P–717 Where do cryopreserved embryos end up after a positive pregnancy test?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Young ◽  
S Garci Argibay ◽  
L Isa ◽  
M P Zappacost. Villarroel ◽  
R Inza ◽  
...  
Keyword(s):  
Assisted Reproductive Technologies ◽  
Search Time ◽  
Live Birth Rate ◽  
Reproductive Technologies ◽  
Miscarriage Rate ◽  
Pregnancy Test ◽  
Exact Test ◽  
Positive Pregnancy Test ◽  
Registration Number ◽  
Cryopreserved Embryos

Abstract Study question What is the destination of supernumerary embryos after a positive pregnancy test? Summary answer Half of the surplus cryopreserved embryos in assisted reproduction treatments are not transferred. What is known already Many of the surpernumerary cryopreserved embryos in assisted reproductive technologies are not transferred. This is a constant issue in many fertility centers around the world. Our objective was to report what happens with vitried surplus embryos after IVF in patients with a positive pregnancy test, carrying out an analysis according to age and final evolution of the pregnancy. Study design, size, duration This is a retrospective descriptive study. We analyzed 245 embryo transfer cycles, performed between January 2013 to December 2017, in 235 patients with a positive pregnancy test and who vitrified surplus embryos. Participants/materials, setting, methods All the patients underwent treatment with their own oocytes. The variables studied were: age, miscarriage rate (MR) and live birth rate (LBR). We compared the destination of the cryopreserved embryos according to the patient’s age and pregnancy evolution. Statistical analysis was performed with Fisher’s exact test. Main results and the role of chance 20% of the IVF cycles (n = 49) were performed in women older than 40 years, 42% between 35 and 39 (n = 103) and 38% in women younger than 35 (n = 94). Average age was 35.8 ± 4.1 years. 859 embryos were cryopreserved (3.5 ± 1.9 cryopreserved embryos/patient). Average search time for surplus embryos was 20.5 ± 17.9 months, rising to 36.9 ± 14.9 months after delivery and decreasing to 8.7 ± 7.8 months after miscarriage (P < 0.0001). Up to date there are 118 (48.2%) patients whose cryopreserved embryos have not been transferred yet. Signficant differences were found in the three groups in using the cryopreserved embryos according to whether or not they had delivery. Almost half of the surplus cryopreserved embryos are not transferred. Regardless of the age of the patient, all groups showed the same behavior regarding the utilization of the cryopreserved embryos after delivery. It is essential to advise couples who perform assisted reproductive technologies, with a good probability of success (regardless of the patient’s age), about the responsibility that embryonic cryopreservation entails. Argentine legislation has limitations regarding the availability of cryopreserved surplus embryos. Limitations, reasons for caution This is a retrospective study. Wider implications of the findings: We believe that Public Health policies related to this issue should be re evaluated based on these results. Trial registration number Not applicable

scholarly journals Hair Cortisol Concentrations as a Biomarker to Predict a Clinical Pregnancy Outcome after an IVF Cycle: A Pilot Feasibility Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3020
Author(s):  
Diana C. Santa-Cruz ◽  
Rafael A. Caparros-Gonzalez ◽  
Borja Romero-Gonzalez ◽  
Maria Isabel Peralta-Ramirez ◽  
Raquel Gonzalez-Perez ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Hair Cortisol ◽  
Pregnancy Test ◽  
Resilience Scale ◽  
Depression Subscale ◽  
Positive Pregnancy Test ◽  
Pilot Feasibility Study

Our objective was to examine the feasibility of hair cortisol concentrations (HCC) as a biomarker to predict clinical pregnancy outcomes and investigate its potential associations with perceived anxiety, resilience, and depressive symptoms. A total of 43 participants were assessed using HCC, the state trait anxiety inventory (STAI), resilience scale (RS), and the depression subscale of the symptom checklist 90-R (SCL-90-R). Participants were approached at their second consultation with the reproductive endocrinologist (T1), before scheduling their IVF cycle, and then 12 weeks after (T2), at their post-transfer visit with the study coordinators, before the human chorionic gonadotropin (HCG) pregnancy test. The logistic regression model revealed that HCC at T2 predicted 46% of a positive pregnancy test [R2 = 0.46, (ß = 0.11, p < 0.05)]. Pregnant women had higher levels of resilience at T2 (M = 149.29; SD = 17.56) when compared with non-pregnant women at T2 (M = 119.96; SD = 21.71). Significant differences were found between both groups in depression at T2 (t = 3.13, p = 0.01) and resilience at T2 (t = −4.89, p = 0.01). HCC might be a promising biomarker to calculate the probability of pregnancy in women using assisted reproductive technologies (ART).

