P–360 Blastocyst biopsy day does have an impact on clinical pregnancies in different frozen embryo transfer (FET) regimens: natural cycle (NC) versus hormone replacement therapy (HRT)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Abdala ◽  
N D Munck ◽  
I ElKhatib ◽  
A Bayram ◽  
A Arnanz ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Study Design ◽  
Hormone Replacement ◽  
Cell Mass ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Pregnancy Test ◽  
Blastocyst Biopsy ◽  
Clinical Pregnancy Rates

Abstract Study question Do euploid blastocysts biopsied on day (D) 5 or D6 differ in clinical pregnancy rates when single FET are performed in NC or HRT cycles? Summary answer In single FET cycles, euploid D5 blastocysts have higher clinical pregnancy rates than D6 in NC, while outcomes are comparable in HRT cycles. What is known already: The synchronization between the endometrium and the embryo development is fundamental for a successful implantation. When performing FET with euploid blastocysts biopsied on D5 or D6, higher clinical pregnancy rates have been reported with D5 blastocysts, however contradictory findings were described due to the study design heterogeneity and endometrial preparation (EP) protocol variabilities. In FET cycles, no consensus has been defined of the superiority of NC over HRT cycles when euploid blastocysts are transferred. Consequently, the question remains unanswered if the clinical pregnancy rates of single euploid FET with D5 or D6 blastocysts differ when the EP protocol remains constant. Study design, size, duration A single center observational study was performed between June 2017 and November 2020, including 1027 single euploid FET with blastocysts biopsied on D5 or D6. All patients with primary or secondary infertility who underwent a FET in a NC or HRT EP protocol, with blastocysts graded ≥ BL3CC (Gardner scoring system) prior to biopsy were included. Vitrified-warmed blastocysts that did not re-expand within 1-hour post-warming were excluded from the analysis. Participants/materials, setting, methods In NCs, vaginal progesterone (P4) (Endometrin®) was administrated (3x100mg) after endocrinological confirmation of ovulation until pregnancy test. For HRT cycles, oral estradiol administration was started on day 2 (4 mg) and increased to 6mg on D5 of the cycle. When endometrial thickness was ≥6 mm, P4 was given (3x100mg) until pregnancy test. All FET were performed on D5 after start of P4 administration. Clinical pregnancy was recorded as the presence of an intrauterine gestational sac. Main results and the role of chance Women’s mean age was 33.8 ± 5.5 years. A total of 651 FETs were performed with D5 euploid blastocysts (37.6% in NC and 62.4% in HRT) and 376 with D6 (43.1% in NC and 56.9% in HRT). Clinical pregnancy rate in NC was higher with D5 blastocysts compared to D6 (66.9% vs 50.0%; OR = 0.494, 95% CI = 0.322–0.758; p < 0.001), while no significant differences were found when vitrified-warmed blastocysts were transferred in HRT cycles (64.3% vs 58.4%; OR = 0.781, 95% CI = 0.548–1.112; p = 0.164). Additionally, clinical miscarriage was significantly higher with D5 euploid blastocysts transferred in NC (D5=10.9% vs D6=3.7%, OR = 0.239, 95% CI = 0.044–0.837; p = 0.019). In HRT, miscarriage outcomes were similar between D5 and D6 euploid blastocysts (D5=18.7% vs D6=20.8%, OR = 0.781, 95% CI = 0.548–1.112; p = 0.164), but significantly higher (p < 0.001) than in NC. From a multinomial logistic regression model including age, blastocyst quality and day of biopsy as confounding factors, the clinical pregnancy rate was significantly affected by D6 blastocyst biopsy (OR = 0.571, 95% CI = 0.360–0.906, p = 0.017) and inner cell mass (ICM) grade A (OR = 3.941, 95% CI = 1.149–10.402; p = 0.006) or B (OR = 2.601, 95% CI = 1.146–5.907, p = 0.022) in NC. In HRT cycles, exclusively ICM was statistically significant (OR = 2.555, 95% CI = 1.214–5.381, p = 0.015 and OR = 2.397, 95% CI = 1.286–4.470, p < 0.001 for grade A and B, respectively). Limitations, reasons for caution The current results are based on an observational retrospective study. Live birth and perinatal outcomes should be considered in a further analysis to evaluate the performance of the NC vs HRT protocols when D5 or D6 euploid blastocysts are transferred in FET cycles. Wider implications of the findings: While the clinical pregnancies of D5 and D6 euploid blastocysts are comparable in HRT protocols only, the miscarriage rates seem to be significantly increased as compared to NC. Further studies are required to personalize EP protocols based on the day of blastocyst biopsy in order to improve clinical outcomes. Trial registration number No

