Pregnancy outcomes in female patients with X chromosome mosaicism after the first IVF/ICSI treatment: A 6-year retrospective cohort study

Objective: The present study focused on the clinical pregnancy and cumulative live birth rate (CLBR) of female patients with X chromosome mosaicism (XM) after the first in-vitro-fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment, and the possible impact of different mosaic subtypes. Design: Retrospective cohort study Setting: Single Center study Population: Infertility couples Methods: In total, 76 couples with XM female partners and normal male partners were included (2014–2019) as the X group, with another 76 couples with normal karyotype included as the control group. Subgroup X1 included 41 45,X/46,XX cases, Subgroup X2 included 22 47,XXX/46,XX cases, and Subgroup X3 included 12 45,X/47,XXX/46,XX cases. Main Outcome Measures: The ovarian stimulation, embryo results and pregnancy outcomes were analyzed. Results: The X group presented similar CLBR but required a higher total gonadotropin (Gn) dosage than the control group (1800 IU vs. 1612 IU). Following subgroup analysis, the number of follicles during oocyte retrieval and average number of fertilized oocytes was lower in subgroup X1 than in X3. The clinical pregnancy rate and CLBR were similar in all groups. Conclusion: Females with XM may present a similar CLBR until one year after oocyte retrieval, but may require a higher total Gn dosage. Females with 45,X cells may recover fewer follicles during oocyte retrieval, resulting in fewer embryos. A higher 45,X cell ratio (over 5%) may lead to a lower CBLR. Funding: This study was supported by the Ministry of Science and Technology of China (2016YFC1000602). Keywords X chromosome mosaicism, IVF/ICSI outcome, cumulative live birth rate

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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 ◽

10.1136/bmjopen-2020-042395 ◽

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).

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Does Ovarian Endometriosis Increase Oocyte Sensitivity to ICSI-Induced Mechanical Damage?

Journal of Clinical Medicine ◽

10.3390/jcm10081757 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1757

Author(s):

Carlotta Scarafia ◽

Martina Masciovecchio ◽

Stefano Canosa ◽

Andrea Roberto Carosso ◽

Gianluca Gennarelli ◽

...

Keyword(s):

Pregnancy Rate ◽

Birth Rate ◽

Detrimental Effect ◽

Mechanical Damage ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Cumulative Live Birth Rate ◽

Ovarian Endometriosis ◽

Cumulative Live Birth

Some studies have shown that ICSI obtains poorer results than conventional IVF in women with ovarian endometriosis, suggesting that oocytes could be sensitive to ICSI-induced mechanical damage. The aims of this study were to clarify (a) whether ovarian endometriosis could induce peculiar fragility in the oocyte, so that ICSI would finally result harmful, and (b) whether endometrioma removal before IVF could be advisable in order to avoid any hypothetical detrimental effect. We retrospectively studied 368 women, 203 with in situ endometrioma (128 of which underwent ICSI, 75 conventional IVF) and 164 who received laparoscopic stripping of endometrioma before ICSI. For women with in situ endometrioma, cIVF and ICSI outcome was comparable for all parameters studied, including the clinical pregnancy rate per embryo transfer (PR/ET: 31.8% vs. 39.5% in the cIVF and ICSI groups) and cumulative live birth rate per ovum pick-up (CLBR/OPU: 24.4% vs. 27.7%). ICSI outcome was similar comparing women with in situ endometrioma and women previously submitted to laparoscopic stripping of cysts (CLPR/OPU 27.7% vs. 25.3%). Our findings suggest that (a) in women with in situ endometrioma ICSI may be performed, when needed, without harming oocytes and compromising the outcome and (b) that there is no advantage in removing endometrioma before ICSI.

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Ovarian Endometrioma Negatively Impacts Oocyte Quality and Quantity But Not Pregnancy Outcomes in Women Undergoing IVF/ICSI Treatment: A Retrospective Cohort Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.739228 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yaoqiu Wu ◽

Rong Yang ◽

Jie Lan ◽

Haiyan Lin ◽

Xuedan Jiao ◽

...

