scholarly journals Cumulative Live Birth Rates for Low-Prognosis Women Over 5 Years or 9 Frozen-Thawed Embryo Transfer Cycles

2022 ◽  
Author(s):  
Di DI CHEN ◽  
Xi Shen ◽  
Li Wang ◽  
Yanping Kuang
Keyword(s):  
Live Birth ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Group 4 ◽  
Cumulative Live Birth ◽  
Group 3 ◽  
Group 5

Abstract Background: For heterogeneous populations of low-prognosis women, it remains unclear as to how long individuals should continue undergoing ART when attempting to have a baby, as there have been insufficient studies to date tracking the cumulative live birth rates (CLBRs) for these women over the entire course of their ART treatment, particularly over extended time periods. Methods: This was a retrospective analysis of 17,698 women at a tertiary care academic medical center who had begun undergoing IVI/ICSI cycles using a PPOS approach between January 2013 and January 2019. Low-prognosis patients were stratified into four groups based upon POSEIDON criteria, with patients exhibiting normal or high ovarian reserves and response to stimulation (defined as AFC ≥5, >9 oocytes retrieved) being included as controls (group 5). The CLBR within 5 years or 9 FET cycles from the OPU day of the first cycle was the primary endpoint for this study, including all repetitive oocyte retrieval cycles and subsequent FET cycles. Optimistic and conservative approaches were used for the analysis of CLBRs and the depiction of cumulative incidence curves.Results: Under both optimistic and conservative model analyses, patients in group 5 exhibited the highest CLBR within 5 years or 9 FET cycles, followed by POSEIDON group 1, group 3, group 2, and group 4. Upward trends in CLBRs were evident across the five groups with the prolongation of time or an increase in FET cycle counts. Within the first 2 years or 3 FET cycles, the CLBRs rose rapidly, followed by more moderate increases over the following 2-3.5 years or 4-6 cycles, with the patients in group 3 and group 4 exhibiting the most obvious improvements. Patients in all groups reached a CLBR plateau after 3.5 years or 6 FET cycles.Conclusions: All low-prognosis women should undergo ART treatment for a minimum of 2 years or 3 FET cycles, and exhibit better outcomes when extending ART treatment to 3.5 years or 6 FET cycles (particularly for POSEIDON groups 3 and 4), but should consider ceasing further treatment thereafter due to a lack of apparent benefit.

Effect of Female and Male Body Mass index on Cumulative Live Birth Rates in the Freeze-all Strategy

2021 ◽  
Author(s):  
Xi Shen ◽  
Yating Xie ◽  
Di Chen ◽  
Wenya Guo ◽  
Gang Feng ◽  
...  
Keyword(s):  
Live Birth ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Live Birth Rate ◽  
Male Body ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
The Impact ◽  
High Bmi

Abstract Context The impact of parental overweight/obese on cumulative live birth rate in IVF/ICSI using a freeze-all strategy is still unknown. Objective To explore the effect of parental BMI on CLBR in a freeze-all strategy over 1.5 years. Design A retrospective study. Setting Tertiary-care academic medical center Patients or Other Participants 23482 patients (35289 FET cycles) were divided into four groups according to Asian BMI classification. Intervention(s) None. Main Outcome Measure(s) CLBR. Results Female overweight/obesity had the lower tendency in CLBR (groups1-4: optimistic: 69.4%, 67.9%, 62.3%, and 65.7%; conservative: 62.9%, 61.1%, 55.4%, and 57.6%) and the prolonged time (groups 1-4: 11.0, 12.2, 15.9, and 13.8 months for 60% CLBR in optimistic method; 8.7, 9.5, 11.7, 11.0 months for 50% CLBR in conservative method). The same trend with less extent was also observed in male BMI groups. When combining parental BMI, “parental overweight/obesity” had lower CLBR and longer time for reaching CLBR>50% (optimistic: 4.5 months for 60% CLBR; conservative: 3 months for 50% CLBR), the next was “only female high BMI” (optimistic: 2.1 months for 60% CLBR; conservative: 1.7 months for 50% CLBR), while “only male high BMI” couldn’t influence these. Conclusions Our results firstly showed that the priorities of parental BMI, female BMI and male BMI on affecting the 1.5-year CLBR in freeze-all strategy, and the postponed time to reach up the certain CLBR (60% in optimistic, 50% in conservative) for overweight and obese patients was only several months, not so uncertain and long as losing weight.