P–604 Effectiveness comparison of antral follicular count (AFC), follicular-output-rate (FORT), follicle-to-oocyte-index (FOI), oocyte-sensitivity-index (OSI), and follicular-sensitivity-idex (FSI) for predicting clinical pregnancy rates in IVF

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Bayu ◽  
H H Syam
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Medical Record ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Ultrasound Measurement ◽  
Sensitivity Index ◽  
Clinical Pregnancy Rates ◽  
Ovulatory Follicles

Abstract Study question Which is better for predicting clinical pregnancy rate : AFC, FORT, FOI, FSI, or OSI? Summary answer Both AFC and OSI can be used to predict clinical pregnancy better than FORT, FOI or FSI. What is known already AFC, FORT, FOI, OSI, FSI can be used to predict clinical pregnancy, but no study compared which one is better Study design, size, duration Retrospective study using data from medical record (2016–2018) Subjects were patients underwent IVF cycle at Aster Clinic in Hasan Sadikin Hospital Bandung. Subjects divided into 2 groups: clinically pregnant that is visible gestational sac on ultrasound (n = 83) and not pregnant (n = 148). Inclusion criteria : antagonist protocols, <45 years, basal follicle stimulating hormone (FSH) ≤ 12 IU/L, ICSI fertilization method, and fresh transfer cycle. Participants/materials, setting, methods AFC categorized < 5 and ≥ 5 (poseidon) FORT=pre-ovulatory follicles(16–20 mm) x 100 divided by AFC(2–10 mm). FOI=oocytes obtained x 100 divided by AFC. OSI=oocytes obtained x 1000 divided by total FSH dose. FSI=pre-ovulatory follicles x 100,000 divided by (AFC x total FSH dose). FORT and FSI divided using percentil 33 and 67. OSI divided into 3 groups by cut-off 1.697/IU for poor-response and 10.07/IU for hyperresponse. FOI divided into 2 groups, ≤ 50% or > 50% Main results and the role of chance Group of AFC ≥ 5 had a significantly higher clinical pregnancy rate than the AFC < 5 group (39.49% vs. 16.67% ; p = 0.009). High and moderate OSI had higher clinical pregnancy rate than low OSI (66.37% vs. 37.72% vs. 25.45% ; p = 0.038). There is a significant negative correlation between OSI and age (–0.454) or total FSH dose (–0.594). There is a significant positive correlation between OSI and AFC (0.625), the number of follicles at trigger (0.792), and oocytes (0.923). There were no significant differences in clinical pregnancy rates between the FORT, FOI, and FSI groups. Limitations, reasons for caution Limitation Retrospective study using medical record data Ultrasound measurement was done by many reproductive gynecology specialist (not 1 person) --- observer bias. Wider implications of the findings: This study found no association between FORT, FOI, FSI on clinical pregnancy. Why? FORT, FSI, FOI use measurement number of follicles at trigger and antral follicle. Differences among observers in interpreting antral follicles and number of follicles at trigger, or inaccurate measurement. No FORT, FOI, and FSI cut off values from previous study. Trial registration number Not applicable

scholarly journals Development of assisted reproductive technology services in Thailand between 2008 and 2014 before the new law: Results generated from the National ART Registry, Royal Thai College of Obstetricians and Gynecologists

2020 ◽  
Vol 13 (5) ◽  
pp. 189-196
Author(s):  
Charoenchai Chiamchanya ◽  
Kamthorn Pruksananonda
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technology ◽  
Birth Rate ◽  
Reproductive Technology ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Total Birth ◽  
Clinical Pregnancy Rates ◽  
Multifetal Pregnancy

