scholarly journals Predicting the chances of live birth for couples undergoing IVF-ICSI: a novel instrument to advise patients and physicians before treatment

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1585
Author(s):  
Bruna Estácio da Veiga ◽  
Duarte Pedro Tavares ◽  
José Luis Metello ◽  
Fernando Ferreira ◽  
Pedro Ferreira ◽  
...  
Keyword(s):  
Live Birth ◽  
Smoking Status ◽  
Antral Follicle ◽  
Developed Countries ◽  
Antral Follicle Count ◽  
Male Factor ◽  
Discriminatory Ability ◽  
Probability Of Success ◽  
Variable Probability

Background: In developed countries, the prevalence of infertility ranges from 3.5% to 16.7%. Therefore, the number of in vitro fertilization technique (IVF) and its subtype intracytoplasmic sperm injection (ICSI) treatments has been significantly increasing across Europe. Several factors affect the success rate of in vitro treatments, which can be used to calculate the probability of success for each couple. As these treatments are complicated and expensive with a variable probability of success, the most common question asked by IVF patients is ‘‘What are my chances of conceiving?”. The main aim of this study is to develop a validated model that estimates the chance of a live birth before they start their IVF non-donor cycle. Methods: A logistic regression model was developed based on the retrospective study of 737 IVF cycles. Each couple was characterized by 14 variables (woman’s and man’s age, duration of infertility, cause of infertility, woman’s and man’s body mass index (BMI), anti-Müllerian hormone (AMH), antral follicle count (AFC), woman’s and man’s ethnicity, woman’s and man’s smoking status and woman’s and man’s previous live children) and described with the outcome of the treatment "Live birth" or "No live birth". Results: The model results showed that from the 14 variables acquired before starting the IVF procedures, only male factor, man’s BMI, man's mixed ethnicity and level of AMH were statistically significant. The interactions between infertility duration and woman’s age, infertility duration and man’s BMI, AFC and AMH, AFC and woman’s age, AFC and woman’s BMI and AFC and disovulation were also statistically significant. The area under the receiver operating characteristic (AUROC) curve test for the discriminatory ability of the final prediction model is 0.700 (95% confidence interval (CI) 0.660–0.741). Conclusions: This model might result in a new validated decision support system to help physicians to manage couples’ expectations.

scholarly journals Predicting the chances of live birth for couples undergoing IVF-ICSI: a novel instrument to advise patients and physicians before treatment

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1585
Author(s):  
Bruna Estácio da Veiga ◽  
Beatriz Brás de Guimarães ◽  
Duarte Pedro Tavares ◽  
José Luis Metello ◽  
Fernando Ferreira ◽  
...  
Keyword(s):  
Live Birth ◽  
Smoking Status ◽  
Antral Follicle ◽  
Developed Countries ◽  
Antral Follicle Count ◽  
Male Factor ◽  
Treatment Expectations ◽  
Probability Of Success ◽  
Pre Treatment

Background: The prevalence of infertility ranges from 3.5% to 16.7% in more developed countries. For this reason, the number of In Vitro Fertilization(IVF)  technique and Intracytoplasmic Sperm Injection (ICSI) treatments has been significantly increasing. Several factors affect the success rate of in vitro treatments, which can be used to calculate the probability of success for each couple. As these treatments are complicated, expensive and with a variable probability of success, the most common question asked by IVF patients is “What are my chances of conceiving before starting an IVF/ICSI treatment?”. The main aim of this study is to develop a validated model that estimates the chance of a live birth before the start of an IVF/ICSI non-donor cycle. Methods: A logistic regression model was developed based on the retrospective study of 737 IVF/ICSI cycles. Overall 14 pre-treatment variables were evaluated (woman’s and man’s age, duration of infertility, cause of infertility, woman’s and man’s Body Mass Index (BMI), Anti-Müllerian Hormone (AMH), Antral Follicle Count (AFC), woman’s and man’s ethnicity, woman’s and man’s smoking status and woman’s and man’s previous live children) and the outcome of the treatment was discriminated as "live birth" or "no live birth". Results: From the 14 variables acquired before starting the IVF/ICSI procedures, only male factor, man’s BMI, man's mixed ethnicity and level of AMH were statistically significant. The interactions between infertility duration and woman’s age, infertility duration and man’s BMI, AFC and AMH, AFC and woman’s age, AFC and woman’s BMI, and AFC and disovulation were also statistically significant. The Area Under the Receiver Operating Characteristic (AUROC) curve test for the discriminatory ability of the final prediction model was 0.700 (95% Confidence Interval (CI) 0.660–0.741). Conclusions: This model might result in a new validated decision support system to help physicians to manage couples’ pre-treatment expectations.

