scholarly journals Comparison of the Pregnancy and Neonatal Outcomes of ICSI Performed With Frozen Versus Fresh TESA Sperm in Patients With Obstructive Azoospermia: a Retrospective Study

2021 ◽  
Author(s):  
Shenghao Wu ◽  
Weiting Xia ◽  
Xin-Xin Xu ◽  
Yanhong Wu ◽  
Yangyang Hu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnancy Rate ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Implantation Rate ◽  
Obstructive Azoospermia ◽  
Sex Ratio At Birth ◽  
Testicular Sperm ◽  
Miscarriage Rate ◽  
Multiple Pregnancy Rate

Abstract BackgroundIt is commonly believed that using frozen sperms after TESA was effective for OA patients. Nevertheless, scholars are worried about the prognosis of ICSI with frozen testicular sperm. In this study, we aim to compare the pregnancy and neonatal outcomes of ICSI using cryopreserved versus fresh spermatozoa collected by TESA.MethodsA total of 317 cases of OA patients treated with ICSI in a university affiliated hospital from January 2016 to December 2020 were included in this retrospective study, and they were divided into two groups according to the sperm used for ICSI: Frozen sperm group (N=154) and Fresh sperm group(N=163). The outcomes were measured by the following indicators: Two pronucleus (2PN) fertilization rate, 2PN cleavage rate, high-quality blastocyst rate, average number of embryos transferred, implantation rate, clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, preterm birth rate, live birth rate (LBR) , sex ratio at birth (male) and average newborn birth weight.ResultsThe present data showed no statistically significant difference in 2PN fertilization rates, 2PN cleavage rates, high-quality blastocyst rates and the average number of embryos transferred in the two groups. Similarly, no difference was found in implantation rate, clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, premature delivery rate, LBR and sex ratio at birth (P>0.05). The average newborn birth weight was similar in the two groups (2932.61±728.40 vs 3100.32±515.64) (P>0.05), but there was a higher incidence of Low-Birth-Weight newborn in the frozen group (20.91% vs 8.49%)(P<0.05). ConclusionsAs for men with obstructive azoospermia, the use of frozen testicular sperm by TESA was efficient. There was a similar pregnancy outcome of ICSI using frozen or fresh spermatozoa collected by TESA. However, it may lead to higher incidence of newborns of low birth weight, which needs further research based on larger samples.

scholarly journals The Feasibility of All-Blastocyst-Culture and Single Blastocyst Transfer Strategy in Elderly Women: A Retrospective Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Weijue Su ◽  
Jialing Xu ◽  
Samuel Kofi Arhin ◽  
Chang Liu ◽  
Junzhao Zhao ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Blastocyst Transfer ◽  
Miscarriage Rate ◽  
Blastocyst Culture ◽  
Single Blastocyst Transfer ◽  
In Pregnancy ◽  
Multiple Pregnancy Rate

Objective. To investigate the feasibility and clinical outcome of the all-blastocyst-culture and single blastocyst transfer strategy in women aged ≥35 years. Methods. A retrospective analysis of patients aged ≥35 years undergoing IVF/ICSI was performed from January 2017 to April 2019 in the reproductive center of the Second Affiliated Hospital of Wenzhou Medical University. A total of 155 cases treated with ovarian hyperstimulation by prolonged protocol and implemented single (84 cases) or double (71 cases) blastocyst transfer were collected. Then, patients were further divided into <38 yr. group and ≥38 yr. group, and the laboratory and clinical outcomes were compared between the groups. Results. The double-blastocyst-transfer (DBT) group showed higher clinical pregnancy rate and multiple pregnancy rate and lower neonatal birth weight than those in the single-blastocyst-transfer (SBT) group (P<0.05). However, there were no statistically significant differences between the groups in the embryo implantation rate, biochemical pregnancy rate, miscarriage rate, preterm delivery rate, and term birth rate. For patients<38 yr., SBT significantly reduced the multiple pregnancy rate and increased the neonate birth weight without significant reduction in the clinical pregnancy rate. While in the ≥38 yr. group, there are no differences in pregnancy outcomes between SBT and DBT. Logistic regression analysis showed that the number of MII oocytes was positively correlated with the live birth rate (OR=1.18) and negatively correlated with the miscarriage rate (OR=0.844), suggesting that elderly patients with relatively normal ovarian reserve would obtain better prospect in pregnancy. The number of fetal heart beat in pregnancy was negatively correlated with the live birth rate (OR=0.322) and positively correlated with the preterm birth rate (OR=7.16). Conclusion. The strategy of all-blastocyst-culture and single blastocyst transfer is feasible, safe, and effective for elderly patients with normal ovarian reserve, which would reduce the multiple pregnancy rate.

