Analysis of efficiency of application of media with hyaluronic acid in cryoprotocols

According to the World Health Organization, about 2 million new couples experience infertility annually, and their number is growing. An effective way to overcome infertility is assisted reproductive technology (ART). Cryopreservation will rationally solve the issue of preservation and further use of embryos: to delay pregnancy for some time considering womans desire and to prevent ovarian hyperstimulation syndrome. Embryo freezing allows to reduce the rate of repeated ovarian stimulation and perform preimplantation genetic diagnosis. Over the past decades, various cryotransfer options have been proposed to increase ART treatment efficacy, including the use of a culture medium with a high concentration of hyaluronic acid, but there are conflicting data on the use of such a medium in ART programs. Aim. Evaluation of thawed embryo transfers efficacy using the hyaluronic acid-containing culture medium. To achieve the goal, the following tasks were set: to evaluate clinical and medical history data of patients with tubal infertility in cryoprotocols, to analyze the previous cycle of in vitro fertilization and embryological stage, to evaluate the effectiveness of the culture medium with a high content of hyaluronic acid. Materials and methods. A detailed description of the patient sample, inclusion and exclusion criteria, embryological stage, embryo grading, devitrified embryo transfer technique. The article includes 3 tables which present the groups general clinical characteristics, the embryological stage, the rate of pregnancy, depending on the cultivation day. Results. The authors established that in patients with a history of pelvic surgery and sexually transmitted infections, it is advisable to use the culture medium with a high content of hyaluronic acid to transfer the thawed embryo. It was shown that pregnancy rate is 1.5 times higher when transferring devitrified embryos on the 5th day of development with the use of hyaluronic acid-containing culture medium. The conclusion about the pregnancy rate in obese patients is not indisputable, which requires further study. The authors also provide practical recommendations on the use of the culture medium with hyaluronic acid in cryoprotocols. Conclusion. The study allows to optimize the devitrified embryo transfer in patients with tubal infertility using a culture medium with a high content of hyaluronan. This work has undoubted scientific and practical significance.

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Pregnancy Success Rates by Different Assisted Reproductive Techniques in Tubal, Ovarian, and Sperm Disorders

Journal of Client-centered Nursing Care ◽

10.32598/jccnc.6.3.334.1 ◽

2020 ◽

Vol 6 (3) ◽

pp. 187-192

Author(s):

Zeinab Hajaliakbari Hafezabad ◽

◽

Milad Ahmadi Gohari ◽

Faezeh Kashi ◽

◽

...

Keyword(s):

Pregnancy Rate ◽

Fertility Rate ◽

Assisted Reproductive Techniques ◽

World Health ◽

Success Rates ◽

Tubal Infertility ◽

Vitro Fertilization ◽

Significant Difference ◽

Reproductive Techniques

Background: Assisted Reproductive Techniques (ART) have been used for addressing numerous causes of infertility. However, it remains unclear which kind of these methods are best for various infertility types. Accordingly, this study aimed at determining pregnancy success rates by different ART in tubal, ovarian, and sperm disorders. Methods: The present descriptive retrospective study used the records of individuals who had referred to the Infertility Center of Kerman University of Medical Sciences from March 2016 to December 2017. All subjects underwent Intracytoplasmic Sperm Injection (ICSI) and In Vitro Fertilization (IVF). The sperm parameters were assessed based on the criteria of the World Health Organization (WHO) for determining the causes of male infertility. The data were documented and compared with the criteria of the WHO. Then, they were analyzed by analysis of variance, Paired Samples t-test, Chi-squared, or Fisher’s Exact tests using SPSS. Results: The overall Mean±SD fertility rate in IVF and ICSI was 4.28±2.87 and 3.62±2.54, respectively and the difference was not significant (t=1.02, P=0.319). There was a significant difference in the fertility rate due to tubal infertility (P=0.018) between ICSI and IVF; the fertility rate in the IVF method was significantly higher than that of the ICSI. The pregnancy rate in the freeze method was higher than those of the other methods (P<0.001). This discrepancy was also found in all causes of infertility. There was no significant difference in the disorders of sperm and the result of two methods (IVF/ICSI). Conclusion: The obtained results suggested that in the freeze method, the pregnancy rate was higher than other approaches; this discrepancy was found in all the causes of infertility. It is suggested that frozen-thawed embryo transfer be used in infertile individuals. This is because it increases the success rate of pregnancy and prevents complications due to the repeated use of infertility treatments and exorbitant treatment costs.