AbstractBackgroundWhile the assisted reproductive technology (ART) relieves the burden of infertility in many couples, it presents significant public health challenges due to the substantial risk for multiple birth delivery and preterm birth, which are associated with poor maternal and fetal health outcomes. For this reason, it is important to monitor the development and effectiveness of ART services in Thailand.ObjectiveTo analyze the trends of ART services in Thailand between 2008 and 2014.MethodsART clinics in Thailand are required to submit data to the Royal Thai College of Obstetricians and Gynecologists via the National Reporting System. The data from 2008 to 2014 were collected and analyzed.ResultsThe number of ART centers was increased from 35 to 47. The total fresh ART cycles were also increased from 3,723 to 6,516. The percentage values of intracytoplasmic sperm injection (ICSI), in vitro fertilization, gamete intrafallopian transfer, and zygote intrafallopian transfer cycles were changed from 77.87 to 95.59, 21.43 to 4.31, 0.21 to 0.09, and 0.45 to 0.05, respectively. The clinical pregnancy rates were 28.79–33.19, 22.84–51.34, 14.29–42.86, and 0.00–26.67, respectively. The clinical pregnancy rates in fresh vs. frozen-thawed cycles were 31.01–36.33 vs. 31.54–37.34 (P < 0.05). The clinical pregnancy rates in female age <35 vs. 35–39 vs. ≥40 years were 36.97–40.70 vs. 32.74–33.42 vs. 21.08–31.34, respectively (P < 0.001), and the percentage values of multifetal pregnancy rate were 18.75 vs. 13.30 and 13.69, respectively (P < 0.001). There were increasing preimplantation genetic screening (PGS) cycles, with the percentage of the clinical pregnancy rate (25.90–42.63, P < 0.05). The clinical pregnancy rates in medium-sized ART centers (100–300 cycles per year) vs. in small and large centers were 30.79–41.14 vs. 28.01–34.04 and 8.70–40.35, respectively (P < 0.001). Trends of increasing percentage of ART birth rate to total birth rate ratio were 0.24–0.34 (P < 0.05).ConclusionsThere were higher clinical pregnancy rates in frozen-thawed cycles. Higher multifetal pregnancy rate and clinical pregnancy rate were also found in younger females. There were increasing uses of ICSI and PGS. A trend toward increasing ART birth to total birth ratio was observed.

scholarly journals Analysis of endometrial thickness patterns and pregnancy outcomes considering 12,991 fresh IVF cycles

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
ShuJie Liao ◽  
Renjie Wang ◽  
Cheng Hu ◽  
Wulin Pan ◽  
Wei Pan ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Multiple Logistic Regression Analysis ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Significant Difference ◽  
Clinical Pregnancy Rates ◽  
The Relationship ◽  
Selection Of

Abstract Background Different endometrial patterns have an important effect on the relationship between endometrial thickness (EMT) and clinical pregnancy rate. There is a significant difference in age, selection of cycle protocols, and clinical pregnancy rates among four groups with diverse endometrial patterns. Methods This retrospective study aimed to assess the association between EMT on human chorionic gonadotropin (HCG) administration day and the clinical outcome of fresh in vitro fertilization (IVF). The 5th, 50th, and 95th percentiles for EMT were determined as 8, 11, and 14 mm, respectively. Patients were sub-divided into four groups based on their EMT in different endometrial patterns (Group 1: < 8 mm; Group 2: ≥ 8 and ≤ 11 mm; Group 3: > 11 and ≤ 14 mm; Group 4: > 14 mm). We divided patients into three groups based on their endometrial pattern and evaluated the correlation between EMT and clinical pregnancy rate. Results We found a positive correlation between pregnancy rates and EMT in all endometrial patterns. Multiple logistic regression analysis proved age, duration of infertility, cycle protocols, number of embryos transferred, progesterone on HCG day, endometrial patterns, and EMT have significant effects on clinical pregnancy rates. Meanwhile, there was a significant difference in age, selection of cycle protocols, and clinical pregnancy rates among four groups with diverse endometrial patterns. Conclusions Different endometrial patterns have an important effect on the relationship between EMT and clinical pregnancy rate.

scholarly journals The effect of low-dose aspirin on the pregnancy rate in frozen-thawed embryo transfer cycles: A randomized clinical trial

2020 ◽  
Author(s):  
Robab Davar ◽  
Soheila Pourmasumi ◽  
Banafsheh Mohammadi ◽  
Maryam Mortazavi Lahijani
Keyword(s):  
Clinical Trial ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Low Dose ◽  
Endometrial Thickness ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Clinical Pregnancy Rates

