Predictive Model for Live Birth at 12 Months After Starting In-Vitro Fertilization Treatment

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 5-20
Author(s):  
Vu Ho ◽  
Toan Pham ◽  
Tuong Ho ◽  
Lan Vuong
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Cox Regression ◽  
Financial Burden ◽  
Oocyte Retrieval ◽  
Operating Characteristics ◽  
Vitro Fertilization ◽  
Cox Regression Analysis ◽  
Significant Difference

IVF carries a considerable physical, emotional and financial burden. Therefore, it would be useful to be able to predict the likelihood of success for each couple. The aim of this retrospective cohort study was to develop a prediction model to estimate the probability of a live birth at 12 months after one completed IVF cycle (all fresh and frozen embryo transfers from the same oocyte retrieval). We analyzed data collected from 2600 women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) at a single center in Vietnam between April 2014 and December 2015. All patients received gonadotropin-releasing hormone (GnRH) antagonist stimulation, followed by fresh and/or frozen embryo transfer (FET) on Day 3. Using Cox regression analysis, five predictive factors were identified: female age, total dose of recombinant follicle stimulating hormone used, type of trigger, fresh or FET during the first transfer, and number of subsequent FET after the first transfer. The area under the receiver operating characteristics curve for the final model was 0.63 (95% confidence interval [CI] 0.60‒0.65) and 0.60 (95% CI 0.57‒0.63) for the validation cohort. There was no significant difference between the predicted and observed probabilities of live birth (Hosmer-Lemeshow test, p > 0.05). The model developed had similar discrimination to existing models and could be implemented in clinical practice.

scholarly journals In Vitro Fertilization Outcome After Intracytoplasmic Sperm Injection with Fresh and with Frozen-Thawed Epididymal Spermatozoa

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Hilma Putri Lubis
Keyword(s):  
In Vitro Fertilization ◽  
Intracytoplasmic Sperm Injection ◽  
Oocyte Retrieval ◽  
Epididymal Sperm ◽  
Vitro Fertilization ◽  
Fertilization Rates ◽  
Sperm Aspiration ◽  
Significant Difference ◽  
Epididymal Spermatozoa

<p><strong>Introduction</strong></p><p>Testicular epididymal sperm aspiration (TESA) is one of the method  to retrieve sperm from the testes in men with azoospermia. The aim of the study is to compare the In vitro fertilization (IVF) outcome of intracytoplasmic sperm injection (ICSI)-ET cycles with fresh testicular epididymal spermatozoa obtained on the same day with  oocyte retrieval and with frozen-thawed testicular epididymal spermatozoa.</p><p><strong>Material &amp; Methods</strong></p><p>A retrospective comparative analysis of  patients who underwent fresh TESA and frozen-thawed TESA in ICSI-ET cycles from January 2012 to December 2014 in Halim Fertility Center was done. Fresh testicular epididymal sperm aspiration (fresh TESA) was performed on the same day with oocyte retrieval in 28 cycles and the frozen-thawed testicular epididymal sperm aspiration (frozen-thawed TESA) was used in 30 cycles.  </p><p><strong>Results</strong></p><p>The two groups were comparable in terms of the ages of male and female patients, etiology of infertility and duration of infertility. Fertilization rates in fresh TESA group were 53,5% and in frozen-thawed TESA group, fertilization rates were 50%. There was no statistically significant difference between the groups. Clinical pregnancy rates in fresh TESA group were 35,7%  and in frozen-thawed TESA group, clinical pregnancy rates were 26,7% and statistically there was no significant difference between the groups.</p><p><strong>Conclusion</strong></p>There is no significant difference in the in vitro fertilization outcome of intracytoplasmic sperm injection (ICSI)-ET cycles between fresh TESA and frozen-thawed TESA .

Unexplained infertility and expectant management in women aged 39 or above: is it acceptable to ask couples to wait one year before receiving IVF? A retrospective cohort study

2020 ◽  
Author(s):  
Andrea Roberto Carosso ◽  
Rik van EEKELEN ◽  
Alberto Revelli ◽  
Stefano CANOSA ◽  
Noemi MERCALDO ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Expectant Management ◽  
Unexplained Infertility ◽  
Vitro Fertilization ◽  
Age Related ◽  
Significant Difference ◽  
Natural Conception ◽  
One Year

