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

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.

scholarly journals Dydrogesterone is Superior as Luteal Phase Support in selected Previously Failed In-Vitro Fertilisation and Embryo Transfer Patients

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
P Value ◽  
Miscarriage Rate ◽  
Secretory Endometrium ◽  
Micronized Progesterone

Different forms of exogenous progesterone have been seen to play a very important role in endometrial maturity. Implantation failure appears to be a significant factor in Assisted reproductive technique (ART) procedures. Even a mature endometrium becomes non-receptive, preventing implantation or rejection of implanted embryo in early months of pregnancy. Hence natural micronized progesterone (NMP) and dydrogesterone have been used since decades to improve endometrial maturity and receptivity. The aim of this study was to investigate causes of failed implantation inspite of uneventful Grade I embryo transfer in ART procedure and the role of natural micronized progesterone (NMP) and dydrogesterone for endometrial maturation. 80 women aged range between 25-40 yr old who visited Department of Reproductive Medicine at Calcutta Fertility Mission, over a period of 24 months (January 2017 to December 2019), satisfying the inclusion criteria, were enrolled in this retrospective observational study. Endometrial aspirate histopathology was done during the secretory phase. They were treated with natural micronized progesterone (NMP) or oral dydrogesterone and results of endometrial changes, clinical pregnancy rate, live birth rate and miscarriage rate were statistically analysed. 26.25% and 29.6% of women were seen to have mid-secretory changes of the endometrium after being treated with NMP in one cycle and dydrogesterone in the subsequent cycle, respectively. 62.71% of women had shown early-secretory changes with dydrogesterone which was statistically significant compared to those treated with NMP (p value=0.006).8.5% of these women showed persistent non-secretory endometrium with either of these medications. The Clinical Pregnancy Rate (CPR) was 38.1% and 47% in the group of patients who were treated with NMP and dydrogesterone respectively. Though pregnancy rate was slightly higher in dydrogesterone group, it was not statistically significant (p value = 0.578). 28.5% and 41% women had live births and 9.5% and 5.8% of them had miscarriage in NMP and dydrogesterone group, respectively, though our data appears to be statistically not significant (p value –0.415) (p value – 0.679). In our study 26.25% women had mid-secretory endometrium after treatment with NMP. 29.6% and 62.71% of these women who had non-secretory or early secretory endometrial changes on treatment with intravaginal NMP, showed endometrial mid-secretory and early-secretory changes respectively, on treatment with dydrogesterone, which implies that oral dydrogesterone is superior to NMP when administered for endometrial maturation in selected patients. Clinical pregnancy rate, live birth rate or miscarriage rate were similar with either NMP or dydrogesterone.

scholarly journals Twice vitrification-warming procedures has no effect on frozen-thawed embryo transfer outcomes

2021 ◽  
Author(s):  
xiaoyue Shen ◽  
Min Ding ◽  
Yuan Yan ◽  
Shanshan Wang ◽  
jianjun Zhou ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Background To evaluate the frozen-thawed embryo transfer (FET) outcomes of repeated cryopreservation by vitrification of blastocysts derived from vitrified-warmed day3 embryos in patients who experienced implantation failure previously. Methods We retrospect the files of patients who underwent single frozen-thawed blastocyst transfer cycles in our reproductive medical center from January 2013 to December 2019. 127 patients transfer of vitrified-warmed blastocysts derived from vitrified-warmed day3 embryos were defined as twice-cryopreserved group. 1567 patients who transfer blastocysts that had experienced once vitrified-warmed were used as once-cryopreserved group. None of them was pregnant at the previous FET. The outcomes were compared between two groups after a 1:1 propensity score matching (PSM). Results The clinical pregnancy rate was 52.76%, live birth rate was 43.31% in twice-cryopreserved group. After PSM,108 pairs of patients were generated for comparison. The clinical pregnancy rate, live birth rate or miscarriage rate was not significantly different between two groups. Logistic regression analysis indicated that double vitrification-warming procedures did not affect FET outcomes in terms of clinical pregnancy rate (OR 0.83, 95%CI 0.47-1.42), live birth rate (OR 0.93, 95%CI 0.54-1.59), miscarriage rate (OR 0.72 95%CI 0.28-1.85). Furthermore, the pregnancy complications rate, gestational age or neonatal abnormalities rate between two groups was also comparable, while twice vitrification-warming procedures might increase the macrosomia rate (19.6% vs. 6.3%, P = 0.05). Conclusion Transfer of double vitrified-warmed embryo at cleavage stage and subsequent blastocyst stage did not affect live birth rate and neonatal abnormalities rate, but there was a tendency to increase macrosomia rate, which needs further investigation.

