scholarly journals Enhancing the scope of in vitro maturation for fertility preservation: transvaginal retrieval of immature oocytes during endoscopic gynaecological procedures

2020 ◽  
Vol 35 (4) ◽  
pp. 837-846 ◽  
Author(s):  
Xue-Ling Song ◽  
Cui-Ling Lu ◽  
Xiao-Ying Zheng ◽  
Victoria Nisenblat ◽  
Xiu-Mei Zhen ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Fertility Preservation ◽  
In Vitro Maturation ◽  
Ovarian Function ◽  
Oocyte Retrieval ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Operative Complications ◽  
Transvaginal Oocyte Retrieval

Abstract STUDY QUESTION Could in vitro maturation (IVM) following transvaginal oocyte retrieval during gynaecological surgery (IVM-surgery) be an effective and safe strategy for fertility preservation? SUMMARY ANSWER IVM-surgery on unstimulated ovaries is a novel option that can be considered for fertility preservation for women requiring gynaecological surgery, but more research is needed to identify appropriate patients who may benefit and to determine the cost-effectiveness of such an approach. WHAT IS KNOWN ALREADY IVM followed by oocyte/embryo cryopreservation has been useful as a safe reproductive strategy for some infertile women. STUDY DESIGN, SIZE, DURATION This prospective cohort study comprised 158 consecutive women with polycystic ovary syndrome (PCOS) who underwent laparoscopy or hysteroscopy for other reasons and had concomitant transvaginal oocyte retrieval followed by IVM between 2014 and 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 158 women with anovulatory PCOS who underwent IVM-surgery in our infertility centre were recruited for this study. Matured IVM oocytes obtained from these women were either freshly fertilized and subsequently frozen at the blastocyst stage (fresh oocyte group, n = 46) or the oocytes were frozen (frozen oocyte group, n = 112) for fertility preservation followed by later thawing for insemination and cleavage embryo transfer (ET) (n = 33). The following outcomes were then evaluated: embryological data, clinical pregnancy rate, live birth rate (LBR), neonatal outcomes, post-operative complications and post-operative ovarian function. MAIN RESULTS AND THE ROLE OF CHANCE Among all the women who underwent IVM-surgery, the clinical pregnancy rate and LBR per initiated IVM cycle were 9.5% (15/158) and 6.9% (11/158), respectively. Women (40.6%, 20/33) who underwent the procedure with frozen-thawed oocytes (oocyte survival rate, 83.0%) obtained a high quality of cleaved embryos. In the fresh oocyte group, the clinical pregnancy rate and LBR per ET cycle were 69.2 and 53.8%, respectively. In the frozen oocyte group, the clinical pregnancy rate and LBR per ET cycle were 28.6 and 19.1%, respectively. No adverse neonatal outcomes were recorded. IVM-surgery was not associated with post-operative complications, a longer hospital stay, or impaired ovarian function. LIMITATIONS, REASONS FOR CAUTION Because of the small sample size and the low utilization rate and cost-effectiveness per retrieval, the present findings should be interpreted with caution, and further studies are needed for the long-term follow-up of live births. WIDER IMPLICATIONS OF THE FINDINGS This strategy can also help patients with normal ovulation to obtain available oocytes and embryos for cryopreservation and subsequent use. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Joint Research Fund for Overseas Natural Science of China (No. 31429004), the National Key Research and Development Program of China (No. 2017YFC1002000, 2017YFC1001504, 2016YFC1000302), the Ministry of Science and Technology of China Grants (No. 2014CB943203), the Chinese Society of Reproductive Medicine Fund (No. 16020400656) and the National Natural Science Foundation of China (No. 81300456). All the authors have nothing to disclose in terms of conflicts of interest. TRIAL REGISTRATION NUMBER chictr-ONC-17011861

scholarly journals Day-2 serum progesterone level and IVF/ICSI outcome: a comparative study

2017 ◽  
Vol 6 (5) ◽  
pp. 1871
Author(s):  
Akshaya Kumar Mahapatro ◽  
Abhishek Radhakrishan
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Progesterone Level ◽  
In Vitro Fertilisation ◽  
Serum Progesterone ◽  
Significant Difference

