scholarly journals Which is better for mothers and babies, fresh or frozen thawed blastocyst transfer?

2020 ◽  
Author(s):  
Meiling Yang ◽  
li Lin ◽  
Chunli Sha ◽  
Taoqiong Li ◽  
Wujiang Gao ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Cochrane Library ◽  
Maternal Complications ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization

Abstract Background: In recent years, there have been emerging many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and freeze-thaw BT, but these couclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods: A meta-analysis was conducted by searching PubMed, Embase, and Cochrane Library until January 2020. Data were extracted independently by two authors. Results: 42 studies, including 12 randomized controlled trials (RCT) met the inclusion criteria. Fresh BT showed lower implantation rate (IR), pregnancy rate (PR), ongoing pregnancy rate (OPR) and higher eptopic pregnancy rate (EPR) compared with frozen-thawed BT consistent with the results of RCT. The risks of moderate or severe ovarian hyperstimulation syndrome (OHSS), placental abruption (PA) and preterm were higher in fresh BT than in the frozen-thawed BT. The risk of pregnancy-induced hypertension (PIH) and pre-eclampsia was decreased in fresh BT , however, no significant differences of risks for PIH, pre-eclampsia, OHSS, and preterm was found between the two group in the 2 RCT included. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age (SGA) and low birth weight (LBW). No differences in the incidences of neonatal mortality and neonatal malformations were observed between fresh and frozen-thawed BT. Conclusions: In summary, Considering the higher IR, PR, OPR, lower EPR, and the decreased risks of OHSS, PA and preterm, as well as the incidences of SGA and LBW in frozen-thawed BT, this meta-analysis indicates that frozen-thawed BT may be a better choice for mothers and babies compared with fresh BT. Key words: Fresh blastocyst transfer, frozen thawed blastocyst transfer, pregnancy outcome, maternal complications, neonatal outcomes

scholarly journals Which is better for mothers and babies: fresh or frozen-thawed blastocyst transfer?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Meiling Yang ◽  
Li Lin ◽  
Chunli Sha ◽  
Taoqiong Li ◽  
Wujiang Gao ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Current Knowledge ◽  
Placenta Previa ◽  
Meta Analysis ◽  
Blastocyst Transfer ◽  
Cochrane Library ◽  
Maternal Complications ◽  
Ongoing Pregnancy Rate

Abstract Background In recent years, there have been many reports on the pregnancy outcomes of fresh blastocyst transfer (BT) and frozen-thawed BT, but the conclusions are controversial and incomplete. To compare the pregnancy outcomes, maternal complications and neonatal outcomes of fresh and frozen-thawed BT in the context of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles, we conducted a meta-analysis. Methods A meta-analysis was conducted by searching the PubMed, Embase, and Cochrane Library databases through May 2020. Data were extracted independently by two authors. Results Fifty-four studies, including 12 randomized controlled trials (RCTs), met the inclusion criteria. Fresh BT was associated with a lower implantation rate, pregnancy rate, ongoing pregnancy rate, and clinical pregnancy rate and higher ectopic pregnancy rate than frozen-thawed BT according to the results of the RCTs. The risks of moderate or severe ovarian hyperstimulation syndrome, placental abruption, placenta previa and preterm delivery were higher for fresh BT than for frozen-thawed BT. The risk of pregnancy-induced hypertension and pre-eclampsia was lower for fresh BT; however, no significant differences in risks for gestational diabetes mellitus and preterm rupture of membrane were found between the two groups. Compared with frozen-thawed BT, fresh BT appears to be associated with small for gestational age and low birth weight. No differences in the incidences of neonatal mortality or neonatal malformation were observed between fresh and frozen-thawed BT. Conclusions At present there is an overall slight preponderance of risks in fresh cycles against frozen, however individualization is required and current knowledge does not permit to address a defintive response.

scholarly journals Transcutaneous Electrical Acupoint Stimulation for Pregnancy Outcomes in Women Undergoing In Vitro Fertilization: A Protocol of Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Han Yang ◽  
Juan Li ◽  
Guixing Xu ◽  
Zihao Zou ◽  
Mingsheng Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Childbearing Age ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization ◽  
Acupoint Stimulation