Endometrium immunomodulation by intrauterine insemination administration of treated peripheral blood mononuclear cell prior frozen/thawed embryos in patients with repeated implantation failure

Zygote ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 214-218 ◽  
Author(s):  
Fattaneh Farifteh Nobijari ◽  
Seyedeh Soheila Arefi ◽  
Ashraf Moini ◽  
Robabeh Taheripanah ◽  
Elham Fazeli ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Peripheral Blood ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Control Group ◽  
Peripheral Blood Mononuclear ◽  
Significant Difference ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

SummaryIn assisted reproductive technology (ART) programmes, approximately 10% of infertile patients have at least two or three repeated implantation failures (RIFs) after an in vitro fertilization (IVF) protocol. Successful implantation mainly depends on local immune tolerance mechanisms involving a spectrum of cytokines, interleukins and growth factors. The latter have played pivotal roles in the recruitment of immune cells (and notably T-lymphocyte cells). In total, 250 couples participating in frozen–thawed embryo transfer programme were incorporated in a randomized clinical trial (peripheral blood mononuclear cells (PBMC) subgroup: n=122; control subgroup: n=128). In the PBMC group, a blood sample was collected 5 days before the scheduled frozen–thawed embryo transfer; PBMCs were isolated using Ficoll separation and then cultured for 72 h. Two days prior to embryo transfer, 0.4 ml of cultured PBMCs were transferred into the patient’s uterus. Although the clinical pregnancy rate was higher in the PBMC group (34.4%) than in the control group (23.4%), this difference was not statistically significant (P=0.05 in a chi-squared test). Nevertheless, when we limited the analysis to patients with ≥3 RIFs (n=138), there was a significant difference in the clinical pregnancy rate between the PBMC group (38.6%) and the control group (19.7%; P=0.01). Our results imply that PBMC transfer can be part of effective fertility treatment for patients with RIF.

Comparison of Oral Dydrogesterone with a Micronized Vaginal Progesterone in Fresh Embryo Transfer in IVF ± ICSI

2021 ◽  
Author(s):  
Marion Cessot ◽  
Eloise Fraison ◽  
Elsa Labrune ◽  
Mehdi Benchaib ◽  
Bruno Salle
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Univariate Analysis ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
University Hospital ◽  
Fresh Embryo Transfer ◽  
Vaginal Progesterone ◽  
Significant Difference

Abstract Introduction: Luteal insufficiency corresponds to a progesterone deficiency affecting women who receive treatment for in vitro fertilization (IVF). Different routes of progesterone administration exist and have varying degrees of acceptability to patients. The aim of this study was to compare two luteal phase support (LPS) treatments: oral dydrogesterone versus micronized vaginal progesterone on the clinical pregnancy rates after fresh embryo transfert. Material and Methods: This study was a retrospective, monocentric and observational study carried out in the reproductive medicine department at the University Hospital, Femme Mère Enfant in Lyon. 580 consecutive women between 18 and 43 years old, who completed an IVF cycle with or without ICSI, followed by fresh embryo transfer on the second or third day after oocyte retrieval (D2 or D3) or at the blastocyst stage (D5 or D6) between July 2019 and July 2020 were included.Results: In the univariate analysis, the clinical pregnancy rate per transfer was comparable between the MVP and OD groups (29.7% and 27.6% respectively with p = 0.6460). In the multivariate analysis, OD also appeared to be associated with a similar pregnancy rate compared to MVP, with a non-significant difference (p > 0.05) (OR [95% CI]): 0.922 [0.626; 1,358] with p = 0.6817. The use of OD compared to MVP did not significantly influence the clinical pregnancy rate in any age group (p > 0.05) (OR [95% CI]): 0.954 [0.657; 1.386] with p = 0.8057. There was no significant difference between the two groups in the clinical pregnancy rate, whether the patients belonged to the reference population of the center or not (p > 0.05) (OR [95% CI]): 2.367 [0.568; 3.568] with p < 0.0001. Conclusion: This is the largest retrospective study comparing these two routes of progestogens in LPS during IVF and it reinforces the use of the oral form to improve patients’ comfort.

