scholarly journals Effect of melatonin on the clinical outcome of patients with repeated cycles after failed cycles of in vitro fertilization and intracytoplasmic sperm injection

2021 ◽  
Author(s):  
Qi Zhu ◽  
Kaijuan Wang ◽  
Chao Zhang ◽  
Beili Chen ◽  
Huijuan Zou ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Clinical Outcome ◽  
Embryonic Development ◽  
Pregnancy Rate ◽  
Intracytoplasmic Sperm Injection ◽  
Clinical Pregnancy ◽  
High Quality ◽  
Vitro Fertilization ◽  
Embryo Cultures

Abstract Background: Melatonin (MT), a powerful antioxidant, can effectively ameliorate the in vitro development of animal embryos, but few studies have been performed on human embryos. Therefore, we investigated whether the application of MT in embryo cultures can improve embryonic development and clinical outcomes of patients with repeated cycles after failed in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.Methods: Human immature oocytes from controlled ovarian hyperstimulation cycles were collected for in vitro maturation culture and ICSI fertilization. The obtained embryos were cultured in vitro in medium containing 0, 10-11, 10-9, 10-7 or 10-5 M MT, and 10-9 M was determined to be the optimal concentration. Subsequently, 140 patients who experienced failed IVF/ICSI cycles underwent 140 cycles of embryo culture in vitro with medium containing 10-9 M MT. High-quality blastocysts were collected and cryopreserved for three months before vitrified-warmed embryo transfer. These culture cycles served as the experimental (10-9 M) group. The control (0 M) group comprised previous failed cycles. The patients were further divided into subgroups of 1, 2 or ≥3 failed cycles. The fertilization and embryo development statuses were compared.Results: The fertilization, cleavage, high-quality embryo, blastocyst, and high-quality blastocyst rates of the 10-9 M group were significantly higher than those of the 0 M group (87.7% vs. 83.6%, p <0.01; 94.1% vs. 90.5%, p <0.01; 58.3% vs. 43.8%, 51.1% vs. 41.8%, 43.4% vs. 22.9%, all p <0.0001). To date, a total of 50 vitrified-warmed cycle transfers were performed in the 10-9 M group and the implantation rate, biochemical pregnancy rate and clinical pregnancy rate were significantly higher than those in the 0 M group (65.6% vs. 9.7%, p <0.0001; 64.0% vs. 12.5%, p <0.0001; 40.0% vs. 11.7%, p <0.0001). Two healthy infants were delivered successfully and the other 18 women who achieved clinical pregnancy also had good examination indexes.Conclusion: The application of MT to embryo cultures in vitro improved embryonic development in patients with repeated cycles after failed IVF/ICSI cycles and had good clinical outcomes. The optimal concentration of MT was 10-9 M.Trial registration: Name in the registry: Effect of melatonin on the clinical outcome of patients with repeated cycles after failed cycles of in vitro fertilization and intracytoplasmic sperm injection; registration number: ChiCTR2100045552; date of registration: April 19, 2021(retrospectively registered); URL of trial registry record: www.medresman.org.cn.

scholarly journals Does the additional use of clomiphene citrate or letrozole for in vitro fertilization deserve more attention?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Liang ◽  
Qing Guo ◽  
Xiao-Hua Wu ◽  
Li-Nan Zhang ◽  
Jun Ge ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Poor Responders ◽  
High Quality ◽  
Vitro Fertilization ◽  
Oral Medications ◽  
High Responders

Abstract Background Adding clomiphene citrate (CC) and/or letrozole (LE) to in vitro fertilization (IVF) cycles for mild ovarian stimulation is a general approach. Although lots of researches have demonstrated partial benefits of the strategy, all-around effects of oral medications remained deficient. This paper aims to assess whether an addition of oral medication will result in considerable outcomes on T-Gn (total dose of gonadotropin), Gn days, total retrieved ova, high quality embryos, blastocyst number, ovarian hyperstimulation syndrome (OHSS) rate, clinical pregnancy rate and cumulative pregnancy rate, even if it was not conventional mild/minimal stimulations. Results Participants were categorized to three diverse populations as high responders, normal responders and poor responders according to basal antral follicle count. T-Gn in patients treated with CC/LE distinctly decreased from 2496.96 IU/d to 1827.68 IU/d, from 2860.28 IU/d to 2119.99 IU/d, and from 3182.15 IU/d to 1802.84 IU/d, respectively. For high ovary responders and normal responders, the OHSS incidence rate also declined from 29.2 to 4.3% (P < 0.001) and from 1.1 to 0.0% (P = 0.090). Other, there was no statistical difference with respect to the T-retrieved ova (total retrieved ova), high quality embryos, cultured blastocyst and blastocyst number in high responders. For normal responders and poor ovary responders, T-Gn, Gn days, T-retrieved ova, high quality embryos, cultured blastocyst and blastocysts number in oral medications group all apparently decreased. Clinical pregnancy rate per fresh cycle of poor responders with prior oral medications was significantly decreased (25.7% vs. 50.8%, P = 0.005), and no significant differences in high responders and normal responders were expressed (52.5% vs. 44.2%, P = 0.310; 51.9% vs. 42.4%, P = 0.163) between two groups of participants. The numbers of cumulative pregnancy rates were lower in the conventional group compared to the add group for high (75.90% versus 81.03%, P = 0.279), normal (62.69% versus 71.36%, P = 0.016) and poor (39.74% versus 68.21%, P < 0.001) responders. Conclusions The addition of CC/LE to the ovulation induction during IVF has certain efficacy in terms of low cost, low OHSS incidence. CC/LE deserves more recommendations as a responsible strategy in high responders due to advantageous pregnancy outcomes. For normal responders, the strategy needs to be considered with more comprehensive factors.

