scholarly journals Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis,GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study

2020 ◽  
Author(s):  
Linli Hu ◽  
Rui Xie ◽  
Mengying Wang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Matched Control ◽  
Live Birth Rate ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Control Group ◽  
Ovarian Hyperstimulation ◽  
Matched Control Group ◽  
Neonatal Complications

Abstract Background: Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetric and neonatal outcomes of this group of patients are unknown. The aim of this study was to explore the effects of late moderate-to-critical OHSS on obstetric and neonatal outcomes.Methods: This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion criteria, including 7,064 eligible patients diagnosed with clinical pregnancy. Ultimately, 6,356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, matching nine maternal baseline covariates and the number of multiple gestations; 385 patients with late moderate-to-critical OHSS were compared with a matched control group of 1,540 patients. The primary outcomes were the live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications.Results: The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and matched control groups. The incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the number of neonates admitted to the NICU were significantly higher in the OHSS group than in the matched control group.Conclusions: Pregnant women undergoing IVF with fresh ET whose course is complicated by late moderate-to-critical OHSS appear to experience shortened gestation and increased obstetrical and neonatal complications compared with matched controls whose course is not complicated by OHSS. However, the live birth rate, average neonatal weight, and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), and low neonatal birth weight (LBW) did not differ significantly between the two groups.

scholarly journals Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis, GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Linli Hu ◽  
Rui Xie ◽  
Mengying Wang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Matched Control ◽  
Live Birth Rate ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Control Group ◽  
Ovarian Hyperstimulation ◽  
Matched Control Group ◽  
Neonatal Complications

Abstract Background Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetric and neonatal outcomes of this group of patients are unknown. The aim of this study was to explore the effects of late moderate-to-critical OHSS on obstetric and neonatal outcomes. Methods This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion criteria, including 7,064 eligible patients diagnosed with clinical pregnancy. Ultimately, 6,356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, matching nine maternal baseline covariates and the number of multiple gestations; 385 patients with late moderate-to-critical OHSS were compared with a matched control group of 1,540 patients. The primary outcomes were the live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications. Results The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and matched control groups. The incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the number of neonates admitted to the NICU were significantly higher in the OHSS group than in the matched control group. Conclusions Pregnant women undergoing IVF with fresh ET whose course is complicated by late moderate-to-critical OHSS appear to experience shortened gestation and increased obstetrical and neonatal complications compared with matched controls whose course is not complicated by OHSS. However, the live birth rate, average neonatal weight, and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), and low neonatal birth weight (LBW) did not differ significantly between the two groups.

scholarly journals Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis,GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study

2020 ◽  
Author(s):  
Linli Hu ◽  
Rui Xie ◽  
Mengying Wang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Ovarian Hyperstimulation Syndrome ◽  
Birth Rate ◽  
Matched Control ◽  
Live Birth Rate ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Control Group ◽  
Ovarian Hyperstimulation ◽  
Matched Control Group

Abstract Background: Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetrics and neonatal outcomes of these group of patients are barely known. The aim of this study was to explore the effects of late moderate-to-critical ovarian hyperstimulation syndrome (OHSS) on obstetric and neonatal outcomes.Methods: This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion and exclusion criteria, including 7064 eligible patients diagnosed with clinical pregnancy. Finally, 6356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, with matching of nine maternal baseline covariates and the number of multiple gestations. 385 patients of late moderate-to-critical OHSS and compared with a matched control group of 1540 patients. The primary outcomes were live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications.Results: The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and the matched control groups, and the incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the numbers of neonates admitted to the NICU in the OHSS group were significantly higher than those in the matched control group.Conclusions: Pregnant women undergoing IVF-ET fresh transplantation will shorten the gestational time and increase obstetric complications and neonatal complications because of Late moderate-to-critical OHSS. However, the live birth rate and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), average neonatal weight and LBW did not statistically significant differ between the two groups.

scholarly journals Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis, GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study

2020 ◽  
Author(s):  
Linli Hu ◽  
Rui Xie ◽  
Mengying Wang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Ovarian Hyperstimulation Syndrome ◽  
Matched Control ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Ovarian Hyperstimulation ◽  
Matched Control Group ◽  
Neonatal Complications

