P–332 Endometrium thickness is increased in gonadotropin stimulated IVF compared to unstimulated cycles, but this increase does not have a positive effect on pregnancy rate

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
I M Magaton ◽  
A Helmer ◽  
M Vo. Wolff ◽  
P Stute ◽  
M C Roumet
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Endometrial Thickness ◽  
Live Birth Rate ◽  
Pregnancy Rates ◽  
Embryo Selection ◽  
Growth Dynamic ◽  
Live Birth Rates ◽  
Positive Effect

Abstract Study question Is endometrial growth and endometrial thickness different in controlled ovarian stimulation (COS)-IVF compared to unstimulated cycles and does this have an effect on pregnancy rates? Summary answer Endometrial growth dynamic is different and endometrium is thicker in COS-IVF but this does not have a positive effect on pregnancy and live birth rates. What is known already Endometrial growth and endometrial thickness are a function of duration and concentration of estradiol (E2) stimulation. Endometrial thickness <8mm is related with lower pregnancy rates in IVF treatments. It is commonly assumed that an increase of endometrial thickness by increasing estrogen stimulation could have a positive effect on pregnancy rate. However, such a relationship has never been systematically analysed. Natural Cycle IVF (NC-IVF) is an ideal model to analyse the effect of high dose gonadotropin stimulation on several parameters such as thickness of endometrium and pregnancy rate. Study design, size, duration Retrospective single center, University based study including 235 COS-IVF and 616 NC-IVF cycles from 2015 to 2019. Polyfollicular COS-IVF cycles were only analysed until 09 2017 as embryo selection was introduced in Switzerland afterwards. Limiting the analysis to cycles without embryo selection enabled us to compare embryos derived from cIVF and NC-IVF. 1550 endometrial and 1068 E2 measurements were included in the analysis. Participants/materials, setting, methods Mean female age at the time when the cycles were performed was in NC-IVF 35.8±3.9y and in COS-IVF 34.9±4.2y (maximum 42y). Each woman performed on average 1.96±1.45 IVF cycles. Endometrial thickness and E2 serum concentrations were evaluated daily between day –4 and –2 (0=day of aspiration). Pregnancy and live birth rate were evaluated per transferred embryo. Statistically, student test and a repeated measure model and a logistic regression model both adjusted for age were used. Main results and the role of chance Endometrial thickness was different in COS-IVF and NC-IVF. At each time point endometrial thickness was found to be higher in COS-IVF compared to NC-IVF (p < 0.001 on days –4,–3, and –2). On day –2, the day when ovulation was triggered, mean endometrial thickness was 9.75 ±2.05mm in COS-IVF and 8.12 ±1.66mm in NC-IVF. Endometrial growth dynamic was also different in COS-IVF and NC-IVF. Endometrial thickness increased significantly faster in NC-IVF cycles (0.58mm/day [0.43,0.73]) than in cIVF cycles (0.22mm/day [–0.12, 0.55], Pval= 0.034). The increase of endometrial thickness per day was less pronounced if E2 concentrations were high (–0.19 [–0.34, 0.05]). Therefore it can be assumed that the observed differences in growth dynamics in both treatments are caused by differences in E2. Increased endometrial thickness in COS-IVF was not associated with higher success rate. There was no significant effect of endometrium thickness on pregnancy (Pval=0.318) and Live birth rate (Pval=0.461). Limitations, reasons for caution Pregnancy and live birth rates might be affected by more than just endometrial thickness. The study was only based on the thickness of the endometrium but not on its ultrasound pattern. Wider implications of the findings: Postponing the aspiration to allow endometrium to further proliferate has only a limited effect in COS-IVF. Increasing gonadotropin stimulation dosage just to increase endometrial thickness is not a feasible strategy to improve pregnancy rate. The need to apply high dosages of estrogen supplementation in thawing cycles need to be questioned. Trial registration number “not applicable”

P–159 Slow-growing embryos should be frozen on day 5

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M J Zamora ◽  
I Katsouni ◽  
D Garcia ◽  
R Vassena ◽  
A Rodríguez
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Study Groups ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Patient Counselling ◽  
Slow Growing

