IVF/ICSI outcomes of euthyroid infertile women with TAI: does treating with aspirin plus prednisone matter?

Abstract Background Thyroid autoimmunity (TAI) has been associated with adverse pregnancy outcomes. To settle with fertility problem, prescribing aspirin combined with prednisone (P+A) to women positive for antithyroid antibodies (ATA) is frequent in clinical practice, but the real effect remains controversial. Methods A multicenter, retrospective study was conducted in three reproductive centers from 2017 to 2020. We recruited 494 euthyroid infertile women positive for anti-thyroperoxidase and/or thyroglobulin antibodies (TPOAb and TgAb, respectively) with thyroid stimulating hormone (TSH) levels ranging 0.35-4.0mIU/L who were undergoing their first in vitro fertilization and embryo transfer (IVF-ET) cycle. Ultimately, 346 women were included of which 150 women were treated with prednisone (10mg/d) and aspirin (100mg/d), while the remaining 196 women were untreated (control group). Treatment started on the day of embryo transfer and continued until clinical pregnancy was determined. Results Clinical pregnancy rate (CPR) was 57.5% vs. 63.5% in the control and treated groups (P=0.414) for first fresh embryo transfer cycles and 57.8% vs. 61.8% for frozen-thawed embryo transfer cycles (P=0.606). Additionally, the live birth rate (LBR) at the fresh embryo transfer was 49.6% vs. 47.3% in the control and treated groups (P=0.762). Logistic regression revealed that P+A did not improve CPR or miscarriage rates (MR). Furthermore, we observed that low free triiodothyronine (FT3) was associated with high MR. Conclusions Utilizing an adjuvant treatment of P+A after the embryo transfer may be unnecessary in euthyroid women with TAI undergoing their first IVF-ET, regardless of embryo type (fresh or frozen).

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IVF/ICSI Outcomes of Euthyroid Infertile Women With TAI: Aspirin Plus Prednisone Treatment, Does It Matter?

10.21203/rs.3.rs-805694/v1 ◽

2021 ◽

Author(s):

Ping Zhou ◽

QiuPing Yao ◽

Lihua Yang ◽

Ya Yu ◽

Jilai Xie ◽

...

Keyword(s):

Embryo Transfer ◽

Treated Group ◽

Clinical Pregnancy ◽

Reference Level ◽

Control Group ◽

Fresh Embryo Transfer ◽

Infertile Women ◽

Frozen Thawed Embryo Transfer ◽

Ivf Et ◽

Thawed Embryo Transfer

Abstract Objective Thyroid autoimmunity (TAI) per se has been demonstrated to be related to adverse pregnancy outcomes, including recurrent miscarriage and unexplained infertility. Although therapy of glucocorticoid to infertile remains controversial, aspirin combined with prednisone(P + A) are used frequently in antithyroid antibodies (ATA) positive infertile women in clinical practice. Methods A multicenter retrospective study was performed in the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children's Hospital and People's Hospital of Jinhua. We recruited 494 euthyroid infertile women positive for anti-thyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) with thyroid stimulating hormone 0.35-4.0mIU/L, who undergoing first in vitro fertilization and embryo transfer (IVF-ET) cycle during the period of 2017 to 2020. 346 women were ultimately recruited, including 187 patients receiving fresh embryo transfer and 159 patients receiving frozen-thawed embryo transfer. Among them, infertile 150 women were treated with prednisone(10mg/d) and aspirin(100mg/d), while the other 196 infertile women were untreated as control group. The treatment commenced on the day of embryo transfer and continued until the clinical pregnancy was determined by ultrasonography around 30 days after embryo transfer. Results Clinical pregnancy rate (CPR) of the first fresh embryo transfer cycle was 57.5% vs. 63.5% in control vs. in treated group (P = 0.414) and CPR was 57.8% versus 61.8% in the two groups in the frozen-thawed embryo transfer cycle(P = 0.606). Additionally, the prevalence of delivering a live birth at the fresh embryo transfer was 49.6% in the non-treatment group and 47.3% in the P + A treated group(P = 0.762). Cumulative CPR was similar in the groups at the fresh embryo transfer (control vs treated group: 56.9% vs 61.0%, P = 0.534). By conducting logistic regression, combined treatment of P + A appeared to have no influence on CPR or miscarriage rates (MR) at the first embryo transfer. Furthermore, the low but within the reference level of free triiodothyronine (FT3) was seen as a poor predictor of spontaneous abortion at the fresh embryo transfer. Conclusions To conclude, with regard to euthyroid women with TAI undergoing the first IVF-ET cycle, adjuvant treatment of P + A after the embryo transfer may be unnecessary irrespective of the fresh or frozen-thawed embryo transfer.

