scholarly journals More Live Births in Primary Subfertile Intracytoplasmic Sperm Injection-Treated Women with High Normal TSH Levels

2021 ◽  
Vol 86 (4) ◽  
pp. 398-407
Author(s):  
Constance Repelaer van Driel-Delprat ◽  
Eveline van Dam ◽  
Peter van de Ven ◽  
Khadija Aissa ◽  
Melanie ter Haar ◽  
...  
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Thyroid Autoimmunity ◽  
Live Birth Rate ◽  
Ongoing Pregnancy ◽  
Male Factor ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Tsh Levels

<b><i>Objectives:</i></b> The aim of this study was to analyze the fertility outcome in intracytoplasmic sperm injection (ICSI)-treated women across normal range thyroid-stimulating hormone (TSH) levels. Published results are inconclusive about optimal TSH levels and fertility. <b><i>Design:</i></b> This is a retrospective cohort study in 752 ICSI-treated women with predominantly severe male factor subfertility, starting treatment between the first of January 2008 and the first of March 2012 with a follow-up until 2014. <b><i>Participants/Materials, Setting, Methods:</i></b> Women aged 22–45 years with TSH 0.3–4.5 mIU/L without thyroid hormone substitution were included in Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands, an iodine-sufficient area. Demographic and baseline characteristics were compared between groups of patients based on TSH, using one-way ANOVA, Kruskal-Wallis ANOVA, and χ<sup>2</sup> test. The patient was the unit of analysis: all cumulative cycles per patient were analyzed up to and including the first ongoing pregnancy. The primary outcome was a cumulative live birth rate. Clinical pregnancy rate, pregnancy loss, and ongoing pregnancy rate were secondary outcomes. The χ<sup>2</sup> test and logistic regression were used to compare interquartile groups while adjusting for confounders. Logistic regression was used with the natural logarithm of TSH as a continuous predictor. Primary and secondary subfertile women were analyzed separately. <b><i>Results:</i></b> Analysis of the total cohort (<i>n</i> = 752) showed no difference in fertility outcomes across the normal TSH range. The cumulative live birth rate for the 4 groups of primary subfertile women (<i>n</i> = 455) was 76% in the upper TSH quartile compared to 56%, 60%, and 59% in the lower TSH quartiles. <b><i>Limitations:</i></b> Levels of thyroxine and presence of thyroid autoimmunity were not measured in this retrospective cohort study. <b><i>Conclusions:</i></b> The observation that a higher live birth rate was found in primary subfertile ICSI-treated women with high but allegedly normal TSH levels contributes to the hypothesis that in certain subfertile women in addition to a male factor, female factors such as subtle hypothyroidism and/or thyroid autoimmunity may play a role in keeping them from conception, which can be overcome by the process of ICSI.

scholarly journals ICSI does not increase the cumulative live birth rate in non-male factor infertility

2018 ◽  
Vol 33 (7) ◽  
pp. 1322-1330 ◽  
Author(s):  
Z Li ◽  
A Y Wang ◽  
M Bowman ◽  
K Hammarberg ◽  
C Farquhar ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth

scholarly journals Impact of time-lapse imaging incubators with single-step culture medium on cumulative live birth rate in IVF cycles: a retrospective cohort study

2021 ◽  
Author(s):  
Mariano Mascarenhas ◽  
Sarah J Owen ◽  
Emily French ◽  
Karen Thompson ◽  
Adam H Balen
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Culture Medium ◽  
Live Birth Rate ◽  
Time Lapse ◽  
Single Step ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Time Lapse Imaging

