scholarly journals Outcomes of Different Treatments for Hydrosalpinx Undergoing in Vitro Fertilization and Embryo Transfer: A Retrospective Study with a Follow-Up of 5 Years

2021 ◽  
Author(s):  
Beibei Bi ◽  
Xiao Han ◽  
Wei Dai ◽  
Lanlan Fang ◽  
Hao Shi ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Freeze Thaw ◽  
Tubal Occlusion ◽  
Proximal Tubal Occlusion

Abstract Background: Except for laparoscopic surgery (salpingectomy or proximal tubal occlusion/ligation), there are also some other common treatments used for hydrosalpinx before IVF such as ultrasonic-guided hydrosalpinx aspiration, hysteroscopic tubal occlusion etc. More evidence is needed to give advice for clinicians on the most effective treatment for hydrosalpinx undergoing IVF-ET.Methods: We reviewed 936 women with hydrosalpinx and 6715 tubal infertile women without hydrosalpinx who underwent IVF/ICSI between January 2014 and August 2019 in our center. Hydrosalpinx patients received different treatments including laparoscopic surgery (only salpingectomy and proximal tubal occlusion/ligation were included), ultrasonic-guided aspiration and hysteroscopic tubal occlusion. Patients received laparoscopic surgery (salpingectomy or proximal tubal occlusion/ligation) before fresh cycles or freeze-thaw embryo transfer cycles. Ultrasonic-guided aspiration was conducted during oocyte retrieval procedure in fresh cycles. Hysteroscopic tubal occlusion was conducted before freeze-thaw embryo transfer cycles. Outcomes were analyzed by One-way ANOVA, Chi-Square test and logistic regression.Results: The live birth rate (LBR) of laparoscopic surgery (salpingectomy or proximal tubal occlusion/ligation) was significantly higher compared with hydrosalpinx aspiration (48.3% vs 39.6%, P=0.024). The cumulative live birth rate (CLBR) of subsequent laparoscopic surgery was significantly higher compared with subsequent hysteroscopic occlusion (65.1% vs 34.1%, P=0.001) and no subsequent treatment (65.1% vs 44.9%, P＜0.005). Subsequent laparoscopic surgery (salpingectomy or proximal tubal occlusion/ligation) significantly improved the CLBR of hydrosalpinx patients who received ultrasonic-guided aspiration and didn't get clinical pregnancy in fresh cycles (Oddis Ratio (OR) =1.875; 95%CI=1.041-3.378, P=0.036).Conclusions: Laparoscopic surgery (salpingectomy or proximal tubal occlusion/ligation) leads to significantly higher LBR than ultrasonic-guided aspiration and significantly higher CLBR than hysteroscopic occlusion and no treatment.

scholarly journals Cumulative live birth rate after up to three consecutive embryo transfer cycles in women with poor ovarian response

2020 ◽  
Vol 47 (2) ◽  
pp. 135-139
Author(s):  
Se Jeong Kim ◽  
Dayong Lee ◽  
Seul Ki Kim ◽  
Byung Chul Jee ◽  
Seok Hyun Kim
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Ovarian Response ◽  
Rank Test ◽  
Poor Ovarian Response ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth

Objective: In the present study, we aimed to retrospectively evaluate the cumulative live birth rate (LBR) after up to three consecutive embryo transfer (ET) cycles, either fresh or frozen, in women with expected poor ovarian response (ePOR). Methods: We selected 115 women who entered the first <i>in vitro</i> fertilization (IVF) cycle between August 2013 and July 2016. The women were divided into an ePOR group (37 women) and a non-ePOR group (78 women). All women in the ePOR group were ≥40 years old or had serum anti-Müllerian hormone levels of less than 1.1 ng/mL at the time of the first IVF cycle. Live birth outcomes were monitored until December 2017. The cumulative LBR (with both conservative and optimistic estimates) was calculated according to the serial number of ET cycles. Results: After up to three ET cycles, the overall cumulative LBR was significantly lower in the ePOR group than in the non-ePOR group (conservative estimate, 10.8% vs. 44.9%, respectively; optimistic estimate, 14.7% vs. 56.1%, respectively; log-rank test, <i>p</i>=0.003). Conclusion: Women with ePOR exhibited a lower cumulative LBR than women in the non-ePOR group, and this information should be provided to ePOR women during counseling before starting IVF.