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Corpus luteal contribution to maternal pregnancy physiology and outcomes in assisted reproductive technologies

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00239.2012 ◽

2013 ◽

Vol 304 (2) ◽

pp. R69-R72 ◽

Cited By ~ 40

Author(s):

Kirk P. Conrad ◽

Valerie L. Baker

Keyword(s):

Embryo Transfer ◽

Assisted Reproductive Technologies ◽

Plasma Osmolality ◽

Reproductive Technologies ◽

Fresh Embryo Transfer ◽

Pregnant Rats ◽

Infertile Women ◽

Increased Risk ◽

Adverse Pregnancy ◽

Donor Eggs

Investigations in the rat model of pregnancy indicate an important role for the corpus luteal (CL) hormone relaxin in the maternal circulatory and osmoregulatory changes in pregnancy, which are epitomized by profound vasodilation and modest hypoosmolality, respectively. In a pilot study of infertile women who became pregnant through donor eggs, in vitro fertilization, and embryo transfer, the gestational rise in glomerular filtration and fall in plasma osmolality were markedly subdued. Because these women were infertile, they lacked a CL and circulating relaxin (and possibly other vasoactive CL hormones). Based on these findings in pregnant rats and women, we hypothesize that infertile women conceiving through donor eggs will have overall subdued circulatory changes (e.g., attenuated reduction in systemic vascular resistance and subdued increase in cardiac output) particularly during early pregnancy when CL hormones predominate before the full development and maturation of the placenta. In contrast, infertile women conceiving by autologous eggs retrieved after ovarian stimulation and fresh embryo transfer may have a relatively hyperdynamic circulation due to the presence of many CL (up to 20 or more) and higher circulating levels of vasodilatory ovarian hormones such as relaxin. Emerging evidence suggests that women undergoing Assisted Reproductive Technologies (ART) have increased risk for adverse pregnancy outcomes such as preeclampsia and small for gestational-age babies. This increased risk may be partly caused by the maternal milieu, which is not physiological in ART pregnancies due to the abnormal status of the CL.

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IVF and ICSI outcomes of female patients with X chromosome mosaicism: A 5-year retrospective cohort study

10.21203/rs.3.rs-27374/v1 ◽

2020 ◽

Author(s):

Shanshan Liang ◽

Jianzhi Yang ◽

Haixia Wu ◽

Shiyi Xiong ◽

Ming Guo ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

X Chromosome ◽

Oocyte Retrieval ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Control Group ◽

Miscarriage Rate ◽

Fresh Embryo Transfer ◽

Chromosome Mosaicism

Abstract BackgroundThis study focused on the assisted reproductive treatment (ART) outcomes of female patients with X chromosome mosaicism (XM), who underwent their first IVF/ICSI and day 2 or day3 fresh embryo transfer, and the possible impacts of the different mosaic types.Results78 couples with XM female and normal male were included as the X group. 78 couples with normal karyotype were included as the control group. Subgroup X1 included 41 45,X/46,XX cases, Subgroup X2 included 23 47,XXX/46,XX cases, and Subgroup X3 included 13 45,X/47,XXX/46,XX cases. With similar female age and similar body mass index (BMI), the X group had higher total gonadotropin (Gn) dosage than the control group (1800 IU VS 1612 IU). In subgroup analysis, the follical number during oocyte retrieval was less in subgroup X1 than that in X2 or X3. The fertilization rate was lower in subgroup X1 than that in subgroup X2. The utilization rate was higher in subgroup X2 than that in subgroup X3. The implantation rate, clinical pregnancy rate, and miscarriage rate before 12 weeks' gestation were similar in all groups.ConclusionsFemale with 45,X cell line may face higher Gn dosage, less follical number during oocyte retrieval and fewer embryos. But female with X chromosome mosaicism may have similar clinical pregnancy rate and miscarriage rate after fresh embryo transfer.

