Does a Large (>24 mm) Follicle Yield a Competent Oocyte/Embryo?

2020 ◽  
Vol 85 (5) ◽  
pp. 416-419
Author(s):  
Raoul Orvieto ◽  
Aya Mohr-Sasson ◽  
Shlomit Blumenfeld ◽  
Ravit Nahum ◽  
Adva Aizer ◽  
...  
Keyword(s):  
Embryo Quality ◽  
Medical Center ◽  
Oocyte Retrieval ◽  
Mature Oocyte ◽  
Group Differences ◽  
Large Follicle ◽  
Follicular Aspiration ◽  
Oocyte Fertilization ◽  
Follicular Size ◽  
Nonsignificant Decrease

<b><i>Aim:</i></b> To evaluate the effect of large follicular size (≥24 mm) at day of oocyte retrieval on oocyte/embryo quality. <b><i>Patients and Methods:</i></b> A cohort study was conducted in a single tertiary medical center between July 2018 and May 2019. Before ultrasound-guided follicular aspiration, follicles were measured and divided into 2 groups according to their maximal dimensional size: large: ≥24 mm and normal: &#x3c;24 mm. Microscopic examination of the follicular aspirates was performed by an embryologist. Each follicle aspirated was evaluated for oocyte maturation, oocyte fertilization, and embryo quality. <b><i>Results:</i></b> 428 follicles were measured, including 383 (62.81%) in the normal and 45 (14.06%) in the large follicle groups. Oocytes were achieved during aspiration from 297 (75.5%) and 29 (64.4%) of the normal and large follicle groups, respectively (<i>p</i> = 0.05). No in-between group differences were observed in mature oocyte (MII), fertilization, and top-quality embryo (TQE) rates. Nevertheless, once a zygote (2PN) was achieved, a trend toward a higher TQE rate/2PN was found in the large follicle group (16/19 [84.2%] vs. 115/171 [67.3%]; <i>p</i> = 0.062). <b><i>Conclusion:</i></b> While a nonsignificant decrease in oocyte recovery rate was found in follicles ≥24 mm, the zygote and TQE per follicle were comparable.

scholarly journals Does large (>24mm) follicle yield a competent oocyte/embryo?

2020 ◽  
Author(s):  
Raoul Orvieto ◽  
Aya Mohr-Sasson ◽  
Shlomit Blumenfeld ◽  
Ravit Nahum ◽  
Adva Aizer ◽  
...  
Keyword(s):  
Embryo Quality ◽  
Medical Center ◽  
Oocyte Retrieval ◽  
Mature Oocyte ◽  
Group Differences ◽  
Ultrasound Guided ◽  
Large Follicle ◽  
Follicular Aspiration ◽  
Oocyte Fertilization ◽  
Follicular Size

Abstract Aim: To evaluate the effect of large follicular size ( > 24mm) at day of oocyte retrieval on oocyte/embryo quality. Patients and Methods: A cohort study conducted in a single tertiary medical center between July 2018 and May 2019. Before ultrasound-guided follicular aspiration, follicles were measured and divided into two groups according to their maximal dimensional size: large: ≥24 mm and normal: <24 mm. Microscopic examination of the follicular aspirates was performed by embryologist. Each follicle aspirated was evaluated for oocyte maturation, oocyte fertilization and embryo quality. Results: 428 follicles were measured, including 383 (62.81%) in the normal and 45 (14.06%) in the large follicle groups. Oocytes were achieved during aspiration from 297 (75.5%) and 29 (64.4%) of the normal and large follicle groups, respectively (p=0.05). No in-between group differences were observed in mature oocyte (MII), fertilization and top quality embryo (TQE) rates. Nevertheless, once a zygote (2PN) was achieved, a trend toward a higher TQE rate/2PN was found in the large follicle group [16 /19 (84.2%) vs. 115/171 (67.3%); p=0.062]. Conclusion: While a non-significant decrease in oocyte recovery rate was found in follicles ≥24 mm, the zygote and TQE per follicles were comparable.** Drs. Orvieto and Mohr-Sasson should be considered "similar in author order."

scholarly journals Trimethylamine-N-oxide is present in human follicular fluid and is a negative predictor of embryo quality

2020 ◽  
Vol 35 (1) ◽  
pp. 81-88 ◽  
Author(s):  
R A Nagy ◽  
I Homminga ◽  
C Jia ◽  
F Liu ◽  
J L C Anderson ◽  
...  
Keyword(s):  
Follicular Fluid ◽  
Embryo Quality ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Academic Medical Center ◽  
Gut Bacteria ◽  
Human Follicular Fluid ◽  
Cross Sectional ◽  
Oocyte Fertilization ◽  
Negative Predictor