Keyword(s):

Live Birth ◽

Pregnancy Outcomes ◽

Birth Rate ◽

Live Birth Rate ◽

Oocyte Quality ◽

Cumulative Live Birth Rate ◽

Fertilization Rates ◽

Cumulative Live Birth ◽

Ovarian Endometrioma ◽

Per Se

PurposeTo determine the impact of ovarian endometrioma per se on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes.MethodsThis retrospective study was conducted using two groups. The endometrioma group consisted of 862 women with infertility who had ovarian endometriomas and underwent their first ovarian stimulation for IVF/ICSI treatment between January 2011 to December 2019 at a public university hospital. A non-endometrioma comparison group, comprising 862 women with other infertility factors, was matched according to maternal age, body mass index (BMI), and infertility duration. Ovarian reserve and response and IVF/ICSI and pregnancy outcomes between the two groups were analyzed. Multivariate logistic regression (MLR) analysis was conducted on the basis of clinical covariates assessed for their association with live birth.ResultsThe results showed that significantly lower antral follicle count (AFC), anti-Müllerian hormone (AMH), ovarian sensitivity index (OSI), oocyte maturation and fertilization rates, blastocyst rate, number of oocytes retrieved, and available embryos were found in women with endometrioma compared with the control, respectively (P < 0.05). The cumulative live birth rate per patient in women with endometrioma was lower than that of women without endometrioma (39.32% vs. 46.87%, P = 0.002). In women with endometrioma, those who underwent surgical intervention prior to IVF/ICSI treatment had higher maturation (86.03% vs. 83.42%, P = 0.003), fertilization (78.16% vs. 74.93%, P = 0.004), and top-quality embryo rates (42.94% vs. 39.93%, P = 0.097) but had fewer oocytes retrieved (8.01 ± 5.70 vs. 9.12 ± 6.69, P = 0.013) than women without surgery. However, live birth rates were comparable between women with endometrioma and women in the control group, regardless of whether they had a prior history of ovarian surgery. MLR analysis showed no correlation between endometrioma per se and live birth after being adjusted for number of top-quality embryos transferred and stage of embryo transfer.ConclusionsThe data from this study supported the conclusion that ovarian endometrioma negatively impacts oocyte quality and quantity, but not overall pregnancy outcomes, in women undergoing IVF/ICSI treatment. Endometrioma lowers the cumulative live birth rate by decreasing the number of embryos. Surgical excision of endometrioma prior to IVF/ICSI can partly improve oocyte maturation and fertilization rates but not pregnancy outcomes.

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IVF and ICSI outcomes of female patients with X chromosome mosaicism: A 5-year retrospective cohort study

10.21203/rs.3.rs-27374/v1 ◽

2020 ◽

Author(s):

Shanshan Liang ◽

Jianzhi Yang ◽

Haixia Wu ◽

Shiyi Xiong ◽

Ming Guo ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

X Chromosome ◽

Oocyte Retrieval ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Control Group ◽

Miscarriage Rate ◽

Fresh Embryo Transfer ◽

Chromosome Mosaicism

Abstract BackgroundThis study focused on the assisted reproductive treatment (ART) outcomes of female patients with X chromosome mosaicism (XM), who underwent their first IVF/ICSI and day 2 or day3 fresh embryo transfer, and the possible impacts of the different mosaic types.Results78 couples with XM female and normal male were included as the X group. 78 couples with normal karyotype were included as the control group. Subgroup X1 included 41 45,X/46,XX cases, Subgroup X2 included 23 47,XXX/46,XX cases, and Subgroup X3 included 13 45,X/47,XXX/46,XX cases. With similar female age and similar body mass index (BMI), the X group had higher total gonadotropin (Gn) dosage than the control group (1800 IU VS 1612 IU). In subgroup analysis, the follical number during oocyte retrieval was less in subgroup X1 than that in X2 or X3. The fertilization rate was lower in subgroup X1 than that in subgroup X2. The utilization rate was higher in subgroup X2 than that in subgroup X3. The implantation rate, clinical pregnancy rate, and miscarriage rate before 12 weeks' gestation were similar in all groups.ConclusionsFemale with 45,X cell line may face higher Gn dosage, less follical number during oocyte retrieval and fewer embryos. But female with X chromosome mosaicism may have similar clinical pregnancy rate and miscarriage rate after fresh embryo transfer.