Cumulative live birth rates in in-vitro fertilization

2019 ◽  
Vol 71 (3) ◽  
Author(s):  
Panagiotis Drakopoulos ◽  
Joaquín Errázuriz ◽  
Samuel Santos-Ribeiro ◽  
Herman Tournaye ◽  
Alberto Vaiarelli ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Birth Rates ◽  
Vitro Fertilization ◽  
Live Birth Rates ◽  
Cumulative Live Birth

scholarly journals Sperm Selection by Magnetic-Activated Cell Sorting Before Microinjection of Autologous Oocytes Increases Cumulative Live Birth Rates with Limited Clinical Impact: A Retrospective Study in Unselected Males

Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 430
Author(s):  
María Gil Juliá ◽  
Irene Hervás ◽  
Ana Navarro-Gómez Lechón ◽  
Fernando Quintana ◽  
David Amorós ◽  
...  
Keyword(s):  
Live Birth ◽  
Clinical Impact ◽  
Sperm Selection ◽  
Reproductive Outcomes ◽  
Birth Rates ◽  
Multicenter Observational Study ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
The Impact ◽  
Autologous Oocytes

The application of MACS non-apoptotic sperm selection in infertility clinics is controversial since the published literature does not agree on its effect on reproductive outcomes. Therefore, it is not part of the routine clinical practice. Classical measures of reproductive success (pregnancy or live birth rates per ovarian stimulation) introduce a bias in the evaluation of a technique’s effect, since only the best embryo is transferred. This retrospective, multicenter, observational study evaluated the impact of MACS on reproductive outcomes, measuring results in classical parameters and cumulative live birth rates (CLBR). Data from ICSI cycles using autologous oocyte in Spanish IVIRMA fertility clinics from January 2008 to February 2020 were divided into two groups according to their semen processing: standard practice (reference: 46,807 patients) versus an added MACS sperm selection (1779 patients). Only when measured as CLBR per embryo transferred and per MII oocyte used was the difference between groups statistically significant. There were no significant differences between MACS and reference groups on pregnancy and live birth rates. In conclusion, results suggest that non-apoptotic sperm selection by MACS on unselected males prior to ICSI with autologous oocytes has limited clinical impact, showing a subtle increase in CLBR per embryo transferred.

O-014 How effective is oocyte cryopreservation?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Cobo
Keyword(s):  
Cancer Patients ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Oocyte Retrieval ◽  
Success Rates ◽  
Birth Rates ◽  
Oocyte Vitrification ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
Different Populations

Abstract text The challenge of cryopreserve, store for prolonged period, and successfully implant the female gamete is nowadays feasible thanks to vitrification. The technology that was initially validated in oocyte recipients is currently applied to a vast population, including women at risk of losing their ovarian function due either to iatrogenic causes as occurs in cancer patients, or due to the natural depletion of the ovarian reserve as a result of age related fertility decline. That is the case of a growing population of women who wish to postpone childbearing and decide on oocyte vitrification as a means of fertility preservation (FP). At present, there is a growing body of evidence regarding the use of vitrified oocytes by many women under different indications, which makes it possible to evaluate the approach from different scenarios. So that vitrification can be evaluated in terms on survival rates, embryo development and the rate at which vitrified oocytes develop into live-born children in IVF cycles using vitrified oocytes which were initially stored due to different reasons. The effects of vitrification at the subcellular level and its impact on oocyte competence is of interest in the evaluation of the efficacy of the technology. Some studies have indicated that vitrification may affect ultrastructure, reactive oxygen species (ROS) generation, gene expression, and epigenetic status. However, it is still controversial whether oocyte vitrification could induce DNA damage in the oocytes and the resulting early embryos. Recent studies show that oocytes survival and clinical outcome after vitrification can be impaired by patients’ age and the clinical indication or the reason for vitrification. These studies show that age at oocyte retrieval strongly affects the survival and reproductive prognosis. In our experience, oocyte survival, pregnancy and cumulative live birth rates are significantly higher when patients are aged 35 years or younger versus patients older than 35 years at oocyte retrieval. Therefore, elective-FP patients should be encouraged to decide at young ages to significantly increase their chances of success. There is also evidence that the reason for vitrification is associated to the success rates. Poorer reproductive outcome was reported in cancer patients, low responders and endometriosis patients when compared to healthy women in age matching groups. Moreover, there are certain individualities linked to specific populations, as occurs when endometriosis patients had cystectomy earlier than the oocyte retrieval for FP. These women achieved lower success rates as compared to non-operated age matching counterparts. In this case, the lower cumulative live birth rates observed in operated women are, most probably, due to the smaller number of oocytes available, as a consequence of the detrimental effect of the surgery on the ovarian reserve. In this regard, several reports show that the number of oocytes available per patient is another variable closely related to the outcome in all populations using vitrified oocytes after FP. Thus, a significant improvement in the cumulative live birth rates can be achieved by adding a few oocytes, especially in healthy young patients. Different populations using vitrified oocytes under several indications achieve differential results in terms of pregnancy rates, when calculated in overall. Nonetheless, when the calculations for the cumulative probability of achieving a baby are made according the number of oocytes used per patient belonging to the same group of age, the results become comparable between different populations, as shown by the comparison between elective freezers versus endometriosis patients. Undoubtedly, vitrification can be recognized as one of the latest brakethrough in the ART field, but certainly the next step forward would be the successfull automatization of the vitrification and warming processes to achieve fully consistency among different laboratories.

