P–128 Audit of testicular sperm in assisted conception for non-azoospermic infertile couples

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Merrett ◽  
D Schlager ◽  
E Yasmin ◽  
S Seshadri ◽  
P Serhal ◽  
...  
Keyword(s):  
Live Birth ◽  
Conversion Rate ◽  
Birth Rate ◽  
Semen Analysis ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Control Group ◽  
Testicular Sperm ◽  
Number Of Patients ◽  
Average Serum

Abstract Study question What live birth rate do we see when we use testicular sperm in ART for non-azoospermic couples after at least one previous failed cycle? Summary answer In our cohort of couples 24% had a live birth using testicular sperm and therefore was not higher than national average ART rates. What is known already There is increased interest in using testicular sperm in assisted reproduction technology (ART) to improve outcomes after previous failed cycles. Mehta et al. reported results of a 50% live birth rate using testicular sperm in the first cycle for couples with oligospermia and a history of failed cycles with ejaculated sperm. We aim to audit our results in a similar population of couples. Study design, size, duration St Peters Andrology Centre in London, United Kingdom completed 128 surgical testicular sperm retrievals reviewed between the two-year period of 2018–2019. We conducted a retrospective audit of their paper-based records to identify those couples with injectable sperm on their semen analysis and who had previous cycles attempts using ejaculated sperm. Participants/materials, setting, methods We identified 27 couples who underwent testicular sperm extraction despite having an ejaculated semen analysis with injectable sperm and at least one previous failed cycle. A systematic review of their paper and electronic medical record was conducted to assess live birth rates and fertilization rates from ART. Main results and the role of chance Couples had an average male age of 41 (range 31–60) and an average female age of 38 (range 30–45). The men had an average serum testosterone of 15 nmol/L (range 8–35 nmol/L) and an average serum FSH of 8.9 IU/L (range 1.7–30 IU/L). 59% (n = 17) of men had a DNA fragmentation index completed with an average score of 41% (range 31%–51[Y1]%). In the women the mean serum anti-Müllerian hormone (AMH) was 15.8 pmol/l (range 1–64 pmol/l). With ejaculated sperm the fertilization rate was 59% (95% CI [27%, 59%]) and blastocyst conversion rate was 43% (95% CI [50%, 69%]). There was no statistical significance with testicular sperm where the fertilization rate was 58% (95% CI [51%, 65%]) and blastocyst conversion rate was 54% (95% CI [40%, 67%]). Overall, there were 7 clinical pregnancies in this population of couples. Of these clinical pregnancies, 2 miscarried and 5 progressed to a live birth. This audit yielded a live birth rate per cycle of 15% and a live birth rate per couple of 24%. Limitations, reasons for caution Limitations of the study are low number of patients and absence of a control group. Wider implications of the findings: We recommend caution and further analysis going forward using testicular sperm in ART where ejaculated sperm in available. Trial registration number Not applicable

scholarly journals Intracytoplasmic sperm injection with fresh versus cryopreserved testicular sperm in azoospermic patients

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Kani M. Falah
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Obstructive Azoospermia ◽  
Testicular Sperm

Abstract Background The purpose of this study is to compare the outcome of intracytoplasmic sperm injection (ICSI) using fresh sperm versus frozen-thawed sperm in both obstructed and non-obstructed azoospermias. This retrospective study included 159 ICSI cycles from 126 couples. In 91 obstructed azoospermia cases, 66 cycles were treated with fresh testicular sperm and 25 cycles were treated with frozen-thawed testicular samples. In 68 non-obstructed azoospermia cases, 32 cycles were treated with fresh testicular sperm and 36 cycles were treated with frozen-thawed testicular sperm, and the main measure and outcomes calculated are fertilization rate, clinical pregnancy, and live birth rate. Results In case of obstructed azoospermia, there were no statistically significant differences between fresh sperm and frozen-thawed testicular sperm used for ICSI regarding fertilization rate, clinical pregnancy rate, and live birth rate as shown (57%, 47%, 0.093 p value; 23.7%, 17.4%, 0.54 p value; and 11.9%, 8.7%, 0.68 p value, respectively). Non-obstructed azoospermia cases also show no significant differences in fertilization rate (37%, 36%, 0.91 p value), clinical pregnancy rate (20%, 14.3%, 0.58 p value), and live birth rate (4%, 3.6%, 0.93 p value). Conclusion Cryopreservation of testicular sperm is reliable if carried out before ovulation induction especially in cases with non-obstructive azoospermia

scholarly journals Analysis of IVF/ICSI Outcomes in Endometriosis Patients With Recurrent Implantation Failure: Influence on Cumulative Live Birth Rate

