P–757 The risk of aspirin and prednisone using in women with antithyroid antibodies undergoing assisted reproductive technology

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Xie ◽  
P Zhou ◽  
Y Yu ◽  
J Chen ◽  
L Zhou ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Miscarriage Rate ◽  
Cleavage Rate ◽  
High Quality ◽  
Antithyroid Antibodies ◽  
Blastulation Rate

Abstract Study question Is it safe using aspirin (A) and prednisone (P) before pregnancy among women with antithyroid antibodies (ATAbs) undergoing assisted reproductive technology? Summary answer Combination therapy of aspirin and prednisone didn’t improve likelihood of clinical pregnancy, but increased miscarriage rate. What is known already Compared with women with negative-ATAb, women with positive-ATAb had a lower live birth rate and a higher miscarriage rate. Insufficient evidence existed to determine whether aspirin and prednisone therapy improved the success of pregnancy following assisted reproductive technology (ART) in ATAb-positive euthyroid women. Aspirin and prednisone were used frequently in clinical practice, but the use of these medicines before pregnancy during ART process is still controversial, and the risks of these medicines were not well understood. Study design, size, duration A prospective study involving 268 women with unexplained reason for infertility who tested positive for antithyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) were being treated for infertility at the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children’s Hospital and People’s Hospital of Jinhua from October 2017 to July 2020. Their TSH level ranged from 0.35–4.0mIU/ml and they all underwent fresh embryo transfer. Participants/materials, setting, methods Overall, a total of 268 ATAb-positive women were divided 2 groups: group A: no treatment; B: A+P. Both medicines were used in the lowest effective dose. Between the two groups, we measured oocytes retrieved, fertilization rate, high-quality embryo rate, blastulation rate, cleavage rate,implantation rate, likelihood of clinical pregnancy and miscarriage rate. Kruskal-Wallis test was used in nonnormally distributed variables, and the χ2 test or Fisher exact test was used to compare categorical variables. Main results and the role of chance A total of 268 infertile women with unexplained reason who tested positive for TPOAb and/or TgAb were recruited in our study. According to assignment, they were divided into two groups. All women in different groups had the similar age, BMI, number of miscarriage and duration of infertility. Levels of FSH, AMH, TSH, FT4, FT3, fibrinogen and d-dimer were similar in all groups. The use of A+P reduced cleavage rate (F = 23.982, P < 0.001) and implantation rate (F = 4.388, P = 0.036). The fertilization rate (P = 0.407), high-quality embryo rate (P = 0.208) and blastulation rate (P = 0.157) were not influenced by the use of medication. In this study, likelihood of clinical pregnancy (P = 0.066) did not change significantly after therapy, and miscarriage rate (P = 0.042) increased after medical treatment. Limitations, reasons for caution Firstly, Aspirin is just one representation of anticoagulation therapy, so additional consideration of low molecular heparin should also be considered. Secondly, further randomized controlled trials of aspirin and prednisone alone are needed. Wider implications of the findings: In this study, use of A+P showed no positive effect, and reduced cleavage rate and implantation rate, while increased miscarriage rate. So, the use of medication for interfile women should be cautious. Trial registration number n/a

scholarly journals Efficiency Comparison Between Dry And Humid Cultures For Clinical Outcome of The In Vitro Fertilization-Embryo Transfer

2021 ◽  
Author(s):  
Weihai Xu ◽  
Lin Zhang ◽  
Ling Zhang ◽  
Shishi Li ◽  
Jing Shu
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Cleavage Rate ◽  
High Quality ◽  
Vitro Fertilization ◽  
Efficiency Comparison ◽  
Ivf Et

Abstract Background: In this study, we compared the in vitro embryo development, embryo transfer outcome and the offspring outcome in the in vitro fertilization-embryo transfer (IVF-ET) between dry culture (DC) and humid culture (HC). Methods: Our study was divided into two parts. Firstly, we determined the fertilization rate, cleavage rate and high-quality embryo rate from 21 cycles in the DC group (N=262 oocytes) and HC group (N=263 oocytes). Secondly, we determined the embryo transfer outcome and the offspring outcome in DC group (N=184 cycles) and HC group (N=136 cycles). Results: Compared with the HC group, significant increase was observed in the high-quality embryo rate (66.1.2% vs. 55.3%, p=0.037) and implantation rate (49.8% vs. 40.6%, p=0.027) in the DC group. No statistical differences were observed in the pregnant outcome and birth defect of the offspring (p>0.05). Compared with HC, DC was associated with a higher high-quality embryo rate and a higher implantation rate after embryo transfer. Conclusions: No statistical differences were noticed in the offspring conditions between the two culture modes. Taken together, DC may serve as a promising method for IVF-ET.