Abstract Background: Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetrics and neonatal outcomes of these group of patients are barely known. The aim of this study was to explore the effects of late moderate-to-critical ovarian hyperstimulation syndrome (OHSS) on obstetric and neonatal outcomes.Methods: This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion and exclusion criteria, including 7064 eligible patients diagnosed with clinical pregnancy. Finally, 6356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group.Results: The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and the matched control groups, and the incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the numbers of neonates admitted to the NICU in the OHSS group were significantly higher than those in the matched control group. Conclusions: Late moderate-to-critical OHSS could reduce the gestational time and increase obstetric complications and neonatal complications. However, the live birth rate and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), average neonatal weight and LBW did not statistically significant differ between the two groups.

scholarly journals Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis,GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study

2020 ◽  
Author(s):  
Linli Hu ◽  
Rui Xie ◽  
Mengying Wang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Ovarian Hyperstimulation Syndrome ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Neonatal Outcomes ◽  
Premature Delivery ◽  
Control Group ◽  
Hypertensive Disorder ◽  
Ovarian Hyperstimulation ◽  
Neonatal Complications

Abstract Background : Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetrics and neonatal outcomes of these group of patients are barely known. The aim of this study was to explore the effects of late moderate-to-critical ovarian hyperstimulation syndrome (OHSS) on obstetric and neonatal outcomes. Methods: This is a prospective observational study including 17,537 patients after IVF/ICSI-fresh embryo transfer (ET) from June 2012 to July 2016, after meeting the inclusion and exclusion criteria, of whom 7064 eligible patients were diagnosed with clinical pregnancy. Finally, 6356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Results: The live birth delivery rate did not significantly differ between the OHSS and the macthed control groups, and the incidence rates of the obstetric complications venous thrombosis (VT), gestational diabetes mellitus (GDM), neonatal complications and the numbers of neonates admitted to the NICU were significantly higher in the OHSS group than that in the macthed control group. The duration of gestation was significantly higher in the macthed control group than that in the OHSS group. Conclusions: Late moderate-to-critical OHSS could reduce gestational time, increase obstetric complications and neonatal complications. However, the incidence rates of live birth rate, premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), Placenta previa (PP), Intrahepatic cholestasis of pregnancy (ICP), average neonatal weight and LBW did not statistically significant difference between the two groups.

scholarly journals Live birth rate and obstetric complications following the hysteroscopic management of intrauterine adhesions including Asherman syndrome

2018 ◽  
Vol 33 (10) ◽  
pp. 1847-1853 ◽  
Author(s):  
Rebecca Deans ◽  
Thierry Vancaillie ◽  
William Ledger ◽  
Jinzhu Liu ◽  
Jason A Abbott
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Obstetric Complications ◽  
Intrauterine Adhesions

scholarly journals Reproductive Outcomes of Women with Polycystic Ovarian Syndrome Following In-Vitro Fertilization — A Meta-Analysis and Systematic Review

2019 ◽  
Vol 01 (04) ◽  
pp. 193-201
Author(s):  
I-Ferne Tan ◽  
Audrey J. R. Lim ◽  
Inthrani R. Indran ◽  
Michael S. Kramer ◽  
Eu-Leong Yong
Keyword(s):  
Live Birth ◽  
Ovarian Hyperstimulation Syndrome ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Ovarian Hyperstimulation ◽  
Vitro Fertilization ◽  
Ivf Outcomes ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a common cause of infertility in women. In-vitro fertilization (IVF) is required in 20–30% of women with PCOS trying to conceive. This is associated with increased risk of multiple gestation and ovarian hyperstimulation syndrome. Improvements in IVF techniques, safety standards, and the increased use of frozen embryos in recent years have lead to improved outcomes for women with PCOS. We performed a systematic review and meta-analysis to compare these outcomes with women without PCOS. Search Methods: A search of PubMed, EMBASE, the Cochrane Central Register of clinical trials, and Scopus databases for all articles published until November 16th, 2017 identified 21 studies comparing IVF outcomes in PCOS and non-PCOS women. Inclusion criteria were Rotterdam criteria PCOS, comparable IVF regimes, immediate IVF outcomes, and pregnancy outcomes. Studies were excluded if the control group included any PCOS criteria, donor oocytes, or in-vitro maturation. Outcomes: No difference was observed in live birth rate per cycle in women with vs. without PCOS (RR [Formula: see text] 1.01 [0.89, 1.16]; [Formula: see text] 82%), but the live birth rate per first cycle in PCOS cycles (RR [Formula: see text] 0.93 [0.88, 0.99]) was slightly lower. There was also no difference in the clinical pregnancy rate (RR 1.02 [0.89, 1.17]) or biochemical pregnancy rate (RR 1.03 [0.99, 1.08]) observed between the two groups. PCOS was associated with a significantly higher number of oocytes retrieved (mean difference [Formula: see text] 3.6; 95% CI [2.8, 4.4]), risk of miscarriage (RR 2.90 [2.09, 4.02]), and risk of ovarian hyperstimulation syndrome (RR 3.42 [2.28, 5.13]) per cycle. Conclusion: Despite a widespread perception of poor reproductive potential, women with PCOS experience IVF outcomes similar to those without PCOS. Although there is a slightly lower live birth rate during their first stimulation cycle, success rates are similar after multiple cycles. PCOS is associated with a higher risk of ovarian hyperstimulation syndrome. Further studies are required to mitigate this risk.

