scholarly journals Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35–39 years: a retrospective study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Tong Chen ◽  
Feiyan Zhao ◽  
Qin Wang ◽  
Chang Liu ◽  
Yonglian Lan ◽  
...  
2021 ◽  
Author(s):  
Quan Tian ◽  
Yujie Liu ◽  
Jiane Liu ◽  
Jianru Wu ◽  
Jianxin Liu ◽  
...  

Abstract BackgroundAbnormal reproductive tract flora may cause infertility, and it may play a key role in the success of assisted reproductive technologies (ART). The obvious short-term changes in estrogen caused by clinical protocols with IVF-ET provide a unique perspective for us to assess the vaginal flora, shifting hormonal condition and investigate the potential associations of the vaginal micro-ecology with cycle outcome of pregnancy. The Vaginal Micro-ecology Evaluation System (VMES) as a tool to analyze the vaginal microbiomes in most areas of China. This study aims to apply the VMES to evaluate the dynamics of vaginal micro-ecology during IVF-ET, and investigate the correlations between vaginal micro-ecology with pregnancy outcome.Methods 150 patients were enrolled who underwent early follicular phase prolonged protocol IVF-ET due to tubal factors. The VMES is used to evaluate vaginal microbiology indicators of vaginal swabs obtained in different hormonal milieu during the IVF-ET cycle. The pregnancy outcomes were observed, if pregnant.Results In our data, the prevalence of bacterial vaginitis (BV) accounts for 3.3%. During IVF procedure, the vaginal microbiome varied across hormonal milieu in some but not all patients. The proportion of BV, and unidentified dysbiosis were increased significantly on the day of human chorionic gonadotropin (HCG) administration. The vaginal micro-ecology on the day of HCG administration correlated with outcome (live birth / no live birth). The multivariable logistic regression model showed that the average age, the duration of infertility, and the vaginal micro-ecology after controlled ovarian hyperstimulation (COH) were associated with the live birth rate.ConclusionOur retrospective cohort study suggests that the VEMS has enabled discovery of unidentified dysbiosis shift in the vaginal micro-ecology during IVF-ET therapy. More importantly, the vaginal micro-ecology on the day of HCG administration was significantly associated with the live birth rate.


2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiqin Bu ◽  
Jiaxin Zhang ◽  
Yile Zhang ◽  
Yingpu Sun

BackgroundCurrently, in China, only women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles can donate oocytes to others, but at least 15 oocytes must be kept for their own treatment. Thus, the aim of this study was to determine whether oocyte donation compromises the cumulative live birth rate (CLBR) of donors and whether it is possible to expand oocyte donors’ crowd.MethodsThis was a retrospective cohort study from August 2015 to July 2017 including a total of 2,144 patients, in which 830 IVF–embryo transfer (IVF-ET) patients were eligible for oocyte donation and 1,314 patients met all other oocyte donation criteria but had fewer oocytes retrieved (10–17 oocytes). All 830 patients were advised to donate approximately three to five oocytes to others and were eventually divided into two groups: the oocyte donation group (those who donated) and the control group (those who declined). The basic patient parameters and CLBR, as well as the number of supernumerary embryos after achieving live birth, were compared. These two factors were also compared in all patients (2,144) with oocyte ≥10.ResultsIn 830 IVF-ET patients who were eligible for oocyte donation, only the oocyte number was significantly different between two groups, and the donation group had more than the control group (25.49 ± 5.76 vs. 22.88 ± 5.11, respectively; p = 0.09). No significant differences were found between the two groups in other factors. The results indicate that the live birth rate in the donation group was higher than that in the control group (81.31% vs. 82.95%, p = 0.371), without significance. In addition, CLBR can still reach as high as 73% when the oocyte number for own use was 10. Supernumerary embryos also increased as the oocyte number increased in all patients (oocyte ≥10).ConclusionsCurrently, oocyte donation did not compromise CLBR, and oocyte donation can decrease the waste of embryos. In addition, in patients with 10 oocytes retrieved, the CLBR was still good (73%). Thus, it is possible to expand oocyte donors if the number of oocyte kept for own use was decreased from 15 to 10 after enough communication with patients.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Marques ◽  
P Rodrigues ◽  
J Aibar ◽  
M J Carvalho ◽  
C E Plancha

