scholarly journals Prediction of Live Birth Rate After ICSI/IVF Cycles in Patients with Polycystic Ovary Syndrome Using a Clinical Prediction Model and Nomogram

2020 ◽  
Author(s):  
Haixia Jin ◽  
YuanYuan Liu ◽  
WenYan Song ◽  
FuLi Zhang ◽  
Lin Qi ◽  
...  
Keyword(s):  
Prediction Model ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Female Age ◽  
Day Of Embryo Transfer

Abstract Background: Achievement of a live birth is the marker of success in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments. For patients with polycystic ovary syndrome (PCOS) who are undergoing these treatments, some predictive models and nomograms have been published. However, further development of these models is required for their useful application in clinical settings.Method: To establish and validate a clinical prediction model and nomogram to predict a live birth rate in women with PCOS undergoing IVF/ICSI. Records on 1193 patients underwent their first IVF/ICSI cycles for PCOS infertility from January 2014 to December 2019.The nomogram was built by a training cohort of 835 patients and tested on a validation cohort of 358 patients. Results: Female age, duration of infertility, total gonadotropin dose, the day of embryo transfer, no. of transferred embryos and the serum testosterone (T) level in PCOS groups were significantly associated with live birth rate. The predictive model was built by female age, duration of infertility, total gonadotropin dose, the day of embryo transfer, no. of transferred embryos, no. of retrieved oocytes, the serum T level, the serum progesterone (P) level, type of fecundation and endometrial thickness on embryo transfer day. The area under the curve (AUC) of the PCOS-specific predictive model in the training cohort was 0.72(95% CI, 0.68-0.76) and the AUC for the validation cohort was 0.63 (95% CI, 0.56-0.69).Conclusions: Our clinical prediction model and nomogram graphically demonstrated the risk factors that were associated with IVF/ICSI live birth rates in patients with PCOS. These findings offer improved clinical guidance for clinicians and patients.

scholarly journals The Effect of Supraphysiological Estradiol on Pregnancy Outcomes Differs Between Women With PCOS and Ovulatory Women

2018 ◽  
Vol 103 (7) ◽  
pp. 2735-2742 ◽  
Author(s):  
Daimin Wei ◽  
Yunhai Yu ◽  
Mei Sun ◽  
Yuhua Shi ◽  
Yun Sun ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Ovarian Stimulation ◽  
Birth Rate ◽  
Polycystic Ovary ◽  
Embryo Implantation ◽  
Live Birth Rate ◽  
Estradiol Level ◽  
Fresh Embryo Transfer

Abstract Context Supraphysiological estradiol exposure after ovarian stimulation may disrupt embryo implantation after fresh embryo transfer. Women with polycystic ovary syndrome (PCOS), who usually overrespond to ovarian stimulation, have a better live birth rate after frozen embryo transfer (FET) than after fresh embryo transfer; however, ovulatory women do not. Objective To evaluate whether the discrepancy in live birth rate after fresh embryo transfer vs FET between these two populations is due to the variation in ovarian response (i.e., peak estradiol level or oocyte number). Design, Setting, Patients, Intervention(s), and Main Outcome Measure(s) This was a secondary analysis of data from two multicenter randomized trials with similar study designs. A total of 1508 women with PCOS and 2157 ovulatory women were randomly assigned to undergo fresh or FET. The primary outcome was live birth. Results Compared with fresh embryo transfer, FET resulted in a higher live birth rate (51.9% vs 40.7%; OR, 1.57; 95% CI, 1.22 to 2.03) in PCOS women with peak estradiol level >3000pg/mL but not in those with estradiol level ≤3000 pg/mL. In women with PCOS who have ≥16 oocytes, FET yielded a higher live birth rate (54.8% vs 42.1%; OR, 1.67; 95% CI, 1.20 to 2.31), but this was not seen in those with <16 oocytes. In ovulatory women, pregnancy outcomes were similar after fresh embryo transfer and FET in all subgroups. Conclusions Supraphysiological estradiol after ovarian stimulation may adversely affect pregnancy outcomes in women with PCOS but not in ovulatory women.

scholarly journals Cumulative Live Birth Rates in Patients with Polycystic Ovary Syndrome: Comparing Progestin Primed Ovarian Stimulation Protocol and GnRH-Antagonist Protocol

2020 ◽  
Author(s):  
Jingjuan Ji ◽  
Lihua Luo ◽  
Lingli Huang
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Ovarian Stimulation ◽  
Birth Rate ◽  
Gnrh Antagonist ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Cumulative Live Birth ◽  
Gnrh Antagonist Protocol ◽  
Antagonist Protocol

