scholarly journals Effects of Half-Dose and Full-Dose GnRH Antagonists on IVF-ET Outcomes: A Retrospective Study

2021 ◽  
Author(s):  
Yingge Zhao ◽  
Fang Lian ◽  
Shan Xiang ◽  
Yi Yu ◽  
Conghui Pang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Production Rate ◽  
Endometrial Receptivity ◽  
Small Sample ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Full Dose ◽  
Half Dose ◽  
Ivf Et

Abstract BackgroundGonadotropin-releasing hormone antagonist(GnRH-ant) has been shown to have a negative effect on endometrial receptivity. Therefore, the use of GnRH-ant dose as small as possible during controlled ovarian stimulation(COS) may has an impact on improving endometrial receptivity and pregnancy rate. However, the GnRH-ant dose is relatively flexible and there is no fixed requirement for guidance. In this retrospective study, we tried to study the effects of half-dose or full-dose GnRH-ant on IVF-ET outcomes.MethodsOf the 316 cycles for 314 patients analyzed in this study, 149 received half-dose GnRH-ant(Group1) and 167 received full-dose GnRH-ant(Group2). According to age and BMI, the two groups were divided into four subgroups. Age subgroups, they were divided into age≤35(subgroupA)and age>35(subgroupB): 180 cycles in subgroup A(107 cycles in subgroupA1,73 cycles in subgroupA2), 136 cycles in subgroup B(42 cycles in subgroup B1,94 cycles in subgroupB2). BMI subgroups, they were divided into BMI<25 (subgroupC)and BMI≥25 (subgroupD):208 cycles in subgroupC(94 cycles in subgroup C1,114 cycles in subgroupC2), 108 cycles in subgroupD (55 cycles in subgroupD1,53 cycles in subgroupD2).ResultsNeither fertilized oocytes and the number of superior-quality embryos nor clinical pregnancy rate and live production rate significantly differed between the two groups. However, the number of retrieved oocytes and available embryos were significantly larger in Group 1 than in Group 2 (8.17±4.10vs.7.07±4.05,2.96±2.03vs.2.52±1.62, respectively,p＜0.05). Indicators in each age subgroups showed no statistical significance.However, in BMI subgroups, neither fertilized oocytes, available embryos and the number of superior-quality embryos nor live production rate significantly differed between the four subgroups. The number of retrieved oocytes was higher in subgroupC1 than in subgroupC2 (8.24±4.04vs.6.83±3.92,p < 0.05), In addition the clinical pregnancy rate was slightly higher in subgroupD1 than in subgroupD2(45.45vs.24.53%,P< 0.05). ConclusionsThe results showed that half-dose GnRH-ant was as effective as full-dose GnRH-ant for most patients. And patients with BMI≥25 may be more suitable for half-dose GnRH-ant. This retrospective analysis and the small sample size are the main limitations of this study, and a large sample RCT will be carried out in the future.Trial registrationRetrospectively registered

scholarly journals The function of metformin in endometrial receptivity (ER) of patients with polycyclic ovary syndrome (PCOS): a systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lifang Yuan ◽  
Hongbo Wu ◽  
Weiyu Huang ◽  
Yin Bi ◽  
Aiping Qin ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Large Scale ◽  
Endometrial Thickness ◽  
Meta Analysis ◽  
Resistance Index ◽  
Endometrial Receptivity ◽  
Small Sample ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate

Abstract Background This meta-analysis summarizes evidence from studies using metformin (Met) to improve endometrial receptivity (ER) in women with PCOS. Methods Following the PRISMA protocol, we conducted a comprehensive search of academic literature from various databases, including PubMed, EMbase and Cochrane libraries. Studies published in English before Jan 27, 2021, were recruited for primary screening. Data on endometrial thickness (EMT), endometrial artery resistance index (RI), clinical pregnancy rate (CPR) and miscarriage rate (MR) were extracted and analyzed. Results Sixty-two eligible studies that included 6571 patients were evaluated in this meta-analysis. Primary indicators are EMT and endometrial aetery RI; secondary indicators include the clinical pregnancy rate and miscarriage rate. Metformin significantly increased EMT (SMD = 2.04, 95% CI (0.96,3.12),P = 0.0002) and reduced endometrial artery RI compared to the non-Met group (SMD = − 2.83, 95% CI: (− 5.06, − 0.59), P = 0.01). As expected, metformin also improved CPR and reduced MR in PCOS patients as a result, clinical pregnancy rate (risk ratio [RR] = 1.26, 95% CI: 1.11–1.43, P = 0.0003), and miscarriage rate (RR = 0.73, 95% CI:0.58–0.91, P = 0.006). Conclusion Metformin may improve endometrial receptivity (ER) in PCOS patients by increasing EMT and reducing endometrial artery RI. However, the level of most original studies was low, with small sample sizes. More large-scale, long-term RCTs with rigorous methodologies are needed.