scholarly journals Controlled Ovarian Stimulation Should Not Be Recommended for Male Infertility Treated With IUI

2020 ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  
Keyword(s):  
Male Infertility ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Abortion Rate ◽  
Clinical Pregnancy ◽  
Ovulatory Follicles ◽  
Multiple Pregnancy Rate

Abstract Background: Some studies stated that intra-uterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the chance of pregnancy, while others suggested that IUI in natural cycle (NC) should be the treatment of first choice. Whether it is necessary to use COS at the same time, when IUI is applied to treat male infertility solely? There is still no consensus.Objective: To investigate the efficacy of IUI with COS in male infertility solely?Methods: 544 IUI cycles from 280 couples who sought medical care for male infertility from January 2010 to February 2019 were divided into two groups: group NC-IUI and group COS-IUI. Besides, the COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (1 follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The outcome of IUI, including clinical pregnancy rate, live birth rate, spontaneous abortion rate, ectopic pregnancy rate and multiple pregnancy rate were compared.Results: The clinical pregnancy rate, live birth rate, early spontaneous abortion rate, and ectopic pregnancy rate were comparable between NC-IUI group and COS-IUI group. Similar results were observed among NC-IUI group, 1 follicle group and ≥ 2 follicles group. However, when it comes to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared that in the NC-IUI group (10.5% (2/19) vs. 0 (0/42), P=0.093), furthermore, a significant difference was found between NC-IUI group and ≥ 2 follicles group (0 vs. 20%, P =0.034).Conclusion: For male infertility, since in cycles with COS, especially in those with at least two pre-ovulatory follicles cycles, the multiple pregnancy rate increased without substantial gain in overall pregnancy rate, COS in IUI should not be recommended. If COS is required, one stimulated follicle and one health baby should be the goal considering the safety both for mothers and fetuses.

scholarly journals Office hysteroscopy prior to ART cycle-analysis and outcome at a private IVF clinic setup in Surat, Gujarat, India

2017 ◽  
Vol 6 (2) ◽  
pp. 611
Author(s):  
Meeta Mohan Mahale ◽  
Purnima Kishore Nadkarni ◽  
Kishore Mohan Nadkarni ◽  
Pooja Prabhakar Singh ◽  
Aditi Akshay Nadkarni ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Pregnancy Rate ◽  
Multiple Pregnancy ◽  
Uterine Cavity ◽  
Standard Test ◽  
Office Hysteroscopy ◽  
Miscarriage Rate ◽  
Infertile Women ◽  
Diagnostic Hysteroscopy ◽  
Multiple Pregnancy Rate

Background: Hysteroscopy is a gold standard test for assessing the uterine cavity. The presence of uterine pathology may negatively affect the chance of implantation .This study investigated the use of routine office hysteroscopy and correction of any intrauterine pathologies prior to starting IVF cycle on treatment outcome in women seeking IVF treatment for primary infertility and recurrent implantation failure.Methods: This was a retrospective study of 100 women who attended our infertility clinic from July 2016 to December 2016 and who were willing for office hysteroscopy. The main outcomes measured were clinical pregnancy rates achieved in the index IVF cycle, multiple pregnancy rate, ectopic pregnancy rate, miscarriage rate and failure rate.Results: Of the 100 patients who participated in the study, 75 patients conceived, 25 patients failed to conceive. 80.64% patients with normal findings on diagnostic hysteroscopy conceived after the procedure, 58.33% patients conceived after polypectomy, 68.42% conceived after septal resection, 71.42% conceived after adhesiolysis, 50% conceived after lateral metroplasty and 73.07% of recurrent implantation failure conceived after local endometrial injury was done on hysteroscopy.Conclusions: Hysteroscopy in infertile women prior to their IVF cycle when performed atleast 3 months in advance could improve treatment outcome.

