Impact of conscious sedation during oocyte retrieval on clinical pregnancy rate in assisted reproductive technology? An equivalence study in France.

AbstractBackgroundWhile the assisted reproductive technology (ART) relieves the burden of infertility in many couples, it presents significant public health challenges due to the substantial risk for multiple birth delivery and preterm birth, which are associated with poor maternal and fetal health outcomes. For this reason, it is important to monitor the development and effectiveness of ART services in Thailand.ObjectiveTo analyze the trends of ART services in Thailand between 2008 and 2014.MethodsART clinics in Thailand are required to submit data to the Royal Thai College of Obstetricians and Gynecologists via the National Reporting System. The data from 2008 to 2014 were collected and analyzed.ResultsThe number of ART centers was increased from 35 to 47. The total fresh ART cycles were also increased from 3,723 to 6,516. The percentage values of intracytoplasmic sperm injection (ICSI), in vitro fertilization, gamete intrafallopian transfer, and zygote intrafallopian transfer cycles were changed from 77.87 to 95.59, 21.43 to 4.31, 0.21 to 0.09, and 0.45 to 0.05, respectively. The clinical pregnancy rates were 28.79–33.19, 22.84–51.34, 14.29–42.86, and 0.00–26.67, respectively. The clinical pregnancy rates in fresh vs. frozen-thawed cycles were 31.01–36.33 vs. 31.54–37.34 (P < 0.05). The clinical pregnancy rates in female age <35 vs. 35–39 vs. ≥40 years were 36.97–40.70 vs. 32.74–33.42 vs. 21.08–31.34, respectively (P < 0.001), and the percentage values of multifetal pregnancy rate were 18.75 vs. 13.30 and 13.69, respectively (P < 0.001). There were increasing preimplantation genetic screening (PGS) cycles, with the percentage of the clinical pregnancy rate (25.90–42.63, P < 0.05). The clinical pregnancy rates in medium-sized ART centers (100–300 cycles per year) vs. in small and large centers were 30.79–41.14 vs. 28.01–34.04 and 8.70–40.35, respectively (P < 0.001). Trends of increasing percentage of ART birth rate to total birth rate ratio were 0.24–0.34 (P < 0.05).ConclusionsThere were higher clinical pregnancy rates in frozen-thawed cycles. Higher multifetal pregnancy rate and clinical pregnancy rate were also found in younger females. There were increasing uses of ICSI and PGS. A trend toward increasing ART birth to total birth ratio was observed.

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Survey of Relation between Midcycle Progesterone Level with IUI Cycles Success Rate

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.v.7n.4p.9 ◽

2020 ◽

Vol 7 (4) ◽

pp. 9

Author(s):

Alieh Ghasemzadeh ◽

Gilda Mostafavi ◽

Mohammad Nouri ◽

Parastoo Chaichi ◽

Laya Farzadi ◽

...

Keyword(s):

Success Rate ◽

Pregnancy Rate ◽

Assisted Reproductive Technology ◽

Endometrial Thickness ◽

Cross Sectional Study ◽

Reproductive Technology ◽

Clinical Pregnancy ◽

Progesterone Level ◽

Sectional Study ◽

Cross Sectional

Introduction: Assisted reproductive technology is used routinely for treatment of infertile spouses. Previous studies reported conflicting results regarding effect of progesterone rise at the HCG injection day. The aim of current study is to evaluate the effects of mid cycle progesterone levels in IUI cycles. Methods: In this analytical cross-sectional study, the outcome of treatment in 200 IUI cycles were evaluated. Patients’ demographic findings, progesterone level at the day of HCG injection, number of follicles >16 mm, endometrial thickness and clinical pregnancy rate were recorded. For better evaluation, progesterone levels were divided to <0.5, 0.5-1.5 and >1.5 ng/dl. Results: Patients’ mean age was 29.70±4.38 years. The progesterone levels of <0.5, 0.5-1.5 and >1.5 ng/dl was detected in 24.5%, 56% and 19.5% of patients, respectively. The rate of clinical pregnancy was 27.5%. Cases with positive pregnancy had significantly lower progesterone levels (0.88±0.31 vs.1.11±0.80, p=0.04). The highest pregnancy rate was in progesterone levels 0.5-1.5 compared to levels <0.5 and >1.5 ng/dl (42% vs. 12.2% vs. 5.2%, p<0.001). There was no significant correlation between progesterone levels with endometrial thickness (r=-0.130, p=0.06) and number of follicles >16 mm(r=0.02, p=0.77). Conclusion: The results of current study showed that the increase in progesterone levels at the day of HCG injection accompanies with lower pregnancy rate. However, this increase has no correlation with number of mature follicles and endometrial thickness.

