scholarly journals Association Between Gestational Trophoblastic Disease (GTD) History and Clinical Outcomes in in Vitro Fertilization/intracytoplasmic Sperm Injection (IVF/ICSI) Cycles

2021 ◽  
Author(s):  
Xinyu Cai ◽  
Mei Zhang ◽  
Chenyang Huang ◽  
Yue Jiang ◽  
Jidong Zhou ◽  
...  
Keyword(s):  
Live Birth ◽  
Gestational Age ◽  
Live Birth Rate ◽  
Gestational Trophoblastic Disease ◽  
Control Group ◽  
Vitro Fertilization ◽  
Gestational Age At Delivery ◽  
History Of ◽  
And Control

Abstract Background: Gestational trophoblastic disease (GTD) usually affects young women of childbearing age. After treatment for GTD, 86% of women wish to achieve pregnancy. On account of the impacts of GTD and treatments as well as patient anxiety, large numbers of couples turn to assisted reproductive technology (ART), especially in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). But few studies have investigated whether a history of GTD affects the outcomes of IVF/ICSI in secondary infertile patients and how it occurs. We investigate whether a history of GTD affects the IVF/ICSI outcomes and the live birth rates in women with secondary infertility.Methods: This retrospective cohort study enrolled 176 women with secondary infertility who underwent IVF/ICSI treatment at the reproductive medical center of Nanjing Drum Tower Hospital from January 1, 2016, to December 31, 2020. Participants were divided into the GTD group (44 women with GTD history) and control group (132 women without GTD history matched from 8318 secondary infertile women ). The control group and the study group were matched at a ratio of 3:1 according to patient age, infertility duration, number of cycles and body mass index (BMI). We assessed retrieved oocytes and high-grade embryos, biochemical pregnancy, miscarriage, ectopic pregnancy, gestational age at delivery, delivery mode and live birth rates.Result(s): We found a significantly reduced live-birth rate (34.1% vs 66.7%) associated with IVF/ICSI cycles in patients with a GTD history compared to those without a GTD history. The biochemical pregnancy and miscarriage rates of the GTD group were slightly higher than those of the control group. In addition, there was a difference in gestational age at delivery between the GTD and control groups (p<0.001) but no differences in the mode of delivery (p=0.267). Furthermore, the number of abandoned embryos in the GTD group was greater than that in the control group (p=0.018), and the number of good-quality embryos was less than that in the control group (p=0.019). The endometrial thickness was thinner (p<0.001) in the GTD group. Immunohistochemistry (IHC) showed abnormal endometrial receptivity in the GTD group.Conclusion(s): The GTD history of patients undergoing IVF/ICSI cycles had an impact on the live-birth rate and gestational age at delivery, which might result from the thinner endometrium and abnormal endometrial receptivity before embryo transfer.

scholarly journals Caesarean section defects may affect pregnancy outcomes after in vitro fertilization-embryo transfer: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junrong Diao ◽  
Ge Gao ◽  
Yunshan Zhang ◽  
Xinyan Wang ◽  
Yinfeng Zhang ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Vitro Fertilization ◽  
Biochemical Pregnancy ◽  
History Of

Abstract Background Caesarean section rates are rising worldwide. One adverse effect of caesarean section reported in some studies is an increased risk of subfertility. Only a few studies have assessed the relationship between the previous mode of delivery and in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) reproductive outcomes. In this study, we primarily investigated the impact of a history of caesarean section with or without defects on IVF/ICSI-ET outcomes compared to a vaginal delivery history. Methods This retrospective study included 834 women who had a IVF or ICSI treatment at our centre between 2015 and 2019 with a delivery history. In total, 401 women with a previous vaginal delivery (VD) were assigned to the VD group, and 433 women with a history of delivery by caesarean section were included, among whom 359 had a caesarean scar (CS) without a defect and were assigned to the CS group and 74 had a caesarean section defect (CSD) and were assigned to the CSD group. Baseline characteristics of the three groups were compared and analysed. Binary logistic regression analyses were performed to explore the association between clinical outcomes and different delivery modes. Results There were no significant differences in the live birth rate, biochemical pregnancy rate, clinical pregnancy rate, mean implantation rate or abnormal pregnancy rate between the CS and VD groups However, the live birth rate and mean implantation rate in the CSD group were significantly lower than those in the VD group (21.6 vs 36.4%, adjusted OR 0.50 [0.27–0.9]; 0.25 ± 0.39 vs 0.35 ± 0.41, adjusted OR 0.90 [0.81–0.99]). Among women aged ≤ 35 years, the subgroup analyses showed that the live birth rate, biochemical pregnancy rate, clinical pregnancy rate, and mean implantation rate in the CSD group were all significantly lower than those in the VD group (21.4 vs 45.8%, adjusted OR 0.35[0.15 ~ 0.85]; 38.1 vs 59.8%, adjusted OR 0.52[0.24–0.82]; 31.0 vs 55.6%, adjusted OR 0.43[0.19–0.92]; 0.27 ± 0.43 vs 0.43 ± 0.43, adjusted OR 0.85[0.43 ± 0.43]). For women older than 35 years, there was no statistically significant difference in any pregnancy outcome among the three groups. Conclusions This study suggested that the existence of a CS without a defect does not decrease the live birth rate after IVF or ICSI compared with a previous VD. However, the presence of a CSD in women, especially young women (age ≤ 35 years), significantly impaired the chances of subsequent pregnancy.