Abstract STUDY QUESTION Are levels of trimethylamine-N-oxide (TMAO) in human follicular fluid (FF) related to IVF outcomes? SUMMARY ANSWER Higher levels of TMAO are a negative predictor of oocyte fertilization and embryo quality. WHAT IS KNOWN ALREADY TMAO is a metabolic product of dietary choline and l-carnitine produced via subsequent enzymatic modifications by the intestinal microbiota and hepatocytes. TMAO promotes inflammatory and oxidative stress pathways and has been characterized as a causative biomarker for the development of cardiometabolic disease. STUDY DESIGN, SIZE, DURATION For the present cross-sectional study, samples (FF and plasma) from 431 modified natural cycle (MNC)-IVF cycles of 132 patients were collected prospectively between October 2014 and March 2018 in a single academic medical center. PARTICIPANTS/MATERIALS, SETTING, METHODS TMAO and its precursors (choline, l-carnitine and gamma-butyrobetaine) were measured by ultra-high-performance liquid chromatography/mass spectrometry in (i) matched FF and plasma from 63 MNC-IVF cycles, in order to compare metabolite levels in the two matrices and (ii) FF from 232 MNC-IVF cycles in which only one oocyte was retrieved at follicular puncture. The association between metabolite levels and oocyte fertilization, embryo fragmentation percentage, embryo quality and the occurrence of pregnancy was analyzed using multilevel generalized estimating equations with adjustment for patient and cycle characteristics. MAIN RESULTS AND THE ROLE OF CHANCE The level of choline was higher in FF as compared to matched plasma (P &lt; 0.001). Conversely, the levels of TMAO and gamma-butyrobetaine were lower in FF as compared to plasma (P = 0.001 and P = 0.075, respectively). For all metabolites, there was a positive correlation between FF and plasma levels. Finally, levels of TMAO and its gut-derived precursor gamma-butyrobetaine were lower in FF from oocytes that underwent normal fertilization (TMAO: odds ratio [OR] 0.66 [0.49–0.90], P = 0.008 per 1.0-μmol/L increase; gamma-butyrobetaine: OR 0.77 [0.60–1.00], P = 0.047 per 0.1-μmol/L increase) and developed into top-quality embryos (TMAO: OR 0.56 [0.42–0.76], P &lt; 0.001 per 1.0-μmol/L increase; gamma-butyrobetaine: OR 0.79 [0.62–1.00], P = 0.050 per 0.1-μmol/L increase) than in FF from oocytes of suboptimal development. LIMITATIONS, REASONS FOR CAUTION The individual contributions of diet, gut bacteria and liver to the metabolite pools have not been quantified in this analysis. WIDER IMPLICATIONS OF THE FINDINGS More research on the contribution of diet and the effect of gut bacteria on FF TMAO is warranted. Since TMAO integrates diet, microbiota and genetic setup of the person, our results indicate potential important clinical implications for its use as biomarker for lifestyle interventions to improve fertility. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received for this project. The Department of Obstetrics and Gynecology of the University Medical Center Groningen received an unrestricted educational grant of Ferring Pharmaceutical BV, the Netherlands. The authors have no other conflicts of interest. TRIAL REGISTRATION NUMBER Netherlands Trial Register number NTR4409.

Effect of follicular size on oocyte retrieval, fertilization, cleavage, and embryo quality in in vitro fertilization cycles: a 6-year data collection

1994 ◽  
Vol 62 (6) ◽  
pp. 1205-1210 ◽  
Author(s):  
Frank M. Wittmaack ◽  
Donald O. Kreger ◽  
Luis Blasco ◽  
Richard W. Tureck ◽  
Luigi Mastroianni ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Data Collection ◽  
Embryo Quality ◽  
Oocyte Retrieval ◽  
Vitro Fertilization ◽  
Follicular Size

scholarly journals OP0159 EFFICACY OF COMPREHENSIVE TECHNOLOGY-ASSISTED HOME-BASED EXERCISE IN ANKYLOSING SPONDYLITIS: A RANDOMIZED, CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Group Differences ◽  
Control Group ◽  
Home Based ◽  
The Mean