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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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Pregnancy outcomes of the first thawing cycle in “freeze-all” strategy of infertility patients with fever during oocyte recruitment: A matched–pair study (Preprint)

10.2196/preprints.18422 ◽

2020 ◽

Author(s):

Mingmei Lin ◽

Zi-Ru Niu ◽

Rong Li

Keyword(s):

Pregnancy Rate ◽

Pregnancy Outcomes ◽

Ovarian Stimulation ◽

Oocyte Retrieval ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Embryo Freezing ◽

Group 2 ◽

Infertility Patients ◽

Group 1

BACKGROUND It is well known that assisted reproduction technology (ART) is currently an effective method for treating infertility. But it is currently unknown whether the patients with fever after control ovulation during egg retrieval could increase risk of pelvic infection or not, and fever itself may be affect oocyte or embryo quantity and quality, thus with poor pregnancy outcomes? But if the oocyte retrieval was cancelled cause of fever, the risk of severe ovulation complications might increase, such as ovarian hyper-stimulation syndrome, thrombus and ovarian pedicle torsion. OBJECTIVE The goal of this study was to analysis the outcomes of the patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer cycle. METHODS This is a 1:3 retrospective paired study matched for age. In this study, 58 infertility patients (Group 1) had fever during the control ovulation and the time of the oocyte retrieval within 72 hours, they undertook ovum pick up and whole embryo freezing (“freeze-all” strategy). The control controls (Group 2) are174 patients matched for age with whole embryo freezing for other reasons. The baseline characteristic, clinical data of ovarian stimulation and the outcomes, such as the clinical pregnancy rate, early miscarriage rate, ectopic pregnancy rate and ongoing clinical pregnancy rate were compared between the two groups. RESULTS There were 58 patients were enrolled in the Group 1, and matched with 174 patients for the Group 2. All the patients had no pelvic inflammatory disease after oocyte retrieval. The basic characteristics of patients refers to age, BMI, nulliparity, basal FSH, basal LH, basal E2 and infertility type (primary or secondary) were with no significantly difference. But the AMH lever (4.2 versus 2.2, P<0.001) were higher and the infertility time (3 versus 2, P=0.035) was longer in the control group. The number of oocytes retrieved and fertilization rate were lower in the group (P< 0.001), but the ovarian stimulation protocol, the usage of Gn both time and dose, the ICSI rate, the 2PN rate, the number of available embryos (D3 and D5), the endometrial thickness, the number of embryo transfer and the type of luteal support supplementation were similar between the two groups. Regarding pregnancy outcomes，the implantation rate, clinical pregnancy rate, early spontaneous rate, ectopic pregnancy rate and ongoing pregnancy rate all were with no significantly difference. CONCLUSIONS The patients with fever during control ovulation and the oocyte retrieval got similar outcomes compared with those with no fever patients when taken the whole embryos freezing. Fever had almost no effect on the quality of embryo and endometrium. Moreover, the oocyte retrieved is relatively safe and reliable under strict disinfection and taken oral antibiotics for prevention infection.

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Enhancing the scope of in vitro maturation for fertility preservation: transvaginal retrieval of immature oocytes during endoscopic gynaecological procedures

Human Reproduction ◽

10.1093/humrep/dez273 ◽

2020 ◽

Vol 35 (4) ◽

pp. 837-846 ◽

Cited By ~ 1

Author(s):

Xue-Ling Song ◽

Cui-Ling Lu ◽

Xiao-Ying Zheng ◽

Victoria Nisenblat ◽

Xiu-Mei Zhen ◽

...

Keyword(s):

Pregnancy Rate ◽

Fertility Preservation ◽

In Vitro Maturation ◽

Ovarian Function ◽

Oocyte Retrieval ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Operative Complications ◽