scholarly journals Is It Possible to Expand Oocyte Donors by Decreasing Number of Oocytes for Own Use? Insights From a Large Single-Center Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiqin Bu ◽  
Jiaxin Zhang ◽  
Yile Zhang ◽  
Yingpu Sun
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Oocyte Donation ◽  
Control Group ◽  
Cumulative Live Birth Rate ◽  
Oocyte Number ◽  
Oocyte Donors ◽  
Supernumerary Embryos ◽  
Ivf Et

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.

scholarly journals Randomized Controlled Study of the Effects of DHEA on the Outcome of IVF in Endometriosis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yanxia Zhang ◽  
Meiqing Li ◽  
Lian Li ◽  
Jianghua Xiao ◽  
Zhe Chen
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Synthesis Process ◽  
Controlled Study ◽  
Control Group

Objective. To investigate the effect of dehydroepiandrosterone (DHEA) on the outcome of in vitro fertilization (IVF) in patients with endometriosis (EMT). Methods. Female patients diagnosed with EMT in our hospital from May 2018 to May 2019 were selected. The patients were divided into the control group (n = 22) and the DHEA group (n = 22) according to the random number table. Patients in the control group received placebo and patients in the DHEA group received DHEA. Patients in both groups received either DHEA (25 mg) or placebo orally 3 times a day for 90 days from the first day of menstruation. Patients were subsequently treated with an IVF cycle. In the control group, 22 patients completed the first cycle and 13 patients completed the second cycle. In the DHEA group, 22 patients completed the first cycle and 11 patients completed the second cycle. Serum sex hormone levels including serum E2 on hCG day, mean progesterone on hCG day, FSH on day 2, AMH on day 2, and gonadotropin dose were determined using a chemiluminescent immunoassay kit. The number of antral follicles of the bilateral ovaries was counted by transvaginal B-ultrasound, and the maximum length and transverse diameter of the ovaries were measured at the same time, to calculate the average diameter of the ovaries, observe the morphology of endometrium, and measure the thickness of the endometrium. The implantation rate, clinical pregnancy rate, persistent pregnancy rate, and live birth rate were compared between the two groups. Results. There were no significant differences in serum E2, progesterone, endometrial thickness, recovered oocytes, mean number of transferred embryos, and mean score of leading embryo transfer between the DHEA group and the women who completed the first and second cycles ( P > 0.05 ). The AMH, antral follicle count, serum E2 on hCG day, the number of recovered oocytes, fertilized oocytes, and the fertilization rate in the DHEA group were higher than those in the control group ( P < 0.05 ). The doses of FSH on day 2, COH on day 3, and gonadotropin were lower than those in the control group ( P < 0.05 ). There was no significant difference in the total number of embryos, the number of high-quality embryos, and the number of transplanted embryos between the two groups ( P > 0.05 ). The implantation rate, clinical pregnancy rate, persistent pregnancy rate, and live birth rate in the DHEA group were higher than those in the control group ( P < 0.05 ). Conclusion. DHEA can significantly increase serum E2 level and improve IVF outcome by regulating the hormone synthesis process, thus improving oocyte and embryo quality.

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