scholarly journals The number of oocytes as a predictor of pregnancy rates in the cycles of assisted reproductive technology

2020 ◽  
Vol 7 (1) ◽  
pp. 53-58
Author(s):  
I. V. Gorelova ◽  
J. A. Galkina ◽  
L. V. Kuznetsova ◽  
M. V. Rulev ◽  
I. E. Zazerskaya
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technology ◽  
Treatment Plan ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Research Centre ◽  
Adequate Treatment ◽  
National Medical ◽  
Group 2 ◽  
Group 1

Background. Data on the effect of the number of received oocytes on the outcomes of assisted reproductive technology (ART) programs are contradictory. The frequency of obtaining a small number of cells ranges from 5.6 to 35.1 %. Identifying women who have chances of getting pregnant, despite this situation, is important for drawing up an adequate treatment plan.Objective of this study is to assess the pregnancy rate depending on the number of retrieved oocytes in ART cycles with ovarian stimulation, which ended with the transfer of embryos, as well as determining the characteristics of patients with a reduced response, in whom the pregnancy occurred.Design and methods. The study included 526 women who were treated for infertility in the department of ART of the Almazov National Medical Research Centre in 2017. Patients were divided into three groups depending on the number of oocytes retrieved: less than 5, from 5 to 9 and 10 or more. Group 1 (number of oocytes less than 5) included 126 women, group 2 (from 5 to 9) — 223 women and group 3 (number of oocytes 10 and more) — 177 patients. The average age of the patients was 33.37 years (from 22 to 48 years).Results. The frequency of obtaining a positive blood test and clinical pregnancy rate were comparable in groups 2 and 3 (53.81 % and 49.72 %, respectively) and significantly lower in group 1 (41.27 %, p > 0.05). Clinical pregnancy in group 1 occurred in 34.13 % of cases, which was significantly different from the indicators of group 2 + 3, where the gestational egg visualized in 47.5 % of cases (p < 0.05). In a group of women with a small number of oocytes, the most important predictors of pregnancy were obtaining 2 or more oocytes, and anti-mullerian hormone (AMH) level above 1 ng / L.Conclusion. The number of oocytes is an important predictor of pregnancy rate. The chances of becoming pregnant in women with a small number of oocytes depend on the level of AMH and the number of oocytes obtained.

P–391 Role of subcutaneous granulocyte colony-stimulating factor infusion in thin endometrium

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
K Banerjee ◽  
B Singla
Keyword(s):  
Pregnancy Rate ◽  
Clinical Pregnancy ◽  
P Value ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Thin Endometrium ◽  
Group 2 ◽  
Stimulating Factor ◽  
Group 1

Abstract Study question To assess the role of subcutaneous granulocyte colony-stimulating factor (G-CSF) in thin endometrium cases. Summary answer G CSF has beneficial role to improve the endometrium thickness in thin endometrium. What is known already Endometrium is very important for embryo implantation and the endometrial thickness is the marker of receptivity of the endometrium. Study design, size, duration Study design - Retrospective analysis Size - 88 infertile females with thin endometrium (&lt; 7 mm) in the age group of 23 to 40 years Duration - one year. Participants/materials, setting, methods In the group 1 of 44 females, subcutaneous infusion of G CSF (300 mcg/ml) was added along with other supplements and if lining was not more than 7 mm in 72 hours, then second infusion was given. In the group 2 of 44 females, only estradiol valerate and sildenafil were given.The efficacy of G CSF was evaluated by assessing the endometrium thickness before embryo transfer, pregnancy rates and clinical pregnancy rates. Main results and the role of chance There was no difference between the two groups regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality. . The pregnancy rate was 60% (24 out of 40 cases) in the group 1 that was significantly higher than in-group 2 that was 31% (9 out of 29 cases) with p value &lt; 0.0001. The clinical pregnancy rate was also significantly higher in-group 1 (55%) as compared to group 2 (24%) with p value &lt; 0.0001. Limitations, reasons for caution Further larger cohort studies are required to explore the subcutaneous role of G CSF in thin endometrium. Wider implications of the findings: Granulocyte colony-stimulating factor has beneficial role to improve the endometrium thickness in thin endometrium. In most of previous studies, the intrauterine infusion of G CSF was given to improve the uterine lining. This is one of the few studies done that showed subcutaneous role of G CSF in thin endometrium. Trial registration number Not applicable

scholarly journals Late follicular phase progesterone elevation during ovarian stimulation is not associated with decreased implantation of chromosomally screened embryos in thaw cycles