2021 ◽  
Vol 12 ◽  
Author(s):  
Chenyi Zhong ◽  
Liusijie Gao ◽  
Li Shu ◽  
Zhen Hou ◽  
Lingbo Cai ◽  
...  
Keyword(s):  
Live Birth ◽  
Early Treatment ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Treated Group ◽  
Fertilization Rate ◽  
Untreated Group ◽  
Cumulative Live Birth Rate ◽  
Treatment Groups ◽  
Cumulative Live Birth

ObjectiveTo study the influence of endometriosis activity on the pregnancy outcomes of patients with recurrent implantation failure (RIF) in in-vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) cycles. The pregnancy outcomes were compared between RIF patients with endometriosis who received treatment at different occasions to explore the appropriate treatment plan for these patients and to optimize the pregnancy-support strategies.DesignAmbispective cohort study.MethodsA total of 330 patients with endometriosis were enrolled from 2008 to 2018 and included 1043 IVF/ICSI cycles. All patients were diagnosed with RIF after IVF/ICSI. Patients were assigned to three subtypes according to different control states of endometriosis, including the untreated, early-treatment, and late-treatment groups. The clinical pregnancy rate, live birth rate, and cumulative live birth rate of endometriosis patients with RIF were the main outcomes; additionally, the fertilization rate, available embryonic rate, and high-quality embryonic rate were also compared.ResultsThe early-treatment and late-treatment groups showed higher cumulative live birth rate than the untreated group (early-treated 43.6% vs. late-treated 46.3% vs. untreated 27.7%, P<0.001), though patients in the two treatment groups had higher rates of adenomyosis and ovarian surgery. The two treatment group showed a better laboratory result than the untreated and especially, the early-treatment group. The untreated group (46.24%) had a lower IVF fertilization rate than the treated group (early-treated [64.40%] and late-treated [60.27%] (P<0.001). In addition, the rates of available embryos and high-quality embryos in the early-treated group were much higher those that in the untreated group (90.30% vs. 85.20%, 76.50% vs. 64.47%). Kaplan–Meier curve showed that patients in the untreated group needed a mean of 23.126 months to achieve one live birth; whereas those in the treated group needed a comparatively shorter duration (early-treated: 18.479 ± 0.882 months and late-treated: 14.183 ± 1.102 months, respectively).ConclusionEndometriosis has a negative influence on IVF/ICSI outcome. The control of endometriosis activity can result in a higher cumulative live birth rate in patients. It is necessary for endometriosis patients to receive medical treatment to achieve a better prognosis especially for those with RIF.

scholarly journals Is It Possible to Expand Oocyte Donors by Decreasing Number of Oocytes for Own Use? Insights From a Large Single-Center Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiqin Bu ◽  
Jiaxin Zhang ◽  
Yile Zhang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Oocyte Donation ◽  
Control Group ◽  
Cumulative Live Birth Rate ◽  
Oocyte Number ◽  
Oocyte Donors ◽  
Supernumerary Embryos ◽  
Ivf Et

BackgroundCurrently, in China, only women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles can donate oocytes to others, but at least 15 oocytes must be kept for their own treatment. Thus, the aim of this study was to determine whether oocyte donation compromises the cumulative live birth rate (CLBR) of donors and whether it is possible to expand oocyte donors’ crowd.MethodsThis was a retrospective cohort study from August 2015 to July 2017 including a total of 2,144 patients, in which 830 IVF–embryo transfer (IVF-ET) patients were eligible for oocyte donation and 1,314 patients met all other oocyte donation criteria but had fewer oocytes retrieved (10–17 oocytes). All 830 patients were advised to donate approximately three to five oocytes to others and were eventually divided into two groups: the oocyte donation group (those who donated) and the control group (those who declined). The basic patient parameters and CLBR, as well as the number of supernumerary embryos after achieving live birth, were compared. These two factors were also compared in all patients (2,144) with oocyte ≥10.ResultsIn 830 IVF-ET patients who were eligible for oocyte donation, only the oocyte number was significantly different between two groups, and the donation group had more than the control group (25.49 ± 5.76 vs. 22.88 ± 5.11, respectively; p = 0.09). No significant differences were found between the two groups in other factors. The results indicate that the live birth rate in the donation group was higher than that in the control group (81.31% vs. 82.95%, p = 0.371), without significance. In addition, CLBR can still reach as high as 73% when the oocyte number for own use was 10. Supernumerary embryos also increased as the oocyte number increased in all patients (oocyte ≥10).ConclusionsCurrently, oocyte donation did not compromise CLBR, and oocyte donation can decrease the waste of embryos. In addition, in patients with 10 oocytes retrieved, the CLBR was still good (73%). Thus, it is possible to expand oocyte donors if the number of oocyte kept for own use was decreased from 15 to 10 after enough communication with patients.