Transvaginal Oocyte Retrieval

Abstract STUDY QUESTION Could in vitro maturation (IVM) following transvaginal oocyte retrieval during gynaecological surgery (IVM-surgery) be an effective and safe strategy for fertility preservation? SUMMARY ANSWER IVM-surgery on unstimulated ovaries is a novel option that can be considered for fertility preservation for women requiring gynaecological surgery, but more research is needed to identify appropriate patients who may benefit and to determine the cost-effectiveness of such an approach. WHAT IS KNOWN ALREADY IVM followed by oocyte/embryo cryopreservation has been useful as a safe reproductive strategy for some infertile women. STUDY DESIGN, SIZE, DURATION This prospective cohort study comprised 158 consecutive women with polycystic ovary syndrome (PCOS) who underwent laparoscopy or hysteroscopy for other reasons and had concomitant transvaginal oocyte retrieval followed by IVM between 2014 and 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 158 women with anovulatory PCOS who underwent IVM-surgery in our infertility centre were recruited for this study. Matured IVM oocytes obtained from these women were either freshly fertilized and subsequently frozen at the blastocyst stage (fresh oocyte group, n = 46) or the oocytes were frozen (frozen oocyte group, n = 112) for fertility preservation followed by later thawing for insemination and cleavage embryo transfer (ET) (n = 33). The following outcomes were then evaluated: embryological data, clinical pregnancy rate, live birth rate (LBR), neonatal outcomes, post-operative complications and post-operative ovarian function. MAIN RESULTS AND THE ROLE OF CHANCE Among all the women who underwent IVM-surgery, the clinical pregnancy rate and LBR per initiated IVM cycle were 9.5% (15/158) and 6.9% (11/158), respectively. Women (40.6%, 20/33) who underwent the procedure with frozen-thawed oocytes (oocyte survival rate, 83.0%) obtained a high quality of cleaved embryos. In the fresh oocyte group, the clinical pregnancy rate and LBR per ET cycle were 69.2 and 53.8%, respectively. In the frozen oocyte group, the clinical pregnancy rate and LBR per ET cycle were 28.6 and 19.1%, respectively. No adverse neonatal outcomes were recorded. IVM-surgery was not associated with post-operative complications, a longer hospital stay, or impaired ovarian function. LIMITATIONS, REASONS FOR CAUTION Because of the small sample size and the low utilization rate and cost-effectiveness per retrieval, the present findings should be interpreted with caution, and further studies are needed for the long-term follow-up of live births. WIDER IMPLICATIONS OF THE FINDINGS This strategy can also help patients with normal ovulation to obtain available oocytes and embryos for cryopreservation and subsequent use. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Joint Research Fund for Overseas Natural Science of China (No. 31429004), the National Key Research and Development Program of China (No. 2017YFC1002000, 2017YFC1001504, 2016YFC1000302), the Ministry of Science and Technology of China Grants (No. 2014CB943203), the Chinese Society of Reproductive Medicine Fund (No. 16020400656) and the National Natural Science Foundation of China (No. 81300456). All the authors have nothing to disclose in terms of conflicts of interest. TRIAL REGISTRATION NUMBER chictr-ONC-17011861

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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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The number of oocytes as a predictor of pregnancy rates in the cycles of assisted reproductive technology

Translational Medicine ◽

10.18705/2311-4495-2020-7-1-53-58 ◽

2020 ◽

Vol 7 (1) ◽

pp. 53-58

Author(s):

I. V. Gorelova ◽

J. A. Galkina ◽

L. V. Kuznetsova ◽

M. V. Rulev ◽

I. E. Zazerskaya

Keyword(s):

Pregnancy Rate ◽

Assisted Reproductive Technology ◽

Treatment Plan ◽

Reproductive Technology ◽

Clinical Pregnancy ◽

Research Centre ◽

Adequate Treatment ◽

National Medical ◽

Group 2 ◽

Group 1

Background. Data on the effect of the number of received oocytes on the outcomes of assisted reproductive technology (ART) programs are contradictory. The frequency of obtaining a small number of cells ranges from 5.6 to 35.1 %. Identifying women who have chances of getting pregnant, despite this situation, is important for drawing up an adequate treatment plan.Objective of this study is to assess the pregnancy rate depending on the number of retrieved oocytes in ART cycles with ovarian stimulation, which ended with the transfer of embryos, as well as determining the characteristics of patients with a reduced response, in whom the pregnancy occurred.Design and methods. The study included 526 women who were treated for infertility in the department of ART of the Almazov National Medical Research Centre in 2017. Patients were divided into three groups depending on the number of oocytes retrieved: less than 5, from 5 to 9 and 10 or more. Group 1 (number of oocytes less than 5) included 126 women, group 2 (from 5 to 9) — 223 women and group 3 (number of oocytes 10 and more) — 177 patients. The average age of the patients was 33.37 years (from 22 to 48 years).Results. The frequency of obtaining a positive blood test and clinical pregnancy rate were comparable in groups 2 and 3 (53.81 % and 49.72 %, respectively) and significantly lower in group 1 (41.27 %, p > 0.05). Clinical pregnancy in group 1 occurred in 34.13 % of cases, which was significantly different from the indicators of group 2 + 3, where the gestational egg visualized in 47.5 % of cases (p < 0.05). In a group of women with a small number of oocytes, the most important predictors of pregnancy were obtaining 2 or more oocytes, and anti-mullerian hormone (AMH) level above 1 ng / L.Conclusion. The number of oocytes is an important predictor of pregnancy rate. The chances of becoming pregnant in women with a small number of oocytes depend on the level of AMH and the number of oocytes obtained.

