scholarly journals The effect of excess body weight and obesity on the effectiveness of assisted reproductive technologies programs

2018 ◽  
Vol 67 (2) ◽  
pp. 32-39
Author(s):  
Manizha R. Mahmadaliyeva ◽  
Igor Yu. Kogan ◽  
Dariko A. Niauri ◽  
Irina D. Mekina ◽  
Alexander M. Gzgzyan

The purpose of the study. To determine the main indicators of the effectiveness of IVF programs in over-weight and obese patients. Based on the Research Institute of obstetrics, gynecology, and reproductology D.O. Ott, we conducted an analysis involving women aged 18–39 years who were treated in the IVF program in the department of assistive technologies in infertility treatment. The study included 97 patients who met the selection criteria. The patients were categorized into three groups: group I, 33 obese women (body mass index (BMI) ≥ 30.8 kg/m2); group II, 34 overweight women (BMI = 25 to 29.9 kg/m2); and the control group, 30 normal weight patients (BMI = 18 to 24.9 kg/m2). As a result, the efficiency of ART programs decreased significantly in women of group I, owing to the weaker response of the ovaries to the stimulation of superovulation, which causes an increased gonadotropin demand to stimulate  ovulation.

2014 ◽  
Vol 63 (4) ◽  
pp. 39-46 ◽  
Author(s):  
Yana Nikolayevna Kravchuk ◽  
Alla Stanislavovna Kalugina ◽  
Olga Vladimirovna Bystrova ◽  
Svetlana Aleksandrovna Shlykova

Background. Embryo cryopreservation is an essential part of ART programs today. In recent years vitrification method is used increasingly widely. Purposes and tasks. To compare the effectiveness of ART programs using vitrified and fresh embryos, as well as different endometrial preparation regimes for frozen\thawed embryo transfer (modified natural cycle (MNC) and the preparatory hormone therapy(PHT)). To analyze the course of pregnancy and perinatal outcomes after vitrified embryo transfer. Materials and methods. We prospectively assessed the ART programs effectiveness and perinatal outcomes in 153 patients (I group), who underwent vitrified embryo transfer in 2011-2013 year. To prepare the endometrium for thawed embryo transfer in 83 patients PHT (Ia subgroup) and MNC in 70 patients (Ib subgroup) were used. Control group consisted of 70 patients, who underwent fresh embryo transfer. Results. The clinical pregnancy rate, birth rate and “take home baby” rate were not significantly different between the I (47,5 %; 30,9 %; 30,9 %) and II (53,0 %; 34,9 %; 32,5 %) groups, and between Ia (48,3 %; 28,4 %; 28,4 %) and IIb (46,6 %; 34,1 %; 34,1 %) subgroups. Complications during pregnancy and delivery, birthweight, length, Apgar score, congenital malformation rate did not differ significantly after vitrified and fresh embryo transfer. Conclusion. Vitrification is an effective method to achieve clinical results, comparable to native cycles. Application of PHT and MNC results in similar clinical outcomes. Transfer Vitrified embryo transfer does not have a negative impact on obstetric and perinatal outcomes when compared with native cycles.


Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 14-19
Author(s):  
S.V. Barinov ◽  
◽  
O.V. Ostrovskaya ◽  
I.V. Shamina ◽  
Yu.I. Tirskaya ◽  
...  

Study Objective: To optimize pregnancy management and improve delivery outcomes in women with infertility of endocrine origin after the use of assisted reproductive technologies (ART). Study Design: This was an analytical prospective study. Materials and Methods: One hundred and twenty patients with singleton pregnancy were observed: 74 women with infertility of endocrine origin who had undergone in vitro fertilization (IVF) (Group I) and 46 women who became pregnant spontaneously (Group II). The main group (Group I) was divided into subgroup IA (n = 44), in which a comprehensive approach to pregnancy was applied (obstetric pessary and micronized progesterone), and subgroup IB (n = 30) consisting of patients for whom micronized progesterone alone was used. Study Results: Groups I and II differed significantly in miscarriage risk rates: 60.8% and 30.4%, respectively. This complication was most often observed in subgroup IB (80.0%), 2.6 times more often than in Group II (χ2 = 5.700; p = 0,029). There were also statistically significant differences between the groups in the rate of preterm delivery (PD), which was 5.6 times higher in the main group than in the control group (24.3% vs. 4.3%, χ2 = 4.915; p = 0.027). The greatest difference from the control group (9.3 times higher rate) was observed in subgroup IB (χ2 = 10.156; p = 0.004). Conclusion: A comprehensive approach makes it possible to prolong pregnancy, reduce rates of PD by a factor of 2.9 and achieve full-term pregnancies in 86.4% of cases. Keywords: pregnancy, IVF, ART, obstetric complications, perinatal outcomes, Arabin pessary.


Author(s):  
Kh. M. Omarova ◽  
E. S.-А. Ibragimova ◽  
T. Kh.-M. Khashaeva ◽  
I. Kh. Magomedova ◽  
R. G. Omarova ◽  
...  