Objective To compare the cumulative live birth rate per egg retrieval between time lapse imaging (TLI) incubators and standard culture (SC) incubators both using a single-step culture medium Design Retrospective cohort study Setting A tertiary level fertility-centre Population Women undergoing an IVF cycle between November 2015 and December 2017 Methods Comparison was done between 1219 IVF cycles using TLI and 1039 cycles using SC after accounting for confounding factors such as age and number of oocytes retrieved. Main outcome measure Cumulative live birth rate per egg retrieval Results The live birth rate per egg retrieval following fresh embryo transfer was noted to be higher for TLI cycles (TLI 39.87% vs SC 38.02%, aOR 1.20, 95% CI 1.01 to 1.44). More embryos were available for cryopreservation in the TLI arm (MD 0.08 embryos, 95% CI 0.10 to 0.41). The live birth rate per frozen embryo transfer was not significantly different. The cumulative live birth rate per egg retrieval was significantly higher in the TLI arm (TLI 50.29% vs SC 46.78%, aOR 1.24, 95% CI 1.04 to 1.48) Conclusions With the use of single step medium, there appears to be a greater benefit of TLI through a reduced interruption in embryo culture conditions, resulting in a higher number of embryos available for cryostorage which in turn appears to improve the cumulative live birth rate. Funding No funding was obtained for this study Keywords Time lapse imaging, cumulative live birth rate, single step culture medium, embryo utilization rate

P–149 Calcium ionophores as an aid to surgically retrieved sperms in male factor infertility for increasing cumulative live birth rate

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Sahu ◽  
S Singh ◽  
A C Varghese ◽  
R Ashraf ◽  
N Majiyd ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Obstructive Azoospermia ◽  
Male Factor Infertility ◽  
Oocyte Activation ◽  
Male Factor ◽  
Cumulative Live Birth Rate ◽  
Cleavage Rate ◽  
Cumulative Live Birth

Abstract Study question Does the addition of calcium ionophores for artificial oocyte activation(AOA) help in improving Cumulative Live Birth Rate in surgically retrieved sperms for male factor infertility? Summary answer AOA significantly improved cumulative live birth rate in Micro-TESE (M-TESE), TESA for non- azoospermia (TESTICULAR) and Non-Obstructive Azoospermia(NOA)-TESA but not in Obstructive Azoospermia (OA)-TESA. What is known already The main cause of Total Fertilization Failure after ICSI is thought to be due to oocyte activation deficiency (OAD) because of oocyte-related or sperm-related factors. Studies have shown that artificial oocyte activation (AOA) is helpful in these situations, but is most effective in couples who have clear sperm-related OAD. Oocyte activation, by Phospholipase- C- Zeta (PLCζ) present in the sperm, leads to series of events resulting in calcium oscillation, oocyte activation and fertilization. AOA increases the free intracellular calcium thereby mimicking physiologic cell signaling mechanisms that result in oocyte activation and fertilization. Study design, size, duration This is a retrospective cohort study done in an academic private ART center, in which patient’s records were analyzed, from January 2016 to December 2019 (total 4 years’ duration) and all ICSI cycles with surgically retrieved sperms were included (n = 365). Study subjects were divided into 4 groups- M-TESE (n = 143), NOA-TESA (n = 38), OA-TESA (n = 62) and TESTICULAR (n = 92). Subdivision was done into cases if AOA was done and control were with conventional ICSI without AOA. Participants/materials, setting, methods Method- Immediately after ICSI, in case group (AOA), all metaphase II oocytes were treated with calcium ionophore (GM508- CultActive) for 15 minutes, then thoroughly washed and incubated under standard conditions. Primary outcome measured was cumulative live birth rate(CLBR) and Secondary outcomes were fertilization rate (Fert. rate), Cleavage rate, clinical pregnancy rate (CPR) and miscarriage rate (MA). Statistical analysis was performed with Chi-square and Mann-Whitney- U test, with significance at P &lt; 0.05. Institutional committee clearance was obtained. Main results and the role of chance The CLBR was significantly higher with AOA- M-TESE (55.8% vs 33.3%, p- 0.008), AOA-NOA-TESA (55.55% vs 15%, p- 0.027) and AOA-TESTICULAR (62.9% vs 32.3%, p- 0.006) group. Fert. rate was significantly higher with AOA-M-TESE (81 ± 0.84 vs 64 ± 0.97, p- 0.001), AOA-NOA-TESA (86 ± 0.76 vs 64 ± 0.13, p- 0.001) and AOA-TESTICULAR (72 ± 0.12 vs 57 ± 0.11, p- 0.001). Cleavage rate, CPR also showed similar significant differences while MA was comparable. However, significant differences were not observed in any of the outcome measured in OA-TESA group between cases and controls - CBLR (51.6% vs 41.9%, p- 0.611), Fert.rate (0.77±0.14 vs 0.75±0.11, p- 0.539), CPR and MA, p- value &gt; 0.05. It may be hypothesized that surgically retrieved sperms in cases of NOA or non- azoospermia where TESTICULAR sperms are taken have reduced or absent capacity to cause Calcium oscillations due to deficient or inadequate PLCζ or there may be some chromatin level abnormalities in these sperms, leading to lesser fertilization and lesser good quality embryos in control group in which AOA was not done. Limitations, reasons for caution This study is retrospective in nature. Sibling oocytes were not compared. The study neither looked at obstetrics complication nor the neonatal outcomes. Further studies are required for long term impact on children born from AOA cycles. Wider implications of the findings: To our knowledge, this is the first study in the literature evaluating the efficacy of calcium ionophores for NOA (M-TESE, TESA), OA (TESA) and TESTICULAR sperms. Further research is needed for use of calcium ionophores in cases of unexplained infertility and recurrent implantation failure. Trial registration number Not applicable

