P–136 Factors predicting clinical outcomes of 511 recipients of vitrified oocyte donation from an UK-regulated egg bank

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Pataia ◽  
S Nair ◽  
M Wolska ◽  
E Linara-Demakakou ◽  
T Shah ◽  
...  
Keyword(s):  
Live Birth ◽  
Oocyte Donation ◽  
Reproductive History ◽  
Clinical Pregnancy ◽  
Stepwise Logistic Regression ◽  
Clinical Markers ◽  
Donor Age ◽  
Related Factors ◽  
Oocyte Donors ◽  
The Impact

Abstract Study question Do established donor and recipient clinical markers predict recipient clinical pregnancy and live birth rates (LBRs) in a vitrified oocyte donation programme? Summary answer Recipient BMI and previous miscarriages predicted cumulative LBR. Likelihood of clinical pregnancy and LBR was higher in recipients of donors aged 23–29 than donors 18–22. What is known already The influence of age on ovarian reserve underlies the upper limit of 35 years for UK donors. However, recent evidence suggests that oocyte aneuploidy rates follow an inverse U-shaped curve in relation to a woman’s age. Conflicting evidence exists regarding the impact of other donor-related factors including BMI, AMH, oocyte yield and prior reproductive history on recipient outcomes. Moreover, the effect of recipient age, BMI, and reproductive history on oocyte donation outcome remains unclear. Study design, size, duration Retrospective cohort study of 325 altruistic oocyte donors matched to a total of 511 recipients. Only first donations taking place between January 2017 and December 2019 were included. Participants/materials, setting, methods All oocyte donors were altruistic volunteers aged 18–35 with no prior infertility diagnosis. Donor and recipient screening for suitability and safety was carried out according to the Human Fertilisation Embryology Authority guidelines. Backward stepwise logistic regression was used to identify donor, recipient and embryology parameters predictive of recipient primary outcomes defined as clinical pregnancy and live birth, either cumulative or after the first embryo transfer (ET). Main results and the role of chance A total of 705 fresh and frozen/thawed ETs were performed, of which 76% were elective single embryo transfers (eSETs) of blastocysts (96.5%), resulting in a cumulative clinical pregnancy and LBR of 83.5% and 70.5% respectively after 3 ETs. Recipient BMI and previous miscarriages were predictors of cumulative LBR (p < 0.05). The ratio of transferrable embryos per oocytes received/fertilised and the number of ETs needed to achieve the intended primary outcome were predictors of cumulative clinical pregnancy and LBR (p < 0.05). Donor age 18–22 was associated with lower incidence of recipient clinical pregnancy and live birth after the first ET, as compared to donor age 23–29 (p < 0.05). Limitations, reasons for caution The present study included only healthy oocyte donors, thus conclusions may not apply to subfertile or less healthy women. Male factors were not accounted for. Wider implications of the findings: We demonstrate the efficacy of vitrified oocyte donation treatment and identify recipient BMI, previous miscarriages and embryology parameters as predictors of cumulative LBR. Additionally, the choice of donors aged 18–22 instead of older donors is found not to be advantageous for increasing the chance of clinical pregnancy and live birth. Trial registration number Not applicable

P–708 Comparison of reproductive outcomes after progestin-primed ovarian stimulation with dydrogesterone versus cetrorelix to inhibit spontaneous ovulation in oocyte donation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J A Moreno ◽  
P Masoli ◽  
C Sferrazza ◽  
H Leiva ◽  
O Espinosa ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Stimulation ◽  
Fertilization Rate ◽  
Oocyte Donation ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Reproductive Outcomes ◽  
Ongoing Pregnancy ◽  
Live Births

