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

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).

scholarly journals Optimization of a single-embryo transfer in patients with good ovarian reserve

2020 ◽  
Author(s):  
NV Saraeva ◽  
NV Spiridonova ◽  
MT Tugushev ◽  
OV Shurygina ◽  
AI Sinitsyna ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Ovarian Reserve ◽  
Selection Procedure ◽  
Time Lapse ◽  
Single Embryo Transfer ◽  
Main Group ◽  
Control Group ◽  
Fisher Exact Test ◽  
Elective Single Embryo Transfer

Due to refinements of assisted reproductive technology, the number of multiple pregnancies has increased substantially. Time-lapse microscopy (TLM) is a tool for selecting quality embryos for transfer. This study aimed to assess the outcomes of single-embryo transfer of autologous oocytes performed on day 5 of embryo incubation in a TLM-equipped system in patients with good ovarian reserve. The study was carried out in 208 infertile women with good ovarian reserve (over 8 oocytes retrieved). Single-embryo transfer following incubation in a TLM-equipped incubator was performed in 95 patients, who formed the main group; the control group consisted of 113 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 pregnancy loss. Two subgroups were identified in each group of the participants: the 5SET subgroup (nonelective single-embryo transfer), which included 45 patients from the main group and 67 controls, and the 5