scholarly journals The impact of down-regulation on obstetrics and perinatal outcomes in singleton pregnancies after IVF: a retrospective cohort study

2020 ◽  
Author(s):  
Xiyuan Dong ◽  
Yu Zheng ◽  
Biao Chen ◽  
Lan Wang ◽  
Lei Jin ◽  
...  
Keyword(s):  
Live Birth ◽  
Lower Risk ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Down Regulation ◽  
Cumulative Live Birth ◽  
The Impact

Abstract Background Down-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study is to evaluate the effect of down-regulation on obstetrics and perinatal outcomes. Methods This is a retrospective cohort study on 3578 patients achieving singleton pregnancy after their first IVF attempt. The patients were grouped by the serum estradiol after down-regulation (E2D) into three groups: <30, 30-55, >55pg/ml. The cumulative live-birth rate, obstetrics and pediatric results were main outcome measures. General linear models and Chi-square test were performed for statistical analysis. Results The patients with E2D <30, 30-55, >55pg/ml had similar cumulative live-birth rate. The patients with E2D <30pg/ml had a lower risk for hypertension disorders than those with E2D 30-55pg/ml. No difference was found in the prevalence of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns of patients with E2D <30pg/ml had a lower risk for PICU attempt than those with E2D >55pg/ml. There was no difference in congenital anomaly or mortality rate. Conclusion We found no effect of down-regulation on cumulative live-birth rate. The patients with E2D<30pg/ml may have advantages in lower risks for maternal hypertension and newborns PICU attempt.

scholarly journals The Impact of Down-Regulation on Obstetrics and Perinatal Outcomes in Singleton Pregnancies After In Vitro Fertilization

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Jin ◽  
Jihui Ai ◽  
Yu Zheng ◽  
Biao Chen ◽  
Lan Wang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Live Birth ◽  
Lower Risk ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Down Regulation ◽  
The Impact

Backgrounddown-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.Methodsthis is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: &lt;30, 30-55, &gt;55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.Resultsthe patients with E2D &lt;30, 30-55, &gt;55 pg/ml had similar live-birth rates. The patients with E2D &lt;30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D &lt;30 pg/ml had a lower risk of PICU admission than those in the group with E2D &gt;55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).ConclusionDown-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D &lt;30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.

scholarly journals Impact of time-lapse imaging incubators with single-step culture medium on cumulative live birth rate in IVF cycles: a retrospective cohort study

2021 ◽  
Author(s):  
Mariano Mascarenhas ◽  
Sarah J Owen ◽  
Emily French ◽  
Karen Thompson ◽  
Adam H Balen
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Culture Medium ◽  
Live Birth Rate ◽  
Time Lapse ◽  
Single Step ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Time Lapse Imaging

Objective To compare the cumulative live birth rate per egg retrieval between time lapse imaging (TLI) incubators and standard culture (SC) incubators both using a single-step culture medium Design Retrospective cohort study Setting A tertiary level fertility-centre Population Women undergoing an IVF cycle between November 2015 and December 2017 Methods Comparison was done between 1219 IVF cycles using TLI and 1039 cycles using SC after accounting for confounding factors such as age and number of oocytes retrieved. Main outcome measure Cumulative live birth rate per egg retrieval Results The live birth rate per egg retrieval following fresh embryo transfer was noted to be higher for TLI cycles (TLI 39.87% vs SC 38.02%, aOR 1.20, 95% CI 1.01 to 1.44). More embryos were available for cryopreservation in the TLI arm (MD 0.08 embryos, 95% CI 0.10 to 0.41). The live birth rate per frozen embryo transfer was not significantly different. The cumulative live birth rate per egg retrieval was significantly higher in the TLI arm (TLI 50.29% vs SC 46.78%, aOR 1.24, 95% CI 1.04 to 1.48) Conclusions With the use of single step medium, there appears to be a greater benefit of TLI through a reduced interruption in embryo culture conditions, resulting in a higher number of embryos available for cryostorage which in turn appears to improve the cumulative live birth rate. Funding No funding was obtained for this study Keywords Time lapse imaging, cumulative live birth rate, single step culture medium, embryo utilization rate

scholarly journals rLH/rFSH Combination Improved Cumulative Live Birth Rate in Patients With LH Over-Suppression Following GnRH Agonist Pituitary Down-Regulation Compared to rFSH or hMG Alone: A Retrospective Cohort Study With Propensity Score Matching