Background:Clinical practice guidelines recommend that exercise is an essential component in the self-management of Ankylosing Spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be burdensome and patients may decline participation, whereas, effective home-based exercise interventions that do not need regular medical center visits are likely to be more accessible and acceptable for patients with AS. Recently, increasing evidences have been accumulated that the wearable devices could facilitate patients with inflammatory arthritis by giving exercise instructions and improving self-efficacy. Therefore, patients with AS may benefit from an effective technology-assisted home-based exercise intervention.Objectives:To investigate the efficacy of a comprehensive technology-assisted home-based exercise intervention on disease activity in patients with AS.Methods:This study was a 16-week assessor-blinded, randomized, waiting-list controlled trial (ChiCTR1900024244). Patients with AS were randomly allocated to the home-based exercise intervention group and the waiting-list control group. A 16-week comprehensive exercise program consisting of a moderate intensity (64%-76% HRmax) aerobic training for 30min on 5 days/week and a functional training for 60min on 3 days/week was given to patients in the intervention group immediately after randomization, with 1.5h training sessions for two consecutive days by a study physical therapist at baseline and Week 8. The aerobic exercise intensity was controlled by a Mio FUSE Wristband with a smartphone application. The functional training consisted of the posture training, range of motion exercises, strength training, stability training and stretching exercises. Patients in control group received standard care during the 16-week follow-up and started to receive the exercise program at Week 16. The primary outcome was ASDAS at Week 16. The secondary outcomes were BASDAI, BASFI, BASMI, ASAS HI, peak oxygen uptake, body composition and muscle endurance tests. The mean difference between groups in change from baseline was analyzed with the analysis of covariance.Results:A total of 54 patients with AS were enrolled (26 in intervention group and 28 in control group) and 46 (85.2%) patients completed the 16-week follow-up. The mean difference of ASDAS between groups in change from baseline to 16-week follow-up was −0.2 (95% CI, −0.4 to 0.003, P = 0.032), and the mean change from baseline was -0.4 (95% CI, -0.5 to -0.2) in the intervention group vs -0.1 (95% CI, -0.3 to 0.01) in the control group, respectively. Significant between-group differences were found between groups for BASDAI (−0.5 [95% CI, −0.9 to −0.2], P = 0.004), BASMI (−0.7 [95% CI, −1.1 to −0.4], P <0.001), BASFI (−0.3 [95% CI, −0.6 to 0.01], P=0.035), peak oxygen uptake (2.7 [95% CI, 0.02 to 5.3] ml/kg/min, P=0.048) and extensor endurance test (17.8 [95% CI, 0.5 to 35.2]s, P=0.044) at Week 16. Between-group differences were detected in ASAS HI (−0.9 [95% CI, −1.7 to −0.1], P=0.030), body fat percentage (−1.0 [95% CI, −2.0 to −0.01] %, P=0.048) and visceral adipose tissue (−4.9 [95% CI, −8.5 to −1.4] cm2, P=0.008) at Week 8, but not at Week 16. No significant between-group differences were detected in the total lean mass, time up and go test and the flexor endurance test during the follow-up.Conclusion:Comprehensive technology-assisted home-based exercise has been shown to have beneficial effects on disease activity, physical function, spinal mobility, aerobic capacity, and body composition as well as in improving fatigue and morning stiffness of patients with AS.References:[1]van der Heijde D, Ramiro S, Landewé R, et al. Ann Rheum Dis 2017;76:978–991.Disclosure of Interests:None declared

scholarly journals PR0P0F0L VS. THIOPENTAL NA

2009 ◽  
Vol 16 (04) ◽  
pp. 542-549
Author(s):  
FARNOUSH FARZI ◽  
Mona Oudi ◽  
MARZIEH MEHRAFZA ◽  
Zahra Mohammad Tabar ◽  
ALI MIRMANSOURI ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Quality ◽  
Postoperative Nausea And Vomiting ◽  
Oocyte Retrieval ◽  
Good Alternative ◽  
Fertilization Rate ◽  
Nausea And Vomiting ◽  
Informed Consent Form ◽  
The Mean ◽  
Post Operative Nausea

O b j e c t i v e : The aim of this study was to compare the side effects, fertilization rate and pregnancy rate (PR) and duration ofrecovery between Propofol and Thiopental Na after ICSI-vaginal retrieval of oocyte in ART cycle. D e s i g n : This study was a prospective,randomized clinical trial Materials and M e t h o d s : Ninety eight ASA(American Society of Anesthesiologist) physical status I and II womenparticipating in an intracytoplasmic sperm injection) ICSI) program were assessed. All of the patients underwent general anesthesia inductionwith Propofol and Thiopental Na. The first group (49cycles) received 2-2.5mg/kg of Propofol, and the second group (49cycles) received 5mg/kgThiopental during transvaginal oocyte retrieval. An informed consent form was obtained for each patients treatment. Variables under studyincluded: female age, cause and duration of infertiIity^postoperative nausea and vomiting(PONV), heamodynamic changes, mean number ofoocyte retrieved, oocyte metaphase II, embryo cleaved, embryo transferred, embryo quality and pregnancy rate(PR)and duration recovery.Statistical analysis was carried out by using SPSS.10 software and statistical test of T-test and chi-square. R e s u l t s : The PR in Propofol groupwas 18(36.7%) and in Thiopental Na group was 19(38.8%) with no significant differences the mean duration of infertility and weight weren'tstatistically significant. The mean number of oocyte retrieved (metaphase II), embryo cleaved, embryo transferred and embryo quality weren'tsignificant between the two groups. The incidence of nausea in Propofol group in comparison with Thiopental Na group was lower withsignificant differences. The incidence of vomiting between two groups was statistically significant (46.9% vs.28.6% respectively)(P<0.05).between two groups. Duration of recovery in Propofol group was 15+/_3min and in Thiopental Na group was 25+/_5 min that was statisticallysignificant(P<0.05). C o n c l u s i o n s : Propofol offered lower incidence of post operative nausea and vomiting and a quick recovery from anesthesia without any adverse effect on pregnancy outcome. These findings showed that Propofol was a good alternative for Thiopental Na in short timeoperation, like ICSI -vaginal retrieval of oocytes.

