scholarly journals A Comparative Study to Assess the Efficacy of Two Different Estradiol Formulations during In Vitro Fertilization

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Manish Banker ◽  
Parul Arora ◽  
Jwal Banker ◽  
Sandeep Shah
Keyword(s):  
In Vitro Fertilization ◽  
Endometrial Thickness ◽  
Hormone Replacement ◽  
Implantation Rate ◽  
Secondary Outcome ◽  
Estradiol Valerate ◽  
Uterine Receptivity ◽  
Clinical Practices ◽  
Vitro Fertilization

Improvements in stimulation protocols, introduction of vitrification, and changes in clinical practices have contributed to improved efficacy and safety of assisted reproductive technology (ART) procedures. This has also led to a concomitant increase in number of cycles requiring hormone replacement therapy (HRT) protocol for performing an embryo transfer. Successful implantation is dependent on endometrial thickness which in turn is regulated by temporal regulation of hormones. Careful control of estrogen levels determines uterine receptivity. One of the most used drugs for achieving appropriate endometrial lining of >7 mm in HRT is estradiol valerate. Although different estrogen formulations with varying physicochemical properties exist, there is not enough literature to support if the differences translate into a discernible clinical outcome in an in vitro fertilization (IVF) setting. Objective and Method. In this study, retrospective in nature, we compare the efficacy of oral estradiol hemihydrate with estradiol valerate in HRT cycles in 2,529 Indian women, undergoing treatment at a center in India between Jan 2017 and May 2019. Results. Our results primarily indicate that between the estradiol valerate and estradiol hemihydrate treatment groups, the implantation rate (IR) was 47.42% and 49.07%, respectively ( P value 0.284), and the endometrial thickness ( mean ± SEM in mm) that was achieved was 9.25 ± 0.038  mm and 9.57 ± 0.058  mm ( P value < 0.001), respectively. There were no significant differences observed in the secondary outcome measures including clinical pregnancy rate, abortion rate, ectopic pregnancy, and live birth rate. Conclusions. Hence, this study concludes that oral estradiol hemihydrate and estradiol valerate are therapeutically equivalent and provide similar clinical outcomes in an IVF setting.

The effectiveness of different protocols of preparation of the endometrium when transferring vitrified/warmed embryos

2017 ◽  
pp. 30-32
Author(s):  
V.Y. Parashchuk ◽  
◽  
A.S. Lutsky ◽  
N.G. Gryshchenko ◽  
◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
In Vitro Fertilization ◽  
Replacement Therapy ◽  
Embryo Transfer ◽  
Ovarian Hyperstimulation Syndrome ◽  
Hormone Replacement ◽  
Implantation Rate ◽  
Vitro Fertilization ◽  
Frozen Embryos

Currently, there is a tendency toward increasing usage of criocycles in programs of in vitro fertilization. This approach allows to achieve pregnancy as well as prevent the development of ovarian hyperstimulation syndrome and utilize the pre-implantation genetic diagnostics. The objective: to improve the efficiency of in vitro fertilization treatment cycles with transferring of cryopreserved/warmed embryos into the uterus. Patients and methods. The study of 824 treatment cycles (in natural menstrual cycle, in cycle with hormone replacement therapy, after egg donation, in natural cycle without embryo transfer in «fresh» cycle, in cycle with hormone replacement therapy without embryo transfer in «fresh» cycle). Vitrification and cryopreservation method. Results. The analysis of the study results has shown that the implantation rate of frozen embryos in the natural cycle is higher than in the cycle with hormone replacement therapy. The implantation rate of frozen embryos after the use of agonist gonadotropin-releasing hormone as a trigger of final maturation of the agonist is higher than that of human chorionic gonadotropin, which allows us to consider vitrification as an effective tool that provides great flexibility of conducting controlled ovarian stimulation cycles and prevention of ovarian hyperstimulation syndrome. Conclusion. The effectiveness of frozen embryo transfer protocols gives us grounds to assert that the optimum cycle for the transfer is a cycle without stimulation. Key words: in vitro fertilization, the endometrium, frozen embryo implantation.

scholarly journals Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Alessio Paffoni ◽  
Marco Reschini ◽  
Valerio Pisaturo ◽  
Cristina Guarneri ◽  
Simone Palini ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Fertilization Failure ◽  
Vitro Fertilization ◽  
Rescue Icsi

Abstract Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

scholarly journals Individualized embryo selection strategy developed by stacking machine learning model for better in vitro fertilization outcomes: an application study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qingsong Xi ◽  
Qiyu Yang ◽  
Meng Wang ◽  
Bo Huang ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Machine Learning ◽  
In Vitro Fertilization ◽  
Endometrial Thickness ◽  
Learning System ◽  
Embryo Selection ◽  
Selection Strategy ◽  
Application Study ◽  
Vitro Fertilization ◽  
The Impact

Abstract Background To minimize the rate of in vitro fertilization (IVF)- associated multiple-embryo gestation, significant efforts have been made. Previous studies related to machine learning in IVF mainly focused on selecting the top-quality embryos to improve outcomes, however, in patients with sub-optimal prognosis or with medium- or inferior-quality embryos, the selection between SET and DET could be perplexing. Methods This was an application study including 9211 patients with 10,076 embryos treated during 2016 to 2018, in Tongji Hospital, Wuhan, China. A hierarchical model was established using the machine learning system XGBoost, to learn embryo implantation potential and the impact of double embryos transfer (DET) simultaneously. The performance of the model was evaluated with the AUC of the ROC curve. Multiple regression analyses were also conducted on the 19 selected features to demonstrate the differences between feature importance for prediction and statistical relationship with outcomes. Results For a single embryo transfer (SET) pregnancy, the following variables remained significant: age, attempts at IVF, estradiol level on hCG day, and endometrial thickness. For DET pregnancy, age, attempts at IVF, endometrial thickness, and the newly added P1 + P2 remained significant. For DET twin risk, age, attempts at IVF, 2PN/ MII, and P1 × P2 remained significant. The algorithm was repeated 30 times, and averaged AUC of 0.7945, 0.8385, and 0.7229 were achieved for SET pregnancy, DET pregnancy, and DET twin risk, respectively. The trend of predictive and observed rates both in pregnancy and twin risk was basically identical. XGBoost outperformed the other two algorithms: logistic regression and classification and regression tree. Conclusion Artificial intelligence based on determinant-weighting analysis could offer an individualized embryo selection strategy for any given patient, and predict clinical pregnancy rate and twin risk, therefore optimizing clinical outcomes.

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 Tumor necrosis factor-308 polymorphism increases the embryo implantation rate in women undergoing in vitro fertilization

2013 ◽  
Vol 28 (10) ◽  
pp. 2774-2783 ◽  
Author(s):  
F. Vialard ◽  
M. El Sirkasi ◽  
V. Tronchon ◽  
R. Boudjenah ◽  
D. Molina-gomes ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Vitro Fertilization ◽  
Embryo Implantation Rate ◽  
Necrosis Factor
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