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Dual Trigger for Final Follicular Maturation Improves Cumulative Live-Birth Rate in Ovarian Stimulation for Freeze-All In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles

Frontiers in Endocrinology ◽

10.3389/fendo.2021.708247 ◽

2021 ◽

Vol 12 ◽

Author(s):

Haiyan Zhu ◽

Chenqiong Zhao ◽

Yibin Pan ◽

Hanjing Zhou ◽

Xiaoying Jin ◽

...

Keyword(s):

Pregnancy Rate ◽

Live Birth ◽

Birth Rate ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Cumulative Live Birth Rate ◽

Cumulative Live Birth ◽

Hcg Trigger

Study QuestionDoes dual trigger in freeze-all in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles improve the cumulative live-birth outcome compared with human chorionic gonadotropin (hCG) trigger?Summary AnswerDual trigger for final follicular maturation improves the cumulative pregnancy and live-birth rates compared with hCG trigger in freeze-all IVF/ICSI cycles.What Is Known AlreadyDual trigger could increase the numbers of oocytes and mature oocytes and improve pregnancy rates.Study Design, Size, DurationThis retrospective cohort analysis included data from 4438 freeze-all IVF/ICSI cycles between January 2012 and December 2017.Participants/Materials, Setting, MethodsWomen aged 20−49 years who underwent ovarian stimulation and oocyte retrieval for autologous IVF/ICSI with a freeze-all policy in our centre were enrolled. Data on number of oocytes retrieved, number of mature oocytes, clinical pregnancy rate, live-birth rate, cumulative pregnancy rate, and cumulative live-birth rate (CLBR) were assessed and compared between patients who underwent a dual trigger and hCG trigger. Multivariate logistic regression was performed to identify and adjust for factors known to independently affect the CLBR.Main Results and the Role of ChanceA total of 4438 IVF/ICSI cycles were analyzed, including 1445 cycles with single hCG trigger and 2993 cycles with dual trigger. The cumulative biochemical pregnancy rate (60.8% vs. 68.1%, P<0.001; odds ratio (OR): 0.727; 95% confidence interval (CI): 0.638–0.828), cumulative clinical pregnancy rate (52.9% vs. 58.5%, P<0.001; OR: 0.796; 95%CI: 0.701–0.903), and CLBR (44.3% vs. 50.5%, P<0.001; OR: 0.781; 95%CI: 0.688–10.886) were all significantly lower in the hCG-trigger group compared with the dual-trigger group. The clinical pregnancy rate (48.2% vs. 58.2%, P=0.002; OR: 0.829; 95%CI: 0.737–0.934) and embryo implantation rate (34.4% vs. 38.9%, P<0.001; OR: 0.823; 95%CI: 0.750–0.903) in each transfer cycle were also significantly lower in the hCG-trigger group compared with the dual-trigger group. After controlling for all potential confounding variables, the trigger method was identified as an independent factor affecting the CLBR. The OR and 95%CI for hCG trigger were 0.780 and 0.641–0.949 (P=0.013).Limitations, Reasons for CautionThe data used to analyse the effect of dual trigger on cumulative pregnancy and live-birth outcomes were retrospective, and the results may thus have been subject to inherent biases. Further prospective randomized controlled trials are required to verify the beneficial effects of dual trigger.Wider Implications of the FindingsDual trigger had a positive effect on CLBRs, suggesting that it could be used as a routine trigger method in freeze-all cycles.Study Funding/Competing Interest(s)This study was supported by grants from National Key Research and Development Program of China (2018YFC1004800), the Natural Science Program of Zhejiang (LY19H040009), the National Natural Science Foundation of China (No. 81601236). No authors have competing interests to declare.