scholarly journals Single-centre retrospective analysis of growth hormone supplementation in IVF patients classified as poor-prognosis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018107 ◽  
Author(s):  
Kevin N Keane ◽  
John L Yovich ◽  
Anahita Hamidi ◽  
Peter M Hinchliffe ◽  
Satvinder S Dhaliwal
Keyword(s):  
Growth Hormone ◽  
Live Birth ◽  
Poor Prognosis ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Clinical Pregnancy ◽  
In Vitro Fertilisation ◽  
Success Rates ◽  
Younger Women

BackgroundPatients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles.MethodsData were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not.ResultsClinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient’s age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for maternal age, antral follicle count and transferred embryo quality.ConclusionThese data provided further evidence to indicate that GH may support more live births, particularly in younger women. It also appears that embryos generated under GH have a better implantation potential, but whether the biological mechanism is embryo-mediated or endometrium-mediated is unclear.

scholarly journals In vitro fertilisation (IVF) versus intracytoplasmic sperm injection (ICSI) in patients without severe male factor infertility: study protocol for the randomised, controlled, multicentre trial INVICSI

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051058
Author(s):  
Sine Berntsen ◽  
Bugge Nøhr ◽  
Marie Louise Grøndahl ◽  
Morten Rønn Petersen ◽  
Lars Franch Andersen ◽  
...  
Keyword(s):  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Controlled Trial ◽  
Male Partner ◽  
In Vitro Fertilisation ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Fertilisation Rate ◽  
Randomised Controlled

IntroductionOver the last decades, the use of intracytoplasmic sperm injection (ICSI) has increased, even among patients without male factor infertility. The increase has happened even though there is no evidence to support that ICSI results in higher live birth rates compared with conventional in vitro fertilisation (IVF) in cases with nonmale factor infertility. The lack of robust evidence on an advantage of using ICSI over conventional IVF in these patients is problematic since ICSI is more invasive, complex and requires additional resources, time and effort. Therefore, the primary objective of the IVF versus ICSI (INVICSI) study is to determine whether ICSI is superior to standard IVF in patients without severe male factor infertility. The primary outcome measure is first live birth from fresh and frozen-thawed transfers after one stimulated cycle. Secondary outcomes include fertilisation rate, ongoing pregnancy rate, birth weight and congenital anomalies.Methods and analysisThis is a two-armed, multicentre, randomised, controlled trial. In total, 824 couples/women with infertility without severe male factor will be recruited and allocated randomly into two groups (IVF or ICSI) in a 1:1 ratio. Participants will be randomised in variable block sizes and stratified by trial site and age. The main inclusion criteria are (1) no prior IVF/ICSI treatment, (2) male partner sperm with an expected count of minimum 2 million progressive motile spermatozoa following density gradient purification on the day of oocyte pick up and (3) age of the woman between 18 and 42 years.Ethics and disseminationThe study will be performed in accordance with the ethical principles in the Helsinki Declaration. The study is approved by the Scientific Ethical Committee of the Capital Region of Denmark. Study findings will be presented, irrespectively of results at international conferences and submitted for publication in peer-reviewed journals.Trial registration numberNCT04128904. Pre-results.

Should fertile women quit drinking alcohol to produce better quality oocytes?

Zygote ◽  
2020 ◽  
pp. 1-3
Author(s):  
Burcu Ozbakir ◽  
Pinar Tulay
Keyword(s):  
Alcohol Consumption ◽  
Young Women ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Control Group ◽  
Social Drinkers ◽  
Antral Follicles ◽  
Healthy Women ◽  
Significant Difference

Summary Alcohol consumption has long been shown to affect both fetal health and pregnancy. In this study, antral follicle count, maturation level of oocytes including morphological assessment and number of metaphase I (MI), metaphase II (MII) and germinal vesicle (GV) stage oocytes obtained from young women (age < 30 years old) with or without alcohol consumption were investigated. In total, 20 healthy women who were social drinkers and 36 healthy women who do not consume alcohol were involved in this study. Women in both study and control groups were undergoing controlled ovarian stimulation. The antral follicle count and the number and quality of the oocytes retrieved were evaluated and recorded. In total, 635 antral follicles, 1098 follicles and 1014 oocytes with 820 MII, 72 MI and 78 GV stage oocytes were collected from the social drinkers. In the control group, 628 antral follicles, 1136 follicles and 1085 oocytes with 838 MII, 93 MI and 102 GV stage oocytes were evaluated. The results of this study showed that the antral follicle count was very similar in both groups. The number of oocytes and MII stage oocytes was slightly higher in the control group, although it was not a significant difference. This study showed that although the consumption of alcohol may have adverse effects post-implantation, it may not have a solid effect during oogenesis in young women. The results of this study are especially important in clinical settings as some women who are social drinkers undergo in vitro fertilization treatments.

scholarly journals Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization

2021 ◽  
Author(s):  
Antonio Palagiano ◽  
Mauro Cozzolino ◽  
Filippo Maria Ubaldi ◽  
Chiara Palagiano ◽  
Maria Elisabetta Coccia
Keyword(s):  
In Vitro Fertilization ◽  
Oocyte Retrieval ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Endometrial Receptivity ◽  
Vitro Fertilization ◽  
Ovid Medline ◽  
Ultrasonographic Guidance

AbstractHydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF). We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal removal could result in improved implantation rates in IVF. In addition, salpingectomy does not affect the ovarian response, nor reduces the antral follicle count. Further studies are needed to establish the therapeutic value of fluid aspiration under ultrasonographic guidance, during or after oocyte retrieval, in terms of pregnancy rate and ongoing pregnancy.