scholarly journals Progesterone- primed ovarian stimulation in polycystic ovarian syndrome: An RCT

2019 ◽  
Author(s):  
Maryam Eftekhar ◽  
Masrooreh Hoseini ◽  
Lida Saeed
Keyword(s):  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Polycystic Ovarian Syndrome ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Control Group ◽  
Miscarriage Rate ◽  
Antagonist Group ◽  
Ovarian Syndrome ◽  
Antagonist Protocol

Background: In vitro fertilization is an important therapy for women with polycystic ovarian syndrome (PCOS). The use of new ways of improving clinical results is yet required. Objective: This study was aimed to investigate the efficacy of progesterone primed ovarian stimulation (PPOS) and compare with conventional antagonist protocol in PCOS. Materials and Methods: A total of 120 PCOS women who were candidates for assisted reproductive technology treatment from August to January 2019 were enrolled in this RCT and were placed into two groups, randomly (n = 60/each). The PPOS group received 20 mg/day Dydrogesterone orally since the second day of the cycle and the control group received antagonist protocol. The pregnancy outcomes including the chemical and clinical pregnancy, the miscarriage rate, and the percent of gestational sacs/transferred embryos was compared in two groups. Results: Number of MII oocyte, maturity rate, Number of 2 pronuclei (2PN) and serum estradiol levels on trigger day were statistically lower in PPOS group (p = 0.019, p = 0.035, p = 0.032, p = 0.030), respectively. Serum LH level on trigger day in PPOS group was higher than antagonist group (p = 0.005). Although there wasn’t sever ovarian hyper simulation syndrome in any participants, mild and moderate ovarian hyper simulation syndrome was less in PPOS group (p = 0.001). Also, the chemical and clinical pregnancy rate were higher in the antagonist group, althoughit was not statistically significant (p = 0.136, p = 0.093 respectively). Conclusion: Our study demonstrate that PPOS does not improve chemical and clinical pregnancy rate of the infertile women with PCOS. Key words: Progesterone, Polycystic ovarian syndrome, Controlled ovarian stimulation, Frozen-thawed embryo transfer, Pregnancy rate.

P–209 Artificial collapse of human expanded blastocysts protects the quality of embryos during vitrification/warming procedure

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Karagianni ◽  
A Papatheodorou ◽  
N Christoforidis ◽  
A Chatziparasidou
Keyword(s):  
Laser Pulse ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Control Group ◽  
Reproductive Outcome ◽  
Blastocyst Quality ◽  
And Control