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P–606 A second stimulation in the same ovarian cycle rescues advanced-maternal-age patients obtaining ≤ 3 blastocysts after the conventional approach by preventing treatment-discontinuation

Human Reproduction ◽

10.1093/humrep/deab130.605 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

A Vaiarelli ◽

D Cimadomo ◽

S Colamaria ◽

M Giuliani ◽

C Argento ◽

...

Keyword(s):

Live Birth ◽

Maternal Age ◽

Birth Rate ◽

Live Birth Rate ◽

Advanced Maternal Age ◽

Ovarian Cycle ◽

Treatment Discontinuation ◽

Control Group ◽

Cumulative Live Birth Rate ◽

Cumulative Live Birth

Abstract Study question Is double stimulation in the same ovarian cycle (DuoStim) a valuable strategy to rescue advanced-maternal-age patients obtaining ≤ 3 blastocysts for chromosomal-testing after conventional stimulation? Summary answer DuoStim is effective to prevent treatment discontinuation thereby increasing the 1-year cumulative-live-birth-rate among advanced-maternal-age patients obtaining 0–3 blastocysts after a first conventional stimulation. What is known already Folliculogenesis is characterized by continuous waves of follicular growth. DuoStim approach exploits these dynamics to conduct two stimulations in a single ovarian cycle and improve the prognosis of advanced-maternal-age and/or reduced-ovarian-reserve women. Independent groups worldwide successfully adopted DuoStim with various regimens reporting similar oocyte/embryo competence after both stimulations. Recently, we have demonstrated the fruitful adoption of DuoStim in patients fulfilling the Bologna criteria, especially because of the prevention of treatment discontinuation. Here we aimed at investigating whether DuoStim can be adopted to rescue poor prognosis patients obtaining 0–3 blastocysts after the conventional approach. Study design, size, duration Proof-of-concept matched case-control study. All patients obtaining 0–3 blastocysts after conventional-stimulation between 2015–2018 were proposed DuoStim. The 143 couples who accepted were matched for maternal age, sperm factor, cumulus-oocyte-complexes and blastocysts obtained after the first stimulation to 143 couples who did not. The primary outcome was the 1-year cumulative-live-birth-rate. If not delivering, the control group had 1 year to undergo a second attempt with conventional-stimulation. All treatments were concluded (live-birth achieved or no euploid left). Participants/materials, setting, methods Only GnRH-antagonist with recombinant-gonadotrophins and agonist trigger stimulation protocols were adopted. All cycles entailed ICSI with ejaculated sperm, blastocyst culture, trophectoderm biopsy, comprehensive-chromosome-testing and vitrified-warmed euploid single-embryo-transfer(s). Cumulative-live-birth-rate was calculated per patient considering both stimulations in the same ovarian cycle (DuoStim group) or up to two stimulations in 1 year (control group). Treatment discontinuation rate in the control group was calculated as patients who did not return for a second stimulation among non-pregnant ones. Main results and the role of chance Among the 286 couples included (41.0±2.9yr;4.9±3.1 cumulus-oocytes-complexes and 0.8±0.9 blastocysts), 126 (63 per group), 98 (49 per group), 52 (26 per group) and 10 (5 per group) obtained 0,1,2 and 3 blastocysts after the first stimulation, respectively. The cumulative-live-birth-rate was 9% in the control group after the first attempt (N = 13/143). Among the 130 non-pregnant patients, only 12 returned within 1-year (165±95days later;discontinuation rate=118/130,91%), and 3 delivered. Thus, the cumulative-live-birth-rate from two stimulations in 1-year was 11% (N = 16/143). In the DuoStim group, the cumulative-live-birth-rate was 24% (N = 35/143; Fisher’s-exact-test< 0.01,power=80%). The odds-ratio of delivering in the DuoStim versus the control group adjusted for all matching criteria was 3.3,95%CI:1.6–7.0,p<0.01. This difference (0%,22%,15% and 20% in the control versus 10%,31%,46% and 40% in the DuoStim group among patients obtaining 0,1,2 and 3 blastocysts at the first stimulation, respectively) is mainly due to treatment discontinuation in the control group (98%,65%,77% and 80% among patients obtaining 0,1,2 and 3 blastocysts at the first stimulation, respectively) and the further increased maternal age at the time of second retrieval (∼6 months). Notably, 2 patients delivered 2 live-births after DuoStim (none in the control) and 14 patients with a live-birth have euploid blastocysts left (2 in the control). Limitations, reasons for caution Randomized-controlled-trials and cost-effectiveness analyses are desirable to confirm these data. Moreover, 75% of the patients included were >39yr and 44% obtained no blastocyst after the first stimulation. Therefore future studies among younger women and/or more women obtaining ≥1 blastocyst are advisable to set reasonable cut-off values to apply this strategy. Wider implications of the findings: A second stimulation in the same ovarian cycle might be envisioned as a rescue strategy for poor IVF outcomes after a first stimulation, so to prevent treatment discontinuation and increase the cumulative-live-birth-rate. This is feasible since 6–7 days span the first and the second stimulation in the DuoStim protocol. Trial registration number none

