scholarly journals Timing of frozen-thawed embryo transfer after controlled ovarian stimulation in a non-elective freeze-all policy

2019 ◽  
Vol 7 (23) ◽  
pp. 752-752 ◽  
Author(s):  
Jialyu Huang ◽  
Xuefeng Lu ◽  
Qin Xie ◽  
Jiaying Lin ◽  
Renfei Cai ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Ovarian Stimulation ◽  
Controlled Ovarian Stimulation ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Successful delivery in 17,20-lyase Deficiency

2021 ◽  
Author(s):  
Zeev Blumenfeld ◽  
Ilana Koren
Keyword(s):  
Embryo Transfer ◽  
Ovarian Stimulation ◽  
Controlled Ovarian Stimulation ◽  
Embryo Cryopreservation ◽  
High Dose ◽  
Human Menopausal Gonadotropin ◽  
Lyase Deficiency ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Objective To study and describe the achievement of successful pregnancy and delivery in a patient with 17,20-lyase deficiency. Design Controlled ovarian stimulation (COS) and In Vitro fertilization (IVF), cryopreservation of embryos and frozen-thawed embryo transfer (ET). Setting IVF clinic. Patient A 24 years old, infertile patient with 17,20-lase deficiency. Interventions Controlled ovarian stimulation, follicular aspiration- egg retrieval, IVF, embryo cryopreservation, thawed ET. Main Outcome Measures Clinical pregnancy, successful delivery. Results Isolated 17,20-lyase deficiency is caused by mutations in the CYP17A1 gene (coding for cytochrome P450c17), POR (coding for cytochrome P450 oxidoreductase) and CYB5A (coding for microsomal cytochrome b5) genes. A 24 yo patient with 17,20-lyase deficiency had undergone IVF with gonadotropin releasing hormone agonist (GnRHa) protocol, prednisone, and gonadotropins. After human chorionic gonadotropin (hCG) trigger 37 oocytes were retrieved, 25 ova fertilized, and 17 embryos cryopreserved. After menstrual bleeding, the endometrium was stimulated with oral estradiol, under progesterone suppression with long acting GnRHa and prednisone. When endometrial width of 8.5 mm was reached, vaginal progesterone was added, while gradually decreasing prednisone. On the fourth day of progesterone supplement, two thawed embryos were transferred. After 11 days of human menopausal gonadotropin (hMG), estradiol concentration moderately increased, but progesterone levels remained high, therefore, no fresh ET was performed. Twelve days after thawed ET, hCG was positive, and seven days later, an intrauterine gestational sac was detected, but the pregnancy ended in missed abortion. After two months, another frozen-thawed embryo transfer (FET) was performed, generating a normal gestation, which ended in successful delivery. Conclusion Pregnancy can be achieved in patients with 17,20-lyase deficiency, by IVF, freezing all embrya, and ET in a subsequent cycle, while suppressing endogenous ovarian progesterone with a GnRHa and adrenal suppression with high dose glucocorticoids.

Association between peak serum estradiol level during controlled ovarian stimulation and neonatal birthweight in freeze-all cycles: a retrospective study of 8501 singleton live births