Abstract Study question What is the live birth rate after frozen embryo transfer (FET) of slow-growing embryos frozen on day 5 (D5) or on day 6 (D6)? Summary answer The live birth rate after single FET is significantly higher for slow-growing embryos frozen on D5 compared to those frozen on D6. What is known already Most data on the outcomes of blastocyst transfer stem from studies that evaluate fresh transfer from normal growing D5 blastocyst ET. However not all embryos will begin blastulation nor reach the fully expanded stage by D5; those are the slow-growing embryos. Studies that compare D5 to D6 embryos in FET cycles show contradictory results. Some have reported higher clinical pregnancy rates after D5 FET, while others have reported similar outcomes for D5 and D6 cryopreserved blastocyst transfers. There is a lack of evidence regarding the best approach for vitrifying embryos that exhibit a slow developmental kinetic. Study design, size, duration This retrospective cohort study included 821 single FET of slow-growing embryos frozen on D5 or D6, belonging to patients undergoing in vitro fertilization with donor oocytes between January 2011 and October 2019, in a single fertility center. The origin of blastocysts was either supernumerary embryos after fresh embryo transfer or blastocysts from freeze-all cycles. All embryos were transferred 2- 4h after thawing. Participants/materials, setting, methods We compared reproductive outcomes of slow-growing embryos frozen on D5 versus (n = 442) slow-growing embryos frozen on D6 (n = 379). D5 group consisted in embryos graded 0, 1, 2 of Gardner scale and frozen on D5. Similarly, D6 group consisted in embryos graded 3, 4, 5 of Gardner scale (blastocyst stage) and frozen on D6. Differences in pregnancy rates between study groups were compared using a Chi2 test. A p-value <0.05 was considered statistically significant. Main results and the role of chance Baseline characteristics were comparable between study groups. Overall, mean age of the woman was 42.3±5.4 years old; donor sperm was used in 25% of cycles, and it was frozen in 73.2% of cycles. Pregnancy rates were significantly higher when transferring slow D5 embryos compared to D6 for all the pregnancy outcomes analyzed: biochemical pregnancy rate was 27.7% vs 20.2%, p < 0.016; clinical pregnancy rate was 17.5% vs 10.2%, p < 0.004); ongoing pregnancy rate was: 15.7% vs 7.8% (p < 0.001); live birth rate was: 15.4% vs 7.5%, (p < 0.001). These results suggest that when embryos exhibit a slow development behavior (not reaching full blastocysts at D5), waiting until D6 for blastulation and expansion does not improve clinical outcomes. Vitrification at D5 will should the preferred option in cases where the oocyte is assumed of high quality Limitations, reasons for caution The retrospective design of the study is its main limitation. Also, morphology as sole selection criterion for transfer. However, blastocyst morphology is a very good predictor of implantation and pregnancy, and a good indicator of the embryo’s chromosomal status (higher euploidy rate in higher morphological quality blastocysts). Wider implications of the findings: These results can help to the standardization of laboratory protocols. As the decision of vitrifying slow developing embryos on D5 or D6 is made by the laboratory team or by the gynaecologist in agreement with the patient, having an evidence based strategy simplifies patient counselling and decision making. Trial registration number Not applicable

scholarly journals Pregnancy Outcomes Following the First Frozen Blastocyst Transfer among Women Aged Less than 35 Years Old

2021 ◽  
Author(s):  
Le Hoang ◽  
Le Duc Thang ◽  
Nguyen Thi Lien Huong ◽  
Nguyen Minh Thuy ◽  
Vu Thi Mai Anh ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Poor Quality ◽  
Live Birth Rates ◽  
Group 2 ◽  
First Time ◽  
Group 1

Abstract Aims of the study were to describe main outcomes (clinical, ongoing single and multiple pregnancy and live birth rates) following frozen blastocyst transfer performed for the first time among women aged less than 35 years old and analyzed according to both quantity and quality of the embryos. A descriptive cross-sectional study was applied to collect and analyze available data of 505 patients who performed transfer of frozen blastocysts for the first time between June, 2018 and September, 2019 at the Assisted Reproductive Technology Centre of Tam Anh General Hospital. One good quality embryo was transferred for 121 patients (Group 1), 2 good quality embryos for 214 patients (Group 2), 1 good and 1 poor quality embryo for 112 patients (Group 3), 1 good and 2 poor quality embryos for 25 patients (Group 4) and 1 or 2 poor quality embryos for 33 patients (Group 5). Main results showed that the pregnancy rate was 71.9%, 74.8%, 69.4%, 84.0% and 39.4% in Group 1, 2, 3, 4 and 5, respectively. The rate of multiple pregnancy was 36.9%, 16.9%, and 32.0% in Group 2, 3, and 4, respectively, higher than in Group 1 (4.9%). Meanwhile, the live birth rate was 55.6%, 50.9%, and 60.0% in Group 2, 3 and 4, respectively, but not significantly different from the live birth rate in Group 1 (47.9%). In conclusion, pregnancy and live birth rates were not significantly different following transfer of 1 or 2 good quality blastocysts while the rate of multiple pregnancy was significantly increased following the transfer of 2 good quality ones. Transfer of 1 or 2 poor quality embryos in addition to 1 good embryo did not significantly improve the pregnancy rate.

