scholarly journals Perinatal Outcomes of Babies Born with Fresh or Frozen-Thawed Testicular Sperm in Patients with Azoospermia

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Mehmet AK ◽  
Nur Dokuzeylul Gungor
Keyword(s):  
Birth Weight ◽  
Live Birth ◽  
Gestational Age ◽  
Neonatal Death ◽  
Perinatal Outcomes ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Testicular Sperm ◽  
Significant Difference ◽  
Gestational Age At Delivery

Aim: To compare the perinatal outcomes of pregnancies obtained with fresh or frozen-thawed sperm in patients who underwent surgical sperm extraction for the diagnosis of azoospermia. Materials and Methods: In this retrospective study, data were collected on couples who conceived following Intracytoplasmic Sperm Injection using surgically retrieved fresh or frozen-thawed sperm. Participants were divided into two equal groups as follows. Group 1 (n = 100) consisted of patients who underwent ICSI and subsequent embryo transfer using fresh testicular sperm and Group 2 (n = 100) consisted of patients who underwent ICSI by using frozen-thawed testicular sperm. Perinatal outcome was compared according to the use of fresh or frozen-thawed sperm. Primary outcome measures included clinical pregancy, miscarriage, live birth, congenital abnormality, birthweight, gestational age at delivery, stillbirth and neonatal death. Results: Live birth and clinical pregnancy rates were found to be significantly higher in patients who underwent ICSI/ET with frozen-thawed testicular sperm compared to fresh sperm group. The miscarriage rates were significantly lower in the frozen-thawed sperm group compared to the fresh testicular sperm group. Clinical pregnancy was detected in 18 cases, while no pregnancy was detected in 82 cases undergoing ICSI with fresh sperm. In the group where ICSI/ET was applied with frozen sperm, clinical pregnancy was detected in 51 cases, whereas pregnancy was not detected in 49 cases. In the frozen sperm group, in addition to C/S and multiple pregnancy rates, the number of babies with a birth weight below 2500 g was significantly higher than in the fresh sperm group. There was no significant difference between the groups in terms of minor and major congenital anomalies, birth weight, gestational age at delivery, stillbirth and neonatal death. Conclusion: Using fresh or frozen testicular sperm does not have a significant effect on perintal outcome in patients with azoospermia.

scholarly journals Effect of Laser-Assisted Hatching on the Clinical Outcomes of Human Vitrified-Thawed Embryo Transfer Cycles with Different Post-Thaw Culture Duration

2020 ◽  
Author(s):  
Yang Luo ◽  
Fang Peng ◽  
Yuan Sun ◽  
Lei Li
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Ectopic Pregnancy ◽  
Live Birth ◽  
Perinatal Outcomes ◽  
Clinical Pregnancy ◽  
Assisted Hatching ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