scholarly journals Cumulative live birth rates of patients in the Peruvian Andes according to the POSEIDON criteria: a single-center retrospective analysis

2021 ◽  
Vol 25 (3) ◽  
Author(s):  
Luis Vargas-Tominaga ◽  
Andrea Vargas ◽  
Fiorella Alarcon ◽  
Andrea Medina ◽  
Maritza Gómez ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Live Birth ◽  
Single Center ◽  
Birth Rates ◽  
Peruvian Andes ◽  
Live Birth Rates ◽  
Cumulative Live Birth

P–513 Analysis of the extent of dropout-rates by extraction from cumulative live birth rates in IVF/ICSI: systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Vereeck ◽  
A Sugihara ◽  
D D Neubourg
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Weighted Average ◽  
Dropout Rate ◽  
Dropout Rates ◽  
Birth Rates ◽  
Complete Cycle ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
Icsi Cycle

Abstract Study question The purpose of this systematic review is to calculate dropout-rates of IVF/ICSI treatment by analysing the published cumulative live birth rates of IVF/ICSI treatment. Summary answer One out of three patients stop their treatment after their first IVF/ICSI cycle and dropout-rates tend to increase per consecutive cycle. What is known already Cumulative live birth rates (CLBRs) have created the possibility to present realistic probabilities of having a live birth after IVF/ICSI treatment. However, it is noted that a significant percentage of the patients stop their treatment before having a child (“dropout”). Possible reasons and predicting factors for dropout of treatment are already extensively investigated. However, only a few studies try to report about the incidence of dropout. Publications on CLBRs of large numbers of patients allow the extraction of dropout-rates. These rates will provide insight in the extent of the problem and could be used as a reference for interventional studies. Study design, size, duration Four databases (PubMed, The Cochrane Library, EMBASE, DoKS) were systematically searched from 1992 to December 2020. Search terms referred to “cumulative live birth” AND “ART/IVF/ICSI”. No restrictions were made on the type or language of publication. Studies were included if they reported absolute numbers of patients and live births per consecutive complete IVF/ICSI cycle or per consecutive embryo transfer cycle, starting from the first IVF/ICSI cycle for each patient. Participants/materials, setting, methods Dropout-rates per cycle were calculated in two manners: “intrinsic dropout-rate” with all patients that started the particular IVF/ICSI cycle in the denominator, and “potential dropout-rate” with all patients who did not achieve a live birth after IVF/ICSI (and potentially could have started a consecutive cycle) in the denominator. Dropout-rates were analysed for consecutive complete cycles and consecutive embryo transfer cycles, because these two manners are used in reporting CLBRs, often related to the reimbursement policy. Main results and the role of chance This review included 29 studies and almost 800,000 patients from different countries and registries. Regarding the patients who started their first IVF/ICSI cycle, trying to conceive their first child by IVF/ICSI, intrinsic dropout-rate was 33% (weighted average) after the first complete cycle, meaning they did not return for their second oocyte retrieval cycle. After the first embryo transfer cycle, intrinsic dropout-rate was 27% (weighted average), meaning those patients did not return for their next frozen-thawed embryo transfer cycle or for the next oocyte retrieval cycle. Regarding the patients who did not achieve a live birth after the first complete cycle, potential dropout-rate was 48% (weighted average), and 37% (weighted average) after the first embryo transfer cycle. Both potential and intrinsic dropout-rates for both consecutive complete and embryo transfer cycles tended to increase with cycle number. One study on second IVF/ICSI conceived children showed a potential dropout-rate after the first complete cycle of 29%. From studies on women >40 years of age, the potential dropout-rate after the first complete cycle was 45% (weighted average) and from studies with the uses of testicular sperm extraction, the potential dropout-rate after the first complete cycle was 34% (weighted average). Limitations, reasons for caution Our analysis was hampered by the different ways of reporting on CLBRs (complete cycles versus embryo transfer cycles), informative censoring, patients changing clinics and spontaneous pregnancies. Dropout-rates were potentially overestimated given that spontaneous pregnancies were not taken into account. Wider implications of the findings: The extent of dropout in IVF/ICSI treatment is substantial and has an important impact on its effectiveness. Therefore, it is a challenge for fertility centers to try to keep patients longer on board, by taking into account the patients’ preferences and managing their expectations. Trial registration number PROSPERO Registration number: CRD42020223512

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