2020 ◽  
Vol 35 (8) ◽  
pp. 1889-1899
Author(s):  
Carlos Hernandez-Nieto ◽  
Joseph A Lee ◽  
Tamar Alkon-Meadows ◽  
Martha Luna-Rojas ◽  
Tanmoy Mukherjee ◽  
...  
Keyword(s):  
Embryonic Development ◽  
Pregnancy Rate ◽  
Follicular Phase ◽  
Clinical Pregnancy ◽  
Cutoff Value ◽  
Ivf Outcomes ◽  
Group 2 ◽  
The Impact ◽  
Late Follicular Phase ◽  
Group 1

Abstract STUDY QUESTION What is the impact of a late follicular phase progesterone elevation (LFPE) during controlled ovarian hyperstimulation (COH) on embryonic competence and reproductive potential in thaw cycles of preimplantation genetic testing for aneuploidy (PGT-A) screened embryos? SUMMARY ANSWER Our study findings suggest that LFPE, utilizing a progesterone cutoff value of 2.0 ng/ml, is neither associated with impaired embryonic development, increased rate of embryonic aneuploidy, nor compromised implantation and pregnancy outcomes following a euploid frozen embryo transfer (FET) cycle. WHAT IS KNOWN ALREADY Premature progesterone elevation during COH has been associated with lower pregnancy rates due to altered endometrial receptivity in fresh IVF cycles. Also, increased levels of progesterone (P) have been suggested to be a marker for ovarian dysfunction, with some evidence to show an association between LFPE and suboptimal embryonic development. However, the effect of LFPE on embryonic competence is still controversial. STUDY DESIGN, SIZE, DURATION Retrospective cohort analysis in a single, academic ART center from September 2016 to March 2020. In total, 5244 COH cycles for IVF/PGT-A were analyzed, of those 5141 were included in the analysis. A total of 23 991 blastocysts underwent trophectoderm biopsy and PGT analysis. Additionally, the clinical IVF outcomes of 5806 single euploid FET cycles were evaluated. PARTICIPANTS/MATERIALS, SETTING, METHODS Cohorts were separated in two groups: Group 1: oocytes retrieved from cycles with normal P levels during ovulation trigger (P ≤ 2.0 ng/ml); Group 2: oocytes retrieved after cycles in which LFPE was noted (P &gt; 2.0 ng/ml). Extended culture and PGT-A was performed. Secondly, IVF outcomes after a single euploid FET were evaluated for each cohort. MAIN RESULTS AND THE ROLE OF CHANCE Four thousand nine hundred and twenty-five cycles in Group 1 were compared with 216 cycles on Group 2. Oocyte maturity rates, fertilization rates and blastulation rates were comparable among groups. A 65.3% (n = 22 654) rate of utilizable blastocysts was found in patients with normal P levels and were comparable to the 62.4% (n = 1337) observed in those with LFPE (P = 0.19). The euploidy rates were 52.8% (n = 11 964) and 53.4% (n = 714), respectively, albeit this difference was not statistically significant (P = 0.81). Our multivariate analysis was fitted with a generalized estimating equation (GEE) and no association was found with LFPE and an increased odds of embryo aneuploidy (adjusted odds ratio 1.04 95% CI 0.86–1.27, P = 0.62). A sub-analysis of subsequent 5806 euploid FET cycles (normal P: n = 5617 cycles and elevated P: n = 189 cycles) showed no differences among groups in patient’s BMI, Anti-Müllerian hormone (AMH), endometrial thickness at FET and number of prior IVF cycles. However, a significant difference was found in patient’s age and oocyte age. The number of good quality embryos transferred, implantation rate, clinical pregnancy rate, ongoing pregnancy rate, multiple pregnancy rate and clinical pregnancy loss rates were comparable among groups. Of the registered live births (normal P group: n = 2198; elevated P group: n = 52), there were no significant differences in gestational age weeks (39.0 ± 1.89 versus 39.24 ± 1.53, P = 0.25) and birth weight (3317 ± 571.9 versus 3 266 ± 455.8 g, P = 0.26) at delivery, respectively. LIMITATIONS, REASONS FOR CAUTION The retrospective nature of the study and probable variability in the study center’s laboratory protocol(s), selected progesterone cutoff value and progesterone assay techniques compared to other ART centers may limit the external validity of our findings. WIDER IMPLICATIONS OF THE FINDINGS Based on robust sequencing data from a large cohort of embryos, we conclude that premature P elevation during IVF stimulation does not predict embryonic competence. Our study results show that LFPE is neither associated with impaired embryonic development nor increased rates of aneuploidy. Embryos obtained from cycles with LFPE can be selected for transfer, and patients can be reassured that the odds of achieving a healthy pregnancy are similar to the embryos exposed during COH cycles to physiologically normal P levels. STUDY FUNDING/COMPETING INTEREST(S) No funding was received for the realization of this study. Dr A.B.C. is advisor and/or board member of Sema 4 (Stakeholder in data), Progyny and Celmatix. The other authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA

The results of assisted reproductive technology programs in patients with “thin” endometrium

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 23-27 ◽  
Author(s):  
F Abdurakhmanova Nigora ◽  
D Gvozdeva Anna ◽  
M Ziganshina Marina ◽  
V Dolgushina Nataliya
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technology ◽  
Endometrial Thickness ◽  
Area Under The Curve ◽  
Reproductive Technology ◽  
Endometrial Polyps ◽  
Art Programs ◽  
Thin Endometrium ◽  
Factors Affecting ◽  
Group 2

Relevance. Effectiveness of assisted reproductive technology (ART) programs is quite high, but for couples who have already had failed attempts of ART programs the likelihood of getting pregnant decreases with each subsequent attempt. Low endometrial thickness is a common cause of a decline in a possibility of getting pregnant. However, data on predictive value of this index in ART programs are contradictory. Some researchers do not find a correlation between the endometrium thickness and ART programs outcomes. Other researchers revealed a statistically significant relationship between endometrium thickness and pregnancy rate in ART cycles. Aim. To evaluate an effect of “thin” endometrium on pregnancy rate in ART programs. Materials and methods. 154 couples who applied for infertility treatment in ART programs were included in this prospective study. The patients were stratified into groups depending on whether a pregnancy to occur: Group 1 (n=43) - pregnancy occurred and Group 2 (n=111) - pregnancy did not occur. Then the endometrial thickness threshold determining pregnancy occurrence was identified by ultrasound and two additional groups were formed: Group 3 (n=85) - patients with “thin” endometrium, Group 4 (n=69) - patients with normal endometrial thickness. Results. The endometrial thickness threshold at which pregnancy probability, as well as the model and area under the curve (AUC) reliability were maximum, was 8.0 mm (AUC=86.7%, sensitivity - 97.7%, specificity - 75.7%). The adjusted odds ratio of pregnancy occurrence depending on endometrial thickness given the excellent quality blastocysts obtained, was 9.1 (95% confidence interval 4.3-19.3). Factors affecting endometrial thickness were endometrial polyps with polypectomy and spontaneous miscarriages in anamnesis that was undoubtedly associated with an inflammatory genesis of endometrial damage Conclusions. "Thin" endometrium plays a negative role in ART programs reducing pregnancy likelihood by 9.1 times.