scholarly journals Estradiol and leptin as conditional prognostic IVF markers

Reproduction ◽  
2005 ◽  
Vol 129 (4) ◽  
pp. 531-534 ◽  
Author(s):  
G Anifandis ◽  
E Koutselini ◽  
K Louridas ◽  
V Liakopoulos ◽  
K Leivaditis ◽  
...  
Keyword(s):  
Follicular Fluid ◽  
Embryo Quality ◽  
Oocyte Retrieval ◽  
Dependent Manner ◽  
Ivf Outcome ◽  
Concentration Dependent Manner ◽  
Conditional Interaction ◽  
Estradiol Levels ◽  
Ivf Et

We studied the concentration of serum estradiol and serum and follicular fluid leptin in 200 women undergoing their first in vitro fertilization with embryo transfer (IVF-ET) program at the time of human chorionic gonadotrophin administration and oocyte retrieval, in an attempt to assess their concerted role on embryo quality and the prognosis of IVF outcome. Low serum (46.49 ± 8.4 ng/ml) and follicular fluid (52 ± 9.8 ng/ml) leptin levels were associated with a high number of ‘good-quality’ embryos (73.6%) and high implantation (11.2%) and pregnancy (35.8%) rates and were observed in women with normal peak estradiol levels of between 1000 and 2000 pg/ml. It appears that leptin and estradiol interact coordinately in a concentration-dependent manner to control IVF outcome. Further studies will be required to substantiate and clarify the mechanism of proposed conditional interaction between the two hormonal systems.

Transabdominal follicular aspiration for oocyte retrieval in patients with ovaries inaccessible by transvaginal ultrasound

2011 ◽  
Vol 95 (5) ◽  
pp. 1773-1776 ◽  
Author(s):  
Sara E. Barton ◽  
Joseph A. Politch ◽  
Carol B. Benson ◽  
Elizabeth S. Ginsburg ◽  
Antonio R. Gargiulo
Keyword(s):  
Transvaginal Ultrasound ◽  
Oocyte Retrieval ◽  
Follicular Aspiration

scholarly journals Transabdominal Ultrasound-guided Follicular Aspiration in Case of Müllerian Anomaly with Ovarian Malposition

2015 ◽  
Vol 7 (3) ◽  
pp. 213-215
Author(s):  
Vineet V Mishra ◽  
Preeti A Goyal
Keyword(s):  
Oocyte Retrieval ◽  
Controlled Ovarian Hyperstimulation ◽  
Fertilization Rate ◽  
Transabdominal Ultrasound ◽  
Ultrasound Guided ◽  
Vitro Fertilization ◽  
Follicular Aspiration ◽  
Mullerian Anomaly ◽  
Embryo Number

ABSTRACT Objective To describe the approach of transabdominal ultrasound-guided oocyte retrieval in a patient of müllerian anomaly and ovarian malposition. Setting A tertiary referral reproductive medicine unit. Patient A 23-year-old patient with müllerian anomaly (right unicornuate with left rudimentary horn uterus) and ovarian malposition. Intervention Controlled ovarian hyperstimulation, transabdominal ultrasound-guided oocyte retrieval. Main outcome measure Total and mature oocytes retrieved, fertilization rate, embryo number and quality. Result Five oocytes were retrieved transabdominally using percutaneous needle puncture under ultrasound guidance. Conclusion In in vitro fertilization (IVF) protocols, patients with müllerian anomaly with inaccessible ovaries vaginally, transabdominal ultrasound-guided follicular aspiration is a safe and efficacious alternative technique for oocyte retrieval. How to cite this article Mishra VV, Choudhary S, Goyal PA, Aggarwal R. Transabdominal Ultrasound-guided Follicular Aspiration in Case of Müllerian Anomaly with Ovarian Malposition. J South Asian Feder Obst Gynae 2015;7(3):213-215.

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