scholarly journals Efficiency comparison between dry and humid cultures for clinical outcome of the in vitro fertilization-embryo transfer

2021 ◽  
Author(s):  
Weihai Xu ◽  
Lin Zhang ◽  
Ling Zhang ◽  
Shishi Li ◽  
Jing Shu
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Cleavage Rate ◽  
High Quality ◽  
Vitro Fertilization ◽  
Efficiency Comparison ◽  
Ivf Et

Abstract Background: In this study, we compared the in vitro embryo development, embryo transfer outcome and the offspring outcome in the in vitro fertilization-embryo transfer (IVF-ET) between dry culture (DC) and humid culture (HC). Methods: Our study was divided into two parts. Firstly, we determined the fertilization rate, cleavage rate and high-quality embryo rate from 21 cycles in the DC group (N=262 oocytes) and HC group (N=263 oocytes). Secondly, we determined the embryo transfer outcome and the offspring outcome in DC group (N=184 cycles) and HC group (N=136 cycles). Results: Compared with the HC group, significant increase was observed in the high-quality embryo rate (66.1.2% vs. 55.3%, p=0.037) and implantation rate (49.8% vs. 40.6%, p=0.027) in the DC group. No statistical differences were observed in the pregnant outcome and birth defect of the offspring (p>0.05). Compared with HC, DC was associated with a higher high-quality embryo rate and a higher implantation rate after embryo transfer. Conclusions: No statistical differences were noticed in the offspring conditions between the two culture modes. Taken together, DC may serve as a promising method for IVF-ET.

scholarly journals Direct swim-up without centrifugation is a more recommended technique for sperm preparation in conventional IVF cycles

2019 ◽  
Author(s):  
Fang-Ting Lu ◽  
Ren-Tao Jin ◽  
Bo Xu ◽  
Li-Min Wu ◽  
Na-Ru Zhou ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Gradient Centrifugation ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Abortion Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
High Quality ◽  
Sperm Preparation ◽  
Fragmentation Index

Abstract Backgroud: The aim of this study is to investigate the most effective and maneuverable technique for sperm preparation in conventional IVF cycles. Method: A retrospective and laboratory-based study was conducted in patients who underwent their first cycle of IVF from January to December in 2016 to compare two sperm preparation techniques: direct swim-up without centrifugation (DSU) technique and density-gradient centrifugation followed by swim-up (DGC-SU) technique. A series of experiments in this study was designed to evaluate the efficiency of these two techniques which include: (i) assessment of quality and quantity of spermatozoa by comparing motility, DNA fragmentation index (DFI), acrosomal reaction (AR) and mitochondrial membrane potential (MMP) of DSU-separated sperm to DGC-SU-separated sperm, (ii) evaluation of safety of DSU technique by assessing the risks of bacterial contamination, (iii) analysis of feasibility of replacing DGC-SU with DSU technique by reviewing ART outcomes including fertilization rate, high-quality embryo rate, implantation rate, clinical pregnancy rate, take-home baby rate and abortion rate. Results: Although there were no significant differences in DFI, AR and MMP between DSU-separated sperm and DGC-SU-separated sperm, significantly higher percentage of progressive motility in DSU-separated sperm were found than that in DGC-SU-separated sperm. Moreover, there were no significant differences between DSU and DGC-SU groups on ART outcomes based on data of fertilization rate, high-quality embryo rate, implantation rate, clinical pregnancy rate, baby delivery rate and abortion rate. In addition, no bacterial contaminations were found in culture medium samples of simulating fertilization from DSU group. However, it is noticeable that DSU technique required less time and labor for sperm preparation compared with DGC-SU.

scholarly journals Comparative effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG HP) in assisted reproductive technology (ART) treatments: a non-interventional study in Germany

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Klaus F. Bühler ◽  
Robert Fischer ◽  
Patrice Verpillat ◽  
Arthur Allignol ◽  
Sandra Guedes ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Follicle Stimulating Hormone ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Human Menopausal Gonadotropin ◽  
Ongoing Pregnancy ◽  
Complete Cycle ◽  
Significant Difference

