scholarly journals Live birth rates in different subgroups of poor ovarian responders according to Bologna and POSEIDON group classification criteria

2020 ◽  
Author(s):  
Mehri Mashayekhy ◽  
Arezoo Arabipoor ◽  
Forouzan Barabi ◽  
Zahra Zolfaghari
Keyword(s):  
Live Birth ◽  
Predictive Factors ◽  
Treatment Cycle ◽  
Group Analysis ◽  
Group Classification ◽  
Birth Rates ◽  
Live Births ◽  
Bologna Criteria ◽  
Live Birth Rates ◽  
Group 3

Abstract Background: Live birth rates (LBRs) have been separately evaluated in two poor ovarian responder (POR) classification methods. We designed the present study to compare the LBRs according to Bologna criteria or Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) group classifications to determine the important predictive factors for LBR in patients with POR. Methods: In this cross-sectional study, we evaluated a database that contained clinical and laboratory information on infertility treatment cycles of all patients with at least one POR after standard controlled ovarian stimulation (COH) during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles from December 2015 to December 2017. The eligible data were collected and the subjects divided into five groups according to Bologna criteria and four groups according to POSEIDON group classification. Results: We assessed 812 patients diagnosed with POR; overall, 517 underwent embryo transfer (ET) during the last treatment cycle (63.6%). The results indicated a total clinical pregnancy rate of 19.3% (100 cases) and LBR of 16.1% (86 cases). According to Bologna criteria, 41 patients were not included in any group. Analysis of treatment cycle outcome showed that patients classified as Bologna group II had a higher LBR than the other groups. In terms of POSEIDON classification, all of the patients could be classified into groups. Patients in POSEIDON group 3 had the highest LBR. According to multivariable regression analysis, the significant independent variables that remained in the model as important predictive factors for live births were the number and quality (good and excellent) of the embryos transferred, and POSEIDON group 3 classification. Conclusion: The results indicated that the POSEIDON group classification could be more comprehensive and practical than Bologna criteria for diagnosing and categorizing POR patients. In addition, we noted that the number and quality of transferred embryos were the most important prognostic factors for live births in POR patients. Therefore, we suggest that clinicians consider COH protocols that have a freezing embryo strategy and the collection of more good quality embryos to improve the probability of a live birth.

scholarly journals Live birth rates in different subgroups of poor ovarian responders according to Bologna criteria and POSEIDON group classification

2020 ◽  
Author(s):  
Mehri Mashayekhy ◽  
Arezoo Arabipoor ◽  
Forouzan Barabi ◽  
Zahra Zolfaghari
Keyword(s):  
Live Birth ◽  
Group Classification ◽  
Birth Rates ◽  
Cross Sectional ◽  
Group Iii ◽  
Live Births ◽  
Bologna Criteria ◽  
Live Birth Rates ◽  
Poor Ovarian Responders

Abstract Background Recently, some studies evaluated the live births rates (LBRs) in two poor ovarian responders (POR) classification methods separately, but present study was designed to compare the LBRs among different groups of patients on the basis of Bologna criteria or POSIEDON group classifications and find the important predictive factors for LBR in patients with POR.Methods In this cross-sectional study, the database containing clinical and laboratory information on infertility treatment cycles were evaluated from December 2015 to December 2017 and all the patients with at least one POR after standard controlled ovarian stimulation (COH) during IVF/ICSI cycles were evaluated. The eligible patients were enrolled and divided into five and four groups according to the Bologna criteria and POSEIDON groups’ classifications, respectively.Results 812 patients with POR diagnosis were investigated which in overall 517 of them had embryo transfer in the last treatment cycle (63.6%) and total clinical pregnancy rate 19.3% (100 cases) and live birth rates 16.1% (86 cases) were found. When the patients were grouped on the Basis of the POSEIDON classification, the highest LBR was observed in the POSEIDON group III. On the other hand, according to the Bologna criteria, 41 patients were not included in any group, and in the analysis of cycle outcome, the LBR in the Bologna group II was more than other groups. The multivariable regression analysis revealed that the significant independent variables remained in the model as important predictive factor for live births in the study population were the number and quality of the transferred embryos transmission (good and excellent quality), and the POSSIDON classification group (POSSIDON group III).ConclusionsOn the basis of present results, the POSEIDON group classification could be more comprehensive and practical than Bologna criteria for diagnosing and categorizing POR patients. In addition, it was found the number and quality of transferred embryos were the most important prognostic factor for live birth in POR patients; therefore we suggest to consider COH protocols with a freezing embryos strategy, and the collection of more good quality embryos to improve the probability of a live birth.

scholarly journals Live birth rates in different subgroups of poor ovarian responders according to Bologna criteria and POSEIDON group classification