scholarly journals Effect of Endometrium Thickness on Clinical Outcomes in Luteal Phase Short-Acting GnRH-a Long Protocol and GnRH-Ant Protocol

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Zhang ◽  
Yi-Fei Sun ◽  
Yue-Ming Xu ◽  
Bao-jun Shi ◽  
Yan Han ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Live Birth ◽  
Birth Rate ◽  
Endometrial Thickness ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Long Protocol

ObjectiveTo investigate the factors that influence luteal phase short-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol and GnRH-antagonist (GnRH-ant) protocol on pregnancy outcome and quantify the influence. About the statistical analysis, it is not correct for the number of gravidities.MethodsInfertile patients (n = 4,631) with fresh in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and embryo transfer were divided into GnRH-a long protocol (n =3,104) and GnRH-ant (n =1,527) protocol groups and subgroups G1 (EMT ≤7mm), G2 (7 mm <EMT ≤10 mm), and G3 (EMT >10 mm) according to EMT on the trigger day. The data were analyzed.ResultsThe GnRH-ant and the GnRH-a long protocols had comparable clinical outcomes in the clinical pregnancy, live birth, and miscarriage rate after propensity score matching. In the medium endometrial thickness of 7–10 mm, the clinical pregnancy rate (61.81 vs 55.58%, P < 0.05) and miscarriage rate (19.43 vs 12.83%, P < 0.05) of the GnRH-ant regime were significantly higher than those of the GnRH-a regime. The EMT threshold for clinical pregnancy rate in the GnRH-ant group was 12 mm, with the maximal clinical pregnancy rate of less than 75% and the maximal live birth rate of 70%. In the GnRH-a long protocol, the optimal range of EMT was >10 mm for the clinical pregnancy rate and >9.5 mm for the live birth rate for favorable clinical outcomes, and the clinical pregnancy and live birth rates increased linearly with increase of EMT. In the GnRH-ant protocol, the EMT thresholds were 9–6 mm for the clinical pregnancy rate and 9.5–15.5 mm for the live birth rate.ConclusionsThe GnRH-ant protocol has better clinical pregnancy outcomes when the endometrial thickness is in the medium thickness range of 7–10 mm. The optimal threshold interval for better clinical pregnancy outcomes of the GnRH-ant protocol is significantly narrower than that of the GnRH-a protocol. When the endometrial thickness exceeds 12 mm, the clinical pregnancy rate and live birth rate of the GnRH-ant protocol show a significant downward trend, probably indicating some negative effects of GnRH-ant on the endometrial receptivity to cause a decrease of the clinical pregnancy rate and live birth rate if the endometrial thickness exceeds 12 mm.

scholarly journals ICSI Versus Conventional IVF in Women Aged 40 Years or More and Unexplained Infertility: A Retrospective Evaluation of 685 Cycles with Propensity Score Model

2019 ◽  
Vol 8 (10) ◽  
pp. 1694 ◽  
Author(s):  
Gianluca Gennarelli ◽  
Andrea Carosso ◽  
Stefano Canosa ◽  
Claudia Filippini ◽  
Sara Cesarano ◽  
...  
Keyword(s):  
Propensity Score ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Unexplained Infertility ◽  
Unbiased Estimation ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Cumulative Live Birth

