P–329 Müllerian anomalies and embryo implantation in oocyte donation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Muño. Muñoz ◽  
I Fernandez ◽  
M Cerrillo ◽  
J Aguilar ◽  
A Pellicer ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Oocyte Donation ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Septate Uterus ◽  
Unicornuate Uterus ◽  
Biochemical Pregnancy ◽  
Embryo Implantation Rate

Abstract Study question Do patients with Mullerian anomalies (MA) who receive donated oocytes have different embryo implantation rate than patients with normal uterus? Summary answer In oocyte donation, patients with MA had lower implantation rate than patients with normal uterus. What is known already MA are associated with infertility and miscarriage but the mechanisms to explain this relation are not known. Some studies describe both oocyte and/or uterine factor. All studies describing the outcome in patients with MA, so far, are with own oocytes but none in oocyte donation. Study design, size, duration A multicentre restrospective cohort study from January 2000 to December 2019. Patients receiving donated oocytes were divided between those with MA (n = 473) according ESHRE classification and other group with normal uterus (n = 57 869). The primary outcome was implantation rate at fresh embryo transfer. Secondary aims were biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate and live pregnancy rate. Participants/materials, setting, methods We considered the first oocyte donation cycle, without severe male factor, myomas, hydrosalpinx, Asherman syndrome, polyps or indication for preimplantational genetic diagnosis divided in two groups; patients with MA and no malformed uterus. MA group includes cycles of complete bicorporeal uterus (162), partial bicorporeal (30), bicorporeal septate (15), T shaped uterus (26), infantilis uterus (8), complete septate uterus (110), partial septate uterus (94) and hemi-uterus without rudimentary cavity (29). Main results and the role of chance We registered 58 342 patients from our oocyte donation program. Results are shown as mean and 95%CI and differences in pregnancy rates were expressed as relative risks (RR) with 95% CI being reference patients with normal uterus. In patients with MA, the implantation rate was different according the categories being significantly lower in patients with unicornuate uterus (0.29 95%CI: 0.14–0.43. p = 0.03). Biochemical pregnancy rate was significantly higher in patients with septate uterus (RR 1.51 (95%CI 1.02–2.22, p = 0.03) and significantly lower in unicornuate uterus (RR 0.49 (95%CI 0.27–0.90). No differences were found in clinical pregnancy rate among groups, but ongoing pregnancy rate and live birth rate were lower in unicornuate uterus ( RR 0.28 (95%CI 0.13–0.63, p = 0.002), (RR 0.32 (95%CI 0.14–0.73, p = 0.007) respectively. Miscarriage rate was significantly higher in patients with septate uterus (RR 1.78 (95%CI 1.18–2.68, p = 0.006) Limitations, reasons for caution As this was a retrospective cohort study, we were unable to study differences due to modifications in medical or laboratory protocols during this long period time. Different size of sample in some groups of MA makes impossible to translate conclusions to general population. Wider implications of the findings: Our results indicate that there might be a defect in the embryo implantation rate in patients with MA depending on uterine factor. Different sample size among groups and some groups with scarce number of cases make less precise results. More studies controlling biases are needed to confirm our results. Trial registration number NCT04571671

P–315 Ultrasound diagnosis of adenomyosis: impact on pregnancy rate in ivf cycles with donated oocytes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Exacoustos ◽  
L Loiudice ◽  
M Cosentino ◽  
D Galliano ◽  
F G Martire ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
First Trimester ◽  
Oocyte Donation ◽  
Control Group ◽  
Miscarriage Rate ◽  
Increased Risk ◽  
The Impact ◽  
Embryo Implantation Rate