Abstract Study question Is dydrogesterone (DYG) equivalent compared to cetrorelix with respect to clinical pregnancy rate, ongoing pregnancy rate and live birth rate in oocyte donation (OD) cycles? Summary answer DYG is comparable to cetrorelix in terms of clinical pregnancy, but higher rates of ongoing pregnancy and live birth were observed in the DYG group What is known already Progestin-primed ovarian stimulation (PPOS) is an ovarian stimulation regimen based on a freeze-all strategy using progestin as an alternative to GnRH analog for suppressing a premature LH surge. DYG is an oral progestin that has been studied in PPOS protocols. Published reports indicate that length of ovarian stimulation, dose of gonadotrophin needed and number of MII retrieved from PPOS cycles are comparable to short protocol of GnRH agonists during OD cycles. However, while some studies noted no differences in terms of live births, worse pregnancy rates have been reported in recipients of oocytes from PPOS cycles compared to GnRH antagonists. Study design, size, duration Prospective controlled study to assess the reproductive outcomes of OD recipients in which the donors were subjected to the DYG protocol (20mg/day) compared with those subjected to the short protocol with cetrorelix (0.25 mg/day) from Day 7 or since a leading follicle reached 14 mm. The OD cycles were triggered with triptoreline acetate and the trigger criterion was ≥3 follicles of diameter >18mm. Participants/materials, setting, methods 202 oocyte donors were included, 92 under DYG and 110 under cetrorelix. The study was performed in a private infertility center between January 2017 and December 2020. The main outcome included the rates of clinical pregnancy, ongoing pregnancy and live births. Secondary outcomes included the number of oocytes retrieved, number of MII, fertilization rate, length of stimulation and total gonadotropin dose. Differences were tested using a Student’s t-test or a Chi2 test, as appropriate. Main results and the role of chance Compared to antagonist cycles, cycles under DYG had fewer days of stimulation (9.9 ± 0.9 vs. 10.8 ± 1.1, p<.001) and a lower total gonadotropin dose (1654 ± 402.4 IU vs. 1844 ± 422 IU, p<.001). The number of MII retrieved was no different: 16.9 (SD 6.2) with DYG and 15.4 (SD 5.8) with cetrorelix (p = 0.072). Recipients and embryo transfer (ET) characteristics were also similar between groups. The mean number of MII assigned to each recipients was 6.7 (SD 1.8) in DYG and 6.6 (SD 1.7) in cetrorelix (P = 0.446). The fertilization rate was 66.2% in DYG versus 67.6% in cetrorelix (P = 0.68). Regarding the reproductive outcomes, the overall clinical pregnancy rate in DYG group (65/87: 74.7%) and cetrorelix group (66/104: 63.4%) (p = 0.118) was similar. Meanwhile, the DYG group compared to cetrorelix group had higher rates of ongoing pregnancy (63.2% vs 45.1%; p = 0.014) and live births (54,9% vs 37.8%; p = 0.040). Limitations, reasons for caution These results should be evaluated with caution. The limitations of this study include the limited number of participants enrolled and the limited data on pregnancy outcomes. A randomized controlled trial is necessary to provide more evidence on the efficacy of the DYG protocol. Wider implications of the findings: The efficacy of PPOS protocol compared to GnRH-antagonist protocol in terms of reproductive outcomes has been little studied. PPOS using DYG yields comparable clinical pregnancy rates compared to cetrorelix in OD cycles. The differences found regarding the rates of ongoing pregnancy and live births should be further investigated. Trial registration number Not applicable

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–318 Short (seven days) versus conventional (fourteen days) estrogen priming in an artificial frozen embryo transfer cycle: a randomised controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Racca ◽  
S Santos-Ribeiro ◽  
D Panagiotis ◽  
L Boudry ◽  
S Mackens ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Transvaginal Ultrasound ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Study question What is the impact of seven days versus fourteen days’ estrogen (E2) priming on the clinical outcome of frozen-embryo-transfer in artificially prepared endometrium (FET-HRT) cycles? Summary answer No significant difference in clinical/ongoing pregnancy rate was observed when comparing 7 versus 14 days of estrogen priming before starting progesterone (P) supplementation. What is known already One (effective) method for endometrial preparation prior to frozen embryo transfer is hormone replacement therapy (HRT), a sequential regimen with E2 and P, which aims to mimic the endocrine exposure of the endometrium in a physiological cycle. The average duration of E2 supplementation is generally 12–14 days, however, this protocol has been arbitrarily chosen whereas, the optimal duration of E2 implementation remains unknown. Study design, size, duration This is a single-center, randomized, controlled, open-label pilot study. All FET-HRT cycles were performed in a tertiary centre between October 2018 and December 2020. Overall, 150 patients were randomized of whom 132 were included in the analysis after screening failure and drop-out. Participants/materials, setting, methods The included patients were randomized into one of 2 groups; group A (7 days of E2 prior to P supplementation) and group B (14 days of E2 prior to P supplementation). Both groups received blastocyst stage embryos for transfer on the 6th day of vaginal P administration. Pregnancy was assessed by an hCG blood test 12 days after FET and clinical pregnancy was confirmed by transvaginal ultrasound at 7 weeks of gestation. Main results and the role of chance Following the exclusion of drop-outs and screening failures, 132 patients were finally included both in group A (69 patients) or group B (63 patients). Demographic characteristics for both groups were comparable. The positive pregnancy rate was 46.4% and 53.9%, (p 0.462) for group A and group B, respectively. With regard to the clinical pregnancy rate at 7 weeks, no statistically significant difference was observed (36.2% vs 36.5% for group A and group B, respectively, p = 0.499). The secondary outcomes of the study (biochemical pregnancy, miscarriage and live birth rate) were also comparable between the two arms for both PP and ITT analysis. Multivariable logistic regression showed that the HRT scheme is not associated with pregnancy rate, however, the P value on the day of ET is significantly associated with the pregnancy outcome. Limitations, reasons for caution This study was designed as a proof of principle trial with a limited study population and therefore underpowered to determine the superiority of one intervention over another. Instead, the purpose of the present study was to explore trends in outcome differences and to allow us to safely design larger RCTs. Wider implications of the findings: The results of this study give the confidence to perform larger-scale RCTs to confirm whether a FET-HRT can be performed safely in a shorter time frame, thus, reducing the TTP, while maintaining comparable pregnancy and live birth rates. Trial registration number NCT03930706

