scholarly journals Chromosomal Analysis of 129 Miscarried Conceptuses: A Retrospective Study

Author(s):  
Juan Gui ◽  
Qian Liu ◽  
Xiaochen Wang ◽  
Qingzhen Xie ◽  
Lei Ming

Abstract Background Embryonic chromosomal abnormality is one of the significant causative factors of pregnancy loss. Our goal was to investigate the differences of chromosomal abnormality between different conception modes in miscarried products of conception (POCs). Methods A retrospective study included 129 miscarried POCs from 81 women undergoing assisted reproductive technology (ART) and 48 spontaneous pregnant (SP) women during March 2019 to March 2021 in Renmin Hospital of Wuhan University. Subgroups were divided according to age, fertilization method, types of embryo transfer. The profiles of cytogenetic abnormalities in the miscarried POCs were measured via next-generation sequencing. Results The total chromosomal abnormality rate was 65.1%. No significant difference was found in the rate of chromosomal abnormalities between ART and SP group (63% vs. 68.8%, P = 0.505). However, the rate of chromosomal structural abnormalities was significantly increased in ART group (P = 0.02). There was no significant difference in the rate of chromosomal abnormalities when stratified by age (62.9% vs. 71.9%, P = 0.355) and frequency of abortion (66.7% vs. 63.2%, P = 0.678). In the patients aged < 35 years, the ART group had more frequent structural abnormality than SP group (P = 0.006). In the patients aged ≥ 35 years, numerical chromosomal abnormality was predominated in both groups (P = 0.655). Compared with the IVF fertilization subgroup, microdeletion was more frequent in the ICSI fertilization subgroup (80% vs.28.6%, P = 0.013). The rate of chromosomal abnormality in the fresh embryo transfer group was significantly higher than that in the frozen embryo transfer group (92.3% vs.50%, P = 0.0001), especially the structural abnormality (46.2% vs. 15.4%, P = 0.016). Conclusion Chromosomal abnormality is the main cause of spontaneous abortion, whether in SP or in ART patients. The incidence of structural abnormalities in miscarried POCs from ART patients was significantly increased and fresh cycles had higher frequency of chromosomal abnormalities than the frozen cycles, hints us that “freezing all” should be considered in the process of assisted reproduction if encountered hyper ovarian stimulation, to avoid the negative effect of high estrogen environment on embryo development.

2016 ◽  
Vol 97 (4) ◽  
pp. 656-661
Author(s):  
M G Tukhbatullin ◽  
K V Yanakova

Aim. To study capabilities of quantitative elastographic study to assess the elasticity of the uterine cervix in women with a fetal chromosomal abnormality in the first trimester of pregnancy.Methods. 230 pregnant women of high-risk group at 11-13.6 weeks of pregnancy (parietal-coccygeal length 45-84 mm) were included in this study. The first group consisted of 213 women without fetal pathology. The second group included 17 women, in whose fetuses different chromosomal abnormalities were detected. In ultrasound examination of pregnant women in the I trimester of pregnancy, in addition to standard methods of examination, quantitative cervical elastography was performed.Results. According to results of quantitative elastography in 14 (82.35%) out of 17 pregnant women (second group) one or another degree of the cervical tissue softening was found, and 3 (17.64%) pregnant women with fetal chromosomal pathology had stiff cervix (all 3 cases with Down syndrome). In the control group in 10 (4.7%) of 213 pregnant women relatively soft cervix was identified, and in 203 (95.3%) women cervical density was higher than the myometrial density. A statistically significant difference between the indices of SWE-Ratio in groups was revealed. Quantitative elastography, as a diagnostic test predicting the risk of miscarriage due to chromosomal abnormalities, has a high sensitivity (84.38%) and even higher specificity (95.26%) of negative predictive value 97.57%.Conclusion. Quantitative elastography reveals a significant decrease in the cervical elasticity (softening) in pregnant women with fetal chromosomal abnormality in the I trimester of pregnancy, which allows us to recommend this method of ultrasound examination as an additional marker for early diagnosis of miscarriage due to fetal chromosomal abnormality.


