Features of establishment of early lactation in women who gave birth after in vitro fertilization

Abstract Background Breastfeeding gives babies the best possible start in life and breastmilk works like a baby’s first vaccine. Pregnancy resulting from IVF is often associated with placental insufficiency in which the hormone-producing function of placenta can be compromised that may result in reduced lactogenesis. The aim was to study the emergence of early lactation after IVF in women with a history of infertility. Methods The study involved 34 women after IVF with a singleton full-term pregnancy with a history of tubal-peritoneal infertility. Control group comprised of 47 women with naturally occurred pregnancy. Delivery occurred naturally. All women were assessed for hormonal function of placenta for a period of 16-18, 28-32, and 37-38 weeks of pregnancy. The average daily amount of milk on a 5th day after delivery was measured. Results In the IVF group vs. control group there was a decrease in the production of hormones by the placenta (progesterone, estriol, placental lactogen) preparing the mammary glands for lactation (p < 0.05). At gestational age of 16-18 weeks progesterone level in IVF group was 172.2±10.72 nmol/l; 28-32: 274.2±8.45 nmol/l; 37-38 weeks: 343.2±9,1 nmol/l. The level of estriol at 16-18 weeks was 2.87±1.42 ng/ml; 28-32: 10.94±0.6 ng/ml; 37-38 weeks: 25.21±0.22 ng/ml. Placental lactogen at16-18 weeks: 1.15±0.2 nmol/l; 28-32: 6.39±0.69 nmol/l; 37-38 weeks: 7.23±0.59 nmol/l. On day 5 normal lactation was observed in 21(62%) and 43(91.5%) women in IVF and control group, respectively (p < 0.05). Conclusions Increased number of cases of hypolactation was observed in women after IVF, which was associated with decrease in the hormonal function of placenta. Women who have given birth to children after IVF require special attention from the side of medical personnel and from loved ones in the early stages of establishment of breastfeeding. Key messages IVF is a risk factor for hypolactation, which is associated with placental hormone-producing insufficiency. Women who have given birth after IVF require support aimed at promotion of early lactation and breastfeeding.

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Association Between Gestational Trophoblastic Disease (GTD) History and Clinical Outcomes in in Vitro Fertilization/intracytoplasmic Sperm Injection (IVF/ICSI) Cycles

10.21203/rs.3.rs-649509/v1 ◽

2021 ◽

Author(s):

Xinyu Cai ◽

Mei Zhang ◽

Chenyang Huang ◽

Yue Jiang ◽

Jidong Zhou ◽

...

Keyword(s):

Live Birth ◽

Gestational Age ◽

Live Birth Rate ◽

Gestational Trophoblastic Disease ◽

Control Group ◽

Vitro Fertilization ◽

Gestational Age At Delivery ◽

History Of ◽

And Control

Abstract Background: Gestational trophoblastic disease (GTD) usually affects young women of childbearing age. After treatment for GTD, 86% of women wish to achieve pregnancy. On account of the impacts of GTD and treatments as well as patient anxiety, large numbers of couples turn to assisted reproductive technology (ART), especially in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). But few studies have investigated whether a history of GTD affects the outcomes of IVF/ICSI in secondary infertile patients and how it occurs. We investigate whether a history of GTD affects the IVF/ICSI outcomes and the live birth rates in women with secondary infertility.Methods: This retrospective cohort study enrolled 176 women with secondary infertility who underwent IVF/ICSI treatment at the reproductive medical center of Nanjing Drum Tower Hospital from January 1, 2016, to December 31, 2020. Participants were divided into the GTD group (44 women with GTD history) and control group (132 women without GTD history matched from 8318 secondary infertile women ). The control group and the study group were matched at a ratio of 3:1 according to patient age, infertility duration, number of cycles and body mass index (BMI). We assessed retrieved oocytes and high-grade embryos, biochemical pregnancy, miscarriage, ectopic pregnancy, gestational age at delivery, delivery mode and live birth rates.Result(s): We found a significantly reduced live-birth rate (34.1% vs 66.7%) associated with IVF/ICSI cycles in patients with a GTD history compared to those without a GTD history. The biochemical pregnancy and miscarriage rates of the GTD group were slightly higher than those of the control group. In addition, there was a difference in gestational age at delivery between the GTD and control groups (p<0.001) but no differences in the mode of delivery (p=0.267). Furthermore, the number of abandoned embryos in the GTD group was greater than that in the control group (p=0.018), and the number of good-quality embryos was less than that in the control group (p=0.019). The endometrial thickness was thinner (p<0.001) in the GTD group. Immunohistochemistry (IHC) showed abnormal endometrial receptivity in the GTD group.Conclusion(s): The GTD history of patients undergoing IVF/ICSI cycles had an impact on the live-birth rate and gestational age at delivery, which might result from the thinner endometrium and abnormal endometrial receptivity before embryo transfer.