A Retrospective Study of Recipient-related Predictors of Success in an Oocyte Donation Program

2017 ◽  
Vol 8 (2) ◽  
pp. 75-82
Author(s):  
Sathya Balasubramanyam ◽  
Ritu Punhani ◽  
Kundavi Shankar ◽  
Thankam R Varma
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Endometrial Thickness ◽  
Roc Curves ◽  
Oocyte Donation ◽  
Clinical Pregnancy ◽  
Predictors Of Success ◽  
Ongoing Pregnancy ◽  
Chi Square Analysis

ABSTRACT Introduction Prior to the era of in vitro fertilization, no options for conception were available to women with primary ovarian insufficiency, decreased ovarian reserve, or genetically transmittable diseases. Oocyte donation (OD) has been used in such women for almost 30 years. It also offers an opportunity to study the participation of the uterus in the process of human embryo implantation. Aim To identify recipient variables that may have a significant impact on the pregnancy outcome of an OD program. Materials and methods The present study was conducted at Madras Medical Mission Hospital, Chennai, India. We retrospectively evaluated 192 patients and 283 embryo transfer cycles as a result of OD over a period of 5 years. Rates of implantation, clinical pregnancy, ongoing pregnancy, miscarriage, and live birth were calculated for different age groups, endometrial thickness (ET), indications of OD, fresh and frozen embryo transfers (FET), type of subfertility, past history of endometriosis, and body mass index (BMI) of the recipients. Data evaluation was mainly done by Chi-square analysis, and receiver operating characteristic (ROC) curves were made for age and ET. Results The results of this study showed a clinical pregnancy rate (CPR) of 37.1%, implantation rate (IR) of 19.3%, miscarriage rate of 20.4%, ongoing pregnancy rate (OPR) of 32.2%, and live birth rate (LBR) of 26.6%. Significant association was seen between age of recipient and OPR (p = 0.014), and also between fresh embryo transfers, CPR, OPR, and LBR (p < 0.05). The ROC curves showed a significant association of LBR with age of recipient. Conclusion Although no single or combined recipient variable(s) could be identified as predictor(s) of pregnancy, significant association was found between OPR, LBR, and recipient's age and also between fresh embryo transfers with CPR, OPR, and LBR. How to cite this article Punhani R, Balasubramanyam S, Shankar K, Varma TR. A Retrospective Study of Recipient-related Predictors of Success in an Oocyte Donation Program. Int J Infertil Fetal Med 2017;8(2):75-82.

scholarly journals Endometriosis and ART outcome: a retrospective analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 536
Author(s):  
Janani S. ◽  
Kundavi Shankar ◽  
Geetha V. ◽  
Abdul Basith
Keyword(s):  
Retrospective Analysis ◽  
Live Birth ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Fertility Treatment ◽  
Male Factor ◽  
Cumulative Live Birth Rate ◽  
The Impact

Background: Endometriosis affects up to 30-40% of women seeking fertility treatment and is known to reduce fecundity. There remains a debate on the effect of endometriosis on the IVF outcome, with live birth not reported in most studies. This study looks at the impact of endometriosis on live birth rates after IVF and compares the chances of success with those without endometriosis.Methods: Retrospective analysis of women who underwent IVF at our institution for 2 years were included. Multiple factor infertility, ovulation disorders and donor program were excluded. The outcomes were compared for 4 cohorts - women with endometriosis, male factor infertility, tubal factor infertility and unexplained infertility. The primary outcome was live birth rate. Other outcome measures were total dose of gonadotropins used, mean number of oocytes collected, M2 oocyte rate, fertilization rate, implantation rate, and clinical pregnancy rate.Results: Patients diagnosed with endometriosis had lower mean number of oocytes collected (6.86 vs 7.69, 7.94, 7.45) and lower mean number of M2 oocytes (5.31 vs 6.21, 6.44, 5.91) but was not statistically significant. Endometriosis patients required significantly higher dose of gonadotropins when compared to controls (5365.79 IU;  p-0.001). The per ET implantation rate (10.4% vs 17.8%, 22.5%, 19.2%), clinical pregnancy rate (8% vs 15%, 20%, 17%), live birth rate (7.92% vs 16.6%, 15.14%, 12%) and the cumulative live birth rate (27.9% vs 46.5%, 60%, 46.7%) were significantly less in women with endometriosis (p-0.039, p-0.021, p-0.001, p-0.039 respectively) and the effect is more pronounced with increasing disease severity.Conclusions: Endometriosis affects all aspects of IVF outcomes including folliculogenesis, embryo development and implantation. Though ovarian factor can be overruled by increasing the stimulation doses as in our study, methods to improve the implantation rates should be thought about in future. 