scholarly journals Fresh versus frozen single embryo transfer in Chinese women of advanced age undergoing IVF/ICSI: a study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Miaoxin Chen ◽  
Yuanyuan Wu ◽  
Xin Huang ◽  
Wenqiang Liu ◽  
Wentao Li ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Controlled Trial ◽  
Live Birth Rate ◽  
Advanced Age ◽  
Cumulative Live Birth Rate ◽  
Fresh Embryo Transfer ◽  
Randomized Controlled

Abstract Background: Elective frozen cleavage embryo transfer resulted in significantly higher live birth rate in patients with polycystic ovary syndrome but not in ovulatory women compared with fresh embryo transfer. Further, elective single frozen blastocyst transfer had significantly higher live birth rate in ovulatory women compared with single fresh blastocyst transfer. However, it is unknown whether single frozen cleavage embryo transfer results in higher cumulative live birth rate in women of advanced age undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). The aim of this study is to compare the effectiveness of frozen cleavage embryo transfer with fresh cleavage embryo transfer in Chinese women of advanced age. Methods: This study is a double-blind randomized controlled clinical trial (1:1 treatment ratio of frozen embryo transfer vs. fresh embryo transfer). A total of 840 women of advanced age with normal ovarian reserve undergoing the first cycle of IVF or ICSI will be enrolled and randomized into two parallel groups. Participants in group A will undergo frozen single cleavage embryo transfer, and participants in group B will undergo fresh single cleavage embryo transfer. The primary outcome is the cumulative live birth rate of the trial IVF/ICSI cycle within 12 months after randomization. This study is powered to detect an absolute difference of 8% (23% vs 15%) at the significance level of 0.05 and 80% statistical power based on a two-sided test. Discussion: The results of this study will provide evidence for the efficacy and safety of frozen cleavage embryo transfer compared with fresh cleavage embryo transfer in women of advanced age undergoing IVF/ICSI. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000029330. Registered on 25 Jan 2020. Keywords: Frozen embryo transfer, advanced age, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), live birth, randomized controlled trial.

scholarly journals Comparing the cumulative live birth rate of cleavage-stage versus blastocyst-stage embryo transfers between IVF cycles: a study protocol for a multicentre randomised controlled superiority trial (the ToF trial)

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042395
Author(s):  
Simone Cornelisse ◽  
Liliana Ramos ◽  
Brigitte Arends ◽  
Janneke J Brink-van der Vlugt ◽  
Jan Peter de Bruin ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Oocyte Retrieval ◽  
Blastocyst Stage ◽  
Cleavage Stage ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Superiority Trial

IntroductionIn vitro fertilisation (IVF) has evolved as an intervention of choice to help couples with infertility to conceive. In the last decade, a strategy change in the day of embryo transfer has been developed. Many IVF centres choose nowadays to transfer at later stages of embryo development, for example, transferring embryos at blastocyst stage instead of cleavage stage. However, it still is not known which embryo transfer policy in IVF is more efficient in terms of cumulative live birth rate (cLBR), following a fresh and the subsequent frozen–thawed transfers after one oocyte retrieval. Furthermore, studies reporting on obstetric and neonatal outcomes from both transfer policies are limited.Methods and analysisWe have set up a multicentre randomised superiority trial in the Netherlands, named the Three or Fivetrial. We plan to include 1200 women with an indication for IVF with at least four embryos available on day 2 after the oocyte retrieval. Women are randomly allocated to either (1) control group: embryo transfer on day 3 and cryopreservation of supernumerary good-quality embryos on day 3 or 4, or (2) intervention group: embryo transfer on day 5 and cryopreservation of supernumerary good-quality embryos on day 5 or 6. The primary outcome is the cLBR per oocyte retrieval. Secondary outcomes include LBR following fresh transfer, multiple pregnancy rate and time until pregnancy leading a live birth. We will also assess the obstetric and neonatal outcomes, costs and patients’ treatment burden.Ethics and disseminationThe study protocol has been approved by the Central Committee on Research involving Human Subjects in the Netherlands in June 2018 (CCMO NL 64060.000.18). The results of this trial will be submitted for publication in international peer-reviewed and in open access journals.Trial registration numberNetherlands Trial Register (NL 6857).

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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