scholarly journals The impact of down-regulation on obstetrics and perinatal outcomes in singleton pregnancies after IVF: a retrospective cohort study

2020 ◽  
Author(s):  
Xiyuan Dong ◽  
Yu Zheng ◽  
Biao Chen ◽  
Lan Wang ◽  
Lei Jin ◽  
...  
Keyword(s):  
Live Birth ◽  
Lower Risk ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Down Regulation ◽  
Cumulative Live Birth ◽  
The Impact

Abstract Background Down-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study is to evaluate the effect of down-regulation on obstetrics and perinatal outcomes. Methods This is a retrospective cohort study on 3578 patients achieving singleton pregnancy after their first IVF attempt. The patients were grouped by the serum estradiol after down-regulation (E2D) into three groups: <30, 30-55, >55pg/ml. The cumulative live-birth rate, obstetrics and pediatric results were main outcome measures. General linear models and Chi-square test were performed for statistical analysis. Results The patients with E2D <30, 30-55, >55pg/ml had similar cumulative live-birth rate. The patients with E2D <30pg/ml had a lower risk for hypertension disorders than those with E2D 30-55pg/ml. No difference was found in the prevalence of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns of patients with E2D <30pg/ml had a lower risk for PICU attempt than those with E2D >55pg/ml. There was no difference in congenital anomaly or mortality rate. Conclusion We found no effect of down-regulation on cumulative live-birth rate. The patients with E2D<30pg/ml may have advantages in lower risks for maternal hypertension and newborns PICU attempt.

Maternal MTHFR C677T polymorphism does not affect live birth rate following IVF in Chinese Han population: a retrospective cohort study of 1265 women

2020 ◽  
Author(s):  
Hong Zeng ◽  
Hebin Xie ◽  
Dongmei He ◽  
Yuhao Zhao ◽  
Nenghui Liu
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Mthfr C677t ◽  
P Value ◽  
Cumulative Live Birth Rate ◽  
Chinese Han ◽  
Mthfr C677t Polymorphism ◽  
Cumulative Live Birth