Abstract Study question The aim was to evaluate in patients who underwent embryo transfer (ET) in an oocyte donation cycle, the impact of adenomyosis, diagnosed by transvaginal sonographic (TVS), on the implantation rate. Summary answer We observed a slightly higher miscarriage rate in the first trimester in patients with adenomyosis in particular in the diffuse type. What is known already What we know from literature is that there are pro studies such as Costello and Vercellini’s which show a reduced pregnancy rate and birth rate, and cons studies which find no effects at all of adenomyosis on IVF treatments. However, both show an increased risk of miscarriage and obstetric complications Study design, size, duration This prospective observational study involved a total of 72 patients: 33 with adenomyosis and 39 without adenomyosis from June 2019 to December 2020. All had a workup which included history, pelvic exam and 2/3D TVS scan which was saved as images, videoclips and volumes and stored. The off line evaluation was performed blind to IVF indication and outcomes by expert sonographer, who assessed the presence or absence of TVS signs of adenomyosis. Participants/materials, setting, methods All the patients aged ≤ 45 years old undergoing, for several personal problems, their first oocyte donation at IVI center Rome.Patients were divided into 2 groups according to findings on a baseline pre-treatment TVS: patients with and without adenomyosis. In the patients with adenomyosis, the disease was further classified according to type (diffuse,focal), localization (inner and outer myometrium) and extension inside the uterus (mild, moderate, severe) and correlated to pregnancy rate and outcome Main results and the role of chance A total of 72 patients were included in this study: 33 with adenomyosis and 39 without adenomyosis. The presence, type and degree of adenomyosis doesn’t show a correlation to embryo implantation rate (64.1% in the control group vs 63.6% in adenomyosis group). However we found an increased risk of early miscarriage in the patients with adenomyosis ( 12% in the control group vs 23.8% in adenomyosis group). Women with adenomyosis that infiltrated only the external myometrium showed a lower pregnancy rate (40%) compared to those who had the involvement of only the inner myometrium (77,7%). The presence of ultrasound findings of focal disease was associated with a lower pregnancy rate (53,3%) compared to the diffuse disease (72,2%); We observed a slightly higher miscarriage rate in the first trimester in patients with adenomyosis in particular in the diffuse type .The presence, type and degree of adenomyosis doesn’t show a correlation to embryo implantation rate. Limitations, reasons for caution Most of the patients included in our study has an age > 40. This could determine an increased number of high-risk pregnancies. Wider implications of the findings: Results of this study may be used to evaluate the impact of different medical or surgical treatment in women with adenomyosis undergoing IVF. Trial registration number Not applicable

scholarly journals Clinical outcomes for Day 3 double cleavage-stage embryo transfers versus Day 5 or 6 single blastocyst transfer in frozen–thawed cycles: a retrospective comparative analysis

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110624
Author(s):  
Jinpeng Rao ◽  
Feng Qiu ◽  
Shen Tian ◽  
Ya Yu ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Implantation Rate ◽  
Cleavage Stage ◽  
Ongoing Pregnancy Rate ◽  
Group Transfer ◽  
Biochemical Pregnancy ◽  
Single Blastocyst Transfer ◽  
Cleavage Stage Embryo ◽  
Stage Embryo

Objective This study aimed to compare the clinical outcomes for transfer of Day 3 (D3) double cleavage-stage embryos and Day 5/6 (D5/6) single blastocysts in the frozen embryo transfer (FET) cycle to formulate a more appropriate embryo transplantation strategy. Methods We retrospectively analyzed 609 FET cycles from 518 women from April 2017 to March 2021. All FETs were assigned to the D3-DET group (transfer of a Day 3 double cleavage-stage embryo), D5-SBT group (transfer of a Day 5 single blastocyst), or D6-SBT group (transfer of a Day 6 single blastocyst). Clinical outcomes were comparatively analyzed. Results There were no significant differences in the biochemical pregnancy rate, clinical pregnancy rate, or ongoing pregnancy rate between the D3-DET and D5-SBT groups, but these rates in the two groups were all significantly higher compared with those in the D6-SBT group. The implantation rate in the D5-SBT group was significantly higher than that in the D3-DET group. The twin pregnancy rate in the D5-SBT and D6-SBT groups was significantly lower than that in the D3-DET group. Conclusion This study suggests that D5-SBT is the preferred option for transplantation. D6-SBT reduces the pregnancy rate, making it a more cautious choice for transfer of such embryos.

P–612 Transdermal testosterone vs. Placebo (lubricant gel) pre-treatment in improving IVF outcomes in diminished ovarian reserve patients (POSEIDON group 3 and 4): a randomised controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
K D Nayar ◽  
S Gupta ◽  
R Bhattacharya ◽  
P Mehra ◽  
J Mishra ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Controlled Trial ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Testosterone Gel ◽  
Group 3 ◽  
Pre Treatment