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P–169 Does increasing the time interval between Oocyte-Retrieval and Oocyte-Denudation improve the results in ICSI cycles ?

Human Reproduction ◽

10.1093/humrep/deab130.168 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

M Singh ◽

R Singh

Keyword(s):

Pregnancy Rate ◽

Embryo Quality ◽

Oocyte Retrieval ◽

Fertilization Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Time Interval ◽

Male Factor ◽

Time Intervals ◽

The Mean

Abstract Study question What should be the optimal time interval which elapses between oocyte retrieval and denudation followed by ICSI , for optimal results in ART cycles ? Summary answer Our study suggests that an optimum interval between oocyte retrieval and oocyte denudation followed by ICSI, leads to better results in ART cycles. What is known already It is widely accepted that the best timing for OPU is 34–39 hours after ovulation trigger. Some studies suggest that preincubation time before ICSI can be beneficial when it comes to fertilization and pregnancy rates while late ICSI (fertilization) may have negative results due to oocyte ageing. Other studies claim that there is no significant difference in ART results when ICSI is performed between 2–6 hours post Oocyte-Retrieval (OR) . Few studies state that 1–3 hours of COC-culture prior to denudation and oocyte injection is better as far as fertilization , embryo quality and improved oocyte cytoplasmic maturity is concerned. Study design, size, duration RCT of 234 ICSI cycles was carried out between 2017–2019. Patients were divided into two groups-: A- Early denudation with ICSI and B- Late denudation with ICSI.Both the groups were comparable in terms of female age, number of oocytes, day of transfer, number of embryos transferred and embryo quality. Fresh or frozen embryos were transferred , which were always derived from the same stimulation cycle. Exclusion criteria were : Severe male factor / TESA / PESA. Participants/materials, setting, methods 234 ICSI cycles with similar ovarian stimulation protocols were analyzed as per time range between triggering, OPU, denudation and ICSI. Patients were divided into two groups: A- Early denudation (1–2 hours after OPU) with ICSI (1–2 hours after denudation) and B- Late denudation (4–6 hours after Oocyte-Retrieval ) with ICSI (1–2 hours after denudation).Primary outcomes were oocyte maturation and fertilization rates and secondary outcomes were clinical pregnancy rate and abortion rates. Main results and the role of chance In group B ( Late denudation and ICSI), the mean fertilization rate was 67% and the Clinical Pregnancy rate was 46%. This was better than the mean fertilization rate of 56% and clinical pregnancy rate of 39% observed in group A ( Early denudation and ICSI). However the difference was not statistically significant. Therefore, ideal maturation rates were observed when denudation ( followed by ICSI ) was delayed and done 4–6 hours after Oocyte-Retrieval. In ICSI cycles in ART , ovarian stimulation is used to induce the simultaneous growth of multiple follicles, followed by final maturation and ovulation triggering with exogenous hCG. or GnRH-Agonist or both. Generally, oocyte retrieval (OR) is performed 34 - 36h later. In addition, 2–4 hours in culture of the cumulus oocyte complexes (COC) prior to oocyte injection is believed beneficial for fertilization and embryo quality, probably due to improved oocyte cytoplasmic maturity. However, in large ART centers with high workloads, following such definite time intervals is frequently very difficult. Limitations, reasons for caution In large busy centers , maintaining meticulous time intervals is difficult . As our study numbers are small, larger multicentric trials are required in order to confirm our findings and to provide more robust data . This data cannot be applied to IVM, TESE / PESE and severe male-factor infertility. Wider implications of the findings: To achieve a successful fertilization, both nuclear and cytoplasmic maturity are required. Our Study indicates that a slight delay in denudation following Oocyte-Retrieval , will yield a higher number of good quality oocytes. A higher success rate can also be expected due to more number of embryos available for transfer. Trial registration number Not applicable

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