Objective. To assess the condition of newborns from women of the late reproductive period (LRP), depending on the parity of births.Material and methods. The authors examined 130 pregnant women and their 130 newborns. Group I consisted of 60 primiparous women of late reproductive period and their 60 newborns, Group II included 40 multiparous women of the late reproductive period and their 40 newborns, Group III (control group) consisted of 30 healthy pregnant women aged from 18 to 25 years and their 30 newborns. The authors performed a retrospective analysis of the gestation course and perinatal outcomes. Ultrasound and neurosonography were used among the instrumental research methods.Results. Women of the late reproductive period gave birth to children in a state of asphyxia twice more often, who develop neurological disorders 1,5 times more often and complex postnatal adaptation and disorders of the perinatal period are twice more likely. Among women of the late reproductive period, primiparous women gave birth to children with the most severe disorders.Conclusion. The high incidence of neurological diseases in children born from women of the late reproductive period is associated with age-related changes in their germ cells, the implementation of assisted reproductive technologies, and the intake of hormonal drugs in early pregnancy. The data obtained should be taken into account by obstetricians in the course of pregnancy in women of late reproductive age; they should be included in the group of high risk of developing neurological disorders in children.


2018 ◽  
pp. 128-131
Author(s):  
A.S. Mandrykova ◽  

The objective: determination of risk factors of early preterm labor in single-pregnant women after ART on the basis of clinical and anamnestic data. Materials and methods. We study of 130 single-pregnancy pregnancies among the contingent of women with restored fertility after the use of therapeutic ART programs, which ended with early preterm labor. Group I consisted of 50 pregnant women with premature rupture of the membranes for which the tactics of pregnancy with were born by natural way. The second group consisted of 30 pregnant women with premature rupture of the membranes, who carried out general medical and prophylactic measures in accordance with the clinical protocols in accordance with the orders of the Ministry of Health of Ukraine. The control group (GC) has formed 50 pregnant women with early preterm labor with unbroken integrity of the membranes. Results. The retrospective analysis of the methods of fertility restoration in women who were included in the study, carried out by us, indicates the probable relationship of risk of early preterm labor with the ICSI method. The obtained data testify that pregnancy 42.5% of women of the main group, who was chosen ICSI technique ended with early preterm labor. In the contingent of patients whose pregnancy came with IVF, the percentage early preterm labor was 37.5 (р<0.05). The obtained results of researches testify to increase of risks early preterm labor (22.1–29.7%) in patients with chronic inflammatory diseases of the urinary system, which had a latent course. Conclusions. Among the reliable factors of early preterm labor risk, it is necessary to note the high frequency of intrauterine manipulations of diagnostic and therapeutic nature in the use of ART, which results in receptor dysfunction of the endometrium. Key words: risk factors of early preterm labor, assistive reproductive technologies, ICSI, IVF, premature rupture of the membranes, dysfunction of the endometrium.


Folia Medica ◽  
2012 ◽  
Vol 54 (3) ◽  
pp. 22-29 ◽  
Author(s):  
Maria M. Orbetzova ◽  
Daniela I. Koleva ◽  
Mitko D. Mitkov ◽  
Iliana B. Atanassova ◽  
Julia G. Nikolova ◽  
...  

ABSTRACT The AIM of the study was to compare the levels of certain adipose tissue hormones in women with the two main morphological types of obesity - android and gynoid obesity. MATERIALS AND METHODS: The study included 2 groups of age- and weight-matched women with android (n = 32) and gynoid (n = 27) type of obesity, and a group of age-matched healthy women (n = 24) with normal weight and body constitution. Leptin, resistin, tumour necrosis factor α (TNFα), neuropeptide Y (NPY), glucose and insulin were measured.HOMA index was calculated. RESULTS: Leptin levels in the women with gynoid obesity did not differ significantly from those in the controls and the women with android obesity. The controls had significantly lower leptin levels compared with the android obesity women. NPY was significantly higher in the control women compared to the women with android obesity and did not differ significantly between the two groups of obese women. TNFα levels in all groups were very similar. Resistin did not show significant differences between all groups but tended to have the lowest levels in the controls. In the women with android obesity, insulin was significantly higher than that in the women with gynoid obesity and the controls. Insulin resistance was found in the women with android obesity only. Basal insulin and HOMA index in the women with gynoid obesity did not differ significantly from the values in the control group. CONCLUSION: The results from this study contribute to understanding the association of adipose tissue hormones and insulin resistance in obesity. When adipose tissue is predominantly distributed in the abdominal area at similar amount and percentage of body fats, leptin production is higher and insulin resistance develops. In the gynoid type of adipose tissue predisposition, overt insulin resistance is not found, leptin levels does not differ significantly from those in the control group.