Abstract Study question To compare the efficacy of transdermal testosterone with placebo (lubricant gel) in improving IVF outcomes using GnRH antagonist protocol in POSEIDON group 3 and 4 patients. Summary answer Patients receiving pre-treatment with testosterone gel had higher mean number of oocytes retrieved and grade A embryos as compared to the patients receiving lubricant gel. What is known already Diminished ovarian reserve (DOR) is associated with suboptimal ovarian response, higher cycle cancellation rate and lower clinical pregnancy rate following IVF cycles. Various treatment regimens have been devised for management of such patients and use of adjuvants in the form of oral or transdermal androgen is one of them. Androgens improves follicular response to gonadotropin stimulation as well as increase FSH receptor expression in granulosa cells, in turn leading to better oocyte yield and pregnancy rate. Aim was to compare the effect of transdermal testosterone gel with placebo gel on ART outcome in DOR patients (POSEIDON Group 3 and 4). Study design, size, duration A prospective, randomised controlled trial was carried out from 1st September 2019 to 31st October 2020 at a tertiary infertility centre in India. 50 patients fulfilling the criteria of Group 3 and Group 4 of POSEIDON classification were included in the study. Patients with endocrine disorders (thyroid, prolactin), endometrioma, history of surgery on the ovaries, sensitivity to testosterone gel, male factor infertility and deranged liver and renal function tests were excluded. Participants/materials, setting, methods Enrolled patients were randomised into two groups of 25 patients each, one group was pretreated (TTG group) with transdermal testosterone gel, 12.5 mg/day from day 6th of previous cycle to day 2nd of stimulation cycle while patients in other group took lubricant gel for the same duration before stimulation with GnRH antagonist fixed protocol followed by fresh Day 3 transfer. Main results and the role of chance The baseline characteristics of the two groups were comparable. The primary outcome measures were the number of oocytes retrieved and number of grade A embryos formed (according to Istanbul consensus). The secondary outcome measures were implantation rate, clinical pregnancy rate, miscarriage rate and ongoing pregnancy rate. The mean number of oocytes retrieved in TTG group was 5±1.02 which was significantly higher than placebo group–3.5±1.2, (p < 0.001). The mean number of Grade A embryos were also significantly higher (4.78±0.54 vs 3.00±0.23, p < 0.001) in TTG group. The TTG group had higher implantation rate (28% vs 20%, p = 0.49), clinical pregnancy rate (32% vs 18%, p = 0.41), ongoing pregnancy rate (32% vs 16%, p = 0.38) and lower miscarriage rate (0% vs 20%, p = 0.38), however, these differences were not statistically significant. Limitations, reasons for caution The study was done at a single centre with small sample size, replication with more subjects and in different centers is needed. Wider implications of the findings: Pre-treatment with testosterone gel in DOR patients improves ovarian response to stimulation and results in higher number of oocytes retrieved and good quality embryos resulting in improved clinical pregnancy rates. Transdermal testosterone is advantageous because of better bioavailability, easy application, patient friendly and less adverse effects. Trial registration number MCDH/2019/54

Implantation: Oocyte donation in humans: a model to study the effect of age on embryo implantation rate

1994 ◽  
Vol 9 (11) ◽  
pp. 2160-2163 ◽  
Author(s):  
Jose P. Balmaceda ◽  
Luca Bernardini ◽  
Italo Ciuffardi ◽  
Carlos Felix ◽  
Teri Ord ◽  
...  
Keyword(s):  
Embryo Implantation ◽  
Implantation Rate ◽  
Oocyte Donation ◽  
Effect Of Age ◽  
Embryo Implantation Rate

P–778 Repeated cryopreservation process impairs embryo implantation potential but does not affect neonatal outcomes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Wang ◽  
L Zhu ◽  
L Jin
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Embryo Cryopreservation ◽  
Miscarriage Rate ◽  
Neonatal Complication ◽  
Embryo Implantation Rate

Abstract Study question Does repeated cryopreservation process effect embryo implantation potential and neonatal outcomes of human embryos? Summary answer Repeated cryopreservation impaired embryo implantation potential, resulting in a lower live birth rate and higher miscarriage rate, despite a comparable neonatal complication rate. What is known already With significant advances in the field of ART, the number of available embryos for transfer per cycle has also increased, resulting in a slew of surplus embryo cryopreservation. However, limited researches have focused on the embryonic development potential, clinical outcomes, pregnancy complications as well as the neonatal complications of embryos experiencing repeated cryopreservation. Study design, size, duration This was a retrospective, single-center cohort study. All ART cycles from January 2014 to December 2018. Age, body mass index, and number of oocytes retrieved were preferentially matched within a required range, with a total of 709 couples included in the study. Participants/materials, setting, methods The study was conducted in the Reproductive Medicine Centre affiliated to a university. Preferentially matched participants were divided into three groups according to the times of embryo cryopreservation: the fresh group (n = 249), the cryopreservation group (n = 244) and the re-cryopreservation group (n = 216). Embryo implantation rate, live birth rate, miscarriage rate, and neonatal complication rate were compared among these three groups. Main results and the role of chance The embryo implantation rate, clinical pregnancy rate and live birth rate in the re-cryopreservation group were significantly lower, and there was also a slight increase in the miscarriage rate. Logistic regression analysis indicated that embryos with repeated cryopreservation and lower TE scores were at higher risk of embryo implantation failure in single embryo transfer cycles (OR = 1.79 and 1.56 respectively). No significant differences were observed in gender, gestational age, birthweight, neonatal abnormality, and neonatal complications among the groups. Limitations, reasons for caution This was a retrospective cohort study conducted in single center. A multi-center prospective study with a larger sample size in well-matched participants is needed to reinforce our findings. Wider implications of the findings: Our findings demonstrated the adverse effect of repeated cryopreservation on embryo implantation potential. To avoid embryo waste, or in some special circumstances such as re-biopsy in PGT cycles, an additional cryopreservation on embryos was considered to be available to achieve clinical pregnancy and live birth. Trial registration number Not applicable