scholarly journals Impact of Body Mass Index on Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Among Polycystic Ovarian Syndrome Patients

2016 ◽  
Vol 39 (5) ◽  
pp. 1723-1734 ◽  
Author(s):  
Na Cui ◽  
Huixia Wang ◽  
Wei Wang ◽  
Jie Zhang ◽  
Yueming Xu ◽  
...  
Keyword(s):  
Body Mass Index ◽  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Intracytoplasmic Sperm Injection ◽  
Polycystic Ovarian Syndrome ◽  
Clinical Pregnancy ◽  
Miscarriage Rate ◽  
Vitro Fertilization ◽  
Ovarian Syndrome

Background: The aim of this study is to assess the effect of body mass index (BMI) on outcomes of in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) among polycystic ovarian syndrome (PCOS) and non-PCOS patients. Methods: This was a retrospective cohort study that was performed in the Second Hospital of Hebei Medical University. Patients who were under 35 years old were included in the study and were divided into four groups based on their BMI. The number of retrieved oocytes, implantation rate, clinical pregnancy rate, miscarriage rate and live births among PCOS and non-PCOS patients were compared between different BMIs. Results: IVF/ICSI pregnancies in obese PCOS women had a considerably higher risk of miscarriage and low rate of clinical pregnancy than in non-obese PCOS pregnancies. However, in non-PCOS patient, obesity significantly elevated miscarriage rate but did not affect clinical pregnancy rate. Conclusion: Obesity in PCOS patients led to poor outcomes of IVF/ICSI.

scholarly journals Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Alessio Paffoni ◽  
Marco Reschini ◽  
Valerio Pisaturo ◽  
Cristina Guarneri ◽  
Simone Palini ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Fertilization Failure ◽  
Vitro Fertilization ◽  
Rescue Icsi

Abstract Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

scholarly journals MicroRNA Expression Profiles Analysis in Sperm Reveals hsa-mir-191 is an Auspicious Omen of in Vitro Fertilization

2019 ◽  
Author(s):  
Hua Xu ◽  
Xin Wang ◽  
Zhikai Wang ◽  
Jianhui Li ◽  
Zhiming Xu ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Embryonic Development ◽  
Roc Curve ◽  
Small Rnas ◽  
Expression Profiles ◽  
High Quality ◽  
Vitro Fertilization ◽  
The Relationship ◽  
Early Human

Abstract Background: MicroRNAs (miRNAs) are a class of noncoding small RNAs that play important roles in many physiological processes by regulating gene expression. Previous studies have shown that the expression levels of total miRNAs increase during mouse embryonic development, and some miRNAs control the regulatory network in development progression. However, few studies have focused on the effects of miRNAs on early human embryonic development. The relationship between miRNAs and early human embryogenesis is still unknown. Results:In this study, RNA-seq data collected from sperm samples from 102 patients with a normal sperm index but treated with assisted reproductive technology (ART) were analyzed for the relationships between differentially expressed small RNAs and the fertilization rate (FR), blastocyst rate and high-quality embryo rate (HQER). The sperm samples with high hsa-mir-191 expression had a higher FR, effective embryo rate (EER) and HQER. hsa-mir-191 was used as a single indicator to predict the HQER. The receiver operating characteristic (ROC) curve had an area under the ROC curve (AUC) of 0.686. We also found that hsa-mir-191 expression is correlated with an abnormal sperm rate (cor = 0.29, p< 0.01). We also evaluated the relationship between hsa-mir-34c and early human embryo development in these 102 sperm samples and obtained negative results. Conclusions: These findings suggest that high hsa-mir-191-5p expression in sperm is associated with early human embryonic quality and that hsa-mir-191-5p could be used as a potential marker to screen high-quality sperm to improve the success rates of in vitro fertilization (IVF).

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