scholarly journals Evaluating of the Pregnancy Rate of Freezing Embryo Transfer in the Presence or Absence of GnRH Agonist

2021 ◽  
Vol 23 (6) ◽  
pp. 818-827
Author(s):  
Leila Naserpoor ◽  
◽  
Katayoun Berjis ◽  
Rahil Jannatifar ◽  
◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Gnrh Agonist ◽  
Assisted Reproductive Technologies ◽  
Implantation Rate ◽  
Study Groups ◽  
Reproductive Technologies ◽  
Abortion Rate ◽  
Frozen Embryo Transfer ◽  
Significant Difference

Background and Aim: Applying Assisted Reproductive Technologies (ARTs) is increasing. A critical step in ART is the frozen embryo transfer, in which the endometrium thickness has great significance in the outcome. In this case, the frozen embryo will be transferred during the next cycle. There are several ways to prepare an endometrium for transmitting embryos; however, choosing the best method remains debated. The present study aimed to evaluate the pregnancy rate of frozen embryo transfer in the presence or absence of GnRH agonists. Methods & Materials: A retrospective analysis was conducted on 146 consecutive patients attending Qom’s infertility treatment center from 2015 to 2017; these subjects were candidates for the transfer cycle of the frozen-thawed embryo and randomly assigned to receive either protocol with or without GnRH agonist. Clinical features, implantation rate, pregnancy rate (chemical & clinical), and abortion rate were assessed. Ethical Considerations: This study was approved by the Research Ethics Committee of the Academic Center for Education, Culture, and Research of Mashhad University (Code: IR.ACECR.JDM.REC.1398.001). Results: There was no significant difference in baseline and clinical characteristics, implantation rate, pregnancy rate (chemical & clinical), and abortion rate between the study groups of endometrial preparations with or without GnRH agonist (P<0.05). Conclusion: In this study, pregnancy outcome was similar in both study groups; thus, this method is recommended as an endometrial preparation without GnRH agonist.

scholarly journals Perinatal outcomes of human singletons conceived naturally versus assisted reproductive technologies: analysis of the effect of stimulated IVF, modified natural IVF, and frozen embryo transfer

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Adhwaa Khudhari ◽  
Ali Mourad ◽  
Simon Phillips ◽  
Mohammad Zubair Alam ◽  
Robert Hemmings ◽  
...  
Keyword(s):  
Birth Weight ◽  
Embryo Transfer ◽  
Gestational Age ◽  
Assisted Reproductive Technologies ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Primary Objective ◽  
Frozen Embryo Transfer ◽  
Significant Difference

Abstract Background Obstetrical outcomes in assisted reproduction techniques (ART) were compared with naturally conceived pregnancies and among each other in multiple reports. However, many important changes in the practice of in vitro fertilization (IVF) over the years, including single embryo transfers (sET) and the introduction of modified natural IVF (mnIVF), and the advances in the frozen embryo transfer (FET) might have impacted the outcomes. Our study is the first to our knowledge to assess four different groups, including spontaneous pregnancies, mnIVF, stimulated IVF (sIVF), and FET altogether in a head-to-head comparison. This is a retrospective study on perinatal outcomes of singleton babies conceived naturally or using three different ART protocols between 2011 and 2014. The primary objective was the comparison of gestational age and birth weight between spontaneously conceived pregnancies (NAT, n= 15,770), mnIVF (n=235), sIVF (n=389), and FET (n=222). Results Our results show a significant difference in favor of naturally conceived pregnancies over ART in term of gestational age. In fact, the gestational age of babies in the NAT group was statistically higher compared to each one of the ART groups alone. Regarding the birth weight, the mean was significantly higher in the FET group compared to the other categories. Conclusion Differences in perinatal outcomes are still found among babies born after different modes of conception. However, there is still need for well-designed high-quality trials assessing perinatal outcomes between naturally conceived pregnancies and different ART protocols based on different maternal and treatment characteristics.

scholarly journals The effects of adding Gonadotropin-releasing Hormone antagonist on cycle characteristics and pregnancy rate in stimulated Intrauterine Insemination (IUI) cycle

2020 ◽  
Vol 11 (3) ◽  
pp. 3053-3060
Author(s):  
Rawaa saad Hassan Abunaila ◽  
Lubna Amer Al-anbari ◽  
Muayad Sraibet Abbood
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Study Groups ◽  
Reproductive Technologies ◽  
Control Group ◽  
Human Menopausal Gonadotropin ◽  
Study Group ◽  
Significant Difference