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Oocyte Degeneration After ICSI Is Not an Indicator of Live Birth in Young Women

Frontiers in Endocrinology ◽

10.3389/fendo.2021.705733 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xiaokun Hu ◽

Yuliang Liu ◽

Xiubing Zhang ◽

Pingyin Lee ◽

Yangxing Wen ◽

...

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Young Women ◽

Birth Rate ◽

Implantation Rate ◽

Live Birth Rate ◽

Oocyte Quality ◽

Clinical Pregnancy ◽

Cumulative Live Birth Rate ◽

Cumulative Live Birth

IntroductionIntracytoplasmic sperm injection (ICSI) was introduced in 1990s as one of the most dramatic breakthroughs in assisted reproductive technology. Even with advances in ICSI technology, this mechanical micromanipulation carries a 5 to 19% risk of oocyte degeneration. Whether the presence of oocyte degeneration reflects the sibling oocyte quality and predicts the sibling embryo development potential and clinical pregnancy outcomes remains controversial. There is no study showing the competence of the sibling embryos from the prospective of cumulative live birth rate. Whether oocyte degeneration is associated with poor quality of the remainder of the cohort remains further to be elucidated.MethodThis retrospective observational study included a total of 488 OPU cycles underwent ICSI with fresh cleavage stage embryo transfer and successive frozen/thawed embryo transfer (FET) cycles from January 2018 to December 2019. All female patients were under the age of 35 years, and underwent ICSI with or without oocyte degeneration (OD). Cycles with at least one oocyte degenerated were defined as oocyte degeneration group (OD group), and cycles with no oocyte degenerated were defined as non-OD group. The OD group was further divided to three subgroups according to different oocyte degeneration rate (<10%, 10-20%, and >20%).ResultsThere were no significant differences with regards to implantation rate (38.5% vs 35.1%, P=0.302), clinical pregnancy rate (54.9% vs 50.3%, P=0.340), and LBR per OPU cycle (47.0% vs 42.9%, P=0.395) between OD and non-OD groups. Initial gonadotropin dosage, E2 level on hCG day and the number of matured oocytes appeared to be independent risk factors for OD. The adjusted odds ratio of live birth rate per OPU cycle were similar in different oocyte degeneration rate subgroups. The ongoing pregnancy/LBR per transfer in FET cycles was not significantly different between OD group and non-OD groups (38.8% vs 43.9%, P=0.439). The cumulative LBR per OPU cycle was also comparable between OD and non-OD group (63.4% vs 64.8%, P=0.760).ConclusionThe results provide cycle-based evidence that the presence of oocyte degeneration after ICSI is not an indicator for predicting the cumulative live birth rate per OPU cycle in young women.