P–249 Does the re-expansion of thawed embryos affect the clinical outcomes of human blastocyst vitrification?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
T Huong ◽  
A Ph. Th. Tú ◽  
L H Mai ◽  
N Doã. Thảo ◽  
C A Mạnh
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Embryo Quality ◽  
Cell Mass ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Group 2 ◽  
Group 1

Abstract Study question Is that essential for prolonged culture of thawed blastocysts in order to be fully re-expanded before transferring? Summary answer Ongoing pregnancy rates decreased in blastocysts that not fully re-expanded after thawing. What is known already: The thaw survival of blastocysts is examined based on morphology of inner cell mass (ICM) and trophectoderm (TE). However, thawed blastocysts experience multiple changes in morphology and might be collapse after thawing due to the presence of blastocoel cavity. It is then difficult to evaluate blastocyst quality. Therefore, the blastocyst re-expansion is considered as a criteria to assess quickly the competent embryos. It also reflects the status energy metabolism from high quality embryo. After all, there are still some controversial opinions about the influence of re-expansion status after thawing. Study design, size, duration This was a retrospective study based on data collected between October 2019 and December 2020. A total 528 thawed blastocysts which were divided into two groups according to the post-thaw reexpansion status: fully re-expanded blastocysts (n = 416), partial or no re-expanded blastocysts (n = 112). The re-expansion status of blastocyst was assess prior to loading on the catheter by senior embryologists. Participants/materials, setting, methods Primary outcome is ongoing pregnancy. Only frozen single D5 transfer cycles were included. We excluded the frozen sperm/oocytes/embryos donation cycles, missing data, non-intact embryos after thawing. Statistical analyses were performed with T or chi-squared tests. Multivariable regression analysis was performed adjusting for the following confounding factors: age, BMI, embryo quality, re-expansion status, biopsied blastocyst. Main results and the role of chance Female age, BMI, number of previous cycles, endometrial thickness, positive HCG results, clinical pregnancy rate were comparable among patients within two groups. The rate of ongoing pregnancy rate in group 1 was significant higher compared with group 2 (51 vs 40.2, p &lt; 0.05). The number of good quality blastocyst transferred in group 1 was higher than in group 2 (p &lt; 0.001). However, under the same embryo quality, there were no difference between clinical pregnancy rate and ongoing pregnancy rate between two groups. When logistic regression were performed: only embryo quality, but not the re-expansion status, was noted to be an independent predictor of ongoing pregnancy (OR = 3.53;95% CI; 1.734–7.184;p=0.001). Limitations, reasons for caution The main limitation of the study is its retrospective design. Wider implications of the findings: Clinical outcomes are comparable between re-expanded blastocyst and partial or no re-expanded blastocysts, although ongoing pregnancy can be improved when embryos are fully expanded. As expected, blastocysts quality has the most important impact on ongoing pregnancy rate. Trial registration number Not applicable

scholarly journals Survey of Relation between Midcycle Progesterone Level with IUI Cycles Success Rate

2020 ◽  
Vol 7 (4) ◽  
pp. 9
Author(s):  
Alieh Ghasemzadeh ◽  
Gilda Mostafavi ◽  
Mohammad Nouri ◽  
Parastoo Chaichi ◽  
Laya Farzadi ◽  
...  
Keyword(s):  
Success Rate ◽  
Pregnancy Rate ◽  
Assisted Reproductive Technology ◽  
Endometrial Thickness ◽  
Cross Sectional Study ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Progesterone Level ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Assisted reproductive technology is used routinely for treatment of infertile spouses. Previous studies reported conflicting results regarding effect of progesterone rise at the HCG injection day. The aim of current study is to evaluate the effects of mid cycle progesterone levels in IUI cycles. Methods: In this analytical cross-sectional study, the outcome of treatment in 200 IUI cycles were evaluated. Patients’ demographic findings, progesterone level at the day of HCG injection, number of follicles >16 mm, endometrial thickness and clinical pregnancy rate were recorded. For better evaluation, progesterone levels were divided to <0.5, 0.5-1.5 and >1.5 ng/dl. Results: Patients’ mean age was 29.70±4.38 years. The progesterone levels of <0.5, 0.5-1.5 and >1.5 ng/dl was detected in 24.5%, 56% and 19.5% of patients, respectively. The rate of clinical pregnancy was 27.5%. Cases with positive pregnancy had significantly lower progesterone levels (0.88±0.31 vs.1.11±0.80, p=0.04). The highest pregnancy rate was in progesterone levels 0.5-1.5 compared to levels <0.5 and >1.5 ng/dl (42% vs. 12.2% vs. 5.2%, p<0.001). There was no significant correlation between progesterone levels with endometrial thickness (r=-0.130, p=0.06) and number of follicles >16 mm(r=0.02, p=0.77). Conclusion: The results of current study showed that the increase in progesterone levels at the day of HCG injection accompanies with lower pregnancy rate. However, this increase has no correlation with number of mature follicles and endometrial thickness.