Abstract Background This study compared the effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa; GONAL-f®) with urinary highly purified human menopausal gonadotropin (hMG HP; Menogon HP®), during assisted reproductive technology (ART) treatments in Germany. Methods Data were collected from 71 German fertility centres between 01 January 2007 and 31 December 2012, for women undergoing a first stimulation cycle of ART treatment with r-hFSH-alfa or hMG HP. Primary outcomes were live birth, ongoing pregnancy and clinical pregnancy, based on cumulative data (fresh and frozen-thawed embryo transfers), analysed per patient (pP), per complete cycle (pCC) and per first complete cycle (pFC). Secondary outcomes were pregnancy loss (analysed per clinical pregnancy), cancelled cycles (analysed pCC), total drug usage per oocyte retrieved and time-to-live birth (TTLB; per calendar week and per cycle). Results Twenty-eight thousand six hundred forty-one women initiated a first treatment cycle (r-hFSH-alfa: 17,725 [61.9%]; hMG HP: 10,916 [38.1%]). After adjustment for confounding variables, treatment with r-hFSH-alfa versus hMG HP was associated with a significantly higher probability of live birth (hazard ratio [HR]-pP [95% confidence interval (CI)]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; relative risk [RR]-pFC [95% CI]: 1.09 [1.05, 1.15], ongoing pregnancy (HR-pP [95% CI]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; RR-pFC [95% CI]: 1.10 [1.05, 1.15]) and clinical pregnancy (HR-pP [95% CI]: 1.10 [1.05, 1.14]; HR-pCC [95% CI]: 1.14 [1.10, 1.19]; RR-pFC [95% CI]: 1.10 [1.06, 1.14]). Women treated with r-hFSH-alfa versus hMG HP had no statistically significant difference in pregnancy loss (HR [95% CI]: 1.07 [0.98, 1.17], were less likely to have a cycle cancellation (HR [95% CI]: 0.91 [0.84, 0.99]) and had no statistically significant difference in TTLB when measured in weeks (HR [95% CI]: 1.02 [0.97, 1.07]; p = 0.548); however, r-hFSH-alfa was associated with a significantly shorter TTLB when measured in cycles versus hMG HP (HR [95% CI]: 1.07 [1.02, 1.13]; p = 0.003). There was an average of 47% less drug used per oocyte retrieved with r-hFSH-alfa versus hMG HP. Conclusions This large (> 28,000 women), real-world study demonstrated significantly higher rates of cumulative live birth, cumulative ongoing pregnancy and cumulative clinical pregnancy with r-hFSH-alfa versus hMG HP.

P–515 Clinical outcome of mosaic-blastocyst transfer versus euploid-blastocyst transfer in single frozen blastocyst transfer cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
W Y Yap ◽  
M W Lim ◽  
C S S Lee
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Statistical Significance ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Miscarriage Rate ◽  
Similar Clinical Outcome ◽  
Group A ◽  
Transfer Group

Abstract Study question What is the clinical outcome of transferring a mosaic blastocyst versus a euploid blastocyst in single frozen blastocyst transfer (sFBT) cycles? Summary answer Single mosaic blastocyst transfer has similar clinical outcome to single euploid blastocyst transfer. What is known already Embryonic mosaicism occurs when there are two or more distinct cell lines found in preimplantation embryos derived from IVF. Data from recent studies show that mosaic blastocysts have the potential to implant and can result in healthy live births. As a result, patients now have the option of transferring mosaic blastocyst when they do not have any euploid blastocyst available for transfer. However, the clinical outcome of transferring mosaic blastocyst has not been definitively reported. Thus, a retrospective study was conducted to compare the clinical outcome of mosaic sFBT and euploid sFBT. Study design, size, duration A total of 602 patients underwent frozen blastocyst transfer in Alpha IVF from January to October 2019 and had their blastocysts screened for aneuploidy. These patients were divided into 2 groups: 26 patients with mosaic blastocysts transferred (Group A, age ranged 19–44), and 576 patients with euploid blastocysts transferred (Group B, age ranged 21–44). The mean age of patients from Group A and B were 34.0 and 32.8 respectively (p > 0.05). Participants/materials, setting, methods All samples had their DNA libraries constructed for sequencing using Next Generation Sequencing according to manufacturer’s specification (IonTorrent, USA). All blastocysts were frozen for subsequent sFBT cycle (Cryotech, Japan). All thawed blastocysts for sFBT survived with morphologically intact inner cell mass and trophectoderm cells. The importance of antenatal confirmation of the fetal chromosome status was emphasized in patients from Group A. The clinical outcomes of both groups were analysed and compared. Main results and the role of chance No significant differences were seen in the clinical pregnancy and implantation rate of Group A and B (65.4% vs 63.0%; p > 0.05). The miscarriage rate of Group A and B were 23.5% and 14.0% respectively. Albeit the higher miscarriage rate in Group A, there was no statistical significance between these two groups (p > 0.05). Group A was further divided into two subgroups, Subgroup A1: low risk mosaic blastocyst transfer; Subgroup A2: high risk mosaic blastocyst transfer. In the comparison of Group A subgroups, the clinical pregnancy and implantation of Group A1 is higher than Group A2 (76.9% vs 44.4%). In addition, the miscarriage rate of Group A1 and A2 were 23.1% and 0.0% respectively. Interestingly, there was no statistical significance in clinical pregnancy rate, implantation rate and miscarriage rate between these two subgroups. Limitations, reasons for caution This is a retrospective study and the sample size was comparatively smaller in the mosaic blastocyst transfer group than the euploid blastocyst transfer group. Further studies with a larger sample size should be carried out to ascertain the clinical outcome. Wider implications of the findings: Single mosaic blastocyst transfer has similar clinical outcome to single euploid blastocyst transfer. Thus, mosaic blastocyst can be considered for transfer when no euploid blastocyst are available. Nevertheless, stringent antenatal surveillance for chromosomal abnormalities to confirm the chromosomal status of the fetus must be followed. Trial registration number Not applicable