P–278 The embryo score provided by the KIDScoreD5 is correlated with implantation rate and clinical outcomes in fresh transfer

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Francisquini ◽  
L M Oliveir. Gomes ◽  
G C Macedo ◽  
L E K Ferreira ◽  
G C Macedo ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Age Groups ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Morphokinetic Parameters ◽  
Embryo Score ◽  
Gestational Sac ◽  
Fresh Transfer

Abstract Study question Can the algorithm used by EmbryoScopePlus software predict implantation and clinical pregnancy in women of different age groups on fresh transfer? Summary answer The embryo score generated by KIDScoreD5 is highly related to the rates of implantation and clinical pregnancy in fresh transfers in women of different age. What is known already Artificial Intelligence algorithms use statistics to find patterns in large amounts of data and describe a non-biased approach to multiparameter analysis. Several algorithms have been described, but none has been adopted for universal use. KIDScoreD5 is the algorithm included in the EmbryoScopePlus system and classifies embryos according to the cleavage times and morphology of the blastocyst. Version 3, more current, includes the annotations of the number of pronuclei, the time of division for 2, 3, 4 and 5 cells, time to start of blastulation, and morphology of the Internal Cell Mass and trophectoderm. Study design, size, duration Retrospective study evaluated 86 embryos from January to December 2019 at the Reproferty clinic, grown at EmbryoScopePlus and transferred fresh on the fifth day of embryo development. The morphological and morphokinetic parameters were automatically evaluated by the software and in case of any mistake, they were manually corrected. The embryos were evaluated by KIDScoreD5 v3 in different scores from 0.0 to 9.9 and divided into 4 groups (0.0–2.5; 2.6–5.0; 5.1–7.5; 7.6 –9.9). Participants/materials, setting, methods The inclusion criterion was transfer of a single embryo with 1 gestational sac and positive FHB and transfer of two embryos with 2 gestational sac and positive FHB. Patients with progesterone on the trigger day ≥ 1.5ng/mL and/or with endometrium ≤7mm were excluded. The implantation and clinical pregnancy rates were calculated according to age group, G1: ≤35 years; G2: between 36 and 39 years old; G3: ≥40 years, within the embryo classification. Main results and the role of chance For patients in group 1 (n = 31 embryos), 33.4% of the embryos were classified between 2.6–5.0; 69.20% of embryos with scores between 5.1–7.5 and 57.10% of embryos with scores between 7.6–9.9, with 100% of embryos that implanted, regardless of classification, resulting in clinical pregnancy . For group 2 (n = 35 embryos), they only showed an implantation rate for embryos where the scores were 5.1–7.5 (33.4%) and 7.6 - 9.9 (71.4%) , with 100% being the clinical pregnancy rate in these groups. For patients in group 3 (n = 24 embryos), we also observed implantation only in groups of embryos with a score of 5.1–7.5 (37.5%) and 7.6–9.9 (18.5%) , but the clinical pregnancy rate was lower when compared to the other age groups of the patients, with 33.5% for embryos having a score between 5.1–7.5 and 50% for the group 7.6–9.9. Regarding the average score given by the classification of KIDScore Day 5 v. 3 for embryos that implanted, for patients aged 35 years or less, the average was 6.92; for patients between 36 and 39 years old, the average was 8.06 and for patients aged 40 years or older, the average was 7.32. Limitations, reasons for caution This project is limited because it is a retrospective study and evaluated embryos from a single breeding center. Multicenter and prospective studies are necessary to validate the universal use of the KIDScoreD5 v3 algorithm in time-lapse incubators. Wider implications of the findings: The study showed the ability of KIDScoreD5 v3 to assist the embryologist in deciding which embryo to transfer fresh, according to the patient’s age, in addition to the software being effective in automatic annotation of morphological and morphokinetic parameters. Validating an algorithm universally will improve embryonic selection. Trial registration number Not applicable

P–371 Clinical value assessment between endometrial receptivity array and immune profiling in patients with implantation failure

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Dong ◽  
Y Jia ◽  
Y Sha ◽  
L Diao ◽  
S Cai ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcomes ◽  
Statistical Difference ◽  
Endometrial Receptivity ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Implantation Failure ◽  
Clinical Value ◽  
Evaluation Approaches ◽  
Immune Profiling