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The effectiveness of collaborative infertility counseling (CIC) on pregnancy outcome in infertile women undergoing in vitro fertilization: A randomized controlled trial

10.21203/rs.2.14093/v1 ◽

2019 ◽

Author(s):

Mahboobeh Rasoulzadeh Bidgoli ◽

robab latifnejad roudsari ◽

ali montazeri

Keyword(s):

In Vitro Fertilization ◽

Pregnancy Rate ◽

Treatment Success ◽

Intervention Group ◽

Control Group ◽

Vitro Fertilization ◽

Infertile Women ◽

Significant Difference ◽

And Control

Abstract Background: Infertility is an emotional tension which influences the whole aspects of relationships in infertile couples. A main objective of infertility treatments is elevation of pregnancy rate. The present study aimed to examine the effect of collaborative counseling on pregnancy rate in infertile women, undergoing in vitro fertilization in Mashhad, Iran. Methods: In this clinical trial, 60 women with primary infertility were selected from an infertility research center and were randomly allocated into intervention (n=29) and control (n=31) groups. The intervention group received individual counseling, based on the collaborative reproductive healthcare model with collaboration of a midwife, a gynecologist and a clinical psychologist in five sessions during a two-month period. The control group received routine care. Positive pregnancy test was considered as a criterion of treatment success at the end of the study. Data were analyzed using statistical tests including independent samples t-test. Results: There was no significant difference in pregnancy rate between intervention and control groups (P = 0.298). Also, there were no significant differences in follicle and embryo numbers between two groups. However, a significant difference was observed between two groups in terms of oocyte numbers where the intervention group had more oocyte (P = 0.014). Conclusion: Overall the findings indicated that the collaborative infertility counseling did not improve treatment success in infertile women undergoing in vitro fertilization

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286 INFLUENCE OF REVERSIBLE MEIOSIS INHIBITION ON SWINE EMBRYOS PRODUCED BY IN VITRO FERTILIZATION AND PATHENOGENETIC ACTIVATION

Reproduction Fertility and Development ◽

10.1071/rdv18n2ab286 ◽

2006 ◽

Vol 18 (2) ◽

pp. 250

Author(s):

M. G. Marques ◽

A. B. Nascimento ◽

V. P. Oliveira ◽

A. R. S. Coutinho ◽

M. E. O. A. Assumpção ◽

...

Keyword(s):