Background: Purpose of this study was to evaluate the in vitro fertilisation outcome in patients having normal or elevated day-2 serum progesterone level undergone IVF by using GnRH antagonist.Methods: A retrospective study conducted in Institute of Reproductive Medicine, Chennai during January 2013 to March 2014. According to patient’s Day-2 serum progesterone level the total no of cases (N=151) were divided into two groups group-1 (N=116) with progesterone value ≤1.5ng/ml and group-2 (N=35) with progesterone value>1.5ng/ml. Ovarian stimulation was started with recombinant FSH on day 2 and GnRH antagonist injections started from day 6 of stimulation. Total dose of gonadotropins, days of gonadotrophin injections, no of eggs collected, Clinical pregnancy rate and live birth rate were compared between two groups.Results: Two groups were similar with regards to age, BMI, days of gonadotrophins and total doses of gonadotrophins. Incidence of elevated P level was 23.17%. Total pregnancy rate was 36.42%. A non-statistically-significant difference was observed in clinical pregnancy (37.06% vs 34.28%) and live birth (32.75% vs 28.57%) between the normal and elevated progesterone groups.Conclusions: Elevated day-2 serum progesterone level   was associated with lower clinical pregnancy rate but it was not statistically-significant.

Luteal phase oocyte retrieval and in vitro maturation is an optional procedure for urgent fertility preservation

2011 ◽  
Vol 95 (1) ◽  
pp. 64-67 ◽  
Author(s):  
Ettie Maman ◽  
Dror Meirow ◽  
Masha Brengauz ◽  
Hila Raanani ◽  
Jehushua Dor ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Luteal Phase ◽  
In Vitro Maturation ◽  
Oocyte Retrieval

P–231 Transnational oocyte donation program between Italy and Spain based on transport of vitrified oocytes: a five-years experience

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Volpes ◽  
S Gullo ◽  
M Modica ◽  
P Scaglione ◽  
A Marino ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Function ◽  
Multiple Pregnancy ◽  
Oocyte Donation ◽  
Blastocyst Stage ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Egg Donation ◽  
Cleavage Stage ◽  
Miscarriage Rate

Abstract Study question What is the clinical efficacy of an oocyte donation program based on the transportation of vitrified oocytes between two countries? Summary answer The transnational oocyte donation program is efficient, safe and comparable to other strategies (transport of frozen sperm and embryos). What is known already Egg donation represents a valid treatment strategy for women who have exhausted their ovarian function and it has considerably increased in the last years. In Italy, egg donation is allowed after the judgment of the Constitutional Court n. 162 in 2014 but no reimbursement for the donors is provided. For this reason, the number of voluntary donors is irrelevant. Therefore, the great majority of egg donation cycles is carried out by using imported cryopreserved oocytes from foreign countries. However, recent evidence has questioned the overall efficacy of this strategy in comparison with the shipment of frozen sperm and vitrified embryos. Study design, size, duration A retrospective cohort study was conducted between July 2015-December 2020 at two private IVF clinics. 264 couples were treated (mean maternal age: 43.1± 4.6 years, range: 26–51; mean donor age: 24 ±3 years, range: 20–33) with vitrified oocytes shipped from a single Spanish egg bank (IMER, Valencia) to the receiving reproductive clinic in Italy (ANDROS Clinic, Palermo). All the oocytes for each batch were thawed. Participants/materials, setting, methods The primary outcome of this study was the cumulative clinical pregnancy rate (CPR) among the completed cycles for each batch of oocytes. Those cycles in which a clinical pregnancy was obtained, or all embryos derived by a single batch of oocytes had been transferred or no embryo was produced were defined as completed. In addition to main analyses, sensitivity analysis was performed to examine how the number of inseminated oocytes may affect CPR. Main results and the role of chance 2,367 oocytes in 355 batches were sent from Spain to Italy. 2,209 oocytes in 334 batches for 264 patients were thawed with a survival rate of 82.4% (1,821/2,209). The mean number of oocytes received per patient was 6.6 ± 1.0. The fertilization rate was 72.1% (1,312/1,821). 499 embryos were transferred (38.0%), 335 at the cleavage stage (67.1%) and 164 at the blastocyst stage (32.9%); 197 supernumerary embryos were vitrified (15.0%), 18 at the cleavage stage (9.1%) and 179 at the blastocyst stage (90.9%). 616 embryos were not viable (47.0%). No more than two embryos were transferred for each embryo transfer (ET). The completed cycles were 307 out of 334 (91.9%). The CPR per completed cycles was 46.6% (143/307) and 54.2% per patient (143/264). Clinical pregnancy rate per fresh ET in completed cycles with supernumerary cryopreserved embryos was significantly higher compared with that of the completed cycles without surplus embryos (56/101 versus 68/193, p = 0.001). Logistic regression revealed that the number of inseminated oocytes was positively associated with CPR in a significant manner (B = 0.220, p = 0.007; OR = 1.25, 95%CI=1.06–1.47). The multiple pregnancy rate was 15.4% (1 triplet and 21 twin pregnancies). The miscarriage rate was 22.4% (32/143). Limitations, reasons for caution The retrospective design of the study needs to be confirmed in larger and multicenter prospective studies comparing the strategy of vitrified donated oocytes and fresh ET with the policy of fresh donated oocyte and frozen/thawed ET. Wider implications of the findings: The transnational oocyte donation program with vitrified oocytes is associated with good success rates. The number of inseminated oocytes represents a crucial factor for increasing the CPR, improving the embryo selection for fresh ET and giving more chances of pregnancy with the transfer of surplus vitrified embryos. Trial registration number Not applicable