Background: The results of previous studies on the effect of low-dose aspirin in frozenthawed embryo transfer (FET) cycles are limited and controversial. Objective: To evaluate the effect of low-dose aspirin on the clinical pregnancy in the FET cycles. Materials and Methods: This study was performed as a randomized clinical trial from May 2018 to February 2019; 128 women who were candidates for the FET were randomly assigned to two groups receiving either 80 mg oral aspirin (n = 64) or no treatment. The primary outcome was clinical pregnancy rate and secondary outcome measures were the implantation rate, miscarriage rate, and endometrial thickness. Results: The endometrial thickness was lower in patients who received aspirin in comparison to the control group. There were statistically significant differences between the two groups (p = 0.018). Chemical and clinical pregnancy rates and abortion rate was similar in the two groups and there was no statistically significant difference. Conclusion: The administration of aspirin in FET cycles had no positive effect on the implantation and the chemical and clinical pregnancy rates, which is in accordance with current Cochrane review that does not recommend aspirin administration as a routine in assisted reproductive technology cycles. Key words: Aspirin, Embryo transfer, Pregnancy rates.

P–249 Does the re-expansion of thawed embryos affect the clinical outcomes of human blastocyst vitrification?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
T Huong ◽  
A Ph. Th. Tú ◽  
L H Mai ◽  
N Doã. Thảo ◽  
C A Mạnh
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Embryo Quality ◽  
Cell Mass ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Group 2 ◽  
Group 1

Abstract Study question Is that essential for prolonged culture of thawed blastocysts in order to be fully re-expanded before transferring? Summary answer Ongoing pregnancy rates decreased in blastocysts that not fully re-expanded after thawing. What is known already: The thaw survival of blastocysts is examined based on morphology of inner cell mass (ICM) and trophectoderm (TE). However, thawed blastocysts experience multiple changes in morphology and might be collapse after thawing due to the presence of blastocoel cavity. It is then difficult to evaluate blastocyst quality. Therefore, the blastocyst re-expansion is considered as a criteria to assess quickly the competent embryos. It also reflects the status energy metabolism from high quality embryo. After all, there are still some controversial opinions about the influence of re-expansion status after thawing. Study design, size, duration This was a retrospective study based on data collected between October 2019 and December 2020. A total 528 thawed blastocysts which were divided into two groups according to the post-thaw reexpansion status: fully re-expanded blastocysts (n = 416), partial or no re-expanded blastocysts (n = 112). The re-expansion status of blastocyst was assess prior to loading on the catheter by senior embryologists. Participants/materials, setting, methods Primary outcome is ongoing pregnancy. Only frozen single D5 transfer cycles were included. We excluded the frozen sperm/oocytes/embryos donation cycles, missing data, non-intact embryos after thawing. Statistical analyses were performed with T or chi-squared tests. Multivariable regression analysis was performed adjusting for the following confounding factors: age, BMI, embryo quality, re-expansion status, biopsied blastocyst. Main results and the role of chance Female age, BMI, number of previous cycles, endometrial thickness, positive HCG results, clinical pregnancy rate were comparable among patients within two groups. The rate of ongoing pregnancy rate in group 1 was significant higher compared with group 2 (51 vs 40.2, p &lt; 0.05). The number of good quality blastocyst transferred in group 1 was higher than in group 2 (p &lt; 0.001). However, under the same embryo quality, there were no difference between clinical pregnancy rate and ongoing pregnancy rate between two groups. When logistic regression were performed: only embryo quality, but not the re-expansion status, was noted to be an independent predictor of ongoing pregnancy (OR = 3.53;95% CI; 1.734–7.184;p=0.001). Limitations, reasons for caution The main limitation of the study is its retrospective design. Wider implications of the findings: Clinical outcomes are comparable between re-expanded blastocyst and partial or no re-expanded blastocysts, although ongoing pregnancy can be improved when embryos are fully expanded. As expected, blastocysts quality has the most important impact on ongoing pregnancy rate. Trial registration number Not applicable

scholarly journals Endometrial Scratching Effect on Pregnancy Rate in Intrauterine Insemination Cycles: A Randomized Controlled Trial