Culture Medium ◽

Cell Number ◽

Control Group ◽

Cleavage Rate ◽

Vitro Fertilization ◽

Electric Pulses ◽

Cell Numbers ◽

Blastocyst Rate ◽

And Control

The present work evaluated the reversible meiosis inhibition effect on the development of swine embryos produced by in vitro fertilization (IVF) or parthenogenetic activation (PA). The efficiency of PZM3 and NCSU23 embryo culture media was also evaluated. Oocytes from ovaries collected at a slaughterhouse were subjected to IVM in two different groups: CHX (cycloheximide 5 µM for 10 h) and control, both with TCM-199 + 3.05 mM glucose + 0.91 mM sodium pyruvate + 10% porcine follicular fluid (pFF) + 0.57 mM cystein + 10 ng epidermal growth factor (EGF)/mL + 10 IU eCG/mL + 10 IU hCG/mL for the initial 22 h. In the remaining period (20 h for CHX and 22 h for control), medium without hormones was utilized. After IVM, oocytes were denuded and fertilized for 6 h (IFV) or the matured oocytes were submitted to activation by electric pulses (PA) (2 DC of 1.5 kV/cm for 30 µs), incubated for 1 h in culture medium with 10 μM of CHX, and again submitted to the same electric pulses for 60 µs. Embryo development was evaluated by cleavage rate on Day 3 and blastocyst rate and blastocyst cell number on Day 7 of culture. Cleavage and blastocyst rates were analyzed by the equality-of-two-ratios test and cell number by the Kruskal-Wallis and Mann-Whitney tests (P < 0.05). In relation to IVF, the PZM3 medium was more efficient than NCSU23 for cleavage rate in the CHX group (PZM3: 68.4%, NCSU23: 44.4%) and had a better blastocyst rate in the control group (PZM3: 13.4%, NCSU23: 5.6%). With reference to PA, NCSU23 presented better cleavage and blastocyst rates than PZM3 in the CHX group (NCSU23: 89.5%, PZM3: 78.5% and NCSU23: 20.4%, PZM3: 13.0%, respectively). In the control group, only the NCSU23 blastocyst rate was higher than that for PZM3 (NCSU23: 22.5%, PZM3: 10.8%). No culture medium effect on cell number mean of IVF and PA blastocysts was observed. Maturation block improved cleavage rates in IVF groups cultured with PZM3 (68.4% and 50.6%, respectively, for CHX and control) and in PA groups cultured with NCSU23 (89.5% and 80.3%, respectively, for CHX and control), but no improvement of blastocyst rates in both groups (IVF and PA) was verified. Table 1 below shows that maturation block decreased the IVF and increased the PA blastocyst cell numbers. As older oocytes are more effectively activated, oocytes blocked with CHX achieved the maturation stage faster than the control group, therefore resulting in high-quality PA blastocysts. In conclusion, PZM3 was more efficient for IVF embryo production in contrast to NCSU23, whereas NCSU23 can be indicated for PA embryo production. Moreover, maturation blockage with CHX influenced blastocyst cell number, decreasing in IVF embryos and increasing in PA embryos. Table 1. Mean (±SD) of blastocyst cell numbers for IVF or PA groups after in vitro maturation without (control) or with cycloheximide (CHX) and cultured in NCSU23 or PZM3 medium This work was supported by FAPESP 02/10747–1.

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Application of nanomaterial for maturation in vitro of cattle embryos

Faktori eksperimental'noi evolucii organizmiv ◽

10.7124/feeo.v28.1385 ◽

2021 ◽

Vol 28 ◽

pp. 112-116

Author(s):

P. A. Trotskyi ◽

O. V. Shcherbak ◽

S. I. Kovtun

Keyword(s):

In Vitro Maturation ◽

Cellular Level ◽

Control Group ◽

Vitro Fertilization ◽

Fragmentation Index ◽

Maturation In Vitro ◽

Conservation Of Genetic Resources ◽

Group B ◽

And Control

Aim. To evaluate the effectiveness of the use of nanomaterial in the environment for the further development of in vitro embryos derived from frozen-thawed oocytes in the system of conservation of genetic resources of animals at the cellular level. Methods. Biotechnological, cryobiological, morphological, cytogenetic, and statistical methods, as well as methods of statistical data processing were used in the research. Results. Oocyte-cumulus complexes (OCC) of cows were divided into four groups: three experimental, in which the maturation was performed in a medium containing 0.1, 0.01 and 0.001% UFS/sucrose and control - without the addition of nanobiomaterial. In vitro fertilization of pre-mature frozen-thawed ova of cows and subsequent maturation of embryos in the medium with the addition of UFS/sucrose (0.001%) showed an increase in the number of embryos by 16.7-22.1% compared with the addition of 0.1; 0.01% and 13.1% compared to the control group. It was found that the fragmentation rate of 2-cell cattle embryos decreased from 65.0 to 39.8% with a decrease in the concentration of UFS/sucrose from 0.1 to 0.001%. The most stable indicators of the fragmentation index from 78.4 to 50.0% were observed on the fourth day of embryo cultivation in experimental group B. Conclusions. Reducing the concentration of UFS/sucrose from 0.1 to 0.001% in the composition of the medium for in vitro maturation of cattle embryos leads to an increase of 16.7-22.1% in the number of embryos obtained. Keywords: oocyte-cumulus complex, cryopreservation, nanomaterial, in vitro maturation, embryo.

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Comparison of Cycle Outcomes Among Women with Endometrioma or Non-Functional Cysts Versus Control

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2020.1110 ◽

2021 ◽

pp. 1-6

Author(s):

Enis Ozkaya ◽

Ebru Cogendez ◽

Elif Tozkir ◽

Saadet Unsal ◽

Ahmet Yavuz ◽

...