2021 ◽  
Author(s):  
Hui Wang ◽  
Chang-hong Liu ◽  
Cui-fang Hao

Abstract The impact of the hysteroscopic features of chronic endometritis (CE) on pregnancy outcomes is unclear. This study explored whether the morphological features of CE on hysteroscopy were associated with in vitro fertilization (IVF) pregnancy outcomes. This retrospective study was conducted at Yantai Yuhuangding Hospital from 01/2017 to 09/2018. Infertile women who underwent hysteroscopy before IVF were grouped according to CE. To decrease confounding, a group of standardized patients was selected from the women enrolled in this study to compare pregnancy outcomes between the CE and non-CE groups. The outcomes were clinical pregnancy rate (CPR), live birth rate (LBR), miscarriage rate, and premature birth rate. In this study, 3280 women underwent IVF, and 3179 of these patients underwent hysteroscopy. In standardized patients, significant differences were found between the CE and non-CE groups in CPR (54.3% vs. 65.6%, P=0.02) and LBR (45.7% vs. 58.3%, P=0.012). In patients who underwent fresh embryo transfer, CPR differed among groups (P=0.002) and was highest in the hemorrhagic spots group (61.7%). In patients who underwent frozen embryo transfer (FET), CPR was higher in the CE group than in the non-CE group (54.7% vs. 43.0%, P<0.001), highest in the hemorrhagic spots group (70.6%, P=0.002) and lowest in the hyperemia combined with micropolyps group (39.4%, P=0.022). The only factor independently associated with CPR was hysteroscopic features of CE (odds ratio: 1.47, 95% confidence interval: 1.21–1.80, P<0.001). Hysteroscopic features of CE are associated with adverse pregnancy outcomes after IVF.


Author(s):  
Preksha T. Singh ◽  
Shreyans D. Singhvi ◽  
Utkarsh Kachhia ◽  
Trishala Punjabi ◽  
Shital Punjabi ◽  
...  

Background: Assisted reproductive technology (ART) cycles include in vitro fertilization of the sperm and ovum and transferring the embryo formed into the uterus of the patients. In ART cycles, there is still a shroud of doubt regarding the pregnancy outcomes of embryo transfer on day 3 versus the embryo transfers on day 5 as well the better pregnancy outcome with fresh versus frozen embryo transfer and the number of embryos transferred. This study is aimed to evaluate these factors and study the way to optimize methods to obtain highest pregnancy outcomes.Methods: A retrospective study was performed of 87 patients who had undergone embryo transfers during the duration of the study from an IVF centre in Ahmedabad. Multiple factors were studied and the clinical outcome was tabulated. The pregnancy outcomes were compared using the values of beta- hcg (human chorionic gonadotropin). The data was compiled and analyzed using Google spreadsheets. To find the statistical difference between different factors- the statistical method of Fischer’s exact test and p-value was used.Results: No statistical difference between day 3 and day 5 embryo transfer as well as between frozen and fresh embryo transfer were both. All of them were found equally efficacious, although 3 and 5 number of embryo transfers were found efficacious.Conclusions: In conclusion authors recommend a day 5 embryo transfer with 3 or 5 embryos which are best-quality frozen or fresh embryos to achieve maximum pregnancy outcomes.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Xitong Liu ◽  
Haiyan Bai ◽  
Ben W. Mol ◽  
Wenhao Shi ◽  
Ming Gao ◽  
...  

AbstractIt is unknown whether seasonal variation influences the outcome of in vitro fertilization (IVF). Previous studies related to seasonal variation of IVF were all small sample size, and the results were conflicting. We performed a retrospective cohort study evaluating the relationship between seasonal variability and live birth rate in the year of 2014–2017. Patients were grouped into four seasons (Winter (December-February), Spring (March-May), Summer (June-August), and Autumn (September-November)) according to the day of oocyte pick-up (OPU). Multivariate logistic regression analysis was performed to evaluate association between seasonal variation and live birth. Models were adjusted for covariates including temperature, sunshine hour, infertility type, infertility duration, infertility factor and BMI. In total 38,476 women were enrolled, of which 25,097 underwent fresh cycles, 13,379 were frozen embryo transfer. Live birth rates of fresh embryo transfer were 50.36%, 53.14%, 51.94% and 51.33% for spring, summer, autumn and winter, respectively. Clinical pregnancy rate between the calendar months varied between 55.1% and 63.4% in fresh embryo transfer (ET) and between 58.8% and 65.1% in frozen embryo transfer (FET) (P-values 0.073 and 0.220). In the unadjusted model and adjust model, seasonal variation was not associated with live birth. In conclusion, there was no significant difference of seasonal variations in the outcome of IVF with fresh embryo transfer and frozen embryo transfer.