Abstract Study question To evaluate whether the pregnancy outcomes could be improved in implantation failure patients by endometrial receptivity array, endometrial immune profiling, or a combination of both. Summary answer There was no statistical difference between different endometrial receptivity evaluation and treatment in improving the clinical pregnancy rate. What is known already Both endometrial receptivity array and endometrial immune profiling were promised to improve the endometrial receptivity and subsequent clinical pregnancy. However, less is known about the efficiency between each other and whether the combination could further enhance their clinical value. Study design, size, duration Between November 2019 and September 2020, 143 women with a history of at least two or more consecutive implantation failure in IVF/ICSI treatment in Chengdu Xinan Gynecology Hospital were included. They were divided into three groups: ‘ERA + Immune Profiling’ (n = 70), ‘Immune Profiling’ (n = 41), and ‘ERA’ (n = 32). Participants/materials, setting, methods Inclusion criteria were age ≤ 38, with normal uterus and uterine cavity. All patients were suggested to evaluate endometrial receptivity by ERA test (Igenomix, Valencia, Spain) and endometrial immune profiling based on immunohistochemistry simultaneously, who would be free to choose each or both evaluation approaches. Personal Embryo Transfer and/or personal medical care were adopted according to evaluation results. Clinical pregnancy was confirmed by gestational sacs observed under ultrasonography. Main results and the role of chance The overall prevalence of displaced window of implantation (WOI) is 84.3%, and nearly 74.8% (83/111) patients were diagnosed as endometrial immune dysregulation. Clinical Pregnancy rate and embryonic implantation rate decreased in the ‘Immune Test’ groups, but without a statistical difference (P = 0.311, and 0.158, respectively). Multivariable logistic regression analysis showed that different endometrial receptivity evaluation and treatment was not associated the clinical pregnancy rate, suggesting the performance of different endometrial receptivity evaluation and treatment is similar in improving the clinical pregnancy rate. Neither the immune profiling (CD56, P = 0.591; FOXP3, P = 0.195; CD68, P = 0.820; CD163, P = 0.926; CD1a, P = 0.561; CD57, P = 0.221; CD8, P = 0.427; CD138 CE, P = 0.372) nor histologic endometrial dating defined by Noyes criteria (P = 0.374) were associated with ERA phases. Limitations, reasons for caution Although the selection of evaluation approaches was based on patients’ willingness, the variances of baseline characteristics and immune profiling existed in different groups. The immunological treatment efficacy based on immune profiling was not evaluated before embryo transfer. Wider implications of the findings: To our knowledge, this is the first study comparing the pregnancy outcomes after two typical endometrial receptivity evaluation approaches. The findings highlight the unsubstitutability for each assessment, indicating that both asynchronous and pathological WOI contribute to implantation failure. Trial registration number X2019004

scholarly journals Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET

Medicine ◽  
2017 ◽  
Vol 96 (49) ◽  
pp. e8842 ◽  
Author(s):  
Xiangqin Zheng ◽  
Danmei Lin ◽  
Yulong Zhang ◽  
Yuan Lin ◽  
Jianrong Song ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Infertile Women ◽  
Ivf Et

scholarly journals Predictive Factors for Pregnancy after Intrauterine Insemination: A Retrospective Study of Factors Affecting Outcome

2016 ◽  
Vol 8 (2) ◽  
pp. 140-144
Author(s):  
Azadeh Pravin Patel ◽  
Megha Snehal Patel ◽  
Sushma Rakesh Shah ◽  
Shashwat Kamal Jani
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Predictive Factors ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Female Age ◽  
Factors Affecting

ABSTRACT Objectives To determine the predictive factors for pregnancy after stimulated intrauterine insemination (IUI). Materials and methods A retrospective analysis of 136 patients undergoing 443 stimulated IUI cycles was done in an attempt to identify significant variables predictive of treatment success. The primary outcome measures were clinical pregnancy and live birth rates. Predictive factors evaluated were female age, duration of infertility, indication for IUI, number of preovulatory follicles, and postwash total motile fraction (TMF). Results The overall clinical pregnancy rate and live birth rate were 7.2% and 5.1 per cycle respectively. The mean number of IUI cycles per patient was 3.2, the miscarriage rate was 15%, and the multiple pregnancy rate was 3.1%. Among the predictive factors evaluated, female age (age > 37 years; p = 0.039), the duration of infertility (5.36 vs 6.71 years, p = 0.032), and the TMF (between 10 and 20 million, p = 0.003) significantly influenced the clinical pregnancy rate. Conclusion The clinical management of the selected infertile couple should be performed in an expedited manner taking into consideration the age of the woman, etiology, and duration of infertility and motile fraction of sperms. How to cite this article Patel AP, Patel MS, Shah SR, Jani SK. Predictive Factors for Pregnancy after Intrauterine Insemination: A Retrospective Study of Factors Affecting Outcome. J South Asian Feder Obst Gynae 2016;8(2):140-144.