The role of the growth hormone in assisted reproductive technologies cycles

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 6-8
Author(s):  
Andrey Y Romanov ◽  
Anastasiya G Syrkasheva ◽  
Nataliya V Dolgushina ◽  
Elena A Kalinina
Keyword(s):  
Growth Hormone ◽  
Live Birth ◽  
Ovarian Stimulation ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Reproductive Technologies ◽  
Blood Levels ◽  
Main Research ◽  
Poor Ovarian Responders

The paper analyzes the literature data on the use of the growth hormone (GH) in ovarian stimulation in assisted reproductive technologies (ART). Routine use of GH in ovarian stimulation in patients with a normal GH level does not increase pregnancy and childbirth rates in ART. Also, no benefits of using GH have been identified for patients with polycystic ovary syndrome, despite the increase in insulin and IGF-1 blood levels. The main research focus is to study the use of GH in patients with poor ovarian response. According to the meta-analysis conducted by X.-L. Li et al. (2017), GH in ovarian stimulation of poor ovarian responders increases the number of received oocytes, mature oocytes number, reduces the embryo transfer cancellation rate and does not affect the fertilization rate. The pregnancy and live birth rates are significantly higher in the group of GH use - by 1.65 (95% CI 1.23-2.22) and 1.73 (95% CI 1.25-2.40) times, respectively. Thus, it is advisable to use GH in ovarian stimulation in poor ovarian responders, since it allows to increases live birth rate in ART. However, further studies should determine the optimal GH dose and assesse it`s safety in ART programs.

scholarly journals INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

2021 ◽  
pp. 68-75
Author(s):  
A.O. Polumiskova ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Art Programs ◽  
Group A ◽  
The Difference ◽  
Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

scholarly journals Psychotherapy of a Relationship Break-Up in the Context of Assisted Reproductive Technologies

2021 ◽  
Vol 29 (1) ◽  
pp. 132-148
Author(s):  
I.I. Znamenskaya ◽  
M.R. Travkova ◽  
K.R. Arutyunova
Keyword(s):  
Decision Making ◽  
Legal Status ◽  
Ethical Issues ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
The Other ◽  
Fertility Treatment ◽  
Break Up ◽  
The One ◽  
Cryopreserved Embryos

The paper is focused on ethical issues of making decisions about cryopreserved embryos in the context of relationship break-up in the framework of the embryo’s legal status and the church’s stand on the matter. All these issues can be viewed as part of a broader problem of intuitive and rational foundations for decision-making when facing difficult situations in life. On the one hand, the stressful context of the situation implies intuitive-driven decision-making; on the other hand, assisted reproductive technologies are largely counter-intuitive. We describe the peculiarities of family psychotherapy with mixed-agenda couples going through a divorce who have joint cryopreserved embryos but disagree on what to do with them. We introduce a protocol for psychotherapeutic work in the situation when one partner wishes to continue with the fertility treatment and have a child while the other partner is determined to utilize joint embryos as unwanted biological material. In addition, we discuss emotional and social complications that may arise (guilt, unfaithfulness of one of the partners, other losses, and grieving).

scholarly journals The Dynamics of the Vaginal Micro-Ecology During in Vitro Fertilization and Embryo Transfer (IVF-ET) Cycles and its Impact on Pregnancy Outcomes

2021 ◽  
Author(s):  
Quan Tian ◽  
Yujie Liu ◽  
Jiane Liu ◽  
Jianru Wu ◽  
Jianxin Liu ◽  
...  
Keyword(s):  
Live Birth ◽  
Pregnancy Outcomes ◽  
Evaluation System ◽  
Birth Rate ◽  
Assisted Reproductive Technologies ◽  
Live Birth Rate ◽  
Reproductive Technologies ◽  
Multivariable Logistic Regression Model ◽  
Hormonal Milieu ◽  
Ivf Et