A prospective randomised (comparative) study was conducted in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in AL-Nahrain University, Baghdad – Iraq, from the 1st of October 2018 till 1st of September 2019 involving seventy women of infertile couples with the same inclusion and exclusion criteria. They were randomly allocated into two groupsreceiving minimal ovarian stimulation protocol (Clomiphene Citrate and Human Menopausal Gonadotropin) with IUI adding flexible GnRH antagonist protocol (Cetrorelix) to the study group. IUI was done 40-44 hours after ovulation trigger. There were no significant statistical variances among control and study groups in demographic characteristics concerning: age, BMI, type, duration and cause of infertility. There was no important variance in a mean day of trigger among control and study groups, 12.43 ±1.56 versus 13.11 ±1.49, at the same order (p = 0.064). The Mean number of dominant follicles was considerably greater in study groups than that of the group control, 2.40±1.03 versus 1.89±0.83, respectively (p = 0.025).Mean serum Estradiol of the study group was significantly higher than that of the control group, 478.68 ±423.61 versus 273.12 ±254.57, respectively (p = 0.016). The proportion of women with LH> 10 were significantly less frequent in the study group in comparison with the control group, 22.9 % versus 68.6 %, at the same order (p < 0.001). There was no important variance in mean serum Progesterone among control and study groups. There was no significant difference in the characteristic of the dominant follicle, ruptured versus not ruptured, (p = 0.124) on the day of IUI. The pregnancy rate was higher in the study group when compared with the control group; however, the difference in pregnancy rate doesn’t reach statistical import (p = 0.145)

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

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.

scholarly journals Effects of Laser Assisted Hatching on Pregnancy Outcomes of Frozen Embryo Transfer Cycles

2020 ◽  
Vol 5 (9) ◽  
pp. 1223-1223
Author(s):  
Dr. Narmadha. R ◽  
Dr . Manjula ◽  
Dr. N.Sanjeeva Reddy ◽  
Dr. Sindhuja. N.S
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Zona Pellucida ◽  
Implantation Rate ◽  
Frozen Embryo Transfer ◽  
Control Group ◽  
Assisted Hatching ◽  
Younger Women ◽  
The Mean ◽  
Baseline Characteristics

The implantation of the embryo into the uterus requires hatching from its zona pellucida (ZP). The inability of the embryo to break its zona pellucida is considered as a factor for implantation failure. Assisted hatching (AH) is performed to make it easier for natural hatching to occur, also providing early embryoendometrium contact, which favors the embryos implantation into the uterus. To evaluate the effect of laser assisted hatching (LAH) on pregnancy rate in frozen embryo transfer cycle.  Materials & methods: In a prospective observational study a total of 80 patients who underwent frozen embryo transfer(FET) cycles were included in the study. Patients were divided into Laser assisted hatching group (LAH) and no LAH group. In the LAH group, zona thinning was done with the help of laser just prior to the embryo transfer. In the control group no hatching was done before transfer. The main outcome measures were pregnancy rate & implantation rate. The baseline characteristics of the 80 patients included in the study ie.,LAH group (n=40) vs no LAH group (n=40),the mean age ( 30.855.4 vs 333.9),mean BMI (25.64.1 vs 27.94.5),duration of infertility ( 6.184.1 vs 8.534.7) , number of embryos transferred (2.750.8 vs 2.70.72) respectively. Younger women < 30 years in no LAH group had higher pregnancy rate compared to the LAH group. Between the two groups, patients between 31-35 years in LAH group had higher pregnancy rate compared to no LAH group. The pregnancy rate (42.85% vs 54.5%) in LAH group of women >35years found lower than the no LAH group. LAH seems to be beneficial in women between 31- 35 years of age group, but LAH does not seem to be beneficial in women > 35 years of age. There is slight increase in pregnancy rates with laser assisted zona thinning in frozen transfer cycle, but it is not statistically significant.

scholarly journals Uterus Size May Affect Reproductive Outcome in Women with Adenomyosis After Gnrh- Agonist Pretreatment Undergoing Frozen Embryo Transfer Cycles: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Wei Xiong ◽  
Ruiyi Tang ◽  
Peng Wu ◽  
Zhengyi Sun ◽  
jingran zhen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Gnrh Agonist ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer

Abstract Background: GnRH-agonist is used to treat adenomyosis, but its efficacy in adenomyosis patients with uterine enlargement undergoing frozen embryo transfer (FET) is unclear. Methods：The retrospective cohort study comprised 112 adenomyosis patients with uterine enlargement undergoing the first FET circle. A long-term GnRH-a pretreatment was administered to 112 patients with uterine enlargement. These patients were divided into two groups according to the therapeutic effect: patients with a normal-size uterus after GnRH-a treatment (GN group) and patients with an enlarged uterus after GnRH-a treatment (GL group). Results：Not all patients can shrink their uterus to a satisfactory level. After receiving GnRH-a pretreatment, the uterus returned to normal size in 77% of patients (GN group), and 23% of patients had a persistently enlarged uterus (GL group). The pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate were significantly higher in the GN group than in the GL group. Controlling for the confounding factors, normal uterus size (odds ratio [OR] 4.50; P=0.03) and low body mass index (OR 3.13; P=0.03) affected the odds of achieving live birth. The cut-off value selected on the ROC curve of uterus volume after GnRH-a treatment for detecting live birth was 144.7Conclusions：GnRH-a pretreatment was associated with the regression of adenomyosis lesions and improved clinical pregnancy outcomes in the adenomyosis patients with uterine enlargement whose lesion are GnRH-a susceptible on FET cycles. However, about a quarter of patients may not be less responsive to GnRH-a and have poorer pregnancy outcomes, especially in overweight women.

Combined treatment of prednisone and hydroxychloroquine may improve outcomes of frozen embryo transfer in antinuclear antibody-positive patients undergoing IVF/ICSI treatment

Lupus ◽  
2021 ◽  
pp. 096120332110558
Author(s):  
Rui Gao ◽  
Wei Deng ◽  
Cheng Meng ◽  
Kemin Cheng ◽  
Xun Zeng ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Pregnancy Loss ◽  
Loss Rate ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Clinical Pregnancy Rate ◽  
High Quality ◽  
Biochemical Pregnancy

Background The influence of anti-nuclear antibody (ANA) on induced ovulation was controversial, and the effect of prednisone plus hydroxychloroquine (HCQ) treatment on frozen embryo transfer outcomes of in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) for ANA-positive women was unclear. Methods Fifty ANA-positive women and one-hundred ANA-negative women matched for age and anti-Mullerian hormone (AMH) were included from a Reproductive Medical Central of a University Hospital. Sixty-one oocytes pick-up (OPU) cycles in ANA+ group and one-hundred OPU cycles in ANA− group were compared; 30 frozen embryo transfer cycles without treatment and 66 with prednisone plus HCQ treatment among ANA-positive women were compared. Results There was no statistical difference in number of retrieved oocytes (13.66 ± 7.71 vs 13.72 ± 7.23, p = .445), available embryos (5.23 ± 3.37 vs 5.47 ± 3.26, p = .347), high-quality embryos (3.64 ± 3.25 vs 3.70 ± 3.52, p = .832), and proportion of high-quality embryos (26.5% vs. 26.7%, p = .940). Biochemical pregnancy rate (33.3% vs. 68.2%, p < .05), clinical pregnancy rate (20.0% vs. 50.1%, p < .05), and implantation rate (5.6% vs. 31.8%, p < .05) were lower, and pregnancy loss rate (83.3% vs. 23.1%, p < .05) was higher in patients with treatment than no treatment. Conclusion The influence of ANA on number of retrieved oocytes, available embryos, high-quality embryos, and proration of high-quality embryos was not found. The treatment of prednisone plus HCQ may improve implantation rate, biochemical pregnancy rate, and clinical pregnancy rate, and reduce pregnancy loss rate in frozen embryo transfer outcomes for ANA-positive women.

P–354 Analysis of pregnancy and miscarriage rates in anti-centromere antibodies (ACA)-positive patients treated with ART

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Kida ◽  
M Tokoro ◽  
H Kitasaka ◽  
T Yoshimura ◽  
N Fukunaga ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Antinuclear Antibody ◽  
Assisted Reproductive Technologies ◽  
Formation Rate ◽  
Reproductive Technologies ◽  
Pregnancy Rates ◽  
Human Embryos ◽  
Antibody Testing ◽  
Miscarriage Rate ◽  
Significant Difference