Effect of resveratrol administration on ovarian morphology, determined by transvaginal ultrasound for the women with PCOS

2021 ◽  
pp. 1-18
Author(s):  
Amir Pejman Hashemi Taheri ◽  
Behnaz Moradi ◽  
Amir Reza Radmard ◽  
Milad Sanginabadi ◽  
Mostafa Qorbani ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Volume ◽  
Exact Test ◽  
Ovarian Morphology ◽  
The Mean

Abstract Background: Intake of resveratrol has been associated with improved ovarian morphology under in vitro and in the animal models; however, this finding has not been confirmed in trials. The aim of our study was, therefore, to use a placebo-controlled approach with the detailed assessment of the ovarian morphology by applying transvaginal ultrasound to examine the effectiveness of this therapeutic approach in this group of women. Methods: Forty-one women with polycystic ovary syndrome (PCOS) were randomly assigned (1:1) to 3 months of daily 1000 mg resveratrol or placebo. Random assignment was done by blocked randomisation. Our primary endpoints were the change in the ovarian volume, stromal area and antral follicle count per ovary (FNPO) from the baseline to 3 months. Secondary endpoints were improvement in the distribution of follicles and ovarian echogenicity. Differences between the resveratrol and control groups were evaluated by Chi-square, fisher’s exact test and repeated-measures of ANOVA. Results: The mean age of all participants was 28.61 ± 4.99 years, with the mean BMI of 28.26 ± 5.62 kg/m2. Resveratrol therapy, as compared with placebo, was associated with a significantly higher rate of improvement in the ovarian morphology (p= 0.02). Women who received resveratrol had a more dominant follicle than those getting placebo, with a significant reduction in the ovarian volume (p<0.05). However, the number of FNPO, stromal area, ovarian echogenicity and distribution of follicles were not significantly altered (P>0.05). Conclusions: Treatment with resveratrol significantly reduced the ovarian volume and PCOM, thus suggesting a disease-modifying effect in PCOS. Trial registration: IRCT, IRCT2017061917139N2. Registered 7 July 2017, http://irct.ir/trial/15836.

scholarly journals Effect of Ayurvedic Treatment Protocol on Diminishing Ovarian Reserve

2020 ◽  
Vol 11 (2) ◽  
pp. 228-234
Author(s):  
Divya U ◽  
Vijayakumar N
Keyword(s):  
Ovarian Reserve ◽  
Reproductive Potential ◽  
Treatment Protocol ◽  
Antral Follicle ◽  
Poor Responder ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Rank Test ◽  
Ayurvedic Treatment

Diminishing ovarian reserve (DOR) is a condition in which the ovary loses reproductive potential, compromising fertility. Nowadays 10-30% of female infertility is due to DOR and considered as “expected poor responder” for In vitro fertilisation (IVF).   Correlation of DOR can be done with Dathukshaya vandya (depletion or inadequate formation of dhatus) explained in Harithasamhita. The objective of the study was to evaluate the effect of Ayurvedic treatment protocol on Diminishing ovarian reserve. The study protocol includes- ashtachurna for deepana (appetiser), pachana (digestives) and kolakulathadi churna for udwarthana (powder massage). Sukumaragrutha used for snehapana (oral administration of medicated ghee), utharabasthi (intrauterine administration) and rasayana (rejuvenation therapy ). Danwantarathaila abhyanga (oleation) and ooshmasweda (sudation) done for 3 days. Sukumaraeranda was used for virechana (therapeutic purgation) and also Yogabasthi (medicated enema). The study design was pre and post interventional study with a sample size of 15 selected as per inclusion and exclusion criteria, conducted at hospital for women and children, Government Ayurveda College, Thiruvananthapuram. Assessment was based on Bologna criteria for DOR. The statistical techniques employed are Wilcoxon’s signed rank test and Paired t test. Results showed statistically significant effect on improving Antral follicle count (AFC) (p- 0.01), Estradiol (p- 0.005), conception (p- 0.014), on regulating amount of bleeding (p- 0.003), menstrual interval correction (p-0.001) and dyspareunia (p-0.005). But insignificant effect on improving Anti Mullerian Hormone (AMH) (p- 0.469) and regularising LH/FSH ratio (p-0.104) was found.

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