Abstract BackgroundAbnormal reproductive tract flora may cause infertility, and it may play a key role in the success of assisted reproductive technologies (ART). The obvious short-term changes in estrogen caused by clinical protocols with IVF-ET provide a unique perspective for us to assess the vaginal flora, shifting hormonal condition and investigate the potential associations of the vaginal micro-ecology with cycle outcome of pregnancy. The Vaginal Micro-ecology Evaluation System (VMES) as a tool to analyze the vaginal microbiomes in most areas of China. This study aims to apply the VMES to evaluate the dynamics of vaginal micro-ecology during IVF-ET, and investigate the correlations between vaginal micro-ecology with pregnancy outcome.Methods　150 patients were enrolled who underwent early follicular phase prolonged protocol IVF-ET due to tubal factors. The VMES is used to evaluate vaginal microbiology indicators of vaginal swabs obtained in different hormonal milieu during the IVF-ET cycle. The pregnancy outcomes were observed, if pregnant.Results　In our data, the prevalence of bacterial vaginitis (BV) accounts for 3.3%. During IVF procedure, the vaginal microbiome varied across hormonal milieu in some but not all patients. The proportion of BV, and unidentified dysbiosis were increased significantly on the day of human chorionic gonadotropin (HCG) administration. The vaginal micro-ecology on the day of HCG administration correlated with outcome (live birth / no live birth). The multivariable logistic regression model showed that the average age, the duration of infertility, and the vaginal micro-ecology after controlled ovarian hyperstimulation (COH) were associated with the live birth rate.ConclusionOur retrospective cohort study suggests that the VEMS has enabled discovery of unidentified dysbiosis shift in the vaginal micro-ecology during IVF-ET therapy. More importantly, the vaginal micro-ecology on the day of HCG administration was significantly associated with the live birth rate.

P–354 Analysis of pregnancy and miscarriage rates in anti-centromere antibodies (ACA)-positive patients treated with ART

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Kida ◽  
M Tokoro ◽  
H Kitasaka ◽  
T Yoshimura ◽  
N Fukunaga ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Antinuclear Antibody ◽  
Assisted Reproductive Technologies ◽  
Formation Rate ◽  
Reproductive Technologies ◽  
Pregnancy Rates ◽  
Human Embryos ◽  
Antibody Testing ◽  
Miscarriage Rate ◽  
Significant Difference

Abstract Study question Do ACA have an effect on pregnancy and miscarriage rates of human embryos? Summary answer The present results suggest that in ACA-positive cases, the pregnancy rate per transfer was significantly lower, although the miscarriage rate was not affected. What is known already We have previously shown that patients with high levels of anti-centromere antibody (ACA), (one of the anti-nuclear antibodies (ANA)), frequently have dispersal of the female chromosomes in the cytoplasm. Additionally, we reported that the clinical outcome was characterized by a low oocyte maturation rate following ovum pick up and high multiple pronuclear formation rate after fertilization. However, the post-implantation course of embryos with ACA-positive cases has not yet been reported. Therefore, in this study, we analyzed the pregnancy and miscarriage rates in ACA-positive patients treated with Assisted Reproductive Technologies (ART). Study design, size, duration 6581 patients who underwent embryo transfer after antinuclear antibody testing between January 2014 and February 2020 were included in the analysis. Participants/materials, setting, methods The subjects were classified into three groups: ANA-negative (without ACA or any other ANA), ACA-positive (with only ACA) and ANA-positive (with ANA but not ACA). The cycle in which the gestational sac was confirmed was considered a positive pregnancy. The pregnancy and miscarriage rates were compared among the groups using “Ryan Test” for statistical analysis. Main results and the role of chance Of the 6581 eligible cases, the incidence of antinuclear antibody were 71.3% (4695/6581; ANA-negative), 0.9% (61/6581; ACA-positive) and 27.7% (1825/6581; ANA-positive). The pregnancy rates based on the total number of embryo transfer cycles for each were ANA-negative: 31.5% (5283/16792), ACA-positive: 17.6% (41/233), and ANA-positive: 32.4% (1891/5833). The pregnancy rates were significantly lower in the ACA-positive group than in the other groups. The miscarriage rate was 29.4% (1553/5283) in ANA-negative, 31.7% (13/41) in ACA-positive, and 28.0% (529/1891) in ANA-positive, with no significant difference between the three groups. Limitations, reasons for caution Retrospective analysis Wider implications of the findings: ACA-positive patients may benefit from a treatment strategy to increase the absolute number of oocytes by obtained in order to increase the chances of normal fertilization and attainment of implantation. Trial registration number none