scholarly journals The efficiency of IVF/ICSI protocols in female subclinical hypothyroidism and thyroid autoimmunity

2019 ◽  
Vol 68 (4) ◽  
pp. 83-94
Author(s):  
Galina Kh. Safaryan ◽  
Alexander M. Gzgzyan ◽  
Lyailya Kh. Dzhemlikhanova ◽  
Dariko A. Niauri
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Autoimmunity ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Current Data ◽  
Human Reproduction ◽  
Overt Hypothyroidism ◽  
Miscarriage Rate ◽  
Immunological Alterations

While overt hypothyroidism is a well-known risk factor for infertility, the association of subclinical hypothyroidism (SCH) or thyroid autoimmunity with reproductive failure has been still not cleared. This literature review focuses on the most current data linking SCH and/or thyroid autoimmunity with human reproduction, starting with the parameters of ovarian reserve and ending with generalized immunological alterations. The main ART outcome measures are as follows: number of oocytes retrieved, fertilization rate, embryo quality, implantation rate, clinical pregnancy rate per embryo transfer, miscarriage rate, and live birth rate. Summary of the information regarding the effect of levothyroxine supplementation on IVF outcome as well as workup and management of women with SCH and thyroid autoimmunity undergoing ART cycles is also presented in this review.

scholarly journals The effect of insemination methods on in vitro maturation outcomes

2020 ◽  
Vol 47 (2) ◽  
pp. 130-134
Author(s):  
Pallop Pongsuthirak
Keyword(s):  
Polycystic Ovary ◽  
Implantation Rate ◽  
Fertilization Rate ◽  
Blastocyst Stage ◽  
Clinical Pregnancy ◽  
Developmental Competence ◽  
Assisted Reproductive Treatment ◽  
Maturation Rate ◽  
A Prospective Study

Objective: The aim of this study was to compare the effects of conventional insemination (<i>in vitro</i> fertilization [IVF]) and intracytoplasmic sperm injection (ICSI) on the fertilization, developmental competence, implantation potential, and clinical pregnancy rate of embryos derived from <i>in vitro</i> matured oocytes of patients with polycystic ovary syndrome (PCOS).Methods: A prospective study was carried out among 38 PCOS patients who had undergone <i>in vitro</i> maturation (IVM) treatment. In total, 828 immature oocytes were collected from 42 cycles and randomly assigned for insemination by IVF (416 oocytes) or ICSI (412 oocytes). After fertilization, the embryos were cultured until the blastocyst stage and single embryos were transferred after endometrial preparation and under ultrasound guidance.Results: No significant differences were found in the maturation rate (78.1% vs. 72.6% for IVF and ICSI insemination, respectively; <i>p</i>= 0.076), fertilization rate (59.4% vs. 66.9% for IVF and ICSI insemination, respectively; <i>p</i>= 0.063), or the formation of good-quality blastocysts (40.9% vs. 46.5% for IVF and ICSI insemination, respectively; <i>p</i>= 0.314). Implantation and clinical pregnancy also did not show significant differences.Conclusion: There was a comparable yield of <i>in vitro</i> matured oocytes derived from PCOS patients in terms of fertilization, blastocyst formation, implantation rate, and clinical pregnancy between IVF and ICSI insemination. These findings provide valuable insights for choosing assisted reproductive treatment in women with PCOS, as IVM offers promising outcomes and is less invasive and less costly.

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