Abstract Background: Zona pellucida(ZP)hardening caused by prolonged in vitro culture and exacerbated by the freeze–thaw process making ZP hatching difficult; In theory, assisted hatching may facilitate the hatching process and have the potential to increase implantation and/or pregnancy rates in frozen embryo transfer (FET) cycles. However, a number of studies have shown controversial results on the clinical benefit of laser-assisted hatching (LAH) in FET cycles. This study firstly investigated the efficacy and safety of LAH using vitrified-thawed embryos with different post-thaw culture duration in FET cycles.Methods: Data from the center’s IVF database were retrospectively analyzed, only embryos thawed for the first FET cycle of each ovarian pick-up were eligible for this study, and only cycles in which at least one embryo was available for transfer were included in the present study. Finally, a total of 1225 infertile couples who underwent 1225 FET cycles between July 2013 and March 2015 were analyzed in this study. According to the duration of post-thaw culture in FET cycles, these patients were allocated to three subgroups: the short culture (4-5 h) group (LAH, n=205; control, n=201), overnight culture (20-24 h) group (LAH, n=197; control, n=203), and blastocyst culture (44-48 h) group (LAH, n=210; control, n=209), respectively.Results: In the short culture(4-5 h) subgroup, no statistically significant differences were found related to the implantation, clinical pregnancy and live birth rates between the two groups (28.0% versus 27.8%, 38.0% versus 36.8%, and 30.7% versus 30.3%, respectively, P＞0.05). When the perinatal outcomes of two groups were compared, there was no significant difference in the gestational weeks (37.96±2.23 versus 37.59±2.35, P＞0.05), birth weight (2.70±0.56 versus 2.82±0.62, P＞0.05), as well as the preterm birth (15.4% versus 17.6%, P＞0.05), ectopic pregnancy (2.6% versus 1.4%, P＞0.05), and miscarriage rates (16.7% versus 16.2%, P＞0.05).In the overnight culture(20-24 h) subgroup, no statistically significant differences were found regarding the implantation, clinical pregnancy and live birth rates (29.5% versus 29.1%, 40.1%versus 37.4%, 33.0%versus 30.5%, respectively, P＞0.05).As to the perinatal outcomes, there was no significant difference in the gestational weeks (36.86±2.28 versus 35.69±2.95, P＞0.05), birth weight (2.73±0.76 versus2.62±0.52, P＞0.05), as well as the preterm birth (15.2% versus 17.1%, P＞0.05), ectopic pregnancy (3.8% versus 2.6%, P＞0.05), and miscarriage rates (13.9% versus 15.8%, P＞0.05).In the blastocyst culture(44-48 h) subgroup, the two groups did not differ significantly in the implantation, clinical pregnancy and live birth rates (56.3% versus 59.3%, 68.6% versus 66.5%, and 55.7% versus56.5%, respectively, P＞0.05).Furthermore, there were also no significant difference in the gestational weeks (38.68±2.76 versus 36.95±2.59, P＞0.05), birth weight (2.78±0.74 versus 2.72±0.59, P＞0.05), as well as the preterm birth (8.3% versus 11.5%, P＞0.05), ectopic pregnancy (2.8% versus 2.2%, P＞0.05), and miscarriage rates (16.0% versus 12.9%, P＞0.05).Conclusions: Our results suggested that LAH does not improve the clinical outcomes in FET cycles, irrespective of the duration of post-thaw culture. Though the risk of perinatal period did not increase, it is still necessary to conduct further investigations to validate the safety of LAH.

scholarly journals Perinatal Outcome in Assisted Reproductive Pregnancies: Comparative Analysis of Reduced versus Unreduced Gestation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Shilpa Bhandari ◽  
Pallavi Agrawal ◽  
Ishita Ganguly ◽  
Aparna Singh ◽  
Nitika Gupta
Keyword(s):  
Birth Weight ◽  
Live Birth ◽  
Gestational Age ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Multiple Gestation ◽  
Fetal Reduction ◽  
Gestation Age ◽  
Gestational Age At Delivery

Objectives. This study aims to evaluate perinatal outcomes such as gestational age at delivery and live birth rate in singleton and twin gestation with or without fetal reduction. Method. A retrospective analysis was done on patients which were divided into reduced and unreduced groups on the basis of order of reduction of one or more fetuses between 6 and 13 weeks of gestation. Patients records were studied to note gestational age at delivery/abortion, birth weight, and neonatal outcome. Result. The cohort included a total of 292 patients: 102 singletons and 190 twins. 52 pregnancies were reduced in singleton cohort and 68 were reduced in twin cohort. No statistical difference was observed in live birth rate, gestational age at delivery, and birth weight and significant higher incidence of IUGR was observed in reduced and unreduced twin gestation. In singleton pregnancies however preterm delivery rate increased with fetal reduction. Conclusion. Although reduction does not reduce the live birth rate, it does reduce gestation age of delivery and birth weight of newborn. This effect is more apparent when multiple gestation is reduced to singleton.

scholarly journals Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017139 ◽  
Author(s):  
Rebecca Garcia ◽  
Nasreen Ali ◽  
Andy Guppy ◽  
Malcolm Griffiths ◽  
Gurch Randhawa
Keyword(s):  
Birth Weight ◽  
Retrospective Analysis ◽  
Preterm Delivery ◽  
Outcome Measures ◽  
Gestational Age ◽  
Secondary Data ◽  
Significant Difference ◽  
Singleton Birth ◽  
Gestational Age At Delivery ◽  
Indian Mothers