2020 ◽  
Vol 35 (2) ◽  
pp. 424-433 ◽  
Author(s):  
Jialyu Huang ◽  
Xuefeng Lu ◽  
Jiaying Lin ◽  
Qiuju Chen ◽  
Hongyuan Gao ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Ovarian Stimulation ◽  
Low Birthweight ◽  
Tertiary Care ◽  
Peak Serum ◽  
Controlled Ovarian Stimulation ◽  
Serum Estradiol ◽  
Z Score ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract STUDY QUESTION Is there an association between peak serum estradiol (E2) level during controlled ovarian stimulation (COS) and neonatal birthweight in freeze-all cycles? SUMMARY ANSWER Peak serum E2 level during ovarian stimulation is not associated with neonatal birthweight in freeze-all cycles. WHAT IS KNOWN ALREADY Supraphysiologic E2 levels during COS have been demonstrated to generate a suboptimal peri-implantation endometrial environment and thus lead to adverse neonatal outcomes in fresh embryo transfer cycles. Previous experimental studies also suggested a potential influence of superovulation on oocyte epigenetic programming, but whether it translates into altered phenotypes of fetal growth and development remains unclear in clinical practice. By segmenting the process of COS and embryo transfer, the freeze-all policy provides a novel model to investigate the sole impact of ovarian stimulation on oocytes after ruling out the effects of hyperestrogenic milieu on endometrium in fresh cycles. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of 8501 patients who underwent their first COS cycles with a freeze-all strategy and delivered live-born singletons in subsequent frozen-thawed embryo transfer cycles from January 2007 to December 2016 at a tertiary-care academic medical center. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients were categorized into six groups according to E2 level on trigger day in regular increments of 1000 pg/mL: <1000, 1000–1999, 2000–2999, 3000–3999, 4000–4999 and ≥5000 pg/mL. Univariable and multivariable linear regression and logistic regression analysis were performed to assess the independent association between peak E2 level and measures of neonatal birthweight including absolute birthweight, Z-score, low birthweight (LBW) and small-for-gestational age (SGA). MAIN RESULTS AND THE ROLE OF CHANCE The six groups did not differ significantly in birthweight, Z-score or the incidence of LBW and SGA. Compared with the E2 <1000 pg/mL group, the adjusted mean difference (95% confidence interval [CI]) of stratified higher E2 groups was 17.2 (−31.0–65.5), 12.3 (−35.9–60.5), −4.1 (−51.9–43.7), −0.6 (−48.9–47.8) and −3.6 (−50.0–42.8) g for birthweight, and 0 (−0.11–0.10), 0.02 (−0.08–0.12), 0.04 (−0.06–0.14), −0.01 (−0.11–0.10) and −0.04 (−0.14–0.06) for Z-score, respectively. Regarding the outcomes of LBW and SGA, no increased risks were observed in each E2 category, with the adjusted odds ratio (95% CI) being 1.21 (0.68–2.16), 1.0 (0.58–1.90), 0.90 (0.50–1.63), 0.93 (0.51–1.69) and 1.08 (0.61–1.90) for LBW, and 0.97 (0.58–1.64), 1.06 (0.63–1.77), 0.77 (0.46–1.31), 0.71 (0.41–1.22) and 1.00 (0.60–1.65) for SGA, respectively. LIMITATIONS, REASONS FOR CAUTION The study was retrospective in design, and other unknown confounding factors may not be included for adjustment. Furthermore, the generalization of the study finding could be limited to some extent by the majority of double cleavage-stage embryo transfer and difference in birthweight reference percentiles between Chinese and other populations. WIDER IMPLICATIONS OF THE FINDINGS Our observations suggest that the hyperestrogenic milieu during COS does not seem to pose adverse effects on neonatal birthweight after frozen-thawed embryo transfer, which provides reassuring information for high ovarian responders in freeze-all cycles concerning their offspring’s health. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the National Key Research and Development Program of China (SQ2018YFC100163) and National Natural Science Foundation of China (81571397, 81771533). The authors declare no conflict of interest.

THE EFFECT OF ASSISTED HATCHING IN FROZEN-THAWED EMBRYO TRANSFER CYCLES

2016 ◽  
pp. 80-84
Author(s):  
Thi Tam An Nguyen ◽  
Minh Tam Le ◽  
Ngoc Thanh Cao
Keyword(s):  
Embryo Transfer ◽  
Zona Pellucida ◽  
Assisted Hatching ◽  
Implantation Failure ◽  
Multiple Pregnancies ◽  
Recurrent Implantation Failure ◽  
Key Words Laser ◽  
Implantation And Pregnancy Rates ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Background: Laser assisted hatching technique based on the hypothesis to make an artificial hole on zona pellucida (ZP) that can help embryo hatching out of ZP easily. This technique has been shown to increase implantation and pregnancy rates in women of advanced age, in women with recurrent implantation failure and following the transfer of frozen–thawed embryos. This study described the outcome of frozen–thawed embryo transfers with laser assisted hatching (LAH), which is one of the safest method in nowadays. Purpose: To assess the effect of assisted hatching technique on the clinical outcomes in vitrified-warmed transfer cycles. Method: A total of 65 thawed-transfer cycles with 153 thawed-embryos undertaken within a 12-month period were analysed, Assisted hatching with laser zona thinning was performed with one-quarter of the zona pellucida circumference. The overall thawed-embryos (day 3) were kept in culture overnight. Patient were prepared the suitable endometrium and transferred embryos advantageously. Results: In which, having the rate of survival embryos were 143 occupying 94.3%, the percentage of grade 1 and 2 embryos occupied 55.9% and 29,3% respectively, and that were enrolled LAH before transfering of frozen–thawed embryos. The average transferred embryos were 2.4±0.8, The rate of implantation per transferred embryos and per transferred embryos cycles was 19.5% and 43.1% respectively. The rate of clinical pregnancies per embryo transfer cycles occupied 33.8% with percentage of early miscarriages (biochemical pregnancies and early clinical miscarriages) was 12.3%. The rate of ongoing pregnancies was 30.8% and multiple pregnancies was low just 12.3%. This result was equal or higher than other researchs in embryos transfer had or no LAH. Conclusion: LAH contributed to stable frozen–thawed embryos transfer effectiveness. Key words: Laser assisted hatching, frozen–thawed embryos transfer, zona pellucida (ZP)

Comparison of four protocols for luteal phase support in frozen-thawed Embryo transfer cycles: a randomized clinical trial

2016 ◽  
Vol 295 (1) ◽  
pp. 239-246 ◽  
Author(s):  
Afsoon Zarei ◽  
Parastoo Sohail ◽  
Mohammad Ebrahim Parsanezhad ◽  
Saeed Alborzi ◽  
Alamtaj Samsami ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Embryo Transfer ◽  
Luteal Phase ◽  
Luteal Phase Support ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer
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