Abstract Background Infertility is a common health problem affecting couples at childbearing age. The proposal of in vitro fertilization (IVF) solves the problem of infertility to a certain extent. However, the average IVF success rates are low. Some studies conclude that transcutaneous electrical acupoint stimulation (TEAS) could improve pregnancy outcomes in women undergoing IVF. In consideration of the lack of comprehensive synthesis and evaluation of existing evidence, conducting a systematic review and meta-analysis is planned to determine whether TEAS is effective and safe to improve the pregnancy outcomes for women undergoing IVF. Methods Eight online databases will be searched from inception to June 2021. In addition, four clinical trial registries will also be searched, relevant references will be screened, and experts will be consulted for possible eligible studies. Randomized controlled trials (RCTs) which included patients with infertility who underwent IVF and used TEAS as the main adjuvant treatment versus non-TEAS or sham TEAS control will be included. The clinical pregnancy rate will be considered as the primary outcome. Ongoing pregnancy rate, miscarriage rate, live birth rate, emotion-related indicators, adverse events related to interventions, and other relevant indicators will be regarded as secondary outcomes. The selection, data extraction, and risk of bias assessment will be conducted by two independent researchers using Endnote software V.9.1 and RevMan software V.5.3. Moreover, data synthesis will be conducted using RevMan software V.5.3 and R software V.3.6.1. Ethics and dissemination: Ethical approval is not necessary because the current study will not include the original information of the individuals. We plan to publish the results in a peer-reviewed journal or disseminated in relevant conferences. Systematic review registration: PROSPERO registration number: CRD42021238871

scholarly journals The correlation between endometrial thickness and pregnancy outcomes in fresh ART cycles with different age groups: a retrospective study

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Maryam Eftekhar ◽  
Sara Zare Mehrjardi ◽  
Behnaz Molaei ◽  
Fatemeh Taheri ◽  
Esmat Mangoli
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Endometrial Thickness ◽  
Age Groups ◽  
Invasive Technique ◽  
Main Role ◽  
Ongoing Pregnancy Rate ◽  
Vitro Fertilization ◽  
The Impact

Abstract Background In assisted reproductive technology (ART) cycles in addition to embryo quality, the receptivity of the endometrium plays the main role in clinical outcomes. Endometrial receptivity is necessary to implantation of an embryo, and ultrasound has been established as an appreciated, simple, and non-invasive technique in the evaluation of the endometrial preparation before embryo transfer in fresh in vitro fertilization (IVF) cycles. Debate on the predictive value measuring endometrial thickness before administering human chorionic gonadotropin (HCG) for ovulation triggering in ART is ongoing. In order to explore the impact of endometrial thickness on triggering day on ongoing pregnancy rate (OPR) in ART cycles, we retrospectively analyzed data from 1000 patients undergoing IVF/ICSI cycles. Results The data showed pregnancy rate was increased in the endometrial thickness of 8 mm to 11 mm then decreased, and in endometrial thickness (Ent) > 14 mm, pregnancy rate was zero. There were significant differences in endometrial thickness and pregnancy outcomes between different age groups. The pregnancy rate was higher (32%) in 23–30 years old women, and the range of Ent in this group was 6–12 mm. Also, the data showed a positive correlation between Ent with AMH and estradiol levels and the number of COC and MII oocytes and a negative correlation between female age with Ent. Conclusion The result showed that Ent on hCG administration day is associated with pregnancy outcomes in fresh IVF/ICSI cycles with different age groups, although some of the clinical parameters may have an effect on Ent. Large studies are needed to make a definitive conclusion.

scholarly journals Effects of Early Cumulus Cell Removal on the Treatment Outcomes in Patients Undergoing in Vitro Fertilization: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Pengcheng Kong ◽  
Mingru Yin ◽  
Chuanling Tang ◽  
Xiuxian Zhu ◽  
Orhan Bukulmez ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Birth Rate ◽  
Cumulus Cell ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Vitro Fertilization