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Effects of Chromosomal Abnormalities on Assisted Reproductive Technology: A Retrospective Cohort Study

10.21203/rs.3.rs-46017/v1 ◽

2020 ◽

Author(s):

Ling Cui ◽

Yonghong Lin ◽

Fang Wang ◽

Xinting Yu ◽

Wending Teng ◽

...

Keyword(s):

Pregnancy Rate ◽

Birth Rate ◽

Chromosomal Abnormalities ◽

Live Birth Rate ◽

Reproductive Technology ◽

Clinical Pregnancy ◽

Exposed Group ◽

Clinical Pregnancy Rate ◽

Cumulative Live Birth Rate ◽

Cumulative Live Birth

Abstract Background: To ascertain whether couples with chromosomal abnormalities have a difference in cumulative clinical pregnancy rate and cumulative live birth rate among assisted reproductive technology population. Methods: Design: A retrospective cohort study. Setting: Department of reproduction and infertility in Chengdu Women's and Children's Central Hospital.Patients: A total of 112 couples were in exposed group with chromosomal abnormalities and 226 couples without chromosomal abnormalities in control group included in the study, totaling 338 cases. From 1st Jan 2017 to 31st Dec 2019. Control group (infertility couples without chromosomal abnormalities) was 1:2 matched by female age, type of infertility (primary, secondary), type of assisted reproductive technology (IVF, ICSI or IUI). Results: Primary outcomes: cumulative clinical pregnancy rate and cumulative live birth rate. The results indicated that chromosomes abnormalities had no statistical difference in primary outcomes. Further analysis revealed exposed group (couples with chromosomal abnormalities) had less 2 pronuclear stage count. The times of embryo transfer by ICSI was less than IVF in exposed group. We found out only female age had an effect on the primary results and the threshold was 33.5years old.Conclusions: There were no significant differences in cumulative clinical pregnancy rate and cumulative live birth rate between two groups. But 2 pronuclear stage count, and the times of embryo transfer were affected by chromosomal abnormalities. It may be better to choose ICSI and PGT in this population.

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P–246 Oocyte degeneration after ICSI is not an indicator of live birth in young women

Human Reproduction ◽

10.1093/humrep/deab130.245 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

X Hu ◽

Y Xu

Keyword(s):

