scholarly journals Impact of time-lapse imaging incubators with single-step culture medium on cumulative live birth rate in IVF cycles: a retrospective cohort study

2021 ◽  
Author(s):  
Mariano Mascarenhas ◽  
Sarah J Owen ◽  
Emily French ◽  
Karen Thompson ◽  
Adam H Balen
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Culture Medium ◽  
Live Birth Rate ◽  
Time Lapse ◽  
Single Step ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Time Lapse Imaging

Objective To compare the cumulative live birth rate per egg retrieval between time lapse imaging (TLI) incubators and standard culture (SC) incubators both using a single-step culture medium Design Retrospective cohort study Setting A tertiary level fertility-centre Population Women undergoing an IVF cycle between November 2015 and December 2017 Methods Comparison was done between 1219 IVF cycles using TLI and 1039 cycles using SC after accounting for confounding factors such as age and number of oocytes retrieved. Main outcome measure Cumulative live birth rate per egg retrieval Results The live birth rate per egg retrieval following fresh embryo transfer was noted to be higher for TLI cycles (TLI 39.87% vs SC 38.02%, aOR 1.20, 95% CI 1.01 to 1.44). More embryos were available for cryopreservation in the TLI arm (MD 0.08 embryos, 95% CI 0.10 to 0.41). The live birth rate per frozen embryo transfer was not significantly different. The cumulative live birth rate per egg retrieval was significantly higher in the TLI arm (TLI 50.29% vs SC 46.78%, aOR 1.24, 95% CI 1.04 to 1.48) Conclusions With the use of single step medium, there appears to be a greater benefit of TLI through a reduced interruption in embryo culture conditions, resulting in a higher number of embryos available for cryostorage which in turn appears to improve the cumulative live birth rate. Funding No funding was obtained for this study Keywords Time lapse imaging, cumulative live birth rate, single step culture medium, embryo utilization rate

scholarly journals Embryo incubation and assessment by time-lapse system versus conventional incubators in Chinese women with diminished ovarian re serve undergoing IVF/ICSI : a study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Miaoxin Chen ◽  
Yuanyuan Wu ◽  
Xin Huang ◽  
Wentao Li ◽  
Chunyan Sun ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Live Birth ◽  
Embryo Culture ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Time Lapse ◽  
Absolute Difference ◽  
Cumulative Live Birth Rate ◽  
Randomized Controlled ◽  
Cumulative Live Birth

Abstract Background: Time-lapse imaging system (TLS) is a newly developed non-invasive embryo assessment system. Compared with conventional incubators, it provides stable culture condition and consistent observation of embryo development, thereby improving embryo quality and selection. In theory, these benefits could improve clinical outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Although this system has been routinely used in many IVF centers globally, it remains unclear if the TLS results in higher cumulative live birth rate and high-quality evidence is warranted. The purpose of this study is to compare the effectiveness of the TLS with conventional incubators in infertile diminished ovarian reserve (DOR) patients. Methods: This study is a double-blind randomized controlled clinical trial (1:1 treatment ratio of TLS vs. conventional incubator). A total of 730 DOR patients undergoing the first or second cycle of IVF or ICSI will be enrolled and randomized into two parallel groups. Participants in group A will undergo embryo culture and selection in the TLS, and participants in group B will undergo embryo culture in the conventional incubators and embryo selection by the morphological characteristics. 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 10% (35% vs 25%) 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 time-lapse system compared with conventional incubators in patients with DOR undergoing IVF/ICSI. Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027746. Registered on 24 Nov 2019.

scholarly journals More Live Births in Primary Subfertile Intracytoplasmic Sperm Injection-Treated Women with High Normal TSH Levels

2021 ◽  
Vol 86 (4) ◽  
pp. 398-407
Author(s):  
Constance Repelaer van Driel-Delprat ◽  
Eveline van Dam ◽  
Peter van de Ven ◽  
Khadija Aissa ◽  
Melanie ter Haar ◽  
...  
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Thyroid Autoimmunity ◽  
Live Birth Rate ◽  
Ongoing Pregnancy ◽  
Male Factor ◽  
Cumulative Live Birth Rate ◽  
Cumulative Live Birth ◽  
Tsh Levels