Abstract Study question Which are the main factors on first oocyte retrievals influencing the time to achieve a live birth? Summary answer The number of oocytes collected on the first retrieval is the most important factor to decrease time to live birth. What is known already The goal of infertile couples when they attend a fertility clinic is to obtain a healthy baby as soon as possible. Cumulative live birth rate is today considered the most reliable estimate of ART success. However, the time used to achieve such goal is still not clear both to health professionals and patients. Although there is a general idea of which factors predict ART success, both clinicians and embryologists are still not aware of which variables can effectively influence the time to a live birth. Study design, size, duration We analyzed retrospectively 333 couples who performed their first fresh IVF/ICSI cycles from January 2015 to December 2018, along with their eventual subsequent FET and/or IVF/ICSI cycles, leading to 146 live births. The aim of this study was to use “Time” as an additional measure of ART success, and to identify which variable of the first oocyte retrieval has a major influence on time to live birth. Participants/materials, setting, methods We included in total 430 oocyte retrievals and 147 FET cycles. Oocyte donation cycles were excluded. Data were studied cumulatively until the childbirth (couples at risk) or until the last treatment record (censored couples). Cox Regression Model for survival analysis was used to study the variables that may influence the time to live birth, in order to take both confounding and collinearity into account. Main results and the role of chance We considered the date of the first oocyte retrieval as the starting point and the date of the first childbirth as the ending point to determine the time to live birth. The mean age of the woman at the first oocyte retrieval was 36.8±4.67, the cumulative pregnancy rate 43.5% (95%CI:41.77%;45.23%) and the live birth rate 34.0%(95%CI:32.32%;35.63%). As variables for the Cox Regression Model we selected the woman’s age and number of collected oocytes from the first oocyte retrieval. We also considered the number of frozen embryo transfers (FET). We have found a positive association between the number of oocytes collected at the first oocyte retrieval and the period until obtaining a healthy singleton (HR = 1.20;95%CI:1.105–1.297;p>0.001). Conversely, a negative association concerning the number of FET and time to live birth (HR = 0.32;95%CI:0.18–0.562;p>0.001) was demonstrated. Importantly, woman’s age, was not found to have a significant effect on time to live birth. Our results indicated that the number of oocytes collected at the first cycle, but not woman’s age, mostly affect time to live birth. Poor prognosis patients were found to be associated with several embryo transfers. Limitations, reasons for caution This is a retrospective study with a small number of cycles and freeze-all procedures were not included. Additional inclusion of freeze-all procedures in a larger study will be needed to confirm our preliminary results. Wider implications of the findings: This study identified oocyte number at first collection as a major influence on time to live birth. Increased attention to the “Time” parameter will be helpful for health professionals and patients, to further personalize reproductive treatment procedures, potentially decreasing psychological burdens associated with ART treatments. Trial registration number Not applicable


Author(s):  
Ze Wang ◽  
Junli Zhao ◽  
Xiang Ma ◽  
Yun Sun ◽  
Guimin Hao ◽  
...  

Abstract Context Obesity management prior to infertility treatment remains a challenge. To date, results from randomized clinical trials involving weight loss by lifestyle interventions have shown no evidence of improved live birth rate. Objective To determine whether pharmacologic weight-loss intervention before in vitro fertilization and embryo transfer (IVF-ET) can improve live birth rate among overweight or obese women. Design, setting, and participants We conducted a randomized, double-blinded, placebo-controlled trial across 19 reproductive medical centers in China, from July 2017 to January 2019. A total of 877 infertile women scheduled for IVF who had a body mass index of 25kg/m 2 or greater were randomly assigned. Interventions The participants were randomized to receive orlistat (n=439) or placebo (n=438) treatment for 4-12 weeks. Main outcomes and measures Live birth rate after fresh embryo transfer. Results The live birth rate was not significantly different between the two groups (112 of 439 [25.5%] with orlistat and 112 of 438 [25.6%] with placebo; P=.984). No significant differences existed between the groups as to the rates of conception, clinical pregnancy, and pregnancy loss. A statistically significant increase in singleton birthweight was observed after orlistat treatment (3487.50g versus 3285.17g in the placebo group; P=.039). The mean change in body weight during the intervention was −2.49kg in the orlistat group, as compared to −1.22kg in the placebo group, with a significant difference (P=.005). Conclusions Orlistat treatment, prior to IVF-ET, did not improve live birth rate among overweight or obese women, although it was beneficial for weight reduction.


2020 ◽  
Author(s):  
Shokichi Teramoto ◽  
Hisao Osada ◽  
Tsuyoshi Okubo ◽  
Tsuyoshi Ueno ◽  
Fumihito Aono ◽  
...  

Abstract Background: Diclofenac inhibits follicle rupture and its use in natural-cycle in vitro fertilization and embryo transfer (IVF-ET) has been reported to increase oocyte retrieval chances but has not been reported to improve the therapeutic outcome (live birth). The question is whether the therapeutic utility of diclofenac is demonstrable when administered to a subgroup of women with an imminent LH surge, a higher risk group for premature ovulation.Methods: Infertile women indicated for the natural-cycle IVF-ET between September 2014 and February 2015 (n=183) were recruited in a private infertility clinic and diclofenac use (50 mg suppositories, thrice every 8 h before oocyte retrieval) was offered when their serum LH level was ≥14.0 IU/L on an LH-triggering day (n=137). Of the 137 women, 108 electively used diclofenac and 29 did not. Oocytes were retrieved from both dominant and subordinate nondominant follicles and were fertilized. The resulting blastocysts were frozen, thawed, and transferred one by one in the following spontaneous ovulatory or hormone replacement cycles. Results: Cumulative live birth rate (after the single oocyte retrieval) was calculated from the dominant and nondominant follicles. The live birth rate from dominant follicles was higher in the diclofenac group (21/108, 19%) than in the no diclofenac group (1/29, 3%) (P < .05). Conversely, the live birth rate from nondominant follicles, which had no potential for ovulation, was not different between the diclofenac group (13/108, 12%) and the no diclofenac group (3/29, 10%). Conclusion: Diclofenac improved the live birth rate from dominant follicles when it was administered to women with an imminent LH surge. However, diclofenac did not affect the live birth rate from non-dominant follicles which were not at risk of follicle rupture.


2018 ◽  
Vol 298 (5) ◽  
pp. 1017-1027 ◽  
Author(s):  
Yun Huang ◽  
Jingyi Li ◽  
Fang Zhang ◽  
Yifeng Liu ◽  
Gufeng Xu ◽  
...  

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