scholarly journals CARTR Plus: the creation of an ART registry in Canada

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
A Lanes ◽  
DB Fell ◽  
M Teitelbaum ◽  
AE Sprague ◽  
M Johnson ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Birth Outcomes ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Fertility Treatment ◽  
Live Births ◽  
Multiple Pregnancy Rate

Abstract STUDY QUESTION What is the status of fertility treatment and birth outcomes documented over the first 6 years of the Canadian Assisted Reproductive Technologies Register (CARTR) Plus registry? SUMMARY ANSWER The CARTR Plus registry is a robust database containing comprehensive Canadian fertility treatment data to assist with providing evidence-based rationale for clinical practice change. WHAT IS KNOWN ALREADY The rate of infertility is increasing globally and having data on fertility treatment cycles and outcomes at a population level is important for accurately documenting and effecting changes in clinical practice. STUDY DESIGN, SIZE, DURATION This is a descriptive manuscript of 183 739 fertility treatment cycles from 36 Canadian clinics over 6 years from the CARTR Plus registry. PARTICIPANTS/MATERIALS, SETTING, METHODS Canadian ART treatment cycles from 2013 through 2018 were included. This manuscript described trends in type of fertility treatment cycles, pregnancy rates, multiple pregnancy rates, primary transfer rates and birth outcomes. MAIN RESULTS AND THE ROLE OF CHANCE Over the 6 years of the CARTR Plus registry, the number of treatment cycles performed ranged from less than 200 to greater than 1000 per clinic. Patient age and the underlying cause of infertility were two of the most variable characteristics across clinics. Similar clinical pregnancy rates were found among IVF and frozen embryo transfer (FET) cycles with own oocytes (38.9 and 39.7% per embryo transfer cycle, respectively). Fertility treatment cycles that used donor oocytes had a higher clinical pregnancy rate among IVF cycles compared with FET cycles (54.9 and 39.8% per embryo transfer cycle, respectively). The multiple pregnancy rate was 7.4% per ongoing clinical pregnancy in 2018, which reflected a decreasing trend across the study period. Between 2013 and 2017, there were 31 811 pregnancies that had live births from all ART treatment cycles, which corresponded to a live birth rate of 21.4% per cycle start and 89.1% of these pregnancies were singleton live births. The low multiple pregnancy rate and high singleton birth rate are associated with the increase in single embryo transfers. LIMITATIONS, REASONS FOR CAUTION There is potential for misclassification of data, which is present in all administrative health databases. WIDER IMPLICATIONS OF THE FINDINGS The CARTR Plus registry is a robust resource for ART data in Canada. It provides easily accessible aggregated data for Canadian fertility clinics, and it contains data that are internationally comparable. STUDY FUNDING/COMPETING INTEREST(S) There was no funding provided for this study. The authors have no competing interests to declare.

scholarly journals Intracytoplasmic sperm injection with fresh versus cryopreserved testicular sperm in azoospermic patients

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Kani M. Falah
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Obstructive Azoospermia ◽  
Testicular Sperm

Abstract Background The purpose of this study is to compare the outcome of intracytoplasmic sperm injection (ICSI) using fresh sperm versus frozen-thawed sperm in both obstructed and non-obstructed azoospermias. This retrospective study included 159 ICSI cycles from 126 couples. In 91 obstructed azoospermia cases, 66 cycles were treated with fresh testicular sperm and 25 cycles were treated with frozen-thawed testicular samples. In 68 non-obstructed azoospermia cases, 32 cycles were treated with fresh testicular sperm and 36 cycles were treated with frozen-thawed testicular sperm, and the main measure and outcomes calculated are fertilization rate, clinical pregnancy, and live birth rate. Results In case of obstructed azoospermia, there were no statistically significant differences between fresh sperm and frozen-thawed testicular sperm used for ICSI regarding fertilization rate, clinical pregnancy rate, and live birth rate as shown (57%, 47%, 0.093 p value; 23.7%, 17.4%, 0.54 p value; and 11.9%, 8.7%, 0.68 p value, respectively). Non-obstructed azoospermia cases also show no significant differences in fertilization rate (37%, 36%, 0.91 p value), clinical pregnancy rate (20%, 14.3%, 0.58 p value), and live birth rate (4%, 3.6%, 0.93 p value). Conclusion Cryopreservation of testicular sperm is reliable if carried out before ovulation induction especially in cases with non-obstructive azoospermia