Abstract Backgrounds: MTHFR is a key enzyme for folic acid metabolism and is important for reproduction. However, whether MTHFR C677T genotype affect live birth rate following IVF is unknown. This study aims to evaluate the association of MTHFR C677T polymorphism and live birth rate following IVF. Methods: This is a retrospective cohort study of 1265 women undergoing first IVF -ET cycle (2015-2017) in Reproductive Medicine Center of Xiangya Hospital. The patients were followed for a minimum of 2 years and maximum of 5 years, the observation endpoint is live birth, or all the embryos derived from the first stimulation cycle are transferred. The study population was divided into three groups based on MTHFR C677T genotype (MTHFR 677CC, MTHFR 677CT, MTHFR 677TT). The primary outcomes are live birth rate and cumulative live birth. The secondary outcomes including laboratory parameters (number of oocytes, number of 2PNs, number of available embryos, number of good embryos) and clinical parameters (chemical pregnancy rate, clinical pregnancy rate, implantation rate, preclinical pregnancy loss rate, miscarriage rate). The logistic regression analysis with different adjusted models were used to analyze the association of MTHFR C677T genotype and live birth. Results: Among the 1265 participants, 541 were MTHFR 677CC genotype, 585 were MTHFR 677CT genotype, and 139 were MTHFR 677TT genotype. The live birth rate was 43.6%, 44.8%, and 40.3% (p-value = 0.63), and the cumulative live birth rate per stimulation cycle was 54.7%, 53.5%, and 51.8% (p-value =0.81) in MTHFR 677CC group, MTHFR 677CT group, and MTHFR 677TT group, respectively. The secondary laboratory outcomes and clinical outcomes were not significantly different between the three groups. Logistic regression analysis showed no significant association of MTHFR C677T genotype and live birth whether in model 1 (p-value for trend = 0.63) , model 2 (p-value for trend = 0.63), or model 3 (p-value for trend = 0.59). Conclusions: MTHFR C677T genotype does not significantly affect live birth rate and cumulative live birth rate following first IVF in Chinese Han couples.

scholarly journals Comparing the cumulative live birth rate of cleavage-stage versus blastocyst-stage embryo transfers between IVF cycles: a study protocol for a multicentre randomised controlled superiority trial (the ToF trial)

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042395
Author(s):  
Simone Cornelisse ◽  
Liliana Ramos ◽  
Brigitte Arends ◽  
Janneke J Brink-van der Vlugt ◽  
Jan Peter de Bruin ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Oocyte Retrieval ◽  
Blastocyst Stage ◽  
Cleavage Stage ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Superiority Trial

IntroductionIn vitro fertilisation (IVF) has evolved as an intervention of choice to help couples with infertility to conceive. In the last decade, a strategy change in the day of embryo transfer has been developed. Many IVF centres choose nowadays to transfer at later stages of embryo development, for example, transferring embryos at blastocyst stage instead of cleavage stage. However, it still is not known which embryo transfer policy in IVF is more efficient in terms of cumulative live birth rate (cLBR), following a fresh and the subsequent frozen–thawed transfers after one oocyte retrieval. Furthermore, studies reporting on obstetric and neonatal outcomes from both transfer policies are limited.Methods and analysisWe have set up a multicentre randomised superiority trial in the Netherlands, named the Three or Fivetrial. We plan to include 1200 women with an indication for IVF with at least four embryos available on day 2 after the oocyte retrieval. Women are randomly allocated to either (1) control group: embryo transfer on day 3 and cryopreservation of supernumerary good-quality embryos on day 3 or 4, or (2) intervention group: embryo transfer on day 5 and cryopreservation of supernumerary good-quality embryos on day 5 or 6. The primary outcome is the cLBR per oocyte retrieval. Secondary outcomes include LBR following fresh transfer, multiple pregnancy rate and time until pregnancy leading a live birth. We will also assess the obstetric and neonatal outcomes, costs and patients’ treatment burden.Ethics and disseminationThe study protocol has been approved by the Central Committee on Research involving Human Subjects in the Netherlands in June 2018 (CCMO NL 64060.000.18). The results of this trial will be submitted for publication in international peer-reviewed and in open access journals.Trial registration numberNetherlands Trial Register (NL 6857).

Sign in / Sign up

Export Citation Format

Share Document