2021 ◽  
Author(s):  
Ansu Tu ◽  
Lihong Geng ◽  
Ying Zhong
Keyword(s):  
Propensity Score ◽  
Pregnancy Rate ◽  
Propensity Score Matching ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Down Regulation ◽  
Cumulative Live Birth ◽  
Secondary Endpoints

Abstract PurposeThe suppression of luteinizing hormone (LH) in patients undergoing gonadotropin-releasing hormone agonist (GnRH-a) pituitary down-regulation may cause LH deficiency which may impact follicular development. However, little is known about effect of LH adding in patients with LH over-suppression. This study to investigate the effects of different gonadotropins on the cumulative live birth rate (CLBR) in the patients with LH over-suppression after GnRH-a pituitary down-regulation. MethodsThis retrospective study used propensity score-matching methodology to compare CLBR, as the primary endpoint, in the patients with LH over-suppression after different GnRH-a pituitary down-regulation regimens, including recombinant follicle stimulating hormone (rFSH) combined with recombinant LH (rLH), or using rFSH alone, or human menopausal gonadotropin (hMG) alone. The secondary endpoints included biochemical pregnancy rate, clinical pregnancy rate, and live birth rate in fresh embryo transfer cycles. ResultsA total of 88 patients were enrolled after matching: 22 patients in the rFSH+rLH group, 44 in the rFSH group, and 22 in the hMG group. The CLBR of the rFSH+rLH group was significantly higher than that of the rFSH and hMG groups (19/22, 86.4% vs. 25/44, 56.8%, P = 0.014; vs. 7/22, 31.8%, P < 0.001). Moreover, the rFSH group had a higher CLBR than the hMG group (P = 0.048). There were no significant differences in any of the secondary endpoints (all P > 0.05). ConclusionExogenous rLH supplementation achieved a higher CLBR than rFSH or hMG alone among patients with LH over-suppression; furthermore, rFSH alone was superior to hMG alone for CLBR.

scholarly journals More Live Births in Primary Subfertile Intracytoplasmic Sperm Injection-Treated Women with High Normal TSH Levels

2021 ◽  
Vol 86 (4) ◽  
pp. 398-407
Author(s):  
Constance Repelaer van Driel-Delprat ◽  
Eveline van Dam ◽  
Peter van de Ven ◽  
Khadija Aissa ◽  
Melanie ter Haar ◽  
...  
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Thyroid Autoimmunity ◽  
Live Birth Rate ◽  
Ongoing Pregnancy ◽  
Male Factor ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Tsh Levels