ObjectiveTo compare mean birth weights and gestational age at delivery of infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK.DesignRetrospective analysis using routinely recorded secondary data in Ciconia Maternity information System, between 2008 and 2013.SettingLuton, UK.ParticipantsMothers whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian and living in Luton, aged over 16, who had a live singleton birth over 24 weeks of gestation were included in the analysis (n=14 871).Outcome measuresPrimary outcome measures were mean birth weight and gestational age at delivery.ResultsAfter controlling for maternal age, smoking, diabetes, gestation age, parity and maternal height and body mass index at booking, a significant difference in infants’ mean birth weight was found between white British and Indian, Pakistani and Bangladeshi infants, F(3, 12 287)=300.32, p<0.0001. The partial Eta-squared for maternal ethnicity was η2=0.067. The adjusted mean birth weight for white British infants was found to be 3377.89 g (95% CI 3365.34 to 3390.44); Indian infants, 3033.09 g (95% CI 3038.63 to 3103.55); Pakistani infants, 3129.49 g (95% CI 3114.5 to 3144.48); and Bangladeshi infants, 3064.21 g (95% CI 3041.36 to 3087.06). There was a significant association in preterm delivery found in primipara Indian mothers, compared with Indian mothers (Wald=8.192, df 1, p<0.005).ConclusionsResults show important differences in adjusted mean birth weight between Indian, Pakistani, Bangladeshi and white British women. Moreover, an association was found between primipara Indian mothers and preterm delivery, when compared with Pakistani, Bangladeshi and white British women.

Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Hassan Mostafa ◽  
Sherif Ahmed Ashoush ◽  
Hassan Awwad Bayoumy ◽  
Wessam Kamal Lotfy Gabr
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Perinatal Morbidity ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Gestational Age At Delivery

Abstract Background Preterm birth with its complications is one of the leading causes of perinatal morbidity and mortality, as well as maternal morbidity, especially in low and middle-income countries. Cervical cerclage is a well-established preventive tool in women at high risk of preterm birth; however, subclinical maternal infection might still cause failure of this method. Thus, adding prophylactic antibiotics, namely macrolides, could prevent preterm birth. Patients and methods This was a randomized controlled clinical trial involving two groups of women who underwent vaginal cerclage at Ain Shams University Maternity Hospital. One group received azithromycin 500mg one tablet orally once daily for 3 days every month from 14th week to 34th week gestation, in addition to routine antenatal care; while the other group received usual antenatal care without antibiotic prophylaxis after cerclage. Follow-up was done and we compared the outcomes in each group: gestational age at delivery, birth weight, mode of delivery, maternal complications, and perinatal complications. ClinicalTrials.gov Identifier NCT04278937. Results Gestational age at delivery was significantly higher in the azithromycin group (36.8weeks vs 34.1weeks; P = 0.017), with significant prolongation of gestation in the azithromycin group (23.7weeks vs 21.1weeks; P = 0.005). As regards birth weight, it was significantly higher in the azithromycin group (2932.6gm vs 2401.8gm; P = 0.006); however babies with low birth weight (birth weight &lt;2500gm) were non-significantly less frequent in the azithromycin group (3cases vs 7cases; P = 0.165). There was no significant difference between the two groups as regards other outcomes (miscarriage, stillbirth, neonatal intensive care unit admission, antepartum hemorrhage, postpartum pyrexia, need for blood transfusion). Conclusion Adding azithromycin as antenatal prophylaxis in women undergoing vaginal cerclage prolongs pregnancy and reduces risk of PTB, with slight increase in birth weight. However, there was no clear effect on incidence of low birth weight, or perinatal morbidity/mortality.

The relationship between maternal and umbilical cord adropin levels with the presence and severity of preeclampsia

2017 ◽  
Vol 45 (7) ◽  
Author(s):  
Burcu Dincgez Cakmak ◽  
Betul Dundar ◽  
Abdullah Serdar Acikgoz ◽  
Gulten Ozgen ◽  
Tayfur Cift ◽  
...  
Keyword(s):  
Platelet Count ◽  
Birth Weight ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Enzyme Linked Immunosorbent Assay ◽  
Gestational Age At Delivery ◽  
Blood Pressures ◽  
The Relationship