scholarly journals Incidence of multiple births in relation to current regulations in Turkey regarding embryo transfer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Semra Kahraman ◽  
Ipek Nur Balin Duzguner ◽  
Soner Duzguner ◽  
Yucel Sahin ◽  
Cihat Sen
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Blastocyst Transfer ◽  
Routine Practice ◽  
Significant Difference ◽  
Multiple Pregnancy Rate

Abstract Background Before 2010, there were no regulations in Turkey regarding the number of embryos to be transferred in one cycle. In March 2010, regulations restricting this number were implemented by the Turkish Ministry of Health. These specify the transfer of a maximum of one embryo in the first and second cycles and a maximum of two embryos in subsequent cycles in women aged < 35, and a maximum of two embryos in women aged ≥35 in any one cycle. Our study evaluates the effect of these regulations. Methods This large retrospective single center study first evaluates the incidence of multiple pregnancies before and after the implementation of the 2010 regulations. Secondly, it compares the clinical outcomes of double blastocyst transfer (DBT) and single blastocyst transfer (SBT) performed in compliance with these regulations from 2014 onwards. Results After the introduction of the 2010 regulations, the multiple pregnancy rate decreased significantly from 37.9 to 15.7%. The singleton live birth rate increased significantly, whereas multıiple live birth rates significantly decreased (p = < 0.001). When the clinical outcomes of SBT and DBT performed in compliance with regulations from 2014 onwards were evaluated, in patients < 35 years, the multiple pregnancy rate decreased from 47.2% in the DBT group to 1.7% in the SBT group (p = < 0.001). In patients ≥35 years, in the DBT group, the twin birth rate was again high at 28.4%, whereas in the SBT group, it was only 1.8% (p = < 0.001). Importantly, there was no statistically significant difference in clinical pregnancy rates between these two groups. Conclusion Turkish regulations have led to an encouragement of double embryo transfer (DET) as a routine practice, with many patients understanding it as an absolute right to have two embryos transferred. The results of our study suggest that, especially in the light of the success of blastocyst transfer, the Turkish regulations should be amended to limit the use of DET and encourage the use of single embryo transfer except in exceptional cases and particularly in women under 35 years old.

Effects of fifth day (D5) or sixth day (D6) frozen–thawed blastocysts on neonatal outcomes

Zygote ◽  
2016 ◽  
Vol 24 (5) ◽  
pp. 684-691 ◽  
Author(s):  
Xue Wang ◽  
Jingran Zhen ◽  
Zhengyi Sun ◽  
Qi Yu ◽  
Chengyan Deng ◽  
...  
Keyword(s):  
Birth Weight ◽  
Sex Ratio ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Neonatal Outcomes ◽  
The Difference

SummaryThis study aimed to compare the neonatal outcomes of transplanted fifth day (D5) or sixth day (D6) frozen–thawed blastocysts, aiming to provide guidance when choosing blastocyst recovery methods. The clinical data of 1109 patients that were performed for recovered blastocyst transplantation, as well as the data of 515 patients who had already delivered were analyzed retrospectively. The patients were divided into single- or twins-birth groups according to blastocyst formation time (D5 or D6) and the number of fetus(es). The implantation rate, clinical pregnancy rate and live birth rate of the D5 group were all significantly higher than those in the D6 group (P < 0.05), and the biochemical pregnancy rate in the D5 group was significantly lower than that in the D6 group (P = 0.049). Other factors, including birth weight, birth length, incidence of low birth weight and sex ratio, differed between the D5 and D6 groups, but the difference was not statistically significant (P > 0.05). In conclusion, the implantation rate, clinical pregnancy rate and live birth rate in the D5 group were all significantly higher than that in the D6 group. The birth weight at D6 was prone to be heavier no matter the birth group, and the sex ratio in the D5 group was higher than that at D6, the difference in neonatal outcomes between the two groups was not statistically significant.