<b><i>Objectives:</i></b> The aim of this study was to analyze the fertility outcome in intracytoplasmic sperm injection (ICSI)-treated women across normal range thyroid-stimulating hormone (TSH) levels. Published results are inconclusive about optimal TSH levels and fertility. <b><i>Design:</i></b> This is a retrospective cohort study in 752 ICSI-treated women with predominantly severe male factor subfertility, starting treatment between the first of January 2008 and the first of March 2012 with a follow-up until 2014. <b><i>Participants/Materials, Setting, Methods:</i></b> Women aged 22–45 years with TSH 0.3–4.5 mIU/L without thyroid hormone substitution were included in Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands, an iodine-sufficient area. Demographic and baseline characteristics were compared between groups of patients based on TSH, using one-way ANOVA, Kruskal-Wallis ANOVA, and χ<sup>2</sup> test. The patient was the unit of analysis: all cumulative cycles per patient were analyzed up to and including the first ongoing pregnancy. The primary outcome was a cumulative live birth rate. Clinical pregnancy rate, pregnancy loss, and ongoing pregnancy rate were secondary outcomes. The χ<sup>2</sup> test and logistic regression were used to compare interquartile groups while adjusting for confounders. Logistic regression was used with the natural logarithm of TSH as a continuous predictor. Primary and secondary subfertile women were analyzed separately. <b><i>Results:</i></b> Analysis of the total cohort (<i>n</i> = 752) showed no difference in fertility outcomes across the normal TSH range. The cumulative live birth rate for the 4 groups of primary subfertile women (<i>n</i> = 455) was 76% in the upper TSH quartile compared to 56%, 60%, and 59% in the lower TSH quartiles. <b><i>Limitations:</i></b> Levels of thyroxine and presence of thyroid autoimmunity were not measured in this retrospective cohort study. <b><i>Conclusions:</i></b> The observation that a higher live birth rate was found in primary subfertile ICSI-treated women with high but allegedly normal TSH levels contributes to the hypothesis that in certain subfertile women in addition to a male factor, female factors such as subtle hypothyroidism and/or thyroid autoimmunity may play a role in keeping them from conception, which can be overcome by the process of ICSI.

Maternal MTHFR C677T polymorphism does not affect live birth rate following IVF in Chinese Han population: a retrospective cohort study of 1265 women

2020 ◽  
Author(s):  
Hong Zeng ◽  
Hebin Xie ◽  
Dongmei He ◽  
Yuhao Zhao ◽  
Nenghui Liu
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Mthfr C677t ◽  
P Value ◽  
Cumulative Live Birth Rate ◽  
Chinese Han ◽  
Mthfr C677t Polymorphism ◽  
Cumulative Live Birth

Abstract Backgrounds: MTHFR is a key enzyme for folic acid metabolism and is important for reproduction. However, whether MTHFR C677T genotype affect live birth rate following IVF is unknown. This study aims to evaluate the association of MTHFR C677T polymorphism and live birth rate following IVF. Methods: This is a retrospective cohort study of 1265 women undergoing first IVF -ET cycle (2015-2017) in Reproductive Medicine Center of Xiangya Hospital. The patients were followed for a minimum of 2 years and maximum of 5 years, the observation endpoint is live birth, or all the embryos derived from the first stimulation cycle are transferred. The study population was divided into three groups based on MTHFR C677T genotype (MTHFR 677CC, MTHFR 677CT, MTHFR 677TT). The primary outcomes are live birth rate and cumulative live birth. The secondary outcomes including laboratory parameters (number of oocytes, number of 2PNs, number of available embryos, number of good embryos) and clinical parameters (chemical pregnancy rate, clinical pregnancy rate, implantation rate, preclinical pregnancy loss rate, miscarriage rate). The logistic regression analysis with different adjusted models were used to analyze the association of MTHFR C677T genotype and live birth. Results: Among the 1265 participants, 541 were MTHFR 677CC genotype, 585 were MTHFR 677CT genotype, and 139 were MTHFR 677TT genotype. The live birth rate was 43.6%, 44.8%, and 40.3% (p-value = 0.63), and the cumulative live birth rate per stimulation cycle was 54.7%, 53.5%, and 51.8% (p-value =0.81) in MTHFR 677CC group, MTHFR 677CT group, and MTHFR 677TT group, respectively. The secondary laboratory outcomes and clinical outcomes were not significantly different between the three groups. Logistic regression analysis showed no significant association of MTHFR C677T genotype and live birth whether in model 1 (p-value for trend = 0.63) , model 2 (p-value for trend = 0.63), or model 3 (p-value for trend = 0.59). Conclusions: MTHFR C677T genotype does not significantly affect live birth rate and cumulative live birth rate following first IVF in Chinese Han couples.

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