AbstractAim:To investigate both maternal and umbilical cord adropin levels in patients with preeclampsia and the possible relations with its severity and perinatal outcomes.Materials and methods:In this study, a total of 38 preeclamptic and 40 age-matched healthy pregnant women between January and June 2016 were included. Serum and cord adropin levels were measured using an enzyme-linked immunosorbent assay (ELISA).Results:The maternal and umbilical cord adropin levels were significantly lower in the preeclamptic group compared to controls [71.19±22.21 vs. 100.76±27.02 ng/L and 92.39 (59.77:129.89) vs. 106.20 (74.42:208.02) ng/L, P<0.001, respectively]. While maternal adropin levels were significantly lower in the severe preeclampsia group as compared to the mild preeclamptic group [66.45 (21.49:98.02) vs. 76.17 (58.06:109.58), P=0.007], umbilical cord adropin levels did not differ between each group [91.32 (59.77:113.34) vs. 92.87 (63.12:129.89), P=0.750]. Maternal adropin level was negatively correlated with systolic and diastolic blood pressures (r=−0.60, P<0.001 and r=−0.58, P<0.001, respectively) and positively correlated with platelet count (r=0.27, P=0.016). Moreover, umbilical cord adropin levels were weakly correlated with gestational age at delivery (r=0.28, P=0.012) and birth weight (r=0.28, P=0.014).Conclusion:The present study is the first to demonstrate a significant association between maternal and umbilical adropin levels and the presence and severity of preeclampsia. Adropin might be a useful parameter for predicting the presence and severity of preeclampsia.

scholarly journals Fresh Versus Frozen Testicular Sperm Samples in Microdissection Testicular Sperm Extraction Intracytoplasmic Sperm Injection Treatment

2017 ◽  
pp. 1
Author(s):  
Şafak Hatırnaz ◽  
Serdar Başaranoğlu ◽  
Ebru Hatırnaz ◽  
Mine Kanat Pektaş
Keyword(s):  
Clinical Outcomes ◽  
Live Birth ◽  
Intracytoplasmic Sperm Injection ◽  
Clinical Pregnancy ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Significant Difference

<p><strong>Objective:</strong> The present study aims to compare the clinical outcomes of fresh versus frozen testicular samples in patients with non-obstructive azoospermia who would undergo intracytoplasmic sperm injection procedure.<br /><strong>Study Design:</strong> This is a retrospective review of 541 patients with non-obstructive azoospermia who consecutively underwent microdissection testicular sperm injection and intracytoplasmic sperm injection between January 2010 and October 2014.<br /><strong>Results:</strong> A total of 4896 mature oocytes were collected from the partners of azoospermic men and 1894 sperms were retrieved by microdissection testicular sperm procedures. About 1036 fresh sperms were used to perform intracytoplasmic sperm injection in 296 men with non-obstructive azoospermia whereas 858 in 245 azoospermic men. Approximately 1228 embryos were obtained after intracytoplasmic sperm injection and 1080 embryos were transferred. After embryo transfer, 146 clinical pregnancies occurred and 125 pregnancies ended up with live birth. The fertilization, implantation, clinical pregnancy and live birth rates were respectively 44.6%, 33.4%, 28.0% and 24.7% for 296 fresh microdissection testicular sperm cycles. On the other hand, the fertilization, implantation, clinical pregnancy and live birth rates were respectively 46.5%, 32.7%, 25.7% and 21.2% for 245 frozen microdissection testicular sperm cycles. There was no statistically significant difference between the fresh and frozen microdissection testicular sperm injection cycles in aspect of fertilization, implantation, clinical pregnancy and liver birth rates (p=0.125, p=0.194, p=0.196 and p=0.182).<br /><strong>Conclusion:</strong> The utilization of fresh and frozen sperms in microdissection testicular sperm - intracytoplasmic sperm injection cycles has similar clinical outcomes. The use of frozen sperms obtained by testicular sperm can be considered as an efficient and safe approach for avoiding unnecessary ovarian hyperstimulation and repetitious interventions on testicular tissues.</p>

scholarly journals A defined grey zone with in fetal growth curves for predicting adverse neonatal morbidity in fetuses being small for their gestational age at term in uncomplicated pregnancies

2019 ◽  
Author(s):  
Mefkure Eraslan Sahin ◽  
Ilknur Col Madendag ◽  
Erdem Sahin ◽  
Yusuf Madendag ◽  
Fatma Ozdemir ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Gestational Age ◽  
Apgar Score ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Neonatal Morbidity ◽  
Grey Zone ◽  
Increased Risk ◽  
Significant Difference