scholarly journals Does hysteroscopic resection of uterine septum improve reproductive outcomes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Monica Krishnan ◽  
Brenda F. Narice ◽  
Bolarinde Ola ◽  
Mostafa Metwally
Keyword(s):  
Live Birth ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Treated Group ◽  
Clinical Pregnancy ◽  
Controlled Trials ◽  
Reproductive Outcomes ◽  
Uterine Septum ◽  
The Impact ◽  
Hysteroscopic Resection

Abstract Purpose Uterine septum in women with subfertility or previous poor reproductive outcomes presents a clinical dilemma. Hysteroscopic septum resection has been previously associated with adverse reproductive outcomes but the evidence remains inconclusive. We aimed to thoroughly and systematically appraise relevant evidence on the impact of hysteroscopically resecting the uterine septum on this cohort of women. Methods AMED, BNI, CINAHL, EMBASE, EMCARE, Medline, PsychInfo, PubMed, Cochrane register of controlled trials, Cochrane database of systematic reviews and CINAHL were assessed to April 2020, with no language restriction. Only randomised control trials and comparative studies which evaluated outcomes in women with uterine septum and a history of subfertility and/or poor reproductive outcomes treated by hysteroscopic septum resection against control were included. The primary endpoint was live birth rate, whereas clinical pregnancy, miscarriage, preterm birth and malpresentation rates were secondary outcomes. Results Seven studies involving 407 women with hysteroscopic septum resection and 252 with conservative management were included in the meta-analysis. Hysteroscopic septum resection was associated with a lower rate of miscarriage (OR 0.25, 95% CI 0.07–0.88) compared with untreated women. No significant effect was seen on live birth, clinical pregnancy rate or preterm delivery. However, there were fewer malpresentations during labour in the treated group (OR 0.22, 95% CI 0.06–0.73). Conclusion Our review found no significant effect of hysteroscopic resection on live birth. However, given the limited evidence available, high-quality randomised controlled trials are recommended before any conclusive clinical guidance can be drawn.

scholarly journals The Impact of Down-Regulation on Obstetrics and Perinatal Outcomes in Singleton Pregnancies After In Vitro Fertilization

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Jin ◽  
Jihui Ai ◽  
Yu Zheng ◽  
Biao Chen ◽  
Lan Wang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Live Birth ◽  
Lower Risk ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Down Regulation ◽  
The Impact

Backgrounddown-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.Methodsthis is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: &lt;30, 30-55, &gt;55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.Resultsthe patients with E2D &lt;30, 30-55, &gt;55 pg/ml had similar live-birth rates. The patients with E2D &lt;30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D &lt;30 pg/ml had a lower risk of PICU admission than those in the group with E2D &gt;55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).ConclusionDown-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D &lt;30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.

A Study On Impact Of Work Life Related Factors On Employee Engagement In Health Care Sector Workers In Dindigul District.

2019 ◽  
Vol 118 (7) ◽  
pp. 20-26
Author(s):  
S. JAYARAMAN ◽  
R. Sindhya ◽  
P. Vijiyalakshmi
Keyword(s):  
Health Care ◽  
Path Analysis ◽  
Employee Engagement ◽  
Health Care Workers ◽  
Health Care Sector ◽  
Work Life ◽  
Primary Data ◽  
Related Factors ◽  
Care Workers ◽  
The Impact

this research aims to find out the intensity of Employee Engagement of the health care sector workers and the relationship between the Work life factors and Employee Engagement of Health care sector workers in Dindigul District. Primary data were used in this research, were collected from 298 Health care workers from Dindigul District. Questionnaire was the major tool used to gather the primary data from the selected sample respondents. For this purpose, a well structured questionnaire was constructed with the help of professionals and the practiced employees of various health care units in Dindigul District. The health care employees were chosen by simple random sampling method. The investigative measures of regression Path analysis, and simple percentage analysis were utilized to find the impact of work life related factors with the Employee Engagement. The maximum Health care workers were generally satisfied with their jobs. The analytical procedure of path analysis multiple regressions was utilized to determine the predicting strength among Work life factors and the employee engagement. This study provides an another view about the importance of Work life factors and Employee engagement for organizational effectiveness and performance .

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