Live Birth ◽

Young Women ◽

Birth Rate ◽

Implantation Rate ◽

Live Birth Rate ◽

Oocyte Retrieval ◽

Cumulative Live Birth Rate ◽

Fresh Embryo Transfer ◽

Cumulative Live Birth ◽

Independent Risk Factors

Abstract Study question To investigate whether oocyte degeneration after intracytoplasmic sperm injection (ICSI) is an indicator for predicting the cumulative live birth rate. Summary answer The presence of oocyte degeneration after ICSI is not an indicator for predicting the cumulative live birth rate per OPU cycle in young women. What is known already Oocyte degeneration may be associated with decreased embryo quality for embryo development kinetics was disturbed. No differences in clinical outcomes such as implantation rate or clinical pregnancy rate were found in fresh embryo transfer cycles in retrospective studies. Study design, size, duration This was a retrospective cohort study, including all the oocyte retrieval cycles from young women who underwent ICSI from January 2018 to December 2019 at the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University. Participants/materials, setting, methods The inclusion criteria were as follows: female age was younger than 35 years; the first or second oocyte retrieval cycles ;the number of oocyte retrieval was between 8 and 20; all the cycles performed fresh embryo transfer on day 3 after insemination. Cycles with at least one oocyte degenerated after ICSI were defined as the oocyte degeneration group (OD group), and cycles with no oocyte degenerated after ICSI were defined as the non-OD group Main results and the role of chance There were no significant differences with regards to implantation rate (38.5% vs 35.1%, P = 0.302), clinical pregnancy rate (54.9% vs 50.3%, P = 0.340), and live birth rate per OPU cycle (47.0% vs 42.9%, P = 0.395) between OD and non-OD groups. Initial gonadotropin dosage, E2 level on hCG day and the number of matured oocytes appeared to be independent risk factors for OD, after adjustment for female age, female BMI, duration of gonadotropin administration, FORT, number of retrieved oocytes and different technicians. The adjusted odds ratio of live birth rate per OPU cycle were similar in subgroups with different oocyte degeneration rates. The ongoing pregnancy/live birth rate per transfer in FET cycles was not significantly different between OD group and non-OD groups (38.8% vs 43.9%, P = 0.439). The cumulative live birth rate per OPU cycle was also comparable between the OD group and non-OD group (63.4% vs 64.8%, P = 0.760). Limitations, reasons for caution The time interval for the follow-up was not long enough for all the frozen embryos to be transferred. Moreover, the retrospective nature of the study introduces the potential to include confounding variables that may bias our results, although we performed multiple logistic regression analysis to minimize these effects. Wider implications of the findings: The presence of oocyte degeneration is not an indicator for predicting the cumulative live birth rate per OPU cycle in young women. Initial gonadotropin dosage, E2 level on hCG day and the number of matured oocytes appeared to be independent risk factors for oocyte degeneration. Trial registration number none

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Dyslipidemia Is Negatively Associated With the Cumulative Live-Birth Rate in Patients Without PCOS Following IVF/ICSI

Frontiers in Physiology ◽

10.3389/fphys.2021.713356 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zhenteng Liu ◽

Jianxiang Cong ◽

Xuemei Liu ◽

Huishan Zhao ◽

Shoucui Lai ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Live Birth ◽

Birth Rate ◽

Multivariate Logistic Regression Analysis ◽

Live Birth Rate ◽

Control Group ◽

Multivariate Logistic Regression ◽

Cumulative Live Birth Rate ◽

Cumulative Live Birth

Objective: To evaluate the effect of dyslipidemia on the cumulative live-birth rate (cLBR) in patients without polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection–embryo transfer (IVF/ICSI–ET) cycles.Methods: A total of 1,132 patients from the Yantai Yuhuangding Hospital Affiliated to Qingdao University from January 2016 to December 2017 were retrospectively included. The subjects were distributed into two groups based on their lipid profiles, namely, dyslipidemia group (n = 195) and control group (n = 937). The clinical and laboratory parameters of the two groups were analyzed, and a multivariate logistic regression analysis of the cLBR was conducted. In addition, subgroup analysis was carried out to avoid deviation according to the body mass index (BMI).Results: Patients with dyslipidemia had significantly greater BMI and longer duration of infertility, as well as lower antral follicle count and basal follicle-stimulating hormone level compared with patients without dyslipidemia. Stratified analysis showed that dyslipidemia was associated with a significantly higher total gonadotrophin dosage required for ovarian stimulation as well as lower number of oocytes retrieved, independent of obesity. The live-birth rate in fresh cycle and cLBR were higher in the control group, although the difference between the groups was not significant (54.9% vs. 47.3%, p = 0.116; 67.6% vs. 62.1%, p = 0.138). However, multivariate logistic regression analysis adjusting for potential confounders showed that dyslipidemia was negatively associated with cLBR (OR, 0.702, 95% CI, 0.533–0.881, p = 0.044).Conclusion: Our findings demonstrate for the first time that dyslipidemia has a deleterious impact on cLBR, independent of obesity, in non-PCOS population considered to have good prognosis. Assessment of serum lipid profiles as well as the provision of nutritional counseling is essential for increasing successful outcomes in assisted reproductive techniques.

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