Abstract Background: “Small for gestational age” (SGA) is a term used to define an important risk factor for both neonatal morbidity and mortality. Our hypothesis suggests that adverse neonatal morbidity (ANM) in fetuses can occur when the birth weight is closer to 10th percentile. For example, although a fetus with a birth weight within the 11th or 12th percentile is appropriate for gestational age (AGA), it is difficult to clearly distinguish these fetuses from SGA fetuses for ANM; therefore we suggest defining a transition zone, or “grey zone”, for ANM. The aim of the present study was to examine ANM frequency in fetuses using this newly defined grey-zone percentile. Methods: This retrospective analysis comprised 7,817 pregnant women with uncomplicated pregnancies and single deliveries between 37 0/7 and 41 6/7 gestational weeks. The babies were divided into groups according to birth weight percentiles as follows: (1) SGA, (2) 10–20 percentile, and 21–90 percentile. The primary outcome was ANM, defined as any of the following: Apgar score <4 at 5 min; respiratory distress; mechanical ventilation; intraventricular hemorrhage, grade III or IV; necrotizing enterocolitis, stage 2 or 3; neonatal sepsis, stillbirth or neonatal death. Results: Demographic and obstetric characteristics of the mothers were similar among the groups. ANM rates were 10.7% in the SGA group, 6.8% in the 10–20 percentile group, and 2.1% in the 21–90 percentile group, a significant difference. ANM was 5-fold higher in the SGA group and 3.2-fold higher in the 10–20 percentile group than in the 21–90 percentile group. Delivery induction or augmentation, cesarean delivery for non-reassuring fetal heart rate or fetal distress, apgar score <4 at 5 min, mechanical ventilation, neonatal sepsis, stillbirth, or neonatal death significantly increased in the 10–20 percentile group compared with those in the 21–90 percentile group. Conclusion: In uncomplicated pregnancies, ANM for SGA fetuses born at term are significantly worse than that for AGA fetuses. Fetuses with a birth weight within the 10–20 percentile (grey zone) had a significant increased risk of ANM than those within the 21–90 percentile.

scholarly journals Randomized, Double-blinded, Placebo-controlled Trial of Amoxicillin/Clavulanic Acid to Prevent Preterm Delivery in Twin Gestation

1995 ◽  
Vol 3 (4) ◽  
pp. 158-163 ◽  
Author(s):  
Mark T. Peters ◽  
Charles E. L. Brown ◽  
Audrey Baum ◽  
Rick Risser
Keyword(s):  
Placebo Group ◽  
Birth Weight ◽  
Clavulanic Acid ◽  
Broad Spectrum ◽  
Gestational Age ◽  
Antimicrobial Therapy ◽  
Controlled Trial ◽  
Significant Difference ◽  
Gestational Age At Delivery ◽  
Amoxicillin Clavulanic Acid

Objective: The objective of this study was to determine whether prophylactic treatment with oral broad-spectrum antimicrobial therapy improves pregnancy outcomes in twin gestations.Methods: Patients with twin gestations between 24 and 32 weeks were randomized to receive amoxicillin/clavulanic acid or placebo. Those patients randomized before 24 weeks received a 1-week course at 24 and at 28 weeks gestation. Those patients entered later than 24 weeks received a 1-week course either at 28 weeks or at enrollment (up to 32 weeks). Other than antibiotic use, the management of the groups was identical and unchanged from the routine care of twin gestations.Results: Of 149 twin pregnancies enrolled, 76 were randomized to the drug group and 73 to the placebo group. There was no significant difference in mean gestational age at delivery (35.9 vs. 35.7 weeks), birth weight (2,358 vs. 2,344 g), mean neonatal nursery stay (9.9 vs. 11.7 days), or respiratory distress syndrome (6/76 vs. 4/73) in the drug vs. placebo group, respectively.Conclusions: The addition of prophylactic oral broad-spectrum antimicrobial therapy to the standard antepartum management of twin gestations had no demonstrable effect on the gestational age at delivery, birth weight, or neonatal complications. There did not appear to be any beneficial effect of the prophylactic use of amoxicillin/clavulanic acid in this clinical setting.

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 Impact of Down-Regulation on Obstetrics and Perinatal Outcomes in Singleton Pregnancies After In Vitro Fertilization

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Jin ◽  
Jihui Ai ◽  
Yu Zheng ◽  
Biao Chen ◽  
Lan Wang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Live Birth ◽  
Lower Risk ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Down Regulation ◽  
The Impact

Backgrounddown-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 was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.Methodsthis is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: &lt;30, 30-55, &gt;55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.Resultsthe patients with E2D &lt;30, 30-55, &gt;55 pg/ml had similar live-birth rates. The patients with E2D &lt;30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D &lt;30 pg/ml had a lower risk of PICU admission than those in the group with E2D &gt;55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).ConclusionDown-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D &lt;30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.

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