scholarly journals Pregnancy outcomes of the first thawing cycle in “freeze-all” strategy of infertility patients with fever during oocyte recruitment: A matched–pair study (Preprint)

2020 ◽  
Author(s):  
Mingmei Lin ◽  
Zi-Ru Niu ◽  
Rong Li
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Ovarian Stimulation ◽  
Oocyte Retrieval ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Embryo Freezing ◽  
Group 2 ◽  
Infertility Patients ◽  
Group 1

BACKGROUND It is well known that assisted reproduction technology (ART) is currently an effective method for treating infertility. But it is currently unknown whether the patients with fever after control ovulation during egg retrieval could increase risk of pelvic infection or not, and fever itself may be affect oocyte or embryo quantity and quality, thus with poor pregnancy outcomes? But if the oocyte retrieval was cancelled cause of fever, the risk of severe ovulation complications might increase, such as ovarian hyper-stimulation syndrome, thrombus and ovarian pedicle torsion. OBJECTIVE The goal of this study was to analysis the outcomes of the patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer cycle. METHODS This is a 1:3 retrospective paired study matched for age. In this study, 58 infertility patients (Group 1) had fever during the control ovulation and the time of the oocyte retrieval within 72 hours, they undertook ovum pick up and whole embryo freezing (“freeze-all” strategy). The control controls (Group 2) are174 patients matched for age with whole embryo freezing for other reasons. The baseline characteristic, clinical data of ovarian stimulation and the outcomes, such as the clinical pregnancy rate, early miscarriage rate, ectopic pregnancy rate and ongoing clinical pregnancy rate were compared between the two groups. RESULTS There were 58 patients were enrolled in the Group 1, and matched with 174 patients for the Group 2. All the patients had no pelvic inflammatory disease after oocyte retrieval. The basic characteristics of patients refers to age, BMI, nulliparity, basal FSH, basal LH, basal E2 and infertility type (primary or secondary) were with no significantly difference. But the AMH lever (4.2 versus 2.2, P<0.001) were higher and the infertility time (3 versus 2, P=0.035) was longer in the control group. The number of oocytes retrieved and fertilization rate were lower in the group (P< 0.001), but the ovarian stimulation protocol, the usage of Gn both time and dose, the ICSI rate, the 2PN rate, the number of available embryos (D3 and D5), the endometrial thickness, the number of embryo transfer and the type of luteal support supplementation were similar between the two groups. Regarding pregnancy outcomes，the implantation rate, clinical pregnancy rate, early spontaneous rate, ectopic pregnancy rate and ongoing pregnancy rate all were with no significantly difference. CONCLUSIONS The patients with fever during control ovulation and the oocyte retrieval got similar outcomes compared with those with no fever patients when taken the whole embryos freezing. Fever had almost no effect on the quality of embryo and endometrium. Moreover, the oocyte retrieved is relatively safe and reliable under strict disinfection and taken oral antibiotics for prevention infection.

scholarly journals Only extremely high peak serum estradiol adversely affects endometrial receptivity in IVF treatment