Keyword(s):

Risk Factor ◽

Cystic Mass ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Control Group ◽

Vitro Fertilization ◽

Clinical Pregnancy Rates ◽

And Control ◽

Cycle Outcome

OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functional cysts versus control. STUDY DESIGN: Women under 35 years of age with unexplained infertility underwent in vitro fertilization cycle. Two hundred and ninety-nine women were included in this study. Study groups consist of women with endometrioma (n=82) or non-functional ovarian cysts (n=100) and control group (n=117). Women in each group were selected consecutively. Groups were matched for age and ovarian reserve and compared in terms of in vitro fertilization cycle outcome. RESULTS: There were no significant differences among groups in terms of mean age, early follicular phase Follicle-Stimulating Hormone, and anti-müllerian hormone levels (p>0.05). Baseline total antral follicle counts were similar among groups (p>0.05). There were significant differences among groups in terms of mean starting and total gonadotropin dose, peak estradiol level, total oocyte number, and mature oocyte numbers (p<0.05). Clinical pregnancy rates were 10.7%, 17.3%, and 31.6% in groups with non-functional cyst, endometrioma and control group respectively (p<0.05). The presence of a non-functional cystic mass of ovary on the starting day of stimulation was a risk factor for poor cycle outcome in terms of clinical pregnancy rates [OR=0.5 (95 % CI; 0.2-0.9, p=0.03)]. CONCLUSION: Our data showed that the presence of any kind of cystic mass of the ovary especially the non-functional cysts on the starting day of stimulation was a risk factor for poor cycle outcomes in terms of clinical pregnancy rates.

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Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

Zaporozhye Medical Journal ◽

10.14739/2310-1210.2021.1.224898 ◽

2021 ◽

Vol 23 (1) ◽

pp. 98-104

Author(s):

L. V. Pakharenko ◽

O. M. Perkhulyn

Keyword(s):

In Vitro Fertilization ◽

Management Strategies ◽

Placental Lactogen ◽

Cervical Insufficiency ◽

Cervical Cerclage ◽

Vitro Fertilization ◽

Vaginal Progesterone ◽

History Of ◽

Anovulatory Infertility

Cervical insufficiency (CI) is one of the causes of preterm birth. The rate of CI is higher in women after in vitro fertilization treatment for infertility compared to the general population. The aim. To assess the hormonal level in women with CI and a history of anovulatory infertility in the second and third trimesters of pregnancy in different management strategies for CI. Materials and methods. 60 pregnant women with CI who conceived through in vitro fertilization treatment for anovulatory infertility were divided into two groups: in the I group (30 women), CI was corrected only with cervical cerclage / pessary in the II trimester of pregnancy, in the II group (30 persons), cervical cerclage / pessary was combined with vaginal progesterone 200 mg ones a day until 34 full weeks of gestation. 30 pregnant women without СІ or infertility with the physiological course of pregnancy were controls. The concentrations of estradiol, progesterone, placental lactogen, prolactin and cortisol were determined in the terms of 19–22 and 30–32 weeks of gestation in the maternal blood serum. Results. In the patients with CI at 19–22 gestational weeks, the estradiol and placental lactogen concentrations were slightly lower in the I and II groups than those in the control women, the level of progesterone was less in the I group by 13.44 %, in the II group – by 17.30 % (P < 0.05) compared to the controls; the levels of prolactin and cortisol in the I and II groups were increased significantly (P < 0.001). At 30–32 gestational weeks, the levels of estradiol (P < 0.05), progesterone (a decrease of 23.10 %, P < 0.001) and placental lactogen (a decrease of 10.74 %, P < 0.05) were significantly less as compared to the physiological ranges, while these parameters in the II group patients were on the lower limit of normal. In the I group, the concentrations of prolactin and cortisol were higher by 41.70 % (P < 0.001) and 27.36 % (P < 0.001), respectively, than the controls, in the II group – only by 24.10 % (P < 0.05) and 13.70 % (P < 0.05), respectively. Conclusions. In the women with cervical insufficiency after in vitro fertilization treatment for anovulatory infertility, the levels of estradiol, progesterone and placental lactogen are not significantly different from physiological indices, but the prolactin and cortisol concentrations are much higher. Adjunctive vaginal progesterone treatment to cervical cerclage/pessary in the third trimester of pregnancy promotes the normalization of progesterone, estradiol and placental lactogen levels, the decrease in prolactin and cortisol indices at 30–32 gestational weeks compared to the women with cervical cerclage/pessary alone.