scholarly journals Male adiposity impairs clinical pregnancy rate by in vitro fertilization without affecting day 3 embryo quality

Obesity ◽  
2013 ◽  
Vol 21 (8) ◽  
pp. 1608-1612 ◽  
Author(s):  
Zaher O. Merhi ◽  
Julia Keltz ◽  
Athena Zapantis ◽  
Joshua Younger ◽  
Dara Berger ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Embryo Quality ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Vitro Fertilization ◽  
Day 3 Embryo

scholarly journals Mean blastomere diameter may predict clinical pregnancy in long agonist protocol intracytoplasmic sperm injection cycles with single embryo transfer

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Suleyman Guven ◽  
Sebnem Alanya Tosun ◽  
Emine Seda Guvendag Guven
Keyword(s):  
Pregnancy Rate ◽  
Single Embryo Transfer ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Female Age ◽  
Vitro Fertilization ◽  
A Value ◽  
The Mean ◽  
Embryo Grade

Abstract Background The main purpose of this study was to investigate the effect of mean blastomere diameter (MBD) on pregnancy rates in in vitro fertilization (IVF) cases undergoing the long agonist cycle protocol. A total of 84 cases were evaluated within the scope of this observational prospective study. All cases were normoresponders, under 35 years old, with the long agonist protocol applied and single embryo (grade I or II) transfer performed. On the third day after ICSI, each embryo selected for transfer was subjected to measurement of the mean blastomere diameter (MBD) at ×25 magnification. Results The mean female age was 30.14 ± 3.32 years, and the total clinical pregnancy rate was 33.3%. In the group that got pregnant, MBD was found to be statistically significantly higher than in the nonpregnant group. In terms of predicting clinical pregnancy, when the MBD value of 49.73 μm was accepted as the best cutoff value, the sensitivity was calculated as 75% and specificity as 53.6%. Clinical pregnancy rate was 18.9% in cases below this value, whereas clinical pregnancy rate was 44.7% in cases with this value and above. In other words, when the MBD value rose above 49.73 μm from a value below 49.73 μm, the clinical pregnancy rate increased by an average of 2.3 times. Conclusions With MBD measurement, it is possible to select the embryo with the best implantation capability in microinjection cycles with the long luteal agonist protocol.

Sign in / Sign up

Export Citation Format

Share Document