Abstract Study question Do ACA have an effect on pregnancy and miscarriage rates of human embryos? Summary answer The present results suggest that in ACA-positive cases, the pregnancy rate per transfer was significantly lower, although the miscarriage rate was not affected. What is known already We have previously shown that patients with high levels of anti-centromere antibody (ACA), (one of the anti-nuclear antibodies (ANA)), frequently have dispersal of the female chromosomes in the cytoplasm. Additionally, we reported that the clinical outcome was characterized by a low oocyte maturation rate following ovum pick up and high multiple pronuclear formation rate after fertilization. However, the post-implantation course of embryos with ACA-positive cases has not yet been reported. Therefore, in this study, we analyzed the pregnancy and miscarriage rates in ACA-positive patients treated with Assisted Reproductive Technologies (ART). Study design, size, duration 6581 patients who underwent embryo transfer after antinuclear antibody testing between January 2014 and February 2020 were included in the analysis. Participants/materials, setting, methods The subjects were classified into three groups: ANA-negative (without ACA or any other ANA), ACA-positive (with only ACA) and ANA-positive (with ANA but not ACA). The cycle in which the gestational sac was confirmed was considered a positive pregnancy. The pregnancy and miscarriage rates were compared among the groups using “Ryan Test” for statistical analysis. Main results and the role of chance Of the 6581 eligible cases, the incidence of antinuclear antibody were 71.3% (4695/6581; ANA-negative), 0.9% (61/6581; ACA-positive) and 27.7% (1825/6581; ANA-positive). The pregnancy rates based on the total number of embryo transfer cycles for each were ANA-negative: 31.5% (5283/16792), ACA-positive: 17.6% (41/233), and ANA-positive: 32.4% (1891/5833). The pregnancy rates were significantly lower in the ACA-positive group than in the other groups. The miscarriage rate was 29.4% (1553/5283) in ANA-negative, 31.7% (13/41) in ACA-positive, and 28.0% (529/1891) in ANA-positive, with no significant difference between the three groups. Limitations, reasons for caution Retrospective analysis Wider implications of the findings: ACA-positive patients may benefit from a treatment strategy to increase the absolute number of oocytes by obtained in order to increase the chances of normal fertilization and attainment of implantation. Trial registration number none

P–318 Short (seven days) versus conventional (fourteen days) estrogen priming in an artificial frozen embryo transfer cycle: a randomised controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Racca ◽  
S Santos-Ribeiro ◽  
D Panagiotis ◽  
L Boudry ◽  
S Mackens ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Transvaginal Ultrasound ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Study question What is the impact of seven days versus fourteen days’ estrogen (E2) priming on the clinical outcome of frozen-embryo-transfer in artificially prepared endometrium (FET-HRT) cycles? Summary answer No significant difference in clinical/ongoing pregnancy rate was observed when comparing 7 versus 14 days of estrogen priming before starting progesterone (P) supplementation. What is known already One (effective) method for endometrial preparation prior to frozen embryo transfer is hormone replacement therapy (HRT), a sequential regimen with E2 and P, which aims to mimic the endocrine exposure of the endometrium in a physiological cycle. The average duration of E2 supplementation is generally 12–14 days, however, this protocol has been arbitrarily chosen whereas, the optimal duration of E2 implementation remains unknown. Study design, size, duration This is a single-center, randomized, controlled, open-label pilot study. All FET-HRT cycles were performed in a tertiary centre between October 2018 and December 2020. Overall, 150 patients were randomized of whom 132 were included in the analysis after screening failure and drop-out. Participants/materials, setting, methods The included patients were randomized into one of 2 groups; group A (7 days of E2 prior to P supplementation) and group B (14 days of E2 prior to P supplementation). Both groups received blastocyst stage embryos for transfer on the 6th day of vaginal P administration. Pregnancy was assessed by an hCG blood test 12 days after FET and clinical pregnancy was confirmed by transvaginal ultrasound at 7 weeks of gestation. Main results and the role of chance Following the exclusion of drop-outs and screening failures, 132 patients were finally included both in group A (69 patients) or group B (63 patients). Demographic characteristics for both groups were comparable. The positive pregnancy rate was 46.4% and 53.9%, (p 0.462) for group A and group B, respectively. With regard to the clinical pregnancy rate at 7 weeks, no statistically significant difference was observed (36.2% vs 36.5% for group A and group B, respectively, p = 0.499). The secondary outcomes of the study (biochemical pregnancy, miscarriage and live birth rate) were also comparable between the two arms for both PP and ITT analysis. Multivariable logistic regression showed that the HRT scheme is not associated with pregnancy rate, however, the P value on the day of ET is significantly associated with the pregnancy outcome. Limitations, reasons for caution This study was designed as a proof of principle trial with a limited study population and therefore underpowered to determine the superiority of one intervention over another. Instead, the purpose of the present study was to explore trends in outcome differences and to allow us to safely design larger RCTs. Wider implications of the findings: The results of this study give the confidence to perform larger-scale RCTs to confirm whether a FET-HRT can be performed safely in a shorter time frame, thus, reducing the TTP, while maintaining comparable pregnancy and live birth rates. Trial registration number NCT03930706

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