Abstract Background: in older women, it is difficult to distinguish between ‘true’ unexplained infertility and age-related infertility. Unexplained infertile couples can have further expectant management before starting assisted reproductive treatments to avoid unnecessary, invasive and expensive treatment. However, ovarian reserve rapidly declines after 39 years or more, as the live birth rate after in vitro fertilization. It is thus uncertain if such a waiting policy, is also appropriate for women of advanced age.Methods: couples who had access to a waiting list for approximately one year before receiving reimbursed public IVF were compared with those paying for access to immediate private treatment at the IVF unit of S. Anna academic hospital and its private appendix. To allow for comparisons between these two strategies, we followed up couples who opted to pay for one year after the last embryo transfer from their first cycle. Clinical procedures regarding diagnosis and treatment were the same for both groups. We calculated the proportion of live births in both groups and compared these using a two-sample Z test for equality of proportions. The imbalance between these groups in terms of prognosis was accounted for using inverse probability weighting.Results: 635 couples were evaluated. Out of 359 couples in the immediate group, 70 (19.5%) had a live birth of which 11 after natural conception and 59 after IVF. Out of 276 couples in the waiting group, 57 (20.7%) had a live birth of which 37 after natural conception and 20 after IVF. There was no statistically significant difference between the two strategies in terms of the cLBR (19.5% immediate versus 20.7% waiting, 95% CI for difference: -0.07to 0.05), also after weighting (16.8% immediate versus 26.6% waiting, bootstrap 95%, CI for difference: -0.20 to 0.01).Conclusion(s): the cLBR for the ‘waiting before in vitro fertilization’ and the ‘immediate’ strategies were similar. Further studies are necessary to validate these findings and to better characterize these patients in order to individualize treatment and optimize economic resources, particularly in a setting of publicly-funded IVF.Trial registration: retrospectively registered

scholarly journals Cumulative Live Birth Rates of Women ≥ 38 Years With Poor, Normal and High Ovarian Response

2021 ◽  
Author(s):  
Conghui Liu ◽  
Yu Li ◽  
Hong Jiang ◽  
Xuemei Wang ◽  
Feng Ni ◽  
...  
Keyword(s):  
Live Birth ◽  
Live Birth Rate ◽  
Oocyte Retrieval ◽  
Ovarian Response ◽  
Fresh Embryo Transfer ◽  
Vitro Fertilization ◽  
Logistic Regression Models ◽  
Significant Difference ◽  
The Relationship

Abstract Background Previous studies have reported that live birth rate (LBR) decreased with aging, however, no study has evaluated the cumulative LBR (CLBR) in accordance with the ovarian response in advanced maternal age (AMA) patients. This study aims to investigate the relationship between the ovarian response and the CLBR in AMA patients. Methods 913 women ≥ 38 years underwent in vitro fertilization (IVF) and fresh embryo transfer (ET) between January 2014 and June 2019 were enrolled in this retrospective study. All subjects were categorized into three groups, poor ovarian response (POR) group: 1–3 oocytes retrieved (n = 127), normal ovarian response (NOR) group: 4–15 oocytes retrieved, and high ovarian response (HOR) group: more than 15 oocytes retrieved. The primary outcome was the CLBR in one oocyte retrieval cycle after transfer of all fresh and frozen embryos. Logistic regression models were used to derive the odds ratio (OR) to identify the relationship of CLBR with different ovarian response, adjusting for age and body mass index. Results Compared with women in POR group, the women in other groups (NOR and HOR groups) achieved higher CLBR [adjusted OR (aOR) = 2.12, 95% confidence interval (CI), 1.16–4.38 for NOR group; aOR = 2.93, 95% CI, 1.44–5.97 for HOR]. The LBR of the fresh ET and the neonate characteristics showed no significant difference among the three groups. Conclusion Ovarian response is significantly associated with CLBR in women with advanced age.

scholarly journals The effect of Propofol versus Dexmedetomidine as anesthetic agents for oocyte pick-up on in vitro fertilization (IVF) outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Özcan Budak ◽  
Mehmet Sühha Bostancı ◽  
AyçaTaş Tuna ◽  
Veysel Toprak ◽  
Hüseyin Çakiroğlu ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Oocyte Retrieval ◽  
Vitro Fertilization ◽  
Ivf Outcomes ◽  
Anesthetic Agents ◽  
Significant Difference ◽  
Embryo Number ◽  
Group 2

AbstractThis study aimed to evaluate the effects of propofol and dexmedetomidine over different timescales on the IVF outcomes for transvaginal oocyte retrieval (TVOR). Twenty-four rats included in the study were divided into two main groups and three subgroups were subjected to the ovulation induction process. Group 1 was administered propofol (100 mg/kg i.v.) and group 2 were administered dexmedetomidine (25 µg/kg i.p.) The oviduct collection procedure was completed within 15 min for subgroup Pro15min, Dex15min (n = 4), within 16 to 30 min for subgroup Pro30min, Dex30min (n = 4) and within 31 to 60 min for subgroup Pro60min, Dex60min (n = 4) after euthanasia. The total number of oocytes was counted. After in vitro fertilization, the number and quality of embryos were evaluated. The number of pups born were evaluated after embryo transfer. The embryo number, quality and pup count decreased as the administration time for propofol increased (p < 0.05). No statistically significant difference was found between the dexmedetomidine subgroups for embryo number, quality and pup count(p > 0.05). As the exposure time to propofol increased, the number and quality of embryos obtained, and the pup count, decreased. The use of dexmedetomidine had no negative impacts on the number of embryos, their quality or the number of pups.