2021 ◽  
Vol 7 (4) ◽  
pp. 1-12
Author(s):  
Salwa Fadhil ◽  
Mohammad Selman ◽  
Manal Al-Obaidi

Purpose: One of the reasons for failed implantation after transferring good quality embryos in an intracytoplasmic sperm injection cycle is the failure of creation a viscid layer between the embryo and the endometrium. Many modifications have been made in embryo transfer medium to improve implantation and increase pregnancy rates such as adding albumin as a source of energy and adding hyaluronic acid in high concentrations such as in Embryo Glue medium: a human embryo transfer medium. To investigate whether the use of Embryo Glue had any effect on clinical pregnancy rates in intracytoplasmic sperm injection-fresh embryo transfer cycles. Methods: A prospective study included one hundred and twenty-eight infertile Iraqi women who were selected and subjected to a stimulation protocol in an intracytoplasmic sperm injection-fresh embryo transfer cycle. All patients were considered to be eligible for embryo transfer (no visible causes could prevent implantation) and only good quality embryos were transferred to them. Those women were divided randomly into two groups according to type of embryo transfer medium: group A: Embryo Glue medium. group B: Conventional medium. Then group A was subdivided according to age into:  AI (34 women with age < 35 years and represented 50.7%) AII (33 women with age ≥ 35 years and represented 49.3%) While group B was subdivided into:  BI (41women with age < 35 years and represented 67.3%)  BII (20 women with age ≥ 35 years and represented 32.7%). Results: Although there was no significant difference between all groups in causes of infertility, the pregnancy rate was significantly higher in subgroup AII (18 pregnant from 33 women) while only 5 patients became pregnant from 20 patients in subgroup BII.  In all women no more than four good quality embryos were transferred, and when total number of transferred embryos was significantly more in group B than group A (P=0.013), the significant increase in pregnancy rates was only observed in subgroup AII (P=0.048). Even though a highly significant difference in number of repeated implantation failure was in group A than group B (P=0.027), the pregnancy rates were significantly higher in group A (P=0.038). Conclusion: This study concluded that using Embryo Glue has a beneficial effect on old women and increase pregnancy rates, also it has a positive effect on pregnancy rates in repeated implantation failure and increases pregnancy rates even if the women is old.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253389
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Emma Norrman ◽  
Christina Bergh ◽  
Ulla-Britt Wennerholm ◽  
Max Petzold

The goal is to examine the risk of conception mode-type-1 diabetes using different survival analysis modelling approaches and examine if there are differentials in the risk of type-1 diabetes between children from fresh and frozen-thawed embryo transfers. We aimed to compare the performances and fitness of different survival analysis regression models with the Cox proportional hazard (CPH) model used in an earlier study. The effect of conception modes and other prognostic factors on type-1 diabetes among children conceived either spontaneously or by assisted reproductive technology (ART) and its sub-groups was modelled in the earlier study. We used the information on all singleton children from the Swedish Medical Birth Register hosted by the Swedish National Board of Health and Welfare, 1985 to 2015. The main explanatory variable was the mode of conception. We applied the CPH, parametric and flexible parametric survival regression (FPSR) models to the data at 5% significance level. Loglikelihood, Akaike and Bayesian information criteria were used to assess model fit. Among the 3,138,540 singletons, 47,938 (1.5%) were conceived through ART (11,211 frozen-thawed transfer and 36,727 fresh embryo transfer). In total, 18,118 (0.58%) of the children had type-1 diabetes, higher among (0.58%) those conceived spontaneously than the ART-conceived (0.42%). The median (Interquartile range (IQR)) age at onset of type-1 diabetes among spontaneously conceived children was 10 (14–6) years, 8(5–12) for ART, 6 (4–10) years for frozen-thawed embryo transfer and 9 (5–12) years for fresh embryo transfer. The estimates from the CPH, FPSR and parametric PH models are similar. There was no significant difference in the risk of type-1 diabetes among ART- and spontaneously conceived children; FPSR: (adjusted Hazard Ratio (aHR) = 1.070; 95% Confidence Interval (CI):0.929–1.232, p = 0.346) vs CPH: (aHR = 1.068; 95%CI: 0.927–1.230, p = 0.361). A sub-analysis showed that the adjusted hazard of type-1 diabetes was 37% (aHR = 1.368; 95%CI: 1.013–1.847, p = 0.041) higher among children from frozen-thawed embryo transfer than among children from spontaneous conception. The hazard of type-1 diabetes was higher among children whose mothers do not smoke (aHR = 1.296; 95%CI:1.240–1.354, p<0.001) and of diabetic mothers (aHR = 6.419; 95%CI:5.852–7.041, p<0.001) and fathers (aHR = 8.808; 95%CI:8.221–9.437, p<0.001). The estimates from the CPH, parametric models and the FPSR model were close. This is an indication that the models performed similarly and any of them can be used to model the data. We couldn’t establish that ART increases the risk of type-1 diabetes except when it is subdivided into its two subtypes. There is evidence of a greater risk of type-1 diabetes when conception is through frozen-thawed transfer.