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Analysis of in vitro fertilization/intracytoplasmic sperm injection outcomes in infertile women with a history of thyroid cancer: a retrospective study

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00763-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ning Huang ◽

Lin Zeng ◽

Jie Yan ◽

Hongbin Chi ◽

Jie Qiao

Keyword(s):

Thyroid Cancer ◽

In Vitro Fertilization ◽

Preterm Delivery ◽

Intracytoplasmic Sperm Injection ◽

Obstetric Outcomes ◽

Control Group ◽

High Grade ◽

Vitro Fertilization ◽

History Of

Abstract Background Recent studies have revealed that women with infertility have a higher risk of thyroid cancer (TC) than fertile women. However, studies on whether a history of thyroid cancer affects clinical outcomes in women who conceive using in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) are scarce. We investigate whether a history of thyroid cancer (TC) affects the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and increases the risk of adverse obstetric outcomes in women with infertility. Methods This retrospective study enrolled 384 women with infertility who underwent their first IVF/ICSI treatment at the Peking University Third Hospital between 2010 and 2019. Participants were divided into the TC (64 women with TC history) and control (320 women matched from 85,272 women without thyroid diseases) groups. Controls were individually matched to the TC group according to age, body mass index, concomitant infertility factors, first IVF/ICSI dates, and controlled ovarian stimulation and embryo transfer procedure protocols. IVF/ICSI outcomes, including the numbers of retrieved oocytes and high-grade embryos, clinical pregnancy, miscarriage, preterm delivery, and live birth rates, and adverse obstetric outcome risk were assessed. Results The TC group had significantly higher thyroid hormone and lower thyroid-stimulating hormone (TSH) levels than the control group. Despite similar gonadotropin treatment dosage, the TC group had a significantly lower numbers of retrieved oocytes and high-grade embryos than the control group. The occurrence rates of clinical pregnancy, miscarriage, preterm delivery, live births, and adverse obstetric outcomes, including multiple gestation, preterm delivery, gestational diabetes mellitus, gestational hypertension, low birth weight, and large-for-gestational-age infants, were not significantly different between the two groups. Conclusions TC history did not affect the pregnancy outcomes or increase the risk of adverse obstetric outcomes after the first IVF/ICSI, but it may decrease the number of retrieved oocytes and high-grade embryos.

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Comparison of Oocyte and Embryo Quality in Women With Polycystic Ovary Syndrome and the Control Group Candidate for In Vitro Fertilization and Intracytoplasmic Sperm Injection

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2021.31 ◽

2020 ◽

Vol 9 (3) ◽

pp. 164-170

Author(s):

Malihe Afiat ◽

Nayere Khadem ◽

Elnaz Nayeri ◽

Roya Jalali ◽

Saeed Akhlaghi ◽

...

Keyword(s):

In Vitro Fertilization ◽

Polycystic Ovary Syndrome ◽

Embryo Quality ◽

Polycystic Ovary ◽

Control Group ◽

Control Groups ◽

Ovary Syndrome ◽

Vitro Fertilization ◽

And Control

Objectives: Polycystic ovary syndrome (PCOS) is the most common cause of female infertility. The aim of this study was to compare the oocyte and embryo quality between the PCOS women with the control group candidate for in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Materials and Methods: The present study was designed at the Infertility Research Center of Milad in the prospective cohort format and was carried out on 100 cases of infertile women with confirmed PCOS (case group) and the male factor (control group) as the first IVF cycle candidates. Both groups underwent the ovary stimulation cycle and ICSI under the standard antagonist protocol. The collected data were then processed and analyzed using the SPSS software, version 16. Results: The average age of study cases was 35±3, and oocyte necrosis was the underlying pathological factor in both groups (28% and 26% in the PCOS and control groups, respectively). In addition, most embryones belonged to either grade 1 or 2 or were 8-cell embryos. Furthermore, the highest number of transferred embryos among the patients was related to the 8-cell and grade 1. The occurrences of biochemical pregnancy in the PCOS and control groups were up to 31.91% and 22%, respectively, leading to 72.73% and 60% childbirth in cases of both groups. Finally, there were no significant differences observed with respect to the quality and the quantity of the embryones, the oocyte, the transferred embryo, the germinal vesicle oocytes, and the rate of pregnancy among the two groups (P>0.05). Conclusions: According to the results of the present study, no differences were found concerning the oocyte quality, embryo, and the pregnancy rate between PCOS cases and any other patients requiring ICSI. Therefore, such cases can similarly benefit from ICSI methods as well.