scholarly journals Donation of oocytes as treatment for infertility in patients with premature ovarian failure: awarded the "Nicolau de Moraes Barros" prize for gynecology

1994 ◽  
Vol 112 (1) ◽  
pp. 510-516 ◽  
Author(s):  
José Gonçalves Franco Júnior ◽  
Ricardo Luiz Razera Baruffi ◽  
Ana Lúcia Mauri ◽  
Cláudia Guilhermino Pertersen ◽  
Márcia Siste Campos ◽  
...  
Keyword(s):  
Premature Ovarian Failure ◽  
Clomiphene Citrate ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Oocyte Donation ◽  
Ovarian Failure ◽  
Cleavage Rate ◽  
Brazilian Literature ◽  
Human Menopausal Gonadotrophin ◽  
Embryo Implantation Rate

A total of 7 cycles of embryo transfer by oocyte donation were performed on 5 patients with premature ovary failure (POF). All donors were under 35 of age and the recipients average age was 38.6 years. For synchronization between donor and recipient a semi programmed menstrual cycle was used by means of oral contraceptive followed by ovarian stimulation of donor with clomiphene citrate and human menopausal gonadotrophin. The recipients were easily adjusted to the donors by a flexible model of gradually increasing doses of estradiol valerianate. The average number of oocytes donated was 3.14 and average embryo cleavage rate was 80.2%. The average number of embryos transferred was 2.57. Embryo implantation rate was 22.2%. Clinical gestations occurred in 57.1% of the cycles. This series is probably the first one in Brazilian literature on oocyte donation as treatment for infertility in patients with premature ovarian failure.

scholarly journals Efficacy of dual progesterone administration (intramuscular and vaginal) for luteal support in fresh day 3 or day 4 embryo transfer cycles

2020 ◽  
Vol 47 (3) ◽  
pp. 227-232
Author(s):  
Eun Jee Nho ◽  
Yeon Hee Hong ◽  
Ju Hee Park ◽  
Seul Ki Kim ◽  
Jung Ryeol Lee ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Implantation Rate ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Embryo Score

Objective: The aim of this study was to compare in vitro fertilization outcomes between fresh day 3 or day 4 embryo transfer cycles with dual progesterone (P) administration (intramuscular and vaginal) and cycles with single intramuscular P administration for luteal support.Methods: We selected 124 cycles from 100 women (under age 40 years) who underwent oocyte pick-up (number of trials ≤ 3, 4–14 oocytes obtained) and transfer of two or three day 3 or day 4 embryos at two infertility centers from January 2014 to June 2019. Dual P (intramuscular P [50 mg] daily+vaginal P) was used in 52 cycles and a single intramuscular administration of P (50 mg daily) was used in 72 cycles.Results: Women’s age, infertility factors, number of oocytes retrieved, number of transferred embryos, and mean embryo score were similar between the dual P group and the single P group. Although the number of trial cycles was significantly higher (1.9 vs. 1.5), and the mean endometrial thickness on the trigger day (10.0 mm vs. 11.0 mm) was significantly lower in the dual P group, the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate for both day 3 and day 4 transfers were similar between the two groups.Conclusion: In fresh day 3 or day 4 embryo transfer cycles, dual P administration did not demonstrate any clinical advantages. Intramuscular P alone appears to be sufficient for luteal support.

scholarly journals Natural Cycle Results in Lower Implantation Failure than Ovarian Stimulation in Advanced-Age Poor Responders Undergoing IVF: Fertility Outcomes from 585 Patients