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Experience of using time-lapse microscopy in IVF and ICSI programs

Medical alphabet ◽

10.33667/2078-5631-2020-16-47-50 ◽

2020 ◽

pp. 47-50

Author(s):

N. V. Saraeva ◽

N. V. Spiridonova ◽

M. T. Tugushev ◽

O. V. Shurygina ◽

A. I. Sinitsyna

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Selection Procedure ◽

Time Lapse ◽

Single Embryo Transfer ◽

Main Group ◽

Clinical Pregnancy ◽

Control Group ◽

Time Lapse Microscopy

In order to increase the pregnancy rate in the assisted reproductive technology, the selection of one embryo with the highest implantation potential it is very important. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the benefits of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in IVF and ICSI programs. Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 282 patients, who formed the main group; the control group consisted of 461 patients undergoing single-embryo transfer following a traditional culture and embryo selection procedure. We assessed the quality of transferred embryos, the rates of clinical pregnancy and delivery. The groups did not differ in the ratio of IVF and ICSI cycles, average age, and infertility factor. The proportion of excellent quality embryos for transfer was 77.0% in the main group and 65.1% in the control group (p = 0.001). In the subgroup with receiving eight and less oocytes we noted the tendency of receiving more quality embryos in the main group (р = 0.052). In the subgroup of nine and more oocytes the quality of the transferred embryos did not differ between two groups. The clinical pregnancy rate was 60.2% in the main group and 52.9% in the control group (p = 0.057). The delivery rate was 45.0% in the main group and 39.9% in the control group (p > 0.050).

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Evaluation of Bovine Embryo Biopsy Techniques according to Their Ability to Preserve Embryo Viability

Journal of Biomedicine and Biotechnology ◽

10.1155/2012/541384 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 13

Author(s):

M. Cenariu ◽

E. Pall ◽

C. Cernea ◽

I. Groza

Keyword(s):

Pregnancy Rate ◽

Genetic Diagnosis ◽

Needle Aspiration ◽

Embryo Biopsy ◽

Embryo Cryopreservation ◽

Bovine Embryo ◽

Bovine Embryos ◽

Embryo Viability ◽

Biopsy Methods ◽

Biopsy Method

The purpose of this research was to evaluate three embryo biopsy techniques used for preimplantation genetic diagnosis (PGD) in cattle and to recommend the least invasive one for current use, especially when PGD is followed by embryo cryopreservation. Three hundred bovine embryos were biopsied by either one of the needle, aspiration or microblade method, and then checked for viability by freezing/thawing and transplantation to recipient cows. The number of pregnancies obtained after the transfer of biopsied frozen/thawed embryos was assessed 30 days later using ultrasounds. The results were significantly different between the three biopsy methods: the pregnancy rate was of 57% in cows that received embryos biopsied by needle, 43% in cows that received embryos biopsied by aspiration, and 31% in cows that received embryos biopsied by microblade. Choosing an adequate biopsy method is therefore of great importance in embryos that will undergo subsequent cryopreservation, as it significantly influences their viability after thawing.

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Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00784-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Alessio Paffoni ◽

Marco Reschini ◽

Valerio Pisaturo ◽

Cristina Guarneri ◽

Simone Palini ◽

...

Keyword(s):

In Vitro Fertilization ◽

Pregnancy Rate ◽

Embryo Transfer ◽

Implantation Rate ◽

Clinical Pregnancy ◽

Frozen Embryo Transfer ◽

Fertilization Failure ◽

Vitro Fertilization ◽

Rescue Icsi

Abstract Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

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Individualised luteal phase support in artificially prepared frozen embryo transfer cycles based on serum progesterone levels: a prospective cohort study

Human Reproduction ◽

10.1093/humrep/deab031 ◽

2021 ◽

Author(s):

Manuel Álvarez ◽

Sofía Gaggiotti-Marre ◽

Francisca Martínez ◽

Lluc Coll ◽

Sandra García ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Pregnancy Outcomes ◽