2020 ◽  
Author(s):  
Mehri Mashayekhy ◽  
Forouzan Barabi ◽  
Arezoo Arabipoor ◽  
Zahra Zolfaghari
Keyword(s):  
Live Birth ◽  
Group Classification ◽  
Birth Rates ◽  
Cross Sectional ◽  
Group Iii ◽  
Live Births ◽  
Bologna Criteria ◽  
Live Birth Rates ◽  
Poor Ovarian Responders

Abstract Background Recently, some studies evaluated the live births rates (LBRs) in two poor ovarian responders (POR) classification methods separately, but present study was designed to compare the LBRs among different groups of patients on the basis of Bologna criteria or POSIEDON group classifications and find the important predictive factors for LBR in patients with POR. Methods In this cross-sectional study, the database containing clinical and laboratory information on infertility treatment cycles were evaluated from December 2015 to December 2017 and all the patients with at least one POR after standard controlled ovarian stimulation (COH) during IVF/ICSI cycles were evaluated. The eligible patients were enrolled and divided into five and four groups according to the Bologna criteria and POSEIDON groups’ classifications, respectively. Results 812 patients with POR diagnosis were investigated which in overall 517 of them had embryo transfer in the last treatment cycle (63.6%) and total clinical pregnancy rate 19.3% (100 cases) and live birth rates 16.1% (86 cases) were found. When the patients were grouped on the Basis of the POSEIDON classification, the highest LBR was observed in the POSEIDON group III. On the other hand, according to the Bologna criteria, 41 patients were not included in any group, and in the analysis of cycle outcome, the LBR in the Bologna group II was more than other groups. The multivariable regression analysis revealed that the significant independent variables remained in the model as important predictive factor for live births in the study population were the number and quality of the transferred embryos transmission (good and excellent quality), and the POSSIDON classification group (POSSIDON group III). Conclusions On the basis of present results, the POSEIDON group classification could be more comprehensive and practical than Bologna criteria for diagnosing and categorizing POR patients. In addition, it was found the number and quality of transferred embryos were the most important prognostic factor for live birth in POR patients; therefore we suggest to consider COH protocols with a freezing embryos strategy, and the collection of more good quality embryos to improve the probability of a live birth.

scholarly journals Time associations between U.S. birth rates and add-Ons to IVF practice between 2005–2016

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Norbert Gleicher ◽  
Lyka Mochizuki ◽  
David H. Barad
Keyword(s):  
Live Birth ◽  
Outcome Data ◽  
Single Embryo Transfer ◽  
Additional Treatment ◽  
Birth Rates ◽  
Preimplantation Genetic Testing ◽  
Vitro Fertilization ◽  
Live Births ◽  
Live Birth Rates

AbstractUntil 2010, the National Assisted Reproductive Technology Surveillance System (NASS) report, published annually by the Center for Disease Control and Prevention (CDC), demonstrated almost constantly improving live birth rates following fresh non-donor (fnd) in vitro fertilization (IVF) cycles. Almost unnoticed by profession and public, by 2016 they, however, reached lows not seen since 1996–1997. We here attempted to understand underlying causes for this decline. This study used publicly available IVF outcome data, reported by the CDC annually under Congressional mandate, involving over 90% of U.S. IVF centers and over 95% of U.S. IVF cycles. Years 2005, 2010, 2015 and 2016 served as index years, representing respectively, 27,047, 30,425, 21,771 and 19,137 live births in fnd IVF cycles. Concomitantly, the study associated timelines for introduction of new add-ons to IVF practice with changes in outcomes of fnd IVF cycles. Median female age remained at 36.0 years during the study period and center participation was surprisingly stable, thereby confirming reasonable phenotype stability. Main outcome measures were associations of specific IVF practice changes with declines in live IVF birth rates. Time associations were observed with increased utilization of “all-freeze” cycles (embryo banking), mild ovarian stimulation protocols, preimplantation genetic testing for aneuploidy (PGT-A) and increasing utilization of elective single embryo transfer (eSET). Among all add-ons, PGT-A, likely, affected fndIVF most profoundly. Though associations cannot denote causation, they can be hypothesis-generating. Here presented time-associations are compelling, though some of observed pregnancy and live birth loss may have been compensated by increases in frozen-thawed cycles and consequential pregnancies and live births not shown here. Pregnancies in frozen-thawed cycles, however, represent additional treatment cycles, time delays and additional costs. IVF live birth rates not seen since 1996–1997, and a likely continuous downward trend in U.S. IVF outcomes, therefore, mandate a reversal of current outcome trends, whatever ultimately the causes.

scholarly journals Applying growth hormone as an adjuvant to correct poor prognosis outcomes in IVF: Study 2 compares dehydroepiandrosterone