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Effects of artificial cycles with and without gonadotropin-releasing hormone agonist pretreatment on frozen embryo transfer outcomes in patients with adenomyosis

10.21203/rs.3.rs-506178/v1 ◽

2021 ◽

Author(s):

Muzi Li ◽

Lihong Xu ◽

Heng Zhao ◽

Lei Yan ◽

Yanbo Du

Keyword(s):

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Embryo Transfer ◽

Hormone Replacement ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Control Group ◽

Live Birth Rates ◽

Gonadotropin Releasing Hormone Agonist ◽

Ivf Et

Abstract Gonadotropin-releasing hormone agonist(GnRH-a) is generally added to improve pregnancy outcomes of adenomyosis based hormone replacement therapy cycle. Our objective in this study is to investigate whether adding GnRH-a can obtain better pregnancy outcomes. In this retrospective analysis, a total of 341 patients with adenomyosis complicated in vitro fertilization-embryo transfer(IVF-ET) of the frozen embryo transfer (FET). The control group was only treated by hormone replacement therapy cycles to prepare emdometrium, and the study group was added GnRH-a before using hormone to adjust menstruation period. Based on the similar baseline values and embryological data, there was no significantly difference about their clinical pregnancy rates (40.63% vs 42.54%, P=0.72) and live birth rates (23.75% vs 23.75%, P=0.74) between the control group and the study group. Other secondary outcomes including clinical miscarriage rates, ectopic pregnancy rates, preterm pregnancy rates and term pregnancy rates did not show significant difference between the two groups. Compared with using hormone replacement therapy cycle alone, GnRH-a down-regulation based on hormone replacement therapy cycle may not increase the rates of clinical pregnancy and live birth rates in IVF-ET of FET for infertile patients with adenomyosis.

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Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy

Frontiers in Endocrinology ◽

10.3389/fendo.2020.595448 ◽

2020 ◽

Vol 11 ◽

Author(s):

Xing Yu Sun ◽

Yun Zhu Lan ◽

Shuang Liu ◽

Xiao Ping Long ◽

Xi Guang Mao ◽

...

Keyword(s):

Embryo Transfer ◽

Endometrial Thickness ◽

Antral Follicle ◽

Clinical Pregnancy ◽

Multivariate Logistic Regression Model ◽

Vitro Fertilization ◽

Factors Affecting ◽

Infertile Women ◽

Ivf Et

ObjectivesTo retrospectively analyze the correlation between anti-Müllerian hormone (AMH) and the number of oocytes obtained by controlled ovarian hyperstimulation (COH) in women of different ages and explore the factors affecting in vitro fertilization and embryo transfer (IVF-ET) in clinical pregnancy of infertile women to provide evidence for infertile women to choose assisted reproduction strategies.MethodsInfertile women who received IVF-ET or intracytoplasmic sperm injection and embryo transfer (ICSI-ET) treatment in the reproductive center of XX hospital between October 2018 and September 2019 were included. Patient data on medical records, age, body mass index (BMI), years of infertility, basic follicle-stimulating hormone (FSH), basic luteinizing hormone (LH), basic estradiol (E2), anti-Müllerian hormone level (AMH), antral follicle count (AFC), gonadotropins (Gn) medication days, Gn dosage, endometrial thickness on transplantation day, the number of retrieved oocytes, the number of mature oocytes obtained, the number of embryos transferred, clinical pregnancy status, etc., were collected.ResultsA total of 314 patients were enrolled in this study, with an average age of 31.0 ± 4.5 years. The infertility period ranged from 0–21 years. The AMH level showed a downward trend with increasing age. Overall, the AMH level of women of all ages was positively correlated with the number of retrieved oocytes (r = 0.335, p < 0.001). The AMH level of women between 22 and 28 years old was positively correlated with the number of retrieved oocytes (r = 0.164, p < 0.061) but it was not statistically significant. Similarly, the AMH level of women aged 29–35 and 36–43 was positively correlated with the number of retrieved oocytes (r = 0.356, p < 0.001; r = 0.461, p < 0.001). The average age of the pregnant group (30.6 ± 4.4 years) was lower than that of the non-pregnant group (32.2 ± 4.6 years) (p < 0.001). The number of oocytes obtained (9.8 ± 4.5) and the number of embryos transferred (1.9 ± 0.4) in the pregnant group was significantly higher than that in the non-pregnant group (9.2 ± 4.5; 1.7 ± 0.5); the difference was statistically significant. The multivariate logistic regression model showed that age (OR = 0.574 95% CI: 0.350–0.940), AMH (OR = 1.430 95% CI: 1.130–1.820) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030–1.790) were factors affecting clinical pregnancy.ConclusionWe found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women was positively correlated with AMH. Moreover, the number of oocytes and embryo transferred in the pregnant group was significantly higher than those in the non-pregnant group. Furthermore, age, AMH and the number of oocytes affected the clinical pregnancy.