2019 ◽  
Vol 8 (1) ◽  
pp. 85-89
Author(s):  
Mina Naghi Jafarabadi ◽  
Maryam Bagheri ◽  
Zahra Ebrahimi ◽  
Mamak Shariat ◽  
Fedyeh Haghollahi
Keyword(s):  
Pregnancy Rate ◽  
Intrauterine Insemination ◽  
Intervention Group ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Control Groups ◽  
Randomized Controlled ◽  
Endometrial Scratch ◽  
Clinical Pregnancy Rates ◽  
And Control

Objectives : This study was aimed to examine the endometrial scratch injury effect to improve pregnancy rate in women undergoing intrauterine insemination (IUI). Materials and Methods: This randomized controlled clinical trial was conducted in a University Clinic from November 2017 to January 2019. A total of 120 candidates entered the study, who were assigned to intervention (n=60) and control (n=60) groups. All subjects underwent controlled ovarian stimulation using letrozole 2.5 mg/BD on a day between 3 and 7 of the cycle. Then, the sonographic monitoring was started from day 8 of the cycles, followed by injecting human chorionic gonadotropins (HCG) 100001U intramuscularly when 1-2 follicles reached 18 mm in diameter. Approximately 36-38 hours afterward, IUI was done and a B-HCG test was performed after 15 days as well. In addition, luteal phase support was performed with the vaginal progesterone 400 mg twice daily for 15 days. In the intervention group, on day 3 of the cycle endometrial cavity on the posterior wall was scratched with the vaginal cannula No. 4 by a single infertility specialist in addition to the routine procedure. The chemical and clinical pregnancy rates were the main outcome measurements. Results: The overall clinical pregnancy rates were 11/59 (18.6%) and 10/59 (16.9%) in intervention and control groups, respectively (P=0.810). Further, the abortion rates were 1/59 (1.7%) and 3/59 (5.1%) in intervention and control groups, respectively (P=0.303). Eventually, no cases of ectopic pregnancy were observed in either group. Conclusions: Based on the findings of this study, endometrial scratch by pipelle cannot improve pregnancy rate in the early proliferative phase.

scholarly journals Pretreatment With a Long-acting GnRH Agonist in Early Follicular Phase Increases Clinical Pregnancy Rate in Frozen-thawed Embryo Transfer Cycles

2021 ◽  
Author(s):  
Bin xu ◽  
Jing Zhao ◽  
Zhaojuan Hou ◽  
Nenghui Liu ◽  
Yanping Li
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Hormone Replacement ◽  
Follicular Phase ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Early Follicular Phase ◽  
Long Acting ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background: It is controversial whether gonadotropin-releasing hormone agonist (GnRHa) pretreatment can benefit the pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles. In most of studies, GnRHa was administered during the mid-luteal phase for pretreatment. Few studies focus on FET cycles with GnRHa administered in early follicle phase.Methods: The retrospective cohort study was conducted in a university-affiliated IVF center. 630 patients in the GnRHa FET group and 1141 patients in the hormone replacement treatment (HRT) FET without GnRHa group from October 2017 to March 2019 were included. The menstruation cycle of these patients was irregular. Results: There were no differences observed between the two groups in patient’s characteristics. However, the GnRHa FET group showed a higher percentage of endometrium with triple line pattern (94.8% vs 89.6%, p<0.001) on the day of progesterone administration, and an increased implantation rate (34.7% vs 30%, p<0.01), biochemical pregnancy rate (60.6% vs 54.3%, p = 0.009), and clinical pregnancy rate (49.8% vs 43.3%, p = 0.008), as compared to that in the HRT FET cycles with similar endometrial thickness, ectopic pregnancy rate, and early miscarriage rate. Binary logistic regression analysis showed the GnRHa FET group to be associated with an increased chance of clinical pregnancy rate compared with HRT FET without GnRHa group (P=0.014, odds ratio [OR] 1.30, 95% confidence interval [CI] 1.06-1.61).Conclusions: Pretreatment with a long-acting GnRHa in early follicular phase can improve the clinical outcome of the FET cycles. However, further randomized control trials (RCTs) will be needed to verify these results.

scholarly journals Fresh versus frozen embryo transfer: a retrospective cohort study