This study compared the cumulative live birth rates following Intracytoplasmic sperm injection (ICSI) versus conventional in vitro fertilization (cIVF) in women aged 40 years or more and unexplained infertility. A cohort of 685 women undergoing either autologous conventional IVF or ICSI was retrospectively analyzed. The effects of conventional IVF or ICSI procedure on cumulative pregnancy and live birth rates were evaluated in univariate and in multivariable analysis. In order to reduce potential differences between women undergoing either IVF or ICSI and to obtain unbiased estimation of the treatment effect, propensity score was estimated. ICSI was performed in 307 couples (ICSI group), whereas cIVF was performed in 297 couples (cIVF group), resulting in 45 and 43 live deliveries, respectively. No differences were observed in morphological embryo quality, in the number of cleavage stage embryos, in the number of transferred embryos, and in the number of vitrified embryos. As for the clinical outcome, no differences were observed in pregnancy rate, cumulative pregnancy rate, live birth rate, cumulative live birth rate, and abortion rate. The present results suggest that ICSI is not associated with increased likelihood of a live birth for unexplained, non-male factor infertility, in women aged 40 years or more.

scholarly journals Endometrial thickness on the day of the LH surge: an effective predictor of pregnancy outcomes after modified natural cycle-frozen blastocyst transfer

2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
Sachie Onogi ◽  
Kenji Ezoe ◽  
Seiko Nishihara ◽  
Junichiro Fukuda ◽  
Tamotsu Kobayashi ◽  
...  
Keyword(s):  
Live Birth ◽  
Pregnancy Outcomes ◽  
Birth Rate ◽  
Endometrial Thickness ◽  
Live Birth Rate ◽  
Pregnancy Rates ◽  
Ongoing Pregnancy ◽  
Female Age ◽  
Lh Surge ◽  
Natural Cycles

Abstract STUDY QUESTION Can the endometrial thickness (EMT) on the day of the LH surge predict pregnancy outcomes after single vitrified-warmed blastocyst transfers (SVBTs) in modified natural cycles? SUMMARY ANSWER Decreased EMT on the day of the LH surge is associated with older female age and a shortened proliferation phase and may be associated with low live birth and high chemical pregnancy rates. WHAT IS KNOWN ALREADY The relation between EMT on the day of embryo transfer (ET) and pregnancy outcomes remains controversial; although numerous studies reported an association between decreased EMT on the day of ET and a reduced likelihood of pregnancy, recent studies demonstrated that the EMT on the day of ET had limited independent prognostic value for pregnancy outcomes after IVF. The relation between EMT on the day of the LH surge and pregnancy outcomes after SVBT in modified natural cycles is currently unknown. STUDY DESIGN, SIZE, DURATION In total, 808 SVBTs in modified natural cycles, performed from November 2018 to October 2019, were analysed in this retrospective cohort study. Associations of EMT on the days of the LH surge with SVBT and clinical and ongoing pregnancy rates were statistically evaluated. Clinical and ongoing pregnancy rates were defined as the ultrasonographic observation of a gestational sac 3 weeks after SVBTs and the observation of a foetal heartbeat 5 weeks after SVBTs, respectively. Similarly, factors potentially associated with the EMT on day of the LH surge, such as patient and cycle characteristics, were investigated. PARTICIPANTS/MATERIALS, SETTING, METHODS The study includes IVF/ICSI patients aged 24–47 years, who underwent their first SVBT in the study period. After monitoring follicular development and serum hormone levels, ovulation was triggered via a nasal spray containing a GnRH agonist. After ovulation was confirmed, SVBTs were performed on Day 5. The EMT was evaluated by transvaginal ultrasonography on the day of the LH surge and immediately before the SVBT procedure. MAIN RESULTS AND THE ROLE OF CHANCE Of the original 901 patients, 93 who were outliers for FSH or proliferative phase duration data were excluded from the analysis. Patients were classified according to quartiles of EMT on day of the LH surge, as follows: EMT < 8.1 mm, 8.1 mm ≤ EMT < 9.1 mm, 9.1 mm ≤ EMT < 10.6 mm and EMT ≥ 10.6 mm. Decreased EMT on day of the LH surge was associated with lower live birth (P = 0.0016) and higher chemical pregnancy (P = 0.0011) rates. Similarly, patients were classified according to quartiles of EMT on day of the SVBT, as follows: EMT < 9.1 mm, 9.1 mm ≤ EMT < 10.1 mm, 10.1 mm ≤ EMT < 12.1 mm and EMT ≥ 12.1 mm. A decreased EMT on the day of SVBT was associated with a lower live birth rate (P = 0.0095) but not chemical pregnancy rate (P = 0.1640). Additionally, multivariate logistic regression analysis revealed a significant correlation between EMT on day of the LH surge and ongoing pregnancy; however, no correlation was observed between EMT on the day of SVBT and ongoing pregnancy (adjusted odds ratio 0.952; 95% CI, 0.850–1.066; P = 0.3981). A decreased EMT on day of the LH surge was significantly associated with greater female age (P = 0.0003) and a shortened follicular/proliferation phase (P < 0.0001). LIMITATIONS, REASONS FOR CAUTION The data used in this study were obtained from a single-centre cohort; therefore, multi-centre studies are required to ascertain the generalisability of these findings to other clinics with different protocols and/or patient demographics. WIDER IMPLICATIONS OF THE FINDINGS This is the first report demonstrating a significant correlation between EMT on day of the LH surge and pregnancy outcomes after frozen blastocyst transfer in modified natural cycles. Our results suggest that EMT on day of the LH surge may be an effective predictor of the live birth rate. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by resources from the Kato Ladies Clinic. The authors have no conflicts of interest to declare.