P–225 The effect of rapid and delayed insemination on reproductive outcome in conventional insemination and intracytoplasmic sperm injection invitro-fertilization cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Esiso ◽  
F Lai ◽  
D Cunningham ◽  
D Garcia ◽  
B Barrett ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Detrimental Effect ◽  
Live Birth Rate ◽  
Oocyte Retrieval ◽  
Fertilization Rate ◽  
Time Intervals ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Abstract Study question Does rapid or delayed insemination after egg retrieval affect fertilization, blastocyst development and live birth rates in CI and ICSI cycles? Summary answer When performing CI or ICSI <1.5h and >6.5h after retrieval, detrimental effects are moderate on fertilization but do not impact blastocyst usage and birth rates. What is known already Several studies have shown that CIor ICSI performed between 3 to 5 h after oocyte retrieval has improved laboratory outcomes. However, some studies indicate that insemination of oocytes, by either CI or ICSI, within 2 hours or more than 8 hours after oocyte retrieval has a detrimental effect on the reproductive outcome. With some ART centres experiencing an increase in workload, respecting these exact time intervals is frequently challenging. Study design, size, duration A single-center retrospective cohort analysis was performed on 6559 patients (9575 retrievals and insemination cycles) between January 1st2017 to July 31st2019. The main outcome measures were live-birth rates. Secondary outcomes included analysis of fertilization per all oocytes retrieved, blastocyst utilization, clinical pregnancy, and miscarriage rates. All analyses used time of insemination categorized in both CI and ICSI cycles. Fertilization rates across categories was analyzed by ANOVA and pregnancy outcomes compared using Chi-square tests. Participants/materials, setting, methods As part of laboratory protocol, oocyte retrieval was performed 36 h post-trigger. Cycles involving injection with testicular/epidydimal sperm, donor or frozen oocytes were excluded. The time interval between oocyte retrieval and insemination was analyzed in eight categories: 0 (0- <0.5h), 1 (0.5-<1.5h), 2 (1.5-<2.5h), 3 (2.5-<3.5h), 4 (3.5-<4.5), 5 (4.5-<5.5), 6 (5.5-<6.5) and 7 (6.5-<8h). The number of retrievals in each group (0–7) was 586, 1594, 1644, 1796, 1836, 1351, 641 and 127 respectively. Main results and the role of chance This study had a mean patient age of 36.0 years and mean of 12.2 oocytes per retrieval in each category. There were 4,955 CI and 4,620 ICSI retrievals. The smallest groups were time category 7 and 0 for CI and ICSI respectively. The results showed that the mean fertilization rate per egg retrieved for CI ranged from 54.1 to 64.9% with a significant difference between time category 0 and 5 (p < 0.001) and category 1 and 5 (p < 0.0.001). Mean fertilization rate for ICSI per egg retrieved ranged from 52.8 to 67.3% with no significant difference between time categories compared to category 5. Blastocyst utilization rate for CI and ICSI were not significantly different for all time categories. In the CI and ICSI groups there were 6,540 and 6,178 total fresh and frozen transfers. The miscarriage and clinical pregnancy rate in CI and ICSI were not significantly different across time categories. The overall mean live birth rate for CI was 32.4% (range: 23.1 to 35.5%). Live-birth rates differed significantly (p = 0.04) in CI with time categories 0 and 7 the lowest. In the ICSI group, the overall mean live birth rate was 30.8% (range: 29.1 to 35.7%),with no significant differences between time categories. Limitations, reasons for caution As this is a retrospective study, the influence of uncontrolled variables cannot be excluded. The group spread was uneven with the early and late time categories having the lowest number of representative retrievals and this could have affected the results obtained. Wider implications of the findings: Our results indicate that both CI and ICSI are optimal when performed between 1.5–6.5 hours after oocyte retrieval. Further prospective studies on reproductive outcomes related to time of insemination are warranted. This data indicates a minimal detrimental effect when it is untenable to follow strict insemination time intervals. Trial registration number 2015P000122

scholarly journals Randomized Controlled Study of the Effects of DHEA on the Outcome of IVF in Endometriosis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yanxia Zhang ◽  
Meiqing Li ◽  
Lian Li ◽  
Jianghua Xiao ◽  
Zhe Chen
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Synthesis Process ◽  
Controlled Study ◽  
Control Group