2019 ◽  
Author(s):  
Jianyuan Song ◽  
Tingting Liao ◽  
Liu Jiang ◽  
Houming Su ◽  
Licheng Ji ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Abortion Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Serum Estradiol ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Purpose To explore the effect of different concentrations of peak serum estradiol levels on endometrial receptivity quantitatively. Methods In our reproductive medicine center, two best quality of day 3 (D3) embryos were transferred or frozen according to E 2 and progesterone levels on the day of human chorionic gonadotropin (hCG) administration and the number of oocytes retrieved. The remaining embryos were cultured to blastocyst stage and frozen. The patients were then categorized into three groups. The patients with frozen-thawed D3 embryo transfer in artificial cycles without blastocyst frozen served as group 1, those with fresh D3 embryo transfer without blastocyst frozen as group 2, and those with fresh D3 embryo transfer with blastocyst frozen as group 3. Each group was further stratified into 4 sub-groups according to E 2 levels on the day of hCG administration. Clinical pregnancy rate, implantation rate and abortion rate of frozen-thawed and fresh D3 embryo transfer were compared among the three groups in the same stratified E 2 levels. Results For E 2 <7,000 pg/mL, group 1 and group 2 had similar clinical pregnancy rate and implantation rate. But for E 2 ≥7,000 pg/mL, the clinical pregnancy rate in group 1 was significantly higher than in group 2 (p<0.05). For E 2 <7,000 pg/mL, pregnancy rate and implantation rate in group 1 were significantly lower than those in group 3 (P<0.05). But for E 2 ≥7,000 pg/mL, the pregnancy rate in group 1 was significantly higher than in group 3 (P<0.05). There was no significant difference in the abortion rate between group 1 and group 2, or between group 1 and group 3. Conclusions High serum E 2 concentration does not impair implantation and pregnancy rates unless exceeding a certain limit (e.g. 7,000 pg/mL) on the day of hCG administration. Since peak E 2 level was related to OHSS and adverse pregnancy outcomes, further study is needed to set a threshold peak E 2 level for fresh embryo transfer.

scholarly journals Does a Very Short Length of Abstinence Improve Assisted Reproductive Technique Outcomes in Infertile Patients with Severe Oligo-Asthenozoospermia?

2021 ◽  
Vol 10 (19) ◽  
pp. 4399
Author(s):  
Federica Barbagallo ◽  
Aldo E. Calogero ◽  
Rosita A. Condorelli ◽  
Ashraf Farrag ◽  
Emmanuele A. Jannini ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Embryo Quality ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Sperm Parameters ◽  
Male Partners ◽  
Group 2 ◽  
Infertile Patients ◽  
Group 1

In recent years, a growing number of studies seem to support the beneficial effects of a very short abstinence period on sperm parameters, especially in patients with oligo-asthenozoospermia (OA). On this basis, the aim of this study was to evaluate the effects of a short period of abstinence (1 h) on intracytoplasmic sperm injection (ICSI) outcomes in infertile patients with severe OA. We performed a retrospective study on 313 ICSI cycles in which couples were divided into two different groups based on sperm parameters of the male partners. Group 1 included normozoospermic men or male partners with a mild OA (n = 223). Group 2 included male partners with severe OA (n = 90). They were asked to provide a second consecutive ejaculation after 1 h from the first one. The best ejaculate was used to perform ICSI. We found a significant increase of total (p < 0.001) and progressive motility (p < 0.001) in the second ejaculate of patients of Group 2 compared with those of the first one. Spermatozoa of the second ejaculate were chosen for ICSI for all patients in Group 2. We found statistically significant improvement of clinical pregnancy rate (p = 0.001) and embryo quality (p = 0.003) in couples in Group 2 compared to those of Group 1. No statistically significant difference was found in fertilization, implantation, live birth delivery, and miscarriage rates between the two groups. Therefore, a second semen sample collected after a very short time-interval in patients with severe OA allowed us to obtain significantly higher clinical pregnancy rate with improved embryo quality compared to normozoospermic men or patients with mild OA. Fertilization, implantation, live birth delivery, and miscarriage rates were similar between the two groups. The present study shows that a second consecutive ejaculate could represent a simple strategy to obtain better sperm parameters and assisted reproductive technology (ART) outcomes in infertile patients with mild-severe OA.

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