Abstract Background: Early cumulus cell removal combined with early rescue intracytoplasmic sperm injection (ICSI) has been widely practiced in many in vitro fertilization (IVF) centers in China in order to avoid total fertilization failure. This study aimed to investigate the effects of early cumulus cell removal alone after 4 h co-incubation of gametes (4 h group) on the pregnancy and neonatal outcomes as compared with the conventional cumulus cell removal after 20 h of insemination (20 h group) in patients undergoing IVF. Methods: This retrospective cohort study included 1784 patients who underwent their first fresh cleavage embryo transfer at the Centre for Assisted Reproduction of Shanghai First Maternity and Infant Hospital from June 2016 to December 2018 (4 h group, n=570; 20 h group, n=1214). There were 1073 infants delivered after the embryo transfer (4 h group, n=337; 20 h group, n=736). A logistic regression analysis was performed to examine the independent association between early cumulus cell removal and pregnancy outcomes after adjustment for the potential confounders. The neonatal outcomes between the two groups were compared.Result(s): The 4 h group had similar pregnancy outcomes, including biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, ectopic pregnancy rate, multiple pregnancy rate, live birth rate, when compared with the 20 h group. Both groups had comparable singleton and twin delivery rates (32.9% versus 33.5% and 13.2% versus 13.9%, respectively). There were 1073 infants delivered after the embryo transfer (4 h group, n=337; 20 h group, n=736). In both singleton and twin gestations, the preterm birth rate and very preterm birth rate, mean birth weight, mean gestational age, sex ratio at birth and rate of congenital birth defects in the 4 h group were similar to those in the 20 h group. In addition, Z-scores (gestational age- and sex-adjusted birthweight), the rates of small for gestational age, very small for gestational age, large for gestational age and very large for gestational age infants were also similar between the two groups in singleton gestations.Conclusion(s): Early cumulus cell removal alone was not associated with adverse pregnancy and neonatal outcomes in patients undergoing IVF. Thus, early cumulus cell removal to assess for a potential early rescue ICSI seems to be safe in terms of pregnancy and live birth outcomes.

scholarly journals Luteal phase support for in vitro fertilization/intracytoplasmic sperm injection fresh cycles: a systematic review and network meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hanglin Wu ◽  
Songying Zhang ◽  
Xiaona Lin ◽  
Shasha Wang ◽  
Ping Zhou
Keyword(s):  
Live Birth ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Meta Analysis ◽  
Oocyte Retrieval ◽  
Gnrh Agonists ◽  
Ongoing Pregnancy ◽  
Vitro Fertilization ◽  
Lps Treatment

Abstract Background Various luteal phase supports (LPSs) have been proven to increase the pregnancy rate in fresh cycles of in vitro fertilization or intracytoplasmic sperm injection; however, there is still significant debate regarding the optimal use of LPS. Methods A systematic review with the use of a network meta-analysis was performed via electronic searching of Ovid MEDLINE, the Cochrane Library, Embase, Web of Science, ClinicalTrials.gov and Google Scholar (up to January 2021) to compare the effectiveness and safety of various LPSs, as well as to evaluate the effects of different initiations of LPSs on pregnancy outcomes. The primary outcomes included live birth and ongoing pregnancy, with the results presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results Eighty-nine randomized controlled trials with 29,625 women comparing 14 interventions or placebo/no LPS treatments were included in the meta-analyses. No significant differences were found in terms of the pregnancy outcomes when LPS was started within 48 h after oocyte retrieval versus a delayed initiation between 48 h and 96 h after oocyte retrieval. The addition of gonadotropin-releasing hormone (GnRH) agonists to progesterone vaginal pessaries showed a significant benefit in terms of live birth (OR 1.39, 95% CI 1.08 to 1.78). Only human chorionic gonadotropin (HCG) was found to be more efficacious than the placebo/no LPS treatment in terms of live birth (OR 15.43, 95% CI 2.03 to 117.12, low evidence). Any active LPSs (except for rectal or subcutaneous progesterone) was significantly more efficacious than the placebo/no LPS treatment in terms of ongoing pregnancy, with ORs ranging between 1.77 (95% CI 1.08 to 2.90) for the vaginal progesterone pessary and 2.14 (1.23 to 3.70) for the intramuscular progesterone treatment. Among the comparisons of efficacy and tolerability between the active treatments, the differences were small and very uncertain. Conclusion Delays in progesterone supplementation until 96 h after oocyte retrieval does not affect pregnancy outcomes. The safety of GnRH agonists during the luteal phase needs to be evaluated in future studies before the applications of these agonists in clinical practice. With comparable efficacy and acceptability, there may be several viable clinical options for LPS.