Luteal Phase ◽

Frozen Embryo Transfer ◽

Ongoing Pregnancy ◽

Serum Progesterone ◽

Endometrial Preparation ◽

Group 2 ◽

Group 1

Abstract STUDY QUESTION Does an individualised luteal phase support (iLPS), according to serum progesterone (P4) level the day prior to euploid frozen embryo transfer (FET), improve pregnancy outcomes when started on the day previous to embryo transfer? SUMMARY ANSWER Patients with low serum P4 the day prior to euploid FET can benefit from the addition of daily subcutaneous P4 injections (Psc), when started the day prior to FET, and achieve similar reproductive outcomes compared to those with initial adequate P4 levels. WHAT IS KNOWN ALREADY The ratio between FET/IVF has spectacularly increased in the last years mainly thanks to the pursuit of an ovarian hyperstimulation syndrome free clinic and the development of preimplantation genetic testing (PGT). There is currently a big concern regarding the endometrial preparation for FET, especially in relation to serum P4 levels around the time of embryo transfer. Several studies have described impaired pregnancy outcomes in those patients with low P4 levels around the time of FET, considering 10 ng/ml as one of the most accepted reference values. To date, no prospective study has been designed to compare the reproductive outcomes between patients with adequate P4 the day previous to euploid FET and those with low, but restored P4 levels on the transfer day after iLPS through daily Psc started on the day previous to FET. STUDY DESIGN, SIZE, DURATION A prospective observational study was conducted at a university-affiliated fertility centre between November 2018 and January 2020 in patients undergoing PGT for aneuploidies (PGT-A) IVF cycles and a subsequent FET under hormone replacement treatment (HRT). A total of 574 cycles (453 patients) were analysed: 348 cycles (leading to 342 euploid FET) with adequate P4 on the day previous to FET, and 226 cycles (leading to 220 euploid FET) under iLPS after low P4 on the previous day to FET, but restored P4 levels on the transfer day. PARTICIPANTS/MATERIALS, SETTING, METHODS Overall we included 574 HRT FET cycles (453 patients). Standard HRT was used for endometrial preparation. P4 levels were measured the day previous to euploid FET. P4 > 10.6 ng/ml was considered as adequate and euploid FET was performed on the following day (FET Group 1). P4 < 10.6 ng/ml was considered as low, iLPS was added in the form of daily Psc injections, and a new P4 analysis was performed on the following day. FET was only performed on the same day when a restored P4 > 10.6 ng/ml was achieved (98.2% of cases) (FET Group 2). MAIN RESULTS AND THE ROLE OF CHANCE Patient’s demographics and cycle parameters were comparable between both euploid FET groups (FET Group 1 and FET Group 2) in terms of age, weight, oestradiol and P4 levels and number of embryos transferred. No statistically significant differences were found in terms of clinical pregnancy rate (56.4% vs 59.1%: rate difference (RD) −2.7%, 95% CI [−11.4; 6.0]), ongoing pregnancy rate (49.4% vs 53.6%: RD −4.2%, 95% CI [−13.1; 4.7]) or live birth rate (49.1% vs 52.3%: RD −3.2%, 95% CI [−12; 5.7]). No significant differences were also found according to miscarriage rate (12.4% vs 9.2%: RD 3.2%, 95% CI [−4.3; 10.7]). LIMITATIONS, REASONS FOR CAUTION Only iLPS through daily Psc was evaluated. The time for Psc injection was not stated and no serum P4 determinations were performed once the pregnancy was achieved. WIDER IMPLICATIONS OF THE FINDINGS Our study provides information regarding an ‘opportunity window’ for improved ongoing pregnancy rates and miscarriage rates through a daily Psc injection in cases of inadequate P4 levels the day previous to FET (P4 < 10.6 ng/ml) and restored values the day of FET (P4 > 10.6 ng/ml). Only euploid FET under HRT were considered, avoiding one of the main reasons of miscarriage and implantation failure and overcoming confounding factors such as female age, embryo quality or ovarian stimulation protocols. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received. B.C. reports personal fees from MSD, Merck Serono, Ferring Pharmaceuticals, IBSA and Gedeon Richter outside the submitted work. N.P. reports grants and personal fees from MSD, Merck Serono, Ferring Pharmaceuticals, Theramex and Besins International and personal fees from IBSA and Gedeon Richter outside the submitted work. The remaining authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NCT03740568.

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Appendectomy and women’s reproductive outcomes: a review of the literature

European Surgery ◽

10.1007/s10353-021-00703-1 ◽

2021 ◽

Author(s):

Lucia Merlino ◽

Alessandra Chiné ◽

Giulia Carletti ◽

Federica Del Prete ◽

Massimo Codacci Pisanelli ◽

...

Keyword(s):

Large Population ◽

Fluid Secretion ◽

Reproductive Period ◽

Pelvic Surgery ◽

Tubal Infertility ◽

Peritoneal Adhesions ◽

Relevant Risk Factor ◽

Perforated Appendix ◽

Embryo Transport ◽

Possible Cause

Summary Background The most frequent abdominal surgery performed for benign disease in females of fertile age is appendectomy, which remains among the most common surgeries and is a possible cause of peritoneal adhesions. The fact that appendectomy can cause adhesions may lead one to think that this may be a relevant risk factor for infertility; however, there is no universal agreement regarding the association between appendectomy and fertility. The aim of this review is to evaluate weather appendectomy may have a relevant impact on female fertility. Methods The search was conducted in PubMed and there was no limitation set on the date of publication. All studies regarding populations of female patients who had undergone appendectomy for inflamed appendix, perforated appendix, or negative appendix between childhood and the end of the reproductive period were included. Results Some authors believe that pelvic surgery can cause adhesions which can potentially lead to tubal infertility by causing tubal obstruction or by altering motility of fimbriae, tubal fluid secretion, and embryo transport. On the other hand, the most recent evidence reported that removal of the appendix seems to be associated with an increased pregnancy rate in large population studies. Conclusion Despite the existence of contrasting opinions concerning fertility after appendectomy, the most recent evidence suggests that appendectomy may actually lead to improved fertility and decreased time to pregnancy. Appendectomy seems to be correlated with improved fertility and higher pregnancy rates.

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