Objective. To investigate the effect of dehydroepiandrosterone (DHEA) on the outcome of in vitro fertilization (IVF) in patients with endometriosis (EMT). Methods. Female patients diagnosed with EMT in our hospital from May 2018 to May 2019 were selected. The patients were divided into the control group (n = 22) and the DHEA group (n = 22) according to the random number table. Patients in the control group received placebo and patients in the DHEA group received DHEA. Patients in both groups received either DHEA (25 mg) or placebo orally 3 times a day for 90 days from the first day of menstruation. Patients were subsequently treated with an IVF cycle. In the control group, 22 patients completed the first cycle and 13 patients completed the second cycle. In the DHEA group, 22 patients completed the first cycle and 11 patients completed the second cycle. Serum sex hormone levels including serum E2 on hCG day, mean progesterone on hCG day, FSH on day 2, AMH on day 2, and gonadotropin dose were determined using a chemiluminescent immunoassay kit. The number of antral follicles of the bilateral ovaries was counted by transvaginal B-ultrasound, and the maximum length and transverse diameter of the ovaries were measured at the same time, to calculate the average diameter of the ovaries, observe the morphology of endometrium, and measure the thickness of the endometrium. The implantation rate, clinical pregnancy rate, persistent pregnancy rate, and live birth rate were compared between the two groups. Results. There were no significant differences in serum E2, progesterone, endometrial thickness, recovered oocytes, mean number of transferred embryos, and mean score of leading embryo transfer between the DHEA group and the women who completed the first and second cycles ( P > 0.05 ). The AMH, antral follicle count, serum E2 on hCG day, the number of recovered oocytes, fertilized oocytes, and the fertilization rate in the DHEA group were higher than those in the control group ( P < 0.05 ). The doses of FSH on day 2, COH on day 3, and gonadotropin were lower than those in the control group ( P < 0.05 ). There was no significant difference in the total number of embryos, the number of high-quality embryos, and the number of transplanted embryos between the two groups ( P > 0.05 ). The implantation rate, clinical pregnancy rate, persistent pregnancy rate, and live birth rate in the DHEA group were higher than those in the control group ( P < 0.05 ). Conclusion. DHEA can significantly increase serum E2 level and improve IVF outcome by regulating the hormone synthesis process, thus improving oocyte and embryo quality.

scholarly journals ICSI Does Not Improve Live Birth Rates but Yields Higher Cancellation Rates Than Conventional IVF in Unexplained Infertility

2021 ◽  
Vol 7 ◽  
Author(s):  
Jianyuan Song ◽  
Tingting Liao ◽  
Kaiyou Fu ◽  
Jian Xu
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Unexplained Infertility ◽  
Clinical Pregnancy ◽  
University Hospital ◽  
Miscarriage Rate ◽  
Birth Rates ◽  
Live Birth Rates

Objectives: Unexplained infertility has been one of the indications for utilization of intracytoplasmic sperm injection (ICSI). However, whether ICSI should be preferred to IVF for patients with unexplained infertility remains an open question. This study aims to determine if ICSI improves the clinical outcomes over conventional in vitro fertilization (IVF) in couples with unexplained infertility.Methods: This was a retrospective cohort study of 549 IVF and 241 ICSI cycles for patients with unexplained infertility at a fertility center of a university hospital from January 2016 and December 2018. The live birth rate and clinical pregnancy rate were compared between the two groups. Other outcome measures included the implantation rate, miscarriage rate, and fertilization rate.Results: The live birth rate was 35.2% (172/488) in the IVF group and 33.3% (65/195) in ICSI group, P = 0.635. The two groups also had similar clinical pregnancy rates, implantation rates, and miscarriage rates. The fertilization rate of IVF group was significantly higher than that of ICSI group (53.8 vs. 45.7%, P = 0.000, respectively). Sixty-one and 46 patients did not transfer fresh embryos in IVF and ICSI cycles, respectively. Patients with IVF cycles had lower cancellation rates than those with ICSI (11.1 vs. 19.1%, P = 0.003, respectively).Conclusion: ICSI does not improve live birth rates but yields higher cancellation rates than conventional IVF in the treatment of unexplained infertility.