P–264 Clinical relevance of re-expansion after blastocyst thawing

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Aparici. González ◽  
L Herrer. Grassa ◽  
L Cascale. Romero ◽  
J Lláce. Aparicio ◽  
J Te. Morro ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Live Birth Rate ◽  
Clinical Results ◽  
Blastocyst Stage ◽  
Good Prognosis ◽  
Culture Conditions ◽  
Miscarriage Rate ◽  
Registration Number ◽  
The Subject

Abstract Study question Are there any differences in clinical outcomes after SET of re-expanded versus non-re-expanded blastocysts? Summary answer The transfer of re-expanded thawed blastocysts is associated with improved clinical outcomes. What is known already Improvements in embryo culture conditions, endometrial receptivity protocols and vitrification as a revolutionary cryopreservation technique have allowed the expansion of blastocyst stage transfers (Lieberman and Tucker, 2006; Stanger et al., 2012; Rienzi et al., 2017), increasing clinical pregnancy and implantation rates in IVF cycles. The re-expansion of thawed blastocyst at the time of transfer has been considered as a good prognosis factor, but not always thawed embryos re-expand. To evaluate the relevance of this event, we compared the clinical results of the re-expanded embryos versus the collapsed ones after their thawing and transfer. Study design, size, duration A total number of 1.125 frozen-thawed blastocyst transfers were included in this retrospective observational study between January 2018 and December 2020. Seven hundred and eighty-six thawed blastocyst were fully expanded at the time of the transfer and 339 thawed blastocysts were non-re-expanded when they were transferred. Participants/materials, setting, methods 1.125 single frozen-thawed blastocyst embryo transfer (SET) cycles (802 from donated and 319 from autologous oocytes) were divided in two groups (re-expanded vs non-re-expanded). Positive beta human chorionic gonadotrophin (bHCG), pregnancy rate (PR), early miscarriage rate (EMR) and live birth rate (LBR) were compared between the two groups. Blastocysts were thawed using an Irvine Scientific® Thaw kit, Irvine Scientific® and were transferring in culture medium (Global® Total® LP, CooperSurgical®). Main results and the role of chance During 2018, 190 re-expanded blastocyst and 94 non-re-expanded were transferred. Statistical significant differences were found in the percentage of positive bHCG (48.4% vs 30.9%, p &lt; 0,0048) and PR (39.5% vs 25.5%, p &lt; 0,0203), respectively. In 2019, statistical differences were found in the LBR between 307 re-expanded blastocyst and 124 non-re-expanded (30.6% vs 12.9%; p &lt; 0,00001). Differences were also found in positive bHCG (50.2% vs 21.8%, p &lt; 0,00001) and PR (40.7% vs 15.3%, p &lt; 0,00001), respectively. Finally, in 2020, 289 re-expanded blastocyst and 121 non-re-expanded were transferred, and significant differences were obtained in the percentage of positive bHCG (46.8% vs 22.3%, p &lt; 0,00001) and PR (32.9% vs 15.7%, p &lt; 0,00001), respectively. Globally, all the variables analysed were statistically significant in favour of the re-expanded embryo group: positive bHCG (48.7% vs 24.5%; p &lt; 0,00001), PR (37.5% vs 18.3%; p &lt; 0,00001) and LBR (20.1% vs 9.5%; p &lt; 0,00001), except for EMR. Limitations, reasons for caution The inherent limitations to a retrospective design. Larger studies are warranted in order to reach robust conclusions on the subject. Wider implications of the findings: Transfer of re-expand blastocyst could be a positive indicator of clinical outcomes. In case of non-re-expand embryos, transfer of two could be reasonable. Trial registration number NONE

scholarly journals To understand the reproductive tract microbiome associated with infertility through metagenomics analysis

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Manisha Vajpeyee ◽  
Lokendra Bahadur Yadav ◽  
Shivam Tiwari ◽  
Parikshit Tank
Keyword(s):  
Reproductive Tract ◽  
Assisted Reproductive Technologies ◽  
Live Birth Rate ◽  
Reproductive Technologies ◽  
Female Reproductive Tract ◽  
Human Reproduction ◽  
Main Body ◽  
Fertility Treatments ◽  
Vaginal Tract ◽  
Human Illness