2019 ◽  
Vol 8 (9) ◽  
pp. 3774
Author(s):  
Raksha K. Shetty ◽  
Purnima K. Nadkarni ◽  
Pooja P. Singh ◽  
Prabhakar Singh ◽  
Aditi A. Nadkarni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Clinical Pregnancy Rate ◽  
Transfer Strategies

Background: Elective frozen embryo transfer (FET), has recently increased significantly with improvements in cryopreservation techniques. Observational studies and randomized controlled trials suggested that the endometrium in stimulated cycles is not optimally prepared for implantation; risk of ovarian hyperstimulation syndrome reduced and pregnancy rates increased following FET and perinatal outcomes are less affected after FET. However, the evidence is not unequivocal and recent randomised control trials challenge the use of elective FET for the general IVF population. Pregnancy rates were analysed in a cohort of patients undergoing embryo transfers.Methods: This was a retrospective cohort study of patients who underwent embryo transfers from April 2018 to March 2019 at study centre in Surat.175 cycles of embryo transfers (119 fresh and 56 frozen) were included in the study. Outcomes measured were positive pregnancy, clinical pregnancy and ongoing clinical pregnancy rates achieved in the IVF-ET cycles.Results: There were no statistically significant differences between positive pregnancy rate (54.6% versus 60.7%, Odds ratio (OR) 0.78; 95% Confidence Interval (CI) 0.41-1.49), clinical pregnancy rate (48.73% versus 57.14%, OR 0.52; 95% CI 0.1- 2.64) and ongoing clinical pregnancy rate  (45.38% versus 51.78% OR 1.4; 95% CI 0.29 - 6.67) in fresh ET and FET cycles, respectively, p < 0.05 was considered statistically significant for all measures.Conclusions: Despite the observed higher rates of positive biochemical, clinical and ongoing clinical pregnancy per transfer in the FET cohort, these did not reach statistical significance. Thus, both transfer strategies are reasonable options, although there is a trend favouring the freeze-all strategy.

scholarly journals Correlation between Serum Levels of Progesterone on HCG Administration Day and Clinical Pregnancy Rate in ICSI cycles

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T A Raafat ◽  
H F Mohammad ◽  
E I Hassan
Keyword(s):  
Pregnancy Rate ◽  
Serum Levels ◽  
Fertilization Rate ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Implantation Failure ◽  
Serum Progesterone ◽  
Clinical Pregnancy Rates ◽  
Hcg Trigger

Abstract Background Infertility is an illness clinically defined as failure to achieve a clinical conception after 12 months of regular and unprotected normal sexual intercourse. It affects around 8 -12% of child bearing-aged couples globally. Premature progesterone elevation is considered for a long time a cornerstone factor to endometrial implantation failure. Although the extensive usage of GnRH analogues for down-regulation of pituitary, rise in progesterone serum levels, still occur at various levels on the day of administration of hCG for ultimate oocyte maturity in fresh IVF management cycles. Aim to investigate and evaluate the correlation between serum progesterone level on the day of HCG administration and the clinical pregnancy rate as a primary outcome, quality of embryo, quality of oocyte, fertilization rate and chemical pregnancy assessed by B-HCG level 2 weeks after embryo transfer as secondary outcomes. Methodology This prospective non interventional study was conducted at Assisted Reproduction Unit, Ain Shams University Maternity Hospital, Cairo, Egypt, starting from December 2015 till March 2017. The study included 240 women scheduled for ICSI presented with primary or secondary infertility, the causes of infertility in this study were male factor, tubal factor and unexplained infertility. Results the current research study displayed that there was unfavorable statistical correlation between serum progesterone elevation at the day of HCG trigger and the clinical pregnancy rates which was 34.2%, the cut off value of serum progesterone was 1.09 ng/ml; above this value the serum pregnancy rates were negatively influenced. Additionally premature rise of serum progesterone levels reduced the embryonic quality, oocyte quality and fertilization rate. Conclusion serum progesterone level equal to or above 1.09 ng/ml at the day of HCG trigger unfavorably influences on the clinical pregnancy rates in ICSI cycles. Recommendations All embryos should be cryopreserved when serum progesterone on the day of HCG trigger equals to or above 1.09 ng/ml during ICSI cycle to be transferred in subsequent cycle to avoid implantation failure.

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