2021 ◽  
Vol 25 (2(98)) ◽  
pp. 119-124
Author(s):  
V. Yuzko

Objective was to investigate the level of melatonin in the blood and follicular fluid in women treated with infertility by ART method and evaluate the effectiveness of melatonin in their preparation for programs.Material and methods. 89 women were examined. The first (control) group included 13 healthy women oocyte donors who gave birth to their own healthy children, the second group - 33 women with infertility, who two weeks before and during ovulation stimulation were taken simultaneously at the same time before bedtime 3 mg of the drug "Vita-melatonin" produced by "Kyiv Vitamin Plant", the third group - 43 women with infertility who did not take the drug melatonin during ovulation stimulation. ELISA (Germany) reagent kits were used to determine melatonin levels. Melatonin levels were determined in blood plasma, and follicular fluid obtained during the puncture at 9:00 am.Results. The level of melatonin in the blood of female donor oocytes was 130.85 ± 16.91 pg/ml. This rate in the blood of women who used the drug melatonin before and during ovulation stimulation was significantly higher than in the blood of women who did not take the drug (respectively, 143.06 ± 14.87 pg/ml and 123.40 ± 12.65 pg / ml, p <0.05), and in the follicular fluid there was an inverse relationship: the level of melatonin in women of the first group was 97.15 ± 8.69 pg / ml, the second group - 39.46 ± 4.52 pg/ml, which is significantly less (p <0.05), the third group - 62.34 ± 3.94 pg / ml, which is almost twice more (p <0.05) compared with women who took melatonin, but less (p <0.05) compared with the first group. The frequency of pregnancy on transfer in patients of the first group was 80.0 ± 11.01%, in women of the second group probably less - 60.6 ± 8.25% (p <0.05), but also probably higher compared to women in the third group - 45.0 ± 7.62% (p <0.05). A similar pattern was observed by us on the onset of pregnancy in general: in the first group - 100.0%, in the second - 68.9 ± 8.05% (p <0.05), in the third - 60.5 ± 7.47% (p> 0.05).Conclusions. The low level of melatonin in the follicular fluid obtained by us in women who underwent ovulation stimulation in ART programs in the treatment of infertility requires further scientific interpretation. At the same time, the best results of pregnancy in women in ART programs who took melatonin in preparation are encouraging.


Zygote ◽  
2021 ◽  
pp. 1-5
Author(s):  
Shiori Ashibe ◽  
Kanade Irisawa ◽  
Ken Yokawa ◽  
Yoshikazu Nagao

Summary Hyaluronidase is widely used in animal and human assisted reproductive technologies (ARTs) to remove cumulus cells around oocytes. However, adverse effects of hyaluronidase treatment, such as increased rates of degeneration and parthenogenesis, have been found after treatment of human and mouse oocytes. Currently, the mechanism(s) of the detrimental effects are unclear. The present study was initiated to identify the mechanism of adverse responses to hyaluronidase treatment in bovine oocytes and early embryos. Cumulus cells were removed from cumulus–oocyte complexes (COCs) with or without hyaluronidase and the oocytes were subjected to intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF). Significantly lower rates of blastocyst formation were obtained in the hyaluronidase treatment group after ICSI (22.4%) and IVF (21.2%) compared with the non-hyaluronidase control groups: 36.1% after ICSI and 30.4% after IVF. Next, we examined the effect of hyaluronidase on parthenogenetic development rates and on the cytoplasmic levels of free calcium ions (Ca2+), reactive oxygen species (ROS) and reduced glutathione (GSH). No differences in parthenogenesis rates were found between treated and untreated groups. Ca2+ levels in oocytes from the hyaluronidase treatment group indicated using mean fluorescence intensity were significantly higher (68.8 ± 5.3) compared with in the control group (45.0 ± 2.5). No differences were found in the levels of ROS or GSH between the treated and untreated groups. We conclude that hyaluronidase might trigger an increase in Ca2+ levels in oocytes, resulting in a decreased potential for normal embryonic development.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yulia A. Koloda ◽  
Yulia V. Denisova ◽  
Natalia M. Podzolkova

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 270-274
Author(s):  
Gunai R. Asfarova ◽  
Veronika I. Smol'nikova ◽  
Natalia P. Makarova ◽  
Iuliia S. Drapkina ◽  
Anastasiia P. Sysoeva ◽  
...  

Cumulus cells are essential during oocytes growth and development, as well as during their maturation and fertilization. Research results have shown that embryo co-cultivation with autologous cumulus cells increases the frequency of blastocyst formation, and also improves the effectiveness of ART programs. Embryo transfer in such programs is recommended to be carried out using the CAT technology (Cumulus-Aided embryo Transfer), which includes embryo cultivation on a layer of cumulus cells and embryo transfer with a certain amount of diluted cumulus cells. Patient G., 38 years old, came to the department with infertility for 15 years and recurrent implantation failure in history. The patient had ART program with autologous co-cultivation of embryos with cumulus cells and a new CAT transfer technology. The patient fell pregnant and gave birth to a healthy child. Autologous cumulus cells can be a source of biologically active substances and improve embryological parameters and implantation rate in ART programs. Embryo co-cultivation with cumulus cells is especially important for patients with recurrent implantation failure. This technique can become an alternative for optimizing human embryos culturing.


2021 ◽  
pp. 68-75
Author(s):  
A.O. Polumiskova ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.


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