2021 ◽  
Vol 16 (3) ◽  
pp. 164-190
Author(s):  
John Lui Yovich ◽  
Shanthi Srinivasan ◽  
Mark Sillender ◽  
Shipra Gaur ◽  
Philip Rowlands ◽  
...  
Keyword(s):  
Live Birth ◽  
Ovarian Reserve ◽  
Poor Prognosis ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Utilization Rate ◽  
Recurrent Implantation Failure ◽  
Birth Rates ◽  
Live Births ◽  
Live Birth Rates

This retrospective study examines the influence of recombinant growth hormone (rGH) and dehydroepiandrosterone (DHEA) adjuvants on oocyte numbers, embryo utilization and live births arising from 3637 autologous IVF±ICSI treatment cycles undertaken on 2376 women across ten years (2011-2020) within a pioneer Australian facility. Despite using an FSH-dosing algorithm enabling maximal doses up to 450 IU for women with reduced ovarian reserve, younger women had significantly higher mean numbers of oocytes recovered than older women ranging from 11.1 for women <35 years to 9.4 for women aged 35-39 years reducing to 6.5 for women aged 40-44 years and 4.1 for those aged ≥45 years (p<0.0001). Overall, the embryo utilization rate was 48.5% and live birth productivity rate was 35.4 % across all ages and neither rGH nor DHEA showed any benefit on these rates, in fact, those women with nil adjuvants showed the highest live birth rate per initiated cycle (44.94% overall: p<0.0001, and 55.2% for the youngest group: p<0.001). Embryo utilization was increased by rGH in those women aged 40-44 years who had low ovarian reserve (p<0.0001), but this benefit did not translate into any improvement in the live birth rate, in fact those women who did not use adjuvants had the highest overall birth rate (p<0.0001). Similarly, other factors known to cause a poor prognosis, including low IGF-1 profile, recurrent implantation failure, and low oocyte numbers at OPU, showed no improvement in embryo utilization nor in live births from the adjuvants. The relevance of embryo quality was examined on 1135 women whose residual embryos after a single fresh-embryo transfer failed to develop to a suitable grade for cryopreservation. From 1727 cycles such women often displayed an improved embryo utilization rate with both rGH, and with DHEA or combined rGH+DHEA. Even so, live birth rates were not improved by either of the adjuvants excepting young women <35 years using rGH without DHEA (p<0.05). Examining poor prognosis sub-groups, indicated both rGH and DHEA or combined rGH+DHEA consistently improved embryo utilization in those women with low ovarian reserve (p<0.0001), or those with low IGF-1 levels (p<0.0001) or with recurrent implantation failure (p<0.02). All the poor-prognosis sub-groups showed low live birth rates and, notwithstanding the improvements in embryo utilization, the live birth rates were not significantly improved by the adjuvants, albeit the rates were closer to the nil adjuvant groups (not significantly different).

scholarly journals Live Birth Rates after Active Immunization with Partner Lymphocytes

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1350
Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Lisa Meyerholz ◽  
Nicolai Maass ◽  
Siegfried Görg ◽  
...  
Keyword(s):  
Live Birth ◽  
Recurrent Miscarriage ◽  
Active Immunization ◽  
Birth Rates ◽  
Live Births ◽  
Live Birth Rates ◽  
History Of ◽  
The Difference ◽  
Immunological Risk Factors ◽  
Routine Therapy

Although many potential causes have been established for recurrent implantation failure (RIF) and recurrent miscarriage (RM), about 50% of these remain idiopathic. Scientific research is focused on immunological risk factors. In the present study, we aim to evaluate live birth rates after immunization with paternal lymphocytes (lymphocyte immunotherapy (LIT)). This retrospective study consisted of 148 couples with a history of RM and/or RIF. The women underwent immunization with lymphocytes of their respective partners from November 2017 to August 2019. Fifty-five patients (43%) had live births. Stratified by indication (RM, RIF, combined), live birth rates in the RM and the combined group were significantly higher than that in the RIF group (53%, 59% and 33%, respectively, p = 0.02). The difference was especially noticeable during the first 90 days after immunization (conception rate leading to live births: 31%, 23% and 8% for RM, the combined group and RIF, respectively; p = 0.005), while there was no difference between groups during the later follow-up. LIT was associated with high live birth rates, especially in women with recurrent miscarriage. In view of the limited data from randomized studies, LIT cannot be recommended as routine therapy. However, it may be considered in individual cases.

scholarly journals Cumulative live birth rates after fresh and vitrified cleavage-stage versus blastocyst-stage embryo transfer in the first treatment cycle

2016 ◽  
Vol 31 (11) ◽  
pp. 2442-2449 ◽  
Author(s):  
Anick De Vos ◽  
Lisbet Van Landuyt ◽  
Samuel Santos-Ribeiro ◽  
Michel Camus ◽  
Hilde Van de Velde ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Treatment Cycle ◽  
Blastocyst Stage ◽  
Stage Versus ◽  
Cleavage Stage ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
Stage Embryo

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.

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