Abstract Background Knowledge of the microbiome is in its infancy in health and human illness, especially concerning human reproduction. We will be better able to treat dysbiosis of the reproductive tract clinically if it is better explained and understood. It has been shown that altered vaginal microbiota affects parturition, and its function is uncertain in assisted reproductive technologies. However, the effects of recognized microbes such as Mycoplasma tuberculosis, Chlamydia trachomatis, and Neisseria gonorrhoeae are well established, resulting in subclinical changes which are considered to be risk factors for infertility and poor reproductive outcomes. Main body Recent studies indicate that the vaginal tract comprises several different organisms of the microbiome. Some microbiota can play an important role not only in the reproductive tract but also in overall health. The microbiome of the female reproductive tract has been identified mainly based on studies that examine vaginal samples across many reproductive technologies, using a metagenomics approach. Conclusion Alteration of reproductive tract microbiota or presence of certain microbiota irrespective of the level of pathogenicity may interfere with fertilization, implantation, and subsequent embryo development. This may lead to failed fertility treatments and reduced live birth rate (LBR).

87 Assessment of pregnancy success following transfer of embryos produced in vitro using frozen - thawed semen from cloned and noncloned Bos indicus bulls

2019 ◽  
Vol 31 (1) ◽  
pp. 169
Author(s):  
O. Sebastián ◽  
F. Guerrero ◽  
R. Romero ◽  
F. Muñoz ◽  
A. Parlange ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Assisted Reproductive Technologies ◽  
Numerical Range ◽  
Bos Indicus ◽  
Reproductive Technologies ◽  
The State ◽  
In Vitro Production ◽  
Exact Test ◽  
Significant Difference

Assisted reproductive technologies (ART) continue to develop rapidly, allowing for the development of techniques to increase reproductive efficiency and contribute to the genetic improvement of cattle. Some of these techniques include in vitro production (IVP) of embryos and embryo transfer. These modern ART can help produce offspring with highly desirable characteristics. However, there is a lack of information on the percentage of pregnancies obtained following transfer (P/ET) of IVP embryos derived using semen of cloned Bos indicus bulls. The objective of this study was to compare embryo transfer results of IVP embryos created using frozen-thawed semen from 5 Brahman bulls (Bos indicus) with characteristics and genetics of high commercial value. The embryos were produced on two different dates, 45 days apart, using pooled oocytes harvested by ovum pickup from 15 Brahman cows at random stages of the oestrous cycle. Procedures for IVP were performed in a commercial laboratory (Genemex Internacional) in the state of Chiapas, Mexico. For IVF, conventional semen was used from 1 bull (B1) and his clone (B12), the grandson of B1 (B2), and from 2 nonrelated bulls (B3 and B4). A total of 100 embryos were transferred nonsurgically by a private practitioner on a ranch in the state of Campeche, Mexico. The recipients were commercial crossbred cows synchronized using a FTET program. On Day 0, recipients received an intravaginal device containing 1.9g of progesterone (CIDR) and 2mg of oestradiol benzoate IM. On Day 8, the CIDR was removed and cows received 25mg of dinoprost tromethamine, 200IU of eCG, and 0.5mg of oestradiol cypionate IM. Embryos were transferred on Day 17. The overall P/ET was 42% (42/100). The P/ET for IVP embryos produced with semen from bulls B1, B12, B2, B3, and B4 was 3/15 (20%), 3/8 (37%), 23/42 (55%), 8/20 (40%), and 5/15 (33%), respectively. The P/ET was numerically greater for embryos produced using semen from the cloned bull (37%; B12) compared to embryos produced using semen from the original noncloned bull (20%; B1), although this difference was not statistically significant (P=0.62, Fisher’s exact test). There was a significant difference (P&lt;0.05) for the P/ET obtained with embryos produced using semen from bulls B1 and B2, but results for the other bulls were not significantly different. As far as we know, this is the first scientific report in Mexico concerning the use and comparison of semen from cloned and noncloned bulls for the production and transfer of bovine IVP embryos. In general, a wide numerical range of P/ET using the different bulls was observed (i.e. 20-55%). In this preliminary study, there was no impact of using frozen-thawed semen from a cloned bull for IVP on P/ET. The results from this research can contribute to the study and development of ART to improve P/ET obtained using Zebu IVP embryos. However, further research with a larger numbers of animals is required to confirm whether using semen from cloned and noncloned Bos indicus bulls for IVP impacts pregnancy success following embryo transfer.

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