scholarly journals Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis,GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study

2020 ◽  
Author(s):  
Linli Hu ◽  
Rui Xie ◽  
Mengying Wang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Matched Control ◽  
Live Birth Rate ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Control Group ◽  
Ovarian Hyperstimulation ◽  
Matched Control Group ◽  
Neonatal Complications

Abstract Background: Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetric and neonatal outcomes of this group of patients are unknown. The aim of this study was to explore the effects of late moderate-to-critical OHSS on obstetric and neonatal outcomes.Methods: This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion criteria, including 7,064 eligible patients diagnosed with clinical pregnancy. Ultimately, 6,356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, matching nine maternal baseline covariates and the number of multiple gestations; 385 patients with late moderate-to-critical OHSS were compared with a matched control group of 1,540 patients. The primary outcomes were the live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications.Results: The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and matched control groups. The incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the number of neonates admitted to the NICU were significantly higher in the OHSS group than in the matched control group.Conclusions: Pregnant women undergoing IVF with fresh ET whose course is complicated by late moderate-to-critical OHSS appear to experience shortened gestation and increased obstetrical and neonatal complications compared with matched controls whose course is not complicated by OHSS. However, the live birth rate, average neonatal weight, and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), and low neonatal birth weight (LBW) did not differ significantly between the two groups.

P–287 Uterine adenomyosis does not affect perinatal outcomes in ART treatments

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Trinchant ◽  
M Cruz ◽  
A Requena
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Ovum Donation ◽  
Uterine Adenomyosis

Abstract Study question Is adenomyosis associated with worse clinical and perinatal outcomes in ovum donation cycles? Summary answer Adenomyosis was associated with reduced live birth rate per embryo transfer but not with increased risk of miscarriage or worse perinatal outcomes than controls. What is known already The effect of adenomyosis on IVF/ICSI outcomes are controversial as studies addressing this issue are limited in number and heterogeneous. Conclusions withdrawn from previous works differ regarding the prospective or retrospective design of the study. Two different metanalysis conducted showed that adenomyosis reduced implantation and clinical pregnancy rate and increased miscarriage risk. However, current data regarding perinatal outcomes of assisted reproduction techniques cycles in patients diagnosed with uterine adenomyosis is scarce. Study design, size, duration A retrospective cohort study in which 3307 patients undergoing ovum donation cycles were included. Patients who underwent single embryo transfer (SET) between years 2018 and 2019 were included and divided into two groups: adenomyosis (n = 179) and controls (n = 3218). Participants/materials, setting, methods Inclusion criteria consisted of patients in an oocyte donation program who had fresh SET on day 5 blastocyst stage development. Patients diagnosed with miomas and/or severe endometriosis and those who had undergone previous uterine surgical interventions were excluded from the study. Cases consisted of patients with a history of either focal or diffuse adenomyosis diagnosed via transvaginal ultrasonography (TVUS). Main results and the role of chance Clinical pregnancy rate per embryo transfer was 82/179 (45.8%) in those women diagnosed with adenomyosis versus 1869/3218 (59.8%) in control group (OR = 0.57 95% CI. 0.41–0.78, p &lt; 0.001). Miscarriage rate was similar in the two study groups and differences found were not statistically significant, being 15/82 (18.3%) for adenomyosis and 309/1869 (16.5%) for control group. A lower live birth rate per embryo transfer was observed in women diagnosed with adenomyosis versus control, being 68/179 (38%) and 1560/3128 (49.9%) respectively (OR = 0.615 95% CI 0.44–0.85, p = 0.002). There were no statistically significant differences between childbirth delivery methods (vaginal versus caesarean section). Furthermore, means of gestational age at the time of delivery, newborn size and weight and incidences of low birth weight, preterm birth and admission in neonate intensive care unit (NICU) did not differ between the two groups. In addition, IVF and perinatal outcomes were similar in patients with diffuse adenomyosis compared to focal adenomyosis. Limitations, reasons for caution This is an observational study and thus possible confounders cannot be completely excluded. Diagnostic of adenomyosis is complex and, despite imaging via TVUS is both sensitive and specific, different criteria may be combined in order to fully assess the diagnostic. Wider implications of the findings: Published literature has described how adenomyosis negatively impacts clinical outcomes in ART cycles; however, data regarding perinatal results is scarce. This study is of interest as it provides a first insight for clinicians showing that adenomyosis affects clinical but not perinatal outcomes in ovum donation cycle. Trial registration number Not applicable

scholarly journals Fertility After Ovarian Cystectomy: How Does Surgery Affect IVF/ICSI Outcomes?