scholarly journals Effect of blastocyst morphology and developmental speed on transfer strategy for grade “C” blastocyst in vitrified‐warmed cycles

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuxia He ◽  
Shiping Chen ◽  
Jianqiao Liu ◽  
Xiangjin Kang ◽  
Haiying Liu
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Multiple Pregnancy ◽  
Poor Quality ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
Blastocyst Transfer ◽  
Blastocyst Development ◽  
Multiple Pregnancy Rate

Abstract Background High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies. Methods A total of 2,038 FET cycles of poor-quality blastocysts from patients 40 years old or less were included from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n = 476), D5-DBT (n = 365), D6-SBT (n = 730), and D6-DBT (n = 467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n = 407), D5-CA/CB (n = 69), D6-AC/BC (n = 580), and D6-CA /CB (n = 150). Results When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44 % vs. 20.82 %) and live birth (32.35 % vs. 14.25 %) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusions For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.

Acupuncture versus placebo acupuncture for in vitro fertilisation: a systematic review and meta-analysis

2020 ◽  
pp. 096452842095871
Author(s):  
Meaghan E Coyle ◽  
Ieva Stupans ◽  
Katherine Abdel-Nour ◽  
Hiba Ali ◽  
Michelle Kotlyarsky ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
In Vitro Fertilisation ◽  
Ongoing Pregnancy ◽  
Miscarriage Rate ◽  
Ongoing Pregnancy Rate ◽  
Placebo Acupuncture

Objective: To evaluate the efficacy of acupuncture compared to placebo acupuncture for women undergoing in vitro fertilisation (IVF) in a systematic review and meta-analysis. Methods: A search was conducted in seven English-language biomedical databases from their inception to 3 April 2019 to identify studies evaluating acupuncture as an adjunct to IVF treatment. Randomised controlled trials (RCTs) that compared acupuncture with placebo acupuncture using a non-invasive placebo acupuncture device in women undergoing a fresh or frozen IVF cycle were eligible, as were studies that tested placebo acupuncture as the intervention. Outcomes were clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, live birth rate and adverse events. Results: Eight RCTs involving 3607 women were included. Studies were judged to be low risk for most of the risk of bias domains. Acupuncture around the time of embryo transfer was not significantly different to placebo acupuncture in terms of the clinical pregnancy rate (6 RCTs, 2473 women, risk ratio (RR) = 0.99 (95% confidence interval (CI) = 0.88, 1.11), I2 = 51%, moderate certainty evidence), ongoing pregnancy rate (4 RCTs, 1459 women, RR = 0.88 (95% CI = 0.75, 1.02), I2 = 50%, moderate certainty evidence), miscarriage rate (4 RCTs, 502 women, RR = 1.23 (95% CI = 0.89, 1.71), I2 = 30%, high certainty evidence) or live birth rate (4 RCTs, 1835 women, RR = 0.87 (95% CI = 0.75, 1.01), I2 = 0%, high certainty evidence). Outcomes with placebo acupuncture were not significantly different to usual care. Adverse events relating to acupuncture, such as discomfort and bruising, were mild to moderate. Conclusion: Acupuncture administered around the time of embryo transfer did not have a statistically significant effect on IVF outcomes compared with placebo acupuncture.

Sign in / Sign up

Export Citation Format

Share Document