Cumulative live birth rates in in-vitro fertilization

2019 ◽  
Vol 71 (3) ◽  
Author(s):  
Panagiotis Drakopoulos ◽  
Joaquín Errázuriz ◽  
Samuel Santos-Ribeiro ◽  
Herman Tournaye ◽  
Alberto Vaiarelli ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Birth Rates ◽  
Vitro Fertilization ◽  
Live Birth Rates ◽  
Cumulative Live Birth

scholarly journals Luteal phase support for in vitro fertilization/intracytoplasmic sperm injection fresh cycles: a systematic review and network meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hanglin Wu ◽  
Songying Zhang ◽  
Xiaona Lin ◽  
Shasha Wang ◽  
Ping Zhou
Keyword(s):  
Live Birth ◽  
Pregnancy Outcomes ◽  
Luteal Phase ◽  
Meta Analysis ◽  
Oocyte Retrieval ◽  
Gnrh Agonists ◽  
Ongoing Pregnancy ◽  
Vitro Fertilization ◽  
Lps Treatment

Abstract Background Various luteal phase supports (LPSs) have been proven to increase the pregnancy rate in fresh cycles of in vitro fertilization or intracytoplasmic sperm injection; however, there is still significant debate regarding the optimal use of LPS. Methods A systematic review with the use of a network meta-analysis was performed via electronic searching of Ovid MEDLINE, the Cochrane Library, Embase, Web of Science, ClinicalTrials.gov and Google Scholar (up to January 2021) to compare the effectiveness and safety of various LPSs, as well as to evaluate the effects of different initiations of LPSs on pregnancy outcomes. The primary outcomes included live birth and ongoing pregnancy, with the results presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results Eighty-nine randomized controlled trials with 29,625 women comparing 14 interventions or placebo/no LPS treatments were included in the meta-analyses. No significant differences were found in terms of the pregnancy outcomes when LPS was started within 48 h after oocyte retrieval versus a delayed initiation between 48 h and 96 h after oocyte retrieval. The addition of gonadotropin-releasing hormone (GnRH) agonists to progesterone vaginal pessaries showed a significant benefit in terms of live birth (OR 1.39, 95% CI 1.08 to 1.78). Only human chorionic gonadotropin (HCG) was found to be more efficacious than the placebo/no LPS treatment in terms of live birth (OR 15.43, 95% CI 2.03 to 117.12, low evidence). Any active LPSs (except for rectal or subcutaneous progesterone) was significantly more efficacious than the placebo/no LPS treatment in terms of ongoing pregnancy, with ORs ranging between 1.77 (95% CI 1.08 to 2.90) for the vaginal progesterone pessary and 2.14 (1.23 to 3.70) for the intramuscular progesterone treatment. Among the comparisons of efficacy and tolerability between the active treatments, the differences were small and very uncertain. Conclusion Delays in progesterone supplementation until 96 h after oocyte retrieval does not affect pregnancy outcomes. The safety of GnRH agonists during the luteal phase needs to be evaluated in future studies before the applications of these agonists in clinical practice. With comparable efficacy and acceptability, there may be several viable clinical options for LPS.

scholarly journals Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization

2021 ◽  
Author(s):  
Antonio Palagiano ◽  
Mauro Cozzolino ◽  
Filippo Maria Ubaldi ◽  
Chiara Palagiano ◽  
Maria Elisabetta Coccia
Keyword(s):  
In Vitro Fertilization ◽  
Oocyte Retrieval ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Endometrial Receptivity ◽  
Vitro Fertilization ◽  
Ovid Medline ◽  
Ultrasonographic Guidance

AbstractHydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF). We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal removal could result in improved implantation rates in IVF. In addition, salpingectomy does not affect the ovarian response, nor reduces the antral follicle count. Further studies are needed to establish the therapeutic value of fluid aspiration under ultrasonographic guidance, during or after oocyte retrieval, in terms of pregnancy rate and ongoing pregnancy.

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