scholarly journals The effects of different post-thawed culture periods on clinical outcomes in frozen embryo transfer cycle: a retrospective study

2021 ◽  
Author(s):  
Yuhu Li ◽  
Xuexiang Cai ◽  
Bo Ma ◽  
Ning LI ◽  
liuguang zhang
Keyword(s):  
Retrospective Study ◽  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Low Birthweight ◽  
Multiple Pregnancy ◽  
Implantation Rate ◽  
Live Birth Rate

Objective To evaluate the effects of different post-thawed culture periods on the clinical outcomes Design A retrospective study. Setting Two IVF centers. Population Women undergoing first cleavage-stage embryo transfer in frozen-thawed cycles. Methods 9832 FET cycles were divided into three groups according to female age: < 35, 35-39 and > 39 years, and two groups depending on post-thawed culture period: short and long culture groups. The long culture group divided into three groups depending on blastomere growth number: ≤ 2, one ≤ 2 and the other > 2, and > 2 groups. Main Outcome Measures Implantation rate (IR), clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), live birth rate (LBR) and neonatal characteristics. Results Long post-thawed culture caused a significant increase in the IR, CPR, MPR and LBR (P/CI = 0.002/1.034-1.162, 0.027/1.011-1.194, 0.028/1.014-1.255 and 0.001/1.054-1.245 respectively), and blastomere growth number had a significant effect on IR, CPR, MPR and LBR (P = 0.000, 0.000, 0.000 and 0.000 respectively). No significant differences were present in neonatal characteristics between the two post-thawed culture groups. Singleton group had a higher average gestational age and birthweight as well as a lower cesarean section rate, preterm labor rate and low birthweight rate. Conclusions Long post-thawed culture was associated with higher IR, CPR, MPR and LBR, and transferring a well-developed embryo after long post-thawed culture might be a viable embryo transfer strategy to decrease MPR while maintaining CPR and LBR. Funding None Keywords Post-thawed culture, blastomere growth, neonatal characteristics, live birth rate.

Increased pregnancy outcome after day 5 versus day 6 transfers of human vitrified-warmed blastocysts

Zygote ◽  
2019 ◽  
Vol 27 (05) ◽  
pp. 279-284 ◽  
Author(s):  
Romualdo Sciorio ◽  
K.J. Thong ◽  
Susan J. Pickering
Keyword(s):  
Pregnancy Rate ◽  
Multiple Pregnancy ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Royal Infirmary ◽  
Assisted Conception ◽  
Single Blastocyst Transfer ◽  
Significant Difference ◽  
Multiple Pregnancy Rate

SummaryVitrification is a highly efficient technique for the cryopreservation of the human embryo. The effect of delayed blastulation may be responsible for implantation failures and negatively affects in vitro fertilization (IVF) outcomes. The current literature displays discordant results; some studies have announced higher pregnancy rates after day 5 (D5) transfer compared with day 6 (D6) transfer, while others have shown equivalent outcomes. In the present study an investigation into the clinical implications of delayed blastulation (D5 versus D6) was carried out. We performed a retrospective study comparing clinical pregnancies and implantation rates following warmed single blastocyst transfer (WSBT). All patients coming for a programmed warmed transfer at Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, were included in this study and divided in two groups according to the day of blastocyst vitrification: D5 (n = 1563) and D6 (n = 517). The overall survival rate was 95.0% (1976/2080) with no significant difference between the D5 and D6 groups: 95.3% (1489/1563) and 94.2% (487/517) respectively. WSBT of D6 blastocysts resulted in a lower implantation and clinical pregnancy compared with D5 embryos. The implantation rate (IPR) and clinical pregnancy rate (CPR) were respectively 49.4% and 42.6% for the D5 and 37.4% and 32.2% for the D6 embryos, which was statistically significant. The multiple pregnancy rate was 1.32% (1.14% for D5 vs 1.84% for D6). Although the transfer of D6 vitrified-warmed blastocyst remains a reasonable option, priority to a D5 embryo would reduce the time to successful pregnancy.

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