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Experience of using time-lapse microscopy in IVF and ICSI programs

Medical alphabet ◽

10.33667/2078-5631-2020-16-47-50 ◽

2020 ◽

pp. 47-50

Author(s):

N. V. Saraeva ◽

N. V. Spiridonova ◽

M. T. Tugushev ◽

O. V. Shurygina ◽

A. I. Sinitsyna

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Selection Procedure ◽

Time Lapse ◽

Single Embryo Transfer ◽

Main Group ◽

Clinical Pregnancy ◽

Control Group ◽

Time Lapse Microscopy

In order to increase the pregnancy rate in the assisted reproductive technology, the selection of one embryo with the highest implantation potential it is very important. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the benefits of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in IVF and ICSI programs. Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 282 patients, who formed the main group; the control group consisted of 461 patients undergoing single-embryo transfer following a traditional culture and embryo selection procedure. We assessed the quality of transferred embryos, the rates of clinical pregnancy and delivery. The groups did not differ in the ratio of IVF and ICSI cycles, average age, and infertility factor. The proportion of excellent quality embryos for transfer was 77.0% in the main group and 65.1% in the control group (p = 0.001). In the subgroup with receiving eight and less oocytes we noted the tendency of receiving more quality embryos in the main group (р = 0.052). In the subgroup of nine and more oocytes the quality of the transferred embryos did not differ between two groups. The clinical pregnancy rate was 60.2% in the main group and 52.9% in the control group (p = 0.057). The delivery rate was 45.0% in the main group and 39.9% in the control group (p > 0.050).

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Live Birth Rate of Fresh Embryo Transfer with GnRH Agonist Long Protocol is Higher Than Frozen Embryo Transfer

10.21203/rs.3.rs-70853/v1 ◽

2020 ◽

Author(s):

Xiaoyan Ding ◽

Jingwei Yang ◽

Lan Li ◽

Na Yang ◽

Ling Lan ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Live Birth ◽

Pregnancy Loss ◽

Birth Rate ◽

Implantation Rate ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Fresh Embryo Transfer ◽

Long Protocol

Abstract Background: Along with progress in embryo cryopreservation, especially in vitrification has made freeze all strategy more acceptable. Some studies found comparable or higher live birth rate with frozen embryo transfer (FET) than with fresh embryo transfer（ET）in gonadotropin releasing hormone antagonist (GnRH-ant) protocol. But there were no reports about live birth rate differences between fresh ET and FET with gonadotropin releasing hormone agonist (GnRH-a) long protocol. The aim of this study is to analyze whether patients benefit from freeze all strategy in GnRH-a protocol from real-world data.Methods: This is a retrospective cohort study, in which women undergoing fresh ET or FET with GnRH-a long protocol at Chongqing Reproductive and Genetics Institute from January 2016 to December 2018 were evaluated. The primary outcome was live birth rate. The secondary outcomes were implantation rate, clinical pregnancy rate, pregnancy loss and ectopic pregnancy rate.Results: A total of 7,814 patients met inclusion criteria, implementing 5,216 fresh ET cycles and 2,598 FET cycles, respectively. The demographic characteristics of the patients were significantly different between two groups, except BMI. After controlling for a broad range of potential confounders (including age, infertility duration, BMI, AMH, no. of oocytes retrieved and no. of available embryos), multivariate logistic regression analysis demonstrated that there was no significant difference in terms of clinical pregnancy rate, ectopic pregnancy rate and pregnancy loss rate between two groups (all P>0.05). However, the implantation rate and live birth rate of fresh ET group were significantly higher than FET group (P<0.001 and P=0.012, respectively).Conclusion: Compared to FET, fresh ET following GnRH-a long protocol could lead to higher implantation rate and live birth rate in infertile patients underwent in vitro fertilization (IVF). The freeze all strategy should be individualized and made with caution especially with GnRH-a long protocol.

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Effectiveness and outcomes of embryo cryopreservation programs in assisted reproductive technologies

Journal of obstetrics and women s diseases ◽

10.17816/jowd63439-46 ◽

2014 ◽

Vol 63 (4) ◽

pp. 39-46 ◽

Cited By ~ 1

Author(s):

Yana Nikolayevna Kravchuk ◽

Alla Stanislavovna Kalugina ◽

Olga Vladimirovna Bystrova ◽

Svetlana Aleksandrovna Shlykova

Keyword(s):

Embryo Transfer ◽

Assisted Reproductive Technologies ◽

Negative Impact ◽

Perinatal Outcomes ◽

Reproductive Technologies ◽

Embryo Cryopreservation ◽

Control Group ◽

Fresh Embryo Transfer ◽

Art Programs ◽

Thawed Embryo Transfer

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.

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