scholarly journals Endometriosis Lowers the Cumulative Live Birth Rates in IVF by Decreasing the Number of Embryos but Not Their Quality

2020 ◽  
Vol 9 (8) ◽  
pp. 2478
Author(s):  
Lisa Boucret ◽  
Pierre-Emmanuel Bouet ◽  
Jérémie Riou ◽  
Guillaume Legendre ◽  
Léa Delbos ◽  
...  
Keyword(s):  
Live Birth ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Control Group ◽  
Birth Rates ◽  
Vitro Fertilization ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
The Impact

Endometriosis and infertility are closely linked, but the underlying mechanisms are still poorly understood. This study aimed to evaluate the impact of endometriosis on in vitro fertilization (IVF) parameters, especially on embryo quality and IVF outcomes. A total of 1124 cycles with intracytoplasmic sperm injection were retrospectively evaluated, including 155 cycles with endometriosis and 969 cycles without endometriosis. Women with endometriosis had significantly lower ovarian reserve markers (AMH and AFC), regardless of previous ovarian surgery. Despite receiving significantly higher doses of exogenous gonadotropins, they had significantly fewer oocytes, mature oocytes, embryos, and top-quality embryos than women in the control group. Multivariate analysis did not reveal any association between endometriosis and the proportion of top-quality embryo (OR = 0.87; 95% CI [0.66–1.12]; p = 0.3). The implantation rate and the live birth rate per cycle were comparable between the two groups (p = 0.05), but the cumulative live births rate was significantly lower in in the endometriosis group (32.1% versus 50.7%, p = 0.001), as a consequence of the lower number of frozen embryos. In conclusion, endometriosis lowers the cumulative live birth rates by decreasing the number of embryos available to transfer, but not their quality.

scholarly journals Live Birth Rate After Transfer of Fresh or Frozen Poor Quality Day-3 Embryos Only

2019 ◽  
Vol 01 (04) ◽  
pp. 161-168
Author(s):  
Lan N. Vuong ◽  
Toan D. Pham ◽  
Bao G. Huynh ◽  
Quynh N. Nguyen ◽  
Tuong M. Ho ◽  
...  
Keyword(s):  
Live Birth ◽  
Birth Rate ◽  
Current Knowledge ◽  
Live Birth Rate ◽  
Poor Quality ◽  
Successful Outcome ◽  
Control Group ◽  
Vitro Fertilization ◽  
Day 3 Embryos

Background: Embryo quality is an important predictor of successful outcome in in vitro fertilization (IVF). However, current knowledge on the live birth rate after transfer of poor quality embryos is limited. This study investigated the live birth rate after transfer of only poor quality day-3 embryos in women undergoing IVF. Methods: This retrospective study included 153 couples who underwent IVF at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam between June 2014 and January 2017 and had only poor quality day-3 embryos available for fresh (n [Formula: see text] 102) or frozen (n [Formula: see text] 51) transfer. The control group included patients who had transfer of one good embryo (n [Formula: see text] 64). Embryos were rated using the Istanbul criteria. Results: In the poor quality embryo group, the mean number of oocytes retrieved and number of embryos were 7.5 ± 4.4 and 1.8 ± 0.9, respectively. Mean number of embryos transferred was 1.6 ± 0.5 in the fresh transfer group and 2.0 ± 0.2 in the freeze-only group. Live births did occur after transfer of poor quality embryos, but the implantation, clinical pregnancy and live birth rates were significantly lower than after fresh or frozen transfer of a single good quality embryo (9.5 vs. 26.6%, p < 0.001; 13.7 vs. 26.6%, p < 0.001; and 7.2 vs. 18.8%, p [Formula: see text] 0.02, respectively). Conclusions: Live birth was achieved after transfer of only poor quality embryos in women undergoing IVF. This suggests that transfer of poor quality embryos could be an option when higher grade embryos are not available, after the chances of live birth have been discussed with the patient.