scholarly journals GnRH agonist and hCG (dual trigger) versus hCG trigger for follicular maturation: a systematic review and meta-analysis of randomized trials

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kai-Lun Hu ◽  
Siwen Wang ◽  
Xiaohang Ye ◽  
Dan Zhang ◽  
Sarah Hunt
Keyword(s):  
Systematic Review ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Gnrh Agonist ◽  
Birth Rate ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Follicular Maturation ◽  
Hcg Trigger

Abstract Background Traditionally, final follicular maturation is triggered by a single bolus of human chorionic gonadotropin (hCG). This acts as a surrogate to the naturally occurring luteinizing hormone (LH) surge to induce luteinization of the granulosa cells, resumption of meiosis and final oocyte maturation. More recently, a bolus of gonadotropin-releasing hormone (GnRH) agonist in combination with hCG (dual trigger) has been suggested as an alternative regimen to achieve final follicular maturation. Methods This study was a systematic review and meta-analysis of randomized trials evaluating the effect of dual trigger versus hCG trigger for follicular maturation on pregnancy outcomes in women undergoing in vitro fertilization (IVF). The primary outcome was the live birth rate (LBR) per started cycle. Results A total of 1048 participants were included in the analysis, with 519 in the dual trigger group and 529 in the hCG trigger group. Dual trigger treatment was associated with a significantly higher LBR per started cycle compared with the hCG trigger treatment (risk ratio (RR) = 1.37 [1.07, 1.76], I2 = 0%, moderate evidence). There was a trend towards an increase in both ongoing pregnancy rate (RR = 1.34 [0.96, 1.89], I2 = 0%, low evidence) and implantation rate (RR = 1.31 [0.90, 1.91], I2 = 76%, low evidence) with dual trigger treatment compared with hCG trigger treatment. Dual trigger treatment was associated with a significant increase in clinical pregnancy rate (RR = 1.29 [1.10, 1.52], I2 = 13%, low evidence), number of oocytes collected (mean difference (MD) = 1.52 [0.59, 2.46), I2 = 53%, low evidence), number of mature oocytes collected (MD = 1.01 [0.43, 1.58], I2 = 18%, low evidence), number of fertilized oocytes (MD = 0.73 [0.16, 1.30], I2 = 7%, low evidence) and significantly more usable embryos (MD = 0.90 [0.42, 1.38], I2 = 0%, low evidence). Conclusion Dual trigger treatment with GnRH agonist and HCG is associated with an increased live birth rate compared with conventional hCG trigger. Trial registration CRD42020204452.

scholarly journals Comparison of IVF Outcomes between Minimal Stimulation and High-Dose Stimulation for Patients with Poor Ovarian Reserve

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tal Lazer ◽  
Shir Dar ◽  
Ekaterina Shlush ◽  
Basheer S. Al Kudmani ◽  
Kevin Quach ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Poor Responders ◽  
High Dose ◽  
Poor Ovarian Reserve

We examined whether treatment with minimum-dose stimulation (MS) protocol enhances clinical pregnancy rates compared to high-dose stimulation (HS) protocol. A retrospective cohort study was performed comparing IVF and pregnancy outcomes between MS and HS gonadotropin-antagonist protocol for patients with poor ovarian reserve (POR). Inclusion criteria included patients with an anti-Müllerian hormone (AMH) ≤8 pmol/L and/or antral follicle count (AFC) ≤5 on days 2-3 of the cycle. Patients from 2008 exclusively had a HS protocol treatment, while patients in 2010 had treatment with a MS protocol exclusively. The MS protocol involved letrozole at 2.5 mg over 5 days, starting from day 2, overlapping with gonadotropins, starting from the third day of letrozole at 150 units daily. GnRH antagonist was introduced once one or more follicles reached 14 mm or larger. The HS group received gonadotropins (≥300 IU/day) throughout their antagonist cycle. Clinical pregnancy rate was significantly higher in the MS protocol compared to the HS protocol (P=0.007). Furthermore, the live birth rate was significantly higher in the MS group compare to the HS group (P=0.034). In conclusion, the MS IVF protocol is less expensive (lower gonadotropin dosage) and resulted in a higher clinical pregnancy rate and live birth rate than a HS protocol for poor responders.