<b><i>Objectives:</i></b> The aim of this study was to analyze the fertility outcome in intracytoplasmic sperm injection (ICSI)-treated women across normal range thyroid-stimulating hormone (TSH) levels. Published results are inconclusive about optimal TSH levels and fertility. <b><i>Design:</i></b> This is a retrospective cohort study in 752 ICSI-treated women with predominantly severe male factor subfertility, starting treatment between the first of January 2008 and the first of March 2012 with a follow-up until 2014. <b><i>Participants/Materials, Setting, Methods:</i></b> Women aged 22–45 years with TSH 0.3–4.5 mIU/L without thyroid hormone substitution were included in Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands, an iodine-sufficient area. Demographic and baseline characteristics were compared between groups of patients based on TSH, using one-way ANOVA, Kruskal-Wallis ANOVA, and χ<sup>2</sup> test. The patient was the unit of analysis: all cumulative cycles per patient were analyzed up to and including the first ongoing pregnancy. The primary outcome was a cumulative live birth rate. Clinical pregnancy rate, pregnancy loss, and ongoing pregnancy rate were secondary outcomes. The χ<sup>2</sup> test and logistic regression were used to compare interquartile groups while adjusting for confounders. Logistic regression was used with the natural logarithm of TSH as a continuous predictor. Primary and secondary subfertile women were analyzed separately. <b><i>Results:</i></b> Analysis of the total cohort (<i>n</i> = 752) showed no difference in fertility outcomes across the normal TSH range. The cumulative live birth rate for the 4 groups of primary subfertile women (<i>n</i> = 455) was 76% in the upper TSH quartile compared to 56%, 60%, and 59% in the lower TSH quartiles. <b><i>Limitations:</i></b> Levels of thyroxine and presence of thyroid autoimmunity were not measured in this retrospective cohort study. <b><i>Conclusions:</i></b> The observation that a higher live birth rate was found in primary subfertile ICSI-treated women with high but allegedly normal TSH levels contributes to the hypothesis that in certain subfertile women in addition to a male factor, female factors such as subtle hypothyroidism and/or thyroid autoimmunity may play a role in keeping them from conception, which can be overcome by the process of ICSI.

scholarly journals The impact of down-regulation on obstetrics and perinatal outcomes in singleton pregnancies after IVF: a retrospective cohort study

2020 ◽  
Author(s):  
Xiyuan Dong ◽  
Yu Zheng ◽  
Biao Chen ◽  
Lan Wang ◽  
Lei Jin ◽  
...  
Keyword(s):  
Live Birth ◽  
Lower Risk ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Cumulative Live Birth Rate ◽  
Down Regulation ◽  
Cumulative Live Birth ◽  
The Impact

Abstract Background Down-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study is to evaluate the effect of down-regulation on obstetrics and perinatal outcomes. Methods This is a retrospective cohort study on 3578 patients achieving singleton pregnancy after their first IVF attempt. The patients were grouped by the serum estradiol after down-regulation (E2D) into three groups: <30, 30-55, >55pg/ml. The cumulative live-birth rate, obstetrics and pediatric results were main outcome measures. General linear models and Chi-square test were performed for statistical analysis. Results The patients with E2D <30, 30-55, >55pg/ml had similar cumulative live-birth rate. The patients with E2D <30pg/ml had a lower risk for hypertension disorders than those with E2D 30-55pg/ml. No difference was found in the prevalence of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns of patients with E2D <30pg/ml had a lower risk for PICU attempt than those with E2D >55pg/ml. There was no difference in congenital anomaly or mortality rate. Conclusion We found no effect of down-regulation on cumulative live-birth rate. The patients with E2D<30pg/ml may have advantages in lower risks for maternal hypertension and newborns PICU attempt.

Maternal MTHFR C677T polymorphism does not affect live birth rate following IVF in Chinese Han population: a retrospective cohort study of 1265 women

2020 ◽  
Author(s):  
Hong Zeng ◽  
Hebin Xie ◽  
Dongmei He ◽  
Yuhao Zhao ◽  
Nenghui Liu
Keyword(s):  
Live Birth ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Mthfr C677t ◽  
P Value ◽  
Cumulative Live Birth Rate ◽  
Chinese Han ◽  
Mthfr C677t Polymorphism ◽  
Cumulative Live Birth

Abstract Backgrounds: MTHFR is a key enzyme for folic acid metabolism and is important for reproduction. However, whether MTHFR C677T genotype affect live birth rate following IVF is unknown. This study aims to evaluate the association of MTHFR C677T polymorphism and live birth rate following IVF. Methods: This is a retrospective cohort study of 1265 women undergoing first IVF -ET cycle (2015-2017) in Reproductive Medicine Center of Xiangya Hospital. The patients were followed for a minimum of 2 years and maximum of 5 years, the observation endpoint is live birth, or all the embryos derived from the first stimulation cycle are transferred. The study population was divided into three groups based on MTHFR C677T genotype (MTHFR 677CC, MTHFR 677CT, MTHFR 677TT). The primary outcomes are live birth rate and cumulative live birth. The secondary outcomes including laboratory parameters (number of oocytes, number of 2PNs, number of available embryos, number of good embryos) and clinical parameters (chemical pregnancy rate, clinical pregnancy rate, implantation rate, preclinical pregnancy loss rate, miscarriage rate). The logistic regression analysis with different adjusted models were used to analyze the association of MTHFR C677T genotype and live birth. Results: Among the 1265 participants, 541 were MTHFR 677CC genotype, 585 were MTHFR 677CT genotype, and 139 were MTHFR 677TT genotype. The live birth rate was 43.6%, 44.8%, and 40.3% (p-value = 0.63), and the cumulative live birth rate per stimulation cycle was 54.7%, 53.5%, and 51.8% (p-value =0.81) in MTHFR 677CC group, MTHFR 677CT group, and MTHFR 677TT group, respectively. The secondary laboratory outcomes and clinical outcomes were not significantly different between the three groups. Logistic regression analysis showed no significant association of MTHFR C677T genotype and live birth whether in model 1 (p-value for trend = 0.63) , model 2 (p-value for trend = 0.63), or model 3 (p-value for trend = 0.59). Conclusions: MTHFR C677T genotype does not significantly affect live birth rate and cumulative live birth rate following first IVF in Chinese Han couples.

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