable between the NC-IUI and COS-IUI group. Similar results were also observed among the NC-IUI, one follicle, and ≥ 2 follicles groups. However, with respect to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared to the NC-IUI group (8.7% vs. 0, P = 0.091), and a significant difference was found between the NC-IUI and ≥ 2 follicles group (0 vs. 16.7%, P = 0.033). Conclusion In COS cycles, especially in those with at least two pre-ovulatory follicles, the multiple pregnancy rate increased without a substantial gain in overall pregnancy rate; thus, COS should not be preferred in IUI for isolated male factor infertility. If COS is required, one stimulated follicle and one healthy baby should be the goal considering the safety of both mothers and foetuses.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuxia He ◽  
Shiping Chen ◽  
Jianqiao Liu ◽  
Xiangjin Kang ◽  
Haiying Liu

Abstract Background High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies. Methods A total of 2,038 FET cycles of poor-quality blastocysts from patients 40 years old or less were included from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n = 476), D5-DBT (n = 365), D6-SBT (n = 730), and D6-DBT (n = 467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n = 407), D5-CA/CB (n = 69), D6-AC/BC (n = 580), and D6-CA /CB (n = 150). Results When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44 % vs. 20.82 %) and live birth (32.35 % vs. 14.25 %) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusions For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.


1999 ◽  
Vol 14 (Suppl_3) ◽  
pp. 386-386
Author(s):  
J.P. Taar ◽  
P. Barbarino-Monnier ◽  
A. Bachelot

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Syuichi Ooki

The purpose of the present study was to examine the effect of single embryo transfer (SET) in assisted reproductive technology (ART) on the reduction of the multiple pregnancy rate. We also estimated the monozygotic (MZ) twinning rates according to the SET diffusion indirectly. A reverse sigmoid curve was assumed and examined using nationwide data of SET from 2007 to 2009 in Japan. The multiple pregnancy rate decreased almost linearly where the SET pregnancy rate was between about 40% and 80% of regression approximation. The linear approximation overestimated multiple pregnancy rates in an early period and underestimated multiple pregnancy rates in the final period. The multiple pregnancy rate seemed to be influenced by the improvement of the total pregnancy rate of ART in the early period and by the MZ twinning after SET in the final period. The estimated MZ twinning rate after SET was around 2%.


2020 ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  

Abstract Background: Some studies stated that intra-uterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the chance of pregnancy, while others suggested that IUI in natural cycle (NC) should be the treatment of first choice. Whether it is necessary to use COS at the same time, when IUI is applied to treat male infertility solely? There is still no consensus.Objective: To investigate the efficacy of IUI with COS in male infertility solely?Methods: 544 IUI cycles from 280 couples who sought medical care for male infertility from January 2010 to February 2019 were divided into two groups: group NC-IUI and group COS-IUI. Besides, the COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (1 follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The outcome of IUI, including clinical pregnancy rate, live birth rate, spontaneous abortion rate, ectopic pregnancy rate and multiple pregnancy rate were compared.Results: The clinical pregnancy rate, live birth rate, early spontaneous abortion rate, and ectopic pregnancy rate were comparable between NC-IUI group and COS-IUI group. Similar results were observed among NC-IUI group, 1 follicle group and ≥ 2 follicles group. However, when it comes to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared that in the NC-IUI group (10.5% (2/19) vs. 0 (0/42), P=0.093), furthermore, a significant difference was found between NC-IUI group and ≥ 2 follicles group (0 vs. 20%, P =0.034).Conclusion: For male infertility, since in cycles with COS, especially in those with at least two pre-ovulatory follicles cycles, the multiple pregnancy rate increased without substantial gain in overall pregnancy rate, COS in IUI should not be recommended. If COS is required, one stimulated follicle and one health baby should be the goal considering the safety both for mothers and fetuses.


Author(s):  
Meeta Mohan Mahale ◽  
Purnima Kishore Nadkarni ◽  
Kishore Mohan Nadkarni ◽  
Pooja Prabhakar Singh ◽  
Aditi Akshay Nadkarni ◽  
...  

Background: Hysteroscopy is a gold standard test for assessing the uterine cavity. The presence of uterine pathology may negatively affect the chance of implantation .This study investigated the use of routine office hysteroscopy and correction of any intrauterine pathologies prior to starting IVF cycle on treatment outcome in women seeking IVF treatment for primary infertility and recurrent implantation failure.Methods: This was a retrospective study of 100 women who attended our infertility clinic from July 2016 to December 2016 and who were willing for office hysteroscopy. The main outcomes measured were clinical pregnancy rates achieved in the index IVF cycle, multiple pregnancy rate, ectopic pregnancy rate, miscarriage rate and failure rate.Results: Of the 100 patients who participated in the study, 75 patients conceived, 25 patients failed to conceive. 80.64% patients with normal findings on diagnostic hysteroscopy conceived after the procedure, 58.33% patients conceived after polypectomy, 68.42% conceived after septal resection, 71.42% conceived after adhesiolysis, 50% conceived after lateral metroplasty and 73.07% of recurrent implantation failure conceived after local endometrial injury was done on hysteroscopy.Conclusions: Hysteroscopy in infertile women prior to their IVF cycle when performed atleast 3 months in advance could improve treatment outcome.


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