scholarly journals Features of establishment of early lactation in women who gave birth after in vitro fertilization

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Samchuk ◽  
Y Rozalieva ◽  
A Gil
Keyword(s):  
Medical Personnel ◽  
Placental Lactogen ◽  
Control Group ◽  
Early Lactation ◽  
Vitro Fertilization ◽  
Hormonal Function ◽  
History Of ◽  
Placental Hormone ◽  
And Control

Abstract Background Breastfeeding gives babies the best possible start in life and breastmilk works like a baby’s first vaccine. Pregnancy resulting from IVF is often associated with placental insufficiency in which the hormone-producing function of placenta can be compromised that may result in reduced lactogenesis. The aim was to study the emergence of early lactation after IVF in women with a history of infertility. Methods The study involved 34 women after IVF with a singleton full-term pregnancy with a history of tubal-peritoneal infertility. Control group comprised of 47 women with naturally occurred pregnancy. Delivery occurred naturally. All women were assessed for hormonal function of placenta for a period of 16-18, 28-32, and 37-38 weeks of pregnancy. The average daily amount of milk on a 5th day after delivery was measured. Results In the IVF group vs. control group there was a decrease in the production of hormones by the placenta (progesterone, estriol, placental lactogen) preparing the mammary glands for lactation (p &lt; 0.05). At gestational age of 16-18 weeks progesterone level in IVF group was 172.2±10.72 nmol/l; 28-32: 274.2±8.45 nmol/l; 37-38 weeks: 343.2±9,1 nmol/l. The level of estriol at 16-18 weeks was 2.87±1.42 ng/ml; 28-32: 10.94±0.6 ng/ml; 37-38 weeks: 25.21±0.22 ng/ml. Placental lactogen at16-18 weeks: 1.15±0.2 nmol/l; 28-32: 6.39±0.69 nmol/l; 37-38 weeks: 7.23±0.59 nmol/l. On day 5 normal lactation was observed in 21(62%) and 43(91.5%) women in IVF and control group, respectively (p &lt; 0.05). Conclusions Increased number of cases of hypolactation was observed in women after IVF, which was associated with decrease in the hormonal function of placenta. Women who have given birth to children after IVF require special attention from the side of medical personnel and from loved ones in the early stages of establishment of breastfeeding. Key messages IVF is a risk factor for hypolactation, which is associated with placental hormone-producing insufficiency. Women who have given birth after IVF require support aimed at promotion of early lactation and breastfeeding.

THE RISK FACTORS OF MOLAR PREGNANCY

2017 ◽  
pp. 53-58
Author(s):  
Lam Huong Le
Keyword(s):  
High Risk ◽  
Gestational Trophoblastic Disease ◽  
Living Standard ◽  
Control Group ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Health It ◽  
Pregnancy Risk ◽  
History Of ◽  
And Control

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead. Aim: To assess the risks of molar pregnancy. Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital. Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage. Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy. Key words: Molar pregnancy, pregnancy women

Growth and Development of Children Conceived by In Vitro Fertilization

PEDIATRICS ◽  
1992 ◽  
Vol 90 (3) ◽  
pp. 424-429
Author(s):  
Joseph M. Brandes ◽  
Joseph Itzkovits ◽  
Anat Scher ◽  
Miriam Sarid ◽  
Israel Thaler ◽  
...  
Keyword(s):  
Birth Weight ◽  
In Vitro Fertilization ◽  
Gestational Age ◽  
Head Circumference ◽  
Healthy Population ◽  
Control Groups ◽  
Vitro Fertilization ◽  
General Physical ◽  
And Control

To assess the physical and mental development of infants born after in vitro fertilization (IVF), we performed a general physical and developmental examination (Bayley and Stanford-Binet scales) on a cohort of 116 IVF children, conceived and born at our institution between February 1985 and March 1989, and on 116 non-IVF matched controls. Study and control groups were each composed of 66 singletons, 19 pairs of twins and 4 sets of triplets, whose age at examination ranged from 12 to 45 months. The developmental indices of IVF infants were within the normal range and did not differ from those of their matched controls. The indices were positively correlated to gestational age, birth weight, head circumference at birth and at examination, and mother's education. Mean birth weight, gestational age, and birth weight percentile of IVF infants were lower than the mean of the healthy population. Mean percentiles of weight and length at examination (mean age 22.4 months) were equally low but did not differ from those of the matched controls. However, mean percentiles of head circumference at birth and at examination compare well with the normal mean, both in IVF and control groups. Twins and triplets (IVF and controls) had significantly lower physical and mental indices as compared to singletons.

scholarly journals The effectiveness of collaborative infertility counseling (CIC) on pregnancy outcome in infertile women undergoing in vitro fertilization: A randomized controlled trial