2019 ◽  
Vol 79 (01) ◽  
pp. 72-78
Author(s):  
Ruth Gomez ◽  
Martin Schorsch ◽  
Aslihan Gerhold-Ay ◽  
Annette Hasenburg ◽  
Rudolf Seufert ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Cyst ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Management Control ◽  
Ovarian Cysts ◽  
Control Group ◽  
Success Rates ◽  
Ovarian Cystectomy

Abstract Introduction For patients considering undergoing assisted reproductive techniques (ART), many concerns arise when persistent ovarian cysts are found. This large study aimed to determine how ovarian cyst removal affects success rates of IVF/ICSI therapies. Methods 550 patients who underwent an IVF/ICSI treatment between 2002 and 2011 with a persistent ovarian cyst ≤ 5 cm before treatment were analyzed retrospectively. 328 patientsʼ preference was to undergo a laparoscopic cystectomy and 222 patients opted for a conservative management. Control subjects included 13 552 patients undergoing IVF/ICSI at the same period of time without an ovarian cyst. Results After adjusting for age, patients with ovarian cysts without surgery needed a significant higher stimulation dose than the control group (2576.4 vs. 2207.5 IU, p < 0.001). However, on average, they had 1.13 (− 0.25 – 2.01) higher oocyte number retrieved compared to the operated patients (9.0 ± 5.5 vs. 8.2 ± 5.0) (p = 0.012). Patients after surgical cyst removal had a significant lower number of oocytes retrieved (MNOR) in comparison to the control group (8.2 ± 5.0 vs. 9.5 ± 5.4) (p = 0.00). Compared to controls, operated patients had similar clinical pregnancy rate (CPR) (34.2 vs. 33.5%) OR 1.031 (95% CI 0.817 – 1.302) (p = 0.815). Compared to controls, patients without surgery showed significant lower pregnancy rate (34.2 vs. 25,7%) OR 1.428 (95% CI 1.054 – 1.936) (p = 0.002) and lower live birth rate (LBR) (21.9 vs. 13.5%) OR 1.685 (95% CI 1.143 – 2.485) (p = 0.008). Conclusions Ovarian cystectomy did not negatively impact the pregnancy rate or the live birth rate compared to controls.

scholarly journals Live Birth Rate After Transfer of Fresh or Frozen Poor Quality Day-3 Embryos Only

2019 ◽  
Vol 01 (04) ◽  
pp. 161-168
Author(s):  
Lan N. Vuong ◽  
Toan D. Pham ◽  
Bao G. Huynh ◽  
Quynh N. Nguyen ◽  
Tuong M. Ho ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Current Knowledge ◽  
Live Birth Rate ◽  
Poor Quality ◽  
Successful Outcome ◽  
Control Group ◽  
Vitro Fertilization ◽  
Day 3 Embryos

Background: Embryo quality is an important predictor of successful outcome in in vitro fertilization (IVF). However, current knowledge on the live birth rate after transfer of poor quality embryos is limited. This study investigated the live birth rate after transfer of only poor quality day-3 embryos in women undergoing IVF. Methods: This retrospective study included 153 couples who underwent IVF at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam between June 2014 and January 2017 and had only poor quality day-3 embryos available for fresh (n [Formula: see text] 102) or frozen (n [Formula: see text] 51) transfer. The control group included patients who had transfer of one good embryo (n [Formula: see text] 64). Embryos were rated using the Istanbul criteria. Results: In the poor quality embryo group, the mean number of oocytes retrieved and number of embryos were 7.5 ± 4.4 and 1.8 ± 0.9, respectively. Mean number of embryos transferred was 1.6 ± 0.5 in the fresh transfer group and 2.0 ± 0.2 in the freeze-only group. Live births did occur after transfer of poor quality embryos, but the implantation, clinical pregnancy and live birth rates were significantly lower than after fresh or frozen transfer of a single good quality embryo (9.5 vs. 26.6%, p < 0.001; 13.7 vs. 26.6%, p < 0.001; and 7.2 vs. 18.8%, p [Formula: see text] 0.02, respectively). Conclusions: Live birth was achieved after transfer of only poor quality embryos in women undergoing IVF. This suggests that transfer of poor quality embryos could be an option when higher grade embryos are not available, after the chances of live birth have been discussed with the patient.

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