Abstract Study question Does artificial collapse of human blastocysts before vitrification affect the post warming quality of embryos and/or the reproductive outcome? Summary answer This study suggests that artificial collapse with laser pulse before vitrification significantly benefits blastocyst quality post-warming without improving reproductive outcome. What is known already The efficiency of vitrification of blastocysts can be influenced by various factors, such as the stage of the expansion and the quality of the embryos. Expanded blastocysts seem to be more sensitive and prone to cryo-injury during vitrification because of the large amount of blastocoelic fluid which may cause insufficient dehydration. Artificial collapse (AC) with micro-needles or with laser pulse can improve the vitrification procedure and protect the expanded blastocysts from cryoinjuries by reducing the fluid of the blastocoel. Study design, size, duration This prospective randomized study was performed at Embryolab Fertility Clinic, in Thessaloniki, Greece between July 2020 and November 2020 and included 94 ICSI treatments with no fresh embryo transfer. Patients with more than 4 blastocysts were randomized and allocated to the study (AC) group or control group. Randomization list was created by a computer-based program. The embryos were vitrified at the blastocyst stage and the best 1–2 embryos were transferred in a subsequent cycle. Participants/materials, setting, methods Patients were divided in two groups: AC group (n = 46) where 1 or 2 best expanded blastocysts were artificially collapsed by a laser pulse before vitrification and control group (n = 48) where the corresponding best expanded embryos remained untreated before vitrification. The embryos were graded according to Gardner’s criteria and vitrified using open system. Quality of embryos, pregnancy rate and clinical pregnancy rate from the first warming cycle were the parameters that were analyzed using z-test. Main results and the role of chance The analyzed embryos were in total 171, 85 in the AC group and 86 in the control group. The day 5 embryos in each group were 6.89 (±3.41) and 6.50 (±3.38) and the number of embryos per embryo transfer was 1.85 (±0.36) and 1.79 (±0.41) respectively. Cryoinjury was determined as the presence of degenerated cell in ICM or TE. In the AC group cryo-injury was significantly lower than in the control group [31.11% with at least 1 embryo per embryo transfer and 52.08% respectively (p = 0.0356), 6.67% with cryo-injury in both embryos and 14.58% respectively (p &lt; 0.0001), 8.89% with cryo-injury in ICM and 10.42% respectively (p &lt; 0.0001), 15.56% with cryo-injury in trophectoderm and 27.08% respectively (p &lt; 0.0001), and 6.67% with cryo-injury in both ICM and trophectoderm and 12.50% respectively (p &lt; 0.0001)]. Pregnancy rate (positive b-hcg) was not significantly different between the two groups (62.22% in AC group and 76.09% in control group, p = 0.1479), nor was the clinical pregnancy rate (52.38% and 60.87% in AC and control group respectively, p = 0.4208). Limitations, reasons for caution The number of cases included in this study was limited and the live birth rate was not yet available. More prospective randomized studies are needed in order to validate the benefit of artificial collapse before the vitrification procedure. Wider implications of the findings: Laser artificial Collapse does not compromise expanded blastocyst quality, on the contrary it seems to reduce the amount of cryoinjury observed post warming. Whether it can improve the reproductive outcome, remains to be examined in larger scale studies. Trial registration number Not applicable

scholarly journals Pregnancy outcomes in female patients with X chromosome mosaicism after the first IVF/ICSI treatment: A 6-year retrospective cohort study

2021 ◽  
Author(s):  
Shanshan Liang ◽  
Jianzhi Yang ◽  
Haixia Wu ◽  
Shiyi Xiong ◽  
Ming Guo ◽  
...  
Keyword(s):  
X Chromosome ◽  
Pregnancy Outcomes ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Oocyte Retrieval ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Cumulative Live Birth Rate ◽  
Chromosome Mosaicism ◽  
Cumulative Live Birth

Objective: The present study focused on the clinical pregnancy and cumulative live birth rate (CLBR) of female patients with X chromosome mosaicism (XM) after the first in-vitro-fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment, and the possible impact of different mosaic subtypes. Design: Retrospective cohort study Setting: Single Center study Population: Infertility couples Methods: In total, 76 couples with XM female partners and normal male partners were included (2014–2019) as the X group, with another 76 couples with normal karyotype included as the control group. Subgroup X1 included 41 45,X/46,XX cases, Subgroup X2 included 22 47,XXX/46,XX cases, and Subgroup X3 included 12 45,X/47,XXX/46,XX cases. Main Outcome Measures: The ovarian stimulation, embryo results and pregnancy outcomes were analyzed. Results: The X group presented similar CLBR but required a higher total gonadotropin (Gn) dosage than the control group (1800 IU vs. 1612 IU). Following subgroup analysis, the number of follicles during oocyte retrieval and average number of fertilized oocytes was lower in subgroup X1 than in X3. The clinical pregnancy rate and CLBR were similar in all groups. Conclusion: Females with XM may present a similar CLBR until one year after oocyte retrieval, but may require a higher total Gn dosage. Females with 45,X cells may recover fewer follicles during oocyte retrieval, resulting in fewer embryos. A higher 45,X cell ratio (over 5%) may lead to a lower CBLR. Funding: This study was supported by the Ministry of Science and Technology of China (2016YFC1000602). Keywords X chromosome mosaicism, IVF/ICSI outcome, cumulative live birth rate

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

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).

scholarly journals INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

2021 ◽  
pp. 68-75
Author(s):  
A.O. Polumiskova ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Art Programs ◽  
Group A ◽  
The Difference ◽  
Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

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