2019 ◽  
Author(s):  
Mahboobeh Rasoulzadeh Bidgoli ◽  
robab latifnejad roudsari ◽  
ali montazeri
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Treatment Success ◽  
Intervention Group ◽  
Control Group ◽  
Vitro Fertilization ◽  
Infertile Women ◽  
Significant Difference ◽  
And Control

Abstract Background: Infertility is an emotional tension which influences the whole aspects of relationships in infertile couples. A main objective of infertility treatments is elevation of pregnancy rate. The present study aimed to examine the effect of collaborative counseling on pregnancy rate in infertile women, undergoing in vitro fertilization in Mashhad, Iran. Methods: In this clinical trial, 60 women with primary infertility were selected from an infertility research center and were randomly allocated into intervention (n=29) and control (n=31) groups. The intervention group received individual counseling, based on the collaborative reproductive healthcare model with collaboration of a midwife, a gynecologist and a clinical psychologist in five sessions during a two-month period. The control group received routine care. Positive pregnancy test was considered as a criterion of treatment success at the end of the study. Data were analyzed using statistical tests including independent samples t-test. Results: There was no significant difference in pregnancy rate between intervention and control groups (P = 0.298). Also, there were no significant differences in follicle and embryo numbers between two groups. However, a significant difference was observed between two groups in terms of oocyte numbers where the intervention group had more oocyte (P = 0.014). Conclusion: Overall the findings indicated that the collaborative infertility counseling did not improve treatment success in infertile women undergoing in vitro fertilization

O-107 Searching for the optimal number of oocytes to reach a life birth following in vitro fertilization: a systematic review with meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Sermondade ◽  
C Sonigo ◽  
M Pasquier ◽  
N Yata-Ahdad ◽  
E Fraison ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Continuous Increase ◽  
Vitro Fertilization ◽  
The Relationship

Abstract Study question To investigate the relationship between the number of oocytes and both the live birth rate after fresh embryo transfer and the cumulative live birth rate. Summary answer Above a 15-oocyte threshold, live birth rate (LBR) following fresh transfer plateaus, whereas a continuous increase in cumulative live birth rate (CLBR) is observed. What is known already Several lines of evidence indicate that number of oocytes represents a key point for in vitro fertilization (IVF) success. However, consensus is lacking regarding the optimal number of oocytes for expecting a live birth. This is a key question because it might impact the way practitioners initiate and adjust COS regimens. Study design, size, duration A systematic review and meta-analysis was performed. MEDLINE, EMBASE, and Cochrane Library were searched for studies published between January 01, 2004, and August 31, 2019 using the search terms: “(intracytoplasmic sperm injection or icsi or ivf or in vitro fertilization or fertility preservation)” and “(oocyte and number)” and “(live birth)”. Participants/materials, setting, methods Two independent reviewers carried out study selection, quality assessment using the adapted Newcastle-Ottawa Quality Assessment Scales, bias assessment using ROBIN-1 tools, and data extraction according to Cochrane methods. Independent analyses were performed according to the outcome (LBR and CLBR). The mean-weighted threshold of optimal oocyte number was estimated from documented thresholds, followed by a one-stage meta-analysis on articles with documented or estimable relative risks. Main results and the role of chance After reviewing 843 records, 64 full-text articles were assessed for eligibility. A total of 36 studies were available for quantitative syntheses. Twenty-one and 18 studies were included in the meta-analyses evaluating the relationship between the number of retrieved oocytes and LBR or CLBR, respectively. Given the limited number of investigations considering mature oocytes, association between the number of metaphase II oocytes and IVF outcomes could not be investigated. Concerning LBR, 7 (35.0%) studies reported a plateau effect, corresponding to a weighted mean of 14.4 oocytes. The pooled dose-response association between the number of oocytes and LBR showed a non-linear relationship, with a plateau beyond 15 oocytes. For CLBR, 4 (19.0%) studies showed a plateau effect, corresponding to a weighted mean of 19.3 oocytes. The meta-analysis of the relationship between the number of oocytes and CLBR found a non-linear relationship, with a continuous increase in CLBR, including for high oocyte yields. Limitations, reasons for caution Statistical models show a high degree of deviance, especially for high numbers of oocytes. Further investigations are needed to assess the generalization of those results to frozen mature oocytes, especially in a fertility preservation context, and to evaluate the impact of female age. Wider implications of the findings Above a 15-oocyte threshold, LBR following fresh transfer plateaus, suggesting that the freeze-all strategy should probably be performed. In contrast, the continuous increase in CLBR suggests that high numbers of oocytes could be offered to improve the chances of cumulative live births, after evaluating the benefit–risk balance. Trial registration number Not applicable

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