2004 ◽  
Vol 16 (2) ◽  
pp. 208
Author(s):  
J. Catt ◽  
T. Wood ◽  
M. Henman ◽  
R. Jansen

Improvements in human IVF have led to increased pregnancy rates but at the expense of increasing twinning rates. Twins are a bad outcome for the offspring, parents and the healthcare system. An obvious solution to this is to transfer only one embryo and freeze the rest for potential further treatment. This study looked at the effect of doing this on the cumulative live birth rate (when the cryopreserved embryos were thawed and transferred). Patients less than 38 years of age presenting for IVF treatment and with more than two embryos suitable for transfer were offered the chance of transferring only one embryo (elective single embryo transfer, eSET) and freezing the rest. Those patients declining a single embryo transfer had two transferred and served as the controls. Patients not achieving a pregnancy returned for a frozen embryo transfer but were not restricted on the number transferred (to a maximum of two). Cumulative live birth rates were recorded over the ensuing two years. Statistical comparisons were made using paired chi-square tests. The live birth rates from the initial fresh transfer was 41% for eSET (41/111) and significantly higher (53%, P&lt;0.05) for the two-embryo transfer group. These differences were eliminated when the frozen embryos were factored in, both groups rising to 61% of patients treated (68 and 172 live births, respectively). The twinning rate was significantly reduced (P&lt;0.01) from 33% in the two-embryo transfer group to 6% (arising from 4 sets of twins in the frozen embryo transfers) in the eSET group. eSET in the fresh embryo transfer cycle does not affect the chances of a live birth and reduces the twinning rate at least fivefold. Currently, 70% of patients under the age of 38 are electing to have eSET.


2021 ◽  
Author(s):  
Fariba Seyedoshohadaei ◽  
Yasamin Honarbakhsh ◽  
Azra Allahveisi ◽  
Masoumeh Rezaei ◽  
Mohammad Jafar Rezaie ◽  
...  

Abstract Purpose The purpose of this retrospective cohort study was to compare fertility rates of fresh versus frozen embryo transfer in antagonist IVF cycles. Methods This cohort study was performed on 105 patients referred to the infertility clinic of Besat Hospital in Sanandaj. These patients were admitted to this infertility clinic from March 2014 to March 2020. Inclusion criteria were infertile couples treated with antagonistic IVF cycle. In this study, we compared the fertility rate in antagonist IVF cycles in two patient groups, the group that fresh embryo was transferred, vs the group that received frozen-thawed embryo. Data collected during this study from both groups were analyzed and compared using SPSS statistical software. Results In this study, out of 105 patients included in the project, 48 were in the fresh embryo transfer group, and 57 were in the frozen embryo transfer group. The rate of chemical pregnancy was 12 (25%) in the fresh group and 15 (26.3%) in the frozen group (P: 0.878); The clinical pregnancy rate was 11 (22.9%) in the fresh group and 11 (19.3%) in the frozen group (P: 0.650); The rate of abortion in the fresh group was 3 (6.3%), and in the frozen group was 8 (14%) (P: 0.194); and live birth rate was 9 (18.8%) in fresh group, compared with 7 (12.3%) in the frozen group (P: 0.358). Conclusion The difference in rate of chemical pregnancy, clinical pregnancy, abortion, and live birth in antagonistic IVF cycles in the two groups of fresh embryo transfer versus frozen embryo transfer is not statistically significant. Although not statistically significant, the percentage of chemical pregnancy was higher in the frozen embryo transfer group. The percentage of abortion was also higher in the frozen embryo transfer group, and the percentage of clinical pregnancy and live birth were higher in fresh embryo transfer group.


Author(s):  
Akiko Konishi ◽  
Osamu Samura ◽  
Jin Muromoto ◽  
Yoko Okamoto ◽  
Hironori Takahashi ◽  
...  

AbstractThe incidence of chromosomal abnormalities in twin pregnancies is not well-studied. In this retrospective study, we investigated the frequency of chromosomal abnormalities in twin pregnancies and compared the incidence of chromosomal abnormalities in dichorionic diamniotic (DD) and monochorionic diamniotic (MD) twins. We used data from 57 clinical facilities across Japan. Twin pregnancies of more than 12 weeks of gestation managed between January 2016 and December 2018 were included in the study. A total of 2899 and 1908 cases of DD and MD twins, respectively, were reported, and the incidence of chromosomal abnormalities in one or both fetuses was 0.9% (25/2899) and 0.2% (4/1908) in each group (p = 0.004). In this study, the most common chromosomal abnormality was trisomy 21 (51.7% [15/29]), followed by trisomy 18 (13.8% [4/29]) and trisomy 13 (6.9% [2/29]). The incidence of trisomy 21 in MD twins was lower than that in DD twins (0.05% vs. 0.5%, p = 0.007). Trisomy 21 was less common in MD twins, even when compared with the expected incidence in singletons (0.05% vs. 0.3%, RR 0.15 [95% CI 0.04–0.68]). The risk of chromosomal abnormality decreases in twin pregnancies, especially in MD twins.


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