scholarly journals Pregnancy Outcomes Following the First Frozen Blastocyst Transfer Among Women Aged Less Than 35 Years Old: A Retrospective Cohort Study

2021 ◽  
pp. 1-7
Author(s):  
Le Hoang ◽  
Le Duc Thang ◽  
Nguyen Thi Lien Huong ◽  
Nguyen Minh Thuy ◽  
Vu Thi Mai Anh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Group 2 ◽  
Group 1

Background: Many guidelines have been issued regarding the number of embryos to be transferred after in vitro fertilization (IVF), but patients and clinicians may be reluctant to accept or offer a single embryo transfer due to the expected lower chance of pregnancy or live birth. This study was aimed to provide additional information on cycle outcome according to the number and quality of thawed transferred blastocysts. Methods:A retrospective cohort study was designed to collect the data of 505 patients who performed the first frozen blastocysts transfer at Tam Anh General Hospital from June 2018 to September 2019. One good-quality embryo was transferred for 121 patients (Group 1), two good for 214 patients (Group 2), one good and one poor for 112 patients (Group 3), one good and two poor for 25 patients (Group 4), and one or two poor for 33 patients (Group 5). Results:The pregnancy rate was 71.9%, 74.8%, 69.4%, 84.0%, and 39.4% in Group 1–5, respectively. The multiple pregnancy rate was 36.9%, 16.9%, and 32.0% in Groups 2–4, respectively, higher than Group 1 (4.9%). The live birth rate was 55.6%, 50.9%, and 60.0% in Group 2–4, respectively, but not significantly different from the Group 1 (47.9%). Conclusions:Transferring an additional good or poor embryo, along with a good embryo, does not increase the live birth rate while the incidence of multiple pregnancies rises significantly.

scholarly journals The effect of air bubble position on ART outcome in frozen-thawed blastocyst transfer

2021 ◽  
Author(s):  
Tingting Yang ◽  
Bo Chen ◽  
Xiaoyan Sun ◽  
Qingyang Li ◽  
Qiumei Li ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Blastocyst Transfer ◽  
Ultrasound Guided ◽  
Air Bubble ◽  
Art Outcome

Abstract Background So far, only few literatures have studied the relationship between blastocyst transfer position and ART outcomes, and the conclusions are still controversial. Our study is to evaluate the effect of air bubble position on ART outcome and to find the optimal embryo transfer position in frozen-thawed blastocyst transfer. Methods This study included a retrospective cohort analysis of 399 frozen-thawed single blastocyst transfers ultrasound-guided performed between June 1, 2017 and November 30, 2020. All of the women scheduled for frozen-thawed single blastocyst transfers ultrasound-guided. The primary outcome is clinical pregnancy rate and the secondary outcome is live birth rate. Statistical analyses were conducted using One-way Anova, Kruscal Whallis H test, chi-square test and Smooth curve fitting. Results When BFD was less than 19 mm, there was no significant change in clinical pregnancy rate as BFD increased (OR = 0.95, 95% CI: 0.89 to 1.02, P = 0.1373); when BFD was more than 19 mm, the clinical pregnancy rate decreased by 16% for every 1 mm increase in BFD (OR = 0.84, 95% CI: 0.72 to 0.98, P = 0.0363). The effect of BFD on live birth rate were similar to that on clinical pregnancy rate, the inflection point was 19mm, when BFD was more than 19 mm, the live birth rate decreases by 58% for every 1 mm increase in BFD (OR = 0.42, 95% CI: 0.21 to 0.86, P = 0.0174) Conclusions The ideal pregnancy outcome can be achieved within 19mm from uterus fundus after single blastocyst transfer, The clinical pregnancy and live birth at a distance of more 19mm from the uterus fundus have a cliff-like downward trend.

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