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Lapatinib Decreases the Preimplantation Aneuploidy Rate of in vitro Fertilized Mouse Embryos without Affecting Completion of Preimplantation Development

Cytogenetic and Genome Research ◽

10.1159/000511371 ◽

2020 ◽

pp. 1-8

Author(s):

Parvaneh Maleki ◽

Hamid Gourabi ◽

Mohammad Tahmaseb ◽

Afsaneh Golkar-Narenji ◽

Masood Bazrgar

Keyword(s):

Blastocyst Stage ◽

Mouse Embryos ◽

Preimplantation Embryos ◽

Control Group ◽

Aneuploid Cell ◽

Vitro Fertilization ◽

Aneuploidy Rate ◽

Morula Stage ◽

And Control

One of the major reasons for implantation failure and spontaneous abortion is a high incidence of preimplantation chromosomal aneuploidy. Lapatinib simultaneously inhibits EGFR and HER2, leading to apoptosis. We hypothesized a higher sensitivity for aneuploid cells in preimplantation embryos to lapatinib based on reports of aneuploid cell lines being sensitive to some anticancer drugs. Late 2-cell mouse embryos were treated with lapatinib after determining a nontoxic dose. Morphologies were recorded 24, 48, and 60 hours later. The effect of lapatinib on the aneuploidy rate was evaluated by studying blastocyst cells using FISH. Although the rate of development to 8-cell and morula stage was higher in the control group (p < 0.05), there was no difference in development to the blastocyst stage at the same studied intervals between lapatinib-treated and control groups (p = 0.924). The mean number of cells in morula and blastocyst stages were not different between the groups (p = 0.331 and p = 0.175, respectively). The frequency of aneuploid cells and diploid embryos was, respectively, significantly lower and higher in lapatinib-treated embryos, (p < 0.001). Since lapatinib treatment reduced the aneuploidy rate without impact on the development of mouse preimplantation embryos to the blastocyst stage and number of total cells, lapatinib seems useful for prevention of preimplantation aneuploidy in in vitro fertilization.

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Do spontaneously decreasing estradiol levels prior to triggering of ovulation adversely impact in vitro fertilization outcomes?

Clinical and Experimental Reproductive Medicine ◽

10.5653/cerm.2019.03419 ◽

2020 ◽

Vol 47 (3) ◽

pp. 213-220

Author(s):

Leonti Grin ◽

Roza Berkovitz-Shperling ◽

Eyal Zohav ◽

Ahmet Namazov ◽

Sophia Leyetes ◽

...

Keyword(s):

Control Group ◽

Single Subject ◽

Study Group ◽

Serum Estradiol ◽

Control Groups ◽

Vitro Fertilization ◽

Percentage Decrease ◽

And Control ◽

Estradiol Levels

Objective: The aim of this study was to explore the potential adverse effect of spontaneously decreasing serum estradiol (SE) levels on in vitro fertilization (IVF) outcomes.Methods: This retrospective single-subject study analyzed IVF cycles conducted at a hospital IVF unit between 2010 and 2017. Overall, 2,417 cycles were analyzed. Only cycles with spontaneously decreasing SE before human chorionic gonadotropin (hCG) triggering were included. Each patient served as her own control, and subsequent cycles were analyzed for recurrent SE decreases. The main outcome was the number of oocytes retrieved.Results: Cycle characteristics were similar between the study (SE decrease) and control groups, with the exception of the median SE on the day of hCG triggering (899.7 pg/mL; interquartile range [IQR], 193–2,116 pg/mL vs. 1,566.8 pg/mL; IQR, 249–2,970 pg/mL; p< 0.001). The study group, relative to the control group, had significantly fewer total oocytes (5 [IQR, 2–9] vs. 7 [IQR, 3–11]; p= 0.002) and significantly fewer metaphase II (MII) oocytes (3 [IQR, 1–6] vs. 4 [IQR, 2–8]; p= 0.001) retrieved. The study group had fewer cleavage-stage embryos than the control cycles (3 [IQR, 1–6] vs. 4 [IQR, 2–7]; p= 0.012). Compared to cycles with a ≤ 20% SE decrease, cycles with a > 20% decrease had significantly fewer total and MII oocytes retrieved. SE decrease recurred in 12% of patients.Conclusion: A spontaneous decrease in SE levels adversely affected IVF outcomes, with a linear correlation between the percentage decrease and the number of oocytes retrieved. SE decrease can repeat in later cycles.

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