2021 ◽  
Author(s):  
Maria Paola De Marco ◽  
Giulia Montanari ◽  
Ilary Ruscito ◽  
Annalise Giallonardo ◽  
Filippo Maria Ubaldi ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Poor Responder ◽  
Advanced Age ◽  
Poor Responders ◽  
Natural Cycle ◽  
Significant Difference ◽  
Over 40 Years

AbstractTo compare pregnancy rate and implantation rate in poor responder women, aged over 40 years, who underwent natural cycle versus conventional ovarian stimulation. This is a retrospective single-center cohort study conducted at the GENERA IVF program, Rome, Italy, between September 2012 and December 2018, including only poor responder patients, according to Bologna criteria, of advanced age, who underwent IVF treatment through Natural Cycle or conventional ovarian stimulation. Between September 2012 and December 2018, 585 patients were included within the study. Two hundred thirty patients underwent natural cycle and 355 underwent conventional ovarian stimulation. In natural cycle group, both pregnancy rate per cycle (6.25 vs 12.89%, respectively, p = 0.0001) and pregnancy rate per patient101 with at least one embryo-transfer (18.85 vs 28.11% respectively, p = 0.025) resulted significant reduced. Pregnancy rate per patient managed with conventional ovarian stimulation resulted not significantly different compared with natural cycle (19.72 vs 15.65% respectively, p = 0.228), but embryo implantation rate was significantly higher in patients who underwent natural cycle rather than patient subjected to conventional ovarian stimulation (13 vs 8.28% respectively, p = 0.0468). No significant difference could be detected among the two groups in terms of abortion rate (p = 0.2915) or live birth pregnancy (p = 0.2281). Natural cycle seems to be a valid treatment in patients over 40 years and with a low ovarian reserve, as an alternative to conventional ovarian stimulation.

scholarly journals Tumor necrosis factor-308 polymorphism increases the embryo implantation rate in women undergoing in vitro fertilization

2013 ◽  
Vol 28 (10) ◽  
pp. 2774-2783 ◽  
Author(s):  
F. Vialard ◽  
M. El Sirkasi ◽  
V. Tronchon ◽  
R. Boudjenah ◽  
D. Molina-gomes ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Vitro Fertilization ◽  
Embryo Implantation Rate ◽  
Necrosis Factor

Acupuncture versus placebo acupuncture for in vitro fertilisation: a systematic review and meta-analysis

2020 ◽  
pp. 096452842095871
Author(s):  
Meaghan E Coyle ◽  
Ieva Stupans ◽  
Katherine Abdel-Nour ◽  
Hiba Ali ◽  
Michelle Kotlyarsky ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
In Vitro Fertilisation ◽  
Ongoing Pregnancy ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Placebo Acupuncture

Objective: To evaluate the efficacy of acupuncture compared to placebo acupuncture for women undergoing in vitro fertilisation (IVF) in a systematic review and meta-analysis. Methods: A search was conducted in seven English-language biomedical databases from their inception to 3 April 2019 to identify studies evaluating acupuncture as an adjunct to IVF treatment. Randomised controlled trials (RCTs) that compared acupuncture with placebo acupuncture using a non-invasive placebo acupuncture device in women undergoing a fresh or frozen IVF cycle were eligible, as were studies that tested placebo acupuncture as the intervention. Outcomes were clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, live birth rate and adverse events. Results: Eight RCTs involving 3607 women were included. Studies were judged to be low risk for most of the risk of bias domains. Acupuncture around the time of embryo transfer was not significantly different to placebo acupuncture in terms of the clinical pregnancy rate (6 RCTs, 2473 women, risk ratio (RR) = 0.99 (95% confidence interval (CI) = 0.88, 1.11), I2 = 51%, moderate certainty evidence), ongoing pregnancy rate (4 RCTs, 1459 women, RR = 0.88 (95% CI = 0.75, 1.02), I2 = 50%, moderate certainty evidence), miscarriage rate (4 RCTs, 502 women, RR = 1.23 (95% CI = 0.89, 1.71), I2 = 30%, high certainty evidence) or live birth rate (4 RCTs, 1835 women, RR = 0.87 (95% CI = 0.75, 1.01), I2 = 0%, high certainty evidence). Outcomes with placebo acupuncture were not significantly different to usual care. Adverse events relating to acupuncture, such as discomfort and bruising, were mild to moderate. Conclusion: Acupuncture administered around the time of embryo transfer did not have a statistically significant effect on IVF outcomes compared with placebo acupuncture.

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