Abstract Background: Cumulative live birth rate (CLBR) becomes a comprehensive and meaningful indictor of the success of IVF nowadays. Frozen-embryo transfer (FET) was associated with a higher rate of live birth and a lower risk of the ovarian hyperstimulation syndrome (OHSS) in polycystic ovary syndrome (PCOS) patients. Progestin-primed ovarian stimulation (PPOS) is a new ovarian stimulation protocol in which oral progestin been used to prevent premature luteinizing hormone (LH) surges during ovarian stimulation. The purpose of the current study is to investigate the CLBR of an in vitro fertilization (IVF) cycle in women with PCOS following PPOS protocol compared with gonadotropin releasing hormone (GnRH) antagonist protocol.Methods: It is a retrospective study. The first IVF cycle of 666 PCOS women were included. Ovarian stimulations were performed with PPOS or GnRH antagonist protocol. All patients included in the analysis had either delivered a baby or had used all their embryos of their first stimulated cycle. The patients were followed for 2–7 years until February 2020.Result(s): The CLBR were similar in the PPOS and GnRH antagonist group (64% vs 60.1%, P = 0.748). Logistic regression analyses showed treatment protocol (PPOS vs GnRH antagonist) did not show any significant correlation with the CLBR (adjusted OR: 0.898; 95% CI: 0.583-1.384, P=0.627). No statistically significant differences were found in the live birth rates per embryo transfer (41.3% vs. 38.4%) in the study group and controls.Conclusion(s): The results of this study showed that both the live birth rate per embryo transfer and the cumulative live birth rate were similar between PPOS and GnRH antagonist group. PPOS protocol is efficient in the controlled ovarian stimulation of patients with PCOS.

scholarly journals Factors Influencing the Live Birth Rate Following Fresh Embryo Transfer Cycles in Infertile Women After Endometrioma Cystectomy

2021 ◽  
Vol 8 ◽  
Author(s):  
Wei Liu ◽  
Tongye Sha ◽  
Yuzhen Huang ◽  
Zizhen Guo ◽  
Lei Yan ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Female Age ◽  
Infertile Women ◽  
Ovarian Cystectomy ◽  
Positive Effects ◽  
Two Factors ◽  
History Of

Background: Reproductive outcomes after fresh in vitro fertilization/intracytoplasmic sperm injection–embryo transfer (IVF/ICSI–ET) cycles are diverse in infertile women with a history of ovarian cystectomy for endometriomas. We aimed to develop a logistic regression model based on patients' characteristics including number of embryos transferred and stimulation protocols to predict the live birth rate in fresh IVF/ICSI–ET cycles for such patients.Methods: We recruited 513 infertile women with a history of ovarian cystectomy for endometriomas who underwent their first fresh ET with different stimulation protocols following IVF/ICSI cycles in our unit from January 2014 to December 2018. One or two embryo are implanted. Clinical and laboratory parameters potentially affecting the live birth rate following fresh ET cycles were analyzed. Univariable and multivariable analyses were performed to assess the relationship between predictive factors and live birth rate.Results: The overall live birth rate was 240/513 (46.8%). Multivariable modified Poisson regression models showed that two factors were significantly lowers the probability of live birth: female age ≥ 5 years (aOR 0.603; 95% CI 0.389–0.933; P = 0.023); BMI range 21–24.99 kg/m2 compared with BMI <21 kg/m2 (aOR 0.572; 95% CI 0.372–0.881, P = 0.011). And two factors significantly increased the probability of live birth: AFC >7 (aOR 1.591; 95% CI 1.075–2.353; P = 0.020); two embryos transferred (aOR 1.607; 95% CI 1.089–2.372; P = 0.017).Conclusions: For these infertile women who had undergone ovarian cystectomy for endometriosis, female age <35 years, AFC > 7, and two embryos transferred might achieve better clinical fresh IVF/ICSI–ET outcomes. BMI <21 kg/m2 or ≥25 kg/m2 might also have positive effects on the live birth rate, but different ovarian stimulation protocols had no significant effects. However, a larger sample size may be needed for further study.

scholarly journals Association between baseline LH/FSH and live-birth rate after fresh-embryo transfer in polycystic ovary syndrome women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nian-jun Su ◽  
Cui-yu Huang ◽  
Jie Liu ◽  
De-ying Kang ◽  
Song-lu Wang ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
In Vitro Fertilisation ◽  
Fresh Embryo Transfer ◽  
Ovary Syndrome

AbstractThis study aimed to retrospectively analyse the effect of the baseline luteinising hormone/follicle-stimulating hormone ratio (bLH/FSH) on the live-birth rate per fresh-embryo transfer cycle (LBR/ET) in infertile women with polycystic ovary syndrome (PCOS) who received a fresh-embryo transfer. A total of 424 patients with PCOS who underwent the first cycle of in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) fresh-embryo transfer at our hospital was enrolled. Univariate and multivariate logistic regression analyses, along with curve fitting and a threshold effect analysis, were performed. Baseline LH/FSH levels were a significant (P < 0.05) independent risk factor affecting live birth. In the first IVF/ICSI antagonist treatment cycles, LBR/ET after fresh-embryo transfer was relatively flat, until bLH/FSH was 1.0; thereafter, it started to decrease by 17% for every 0.1-unit bLH/FSH increase. Considering the decline in LBR/ET, it is recommended that PCOS women with bLH/FSH > 1.0 carefully consider fresh-embryo transfer during their first IVF/ICSI.

Sign in / Sign up

Export Citation Format

Share Document