P–226 Failure of blastocoele expansion within the first two hours post thawing could halve the chances of implantation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
O Delikari ◽  
E Linara-Demakakou ◽  
A Mclaughlin ◽  
C Porta ◽  
N Macklon ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Time Lapse ◽  
Small Sample ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Embryo Morphology ◽  
Patient Counselling ◽  
The Third ◽  
Expansion Time ◽  
Frozen Embryo Transfers

Abstract Study question The aim of this study was to evaluate the influence of blastocoele re-expansion time of warmed vitrified blastocysts on clinical pregnancy outcome. Summary answer Clinical pregnancy rate was significantly higher after transfer of warmed vitrified blastocysts that were fully expanded within 2 hours post thaw. What is known already The number of blastocysts being vitrified worldwide has increased dramatically over recent years. A combination of factors has led to this including the introduction of vitrification, an increase in freeze-all policies, single embryo transfer and an increase in preimplantation genetic testing. Currently, blastocyst re-expansion after thawing is used to indicate the survival status of the blastocyst and when combined with the morphology of blastocyst can predict its reproductive potential. While time taken for blastocoele re-expansion has been proposed to be a biomarker of viability, its value in clinical practice remains unclear. Study design, size, duration This retrospective study analysed outcomes in patients who had frozen embryo transfers between June-December 2020. 233 embryos were reviewed with time-lapse to assess their blastocoele expansion post-warming and three groups were identified. The first included fully expanded blastocysts post-warming. The second group included partially expanded blastocysts and the third non-expanded blastocysts. In addition, the groups were subcategorised into two further categories depending on whether they took less or more than 2 hours to complete expansion. Participants/materials, setting, methods 233 vitrified/warmed embryos from 216 patients were analysed using time-lapse incubators. The first group included 134 blastocysts, of which 70 were fully expanded within 2 hours and 64 after 2 hours post thaw. The second group had 70 embryos of which 45 expanded partially within 2 hours and 25 after 2 hours. The third had 28 embryos that had no expansion within the first 2 hours (n = 20) or after 2 hours (n = 8). Main results and the role of chance Blastocysts were collapsed by laser prior to vitrification. Single blastocyst transfer was performed for all patients. The mean transferred embryo age was 32.1± 5.5 and the recipient’s was 37.5± 5.9. Fully expanded blastocysts (n = 70) within 2 hours demonstrated a clinical pregnancy rate (CPR) of 57% compared with 38% from those that expanded fully after 2 hours (n = 64) (p = 0.02). Blastocysts with some form of expansion (full or partial) within 2 hours post-warming (n = 115) were associated a significantly higher CPR compared to those expanding after 2 hours (n = 89). The CPR was 55% and 39% respectively (p = 0.02). Embryos that showed no expansion (n = 20) within the first 2 hours post thaw resulted in CPR of 28%. Interestingly, embryos that showed no expansion after 2 hours resulted in no pregnancy. When combining morphology as a selection criterion, expansion within 2 hours of thawing was associated with a CPR of 62.5% for ≥4AB embryos, 50% for BB embryos and 45% for poorer embryos ≤CB.In conclusion, failure of blastocoele expansion post 2 hours reduced by half the chances of clinical pregnancy (p = 0.03). Combination of the degree of re-expansion and embryo morphology is an important predictor tool to improve clinical outcomes in frozen embryo transfers. Limitations, reasons for caution This study uses a small sample size of patients. The data are observational and were retrospectively analysed so unknown confounders could not be assessed. The addition of more cycles and further multivariate analysis, is essential for confirmation of the findings. However, initial results are very reassuring. Wider implications of the findings: The degree of speed of re-expansion post warming should be used as a predictor for prioritisation of embryos for transfer. Owing to these preliminary findings there is rationale for a larger scale study combining other morphological indicators that could further assess implantation indicators and assist patient counselling Trial registration number Not applicable

Clinical pregnancy rate but not embryo quality is reduced following IVF-ET in couples with overweight male partner

2010 ◽  
Vol 94 (4) ◽  
pp. S191
Author(s):  
Z.O. Merhi ◽  
J. Keltz ◽  
A. Zapantis ◽  
S. Jindal ◽  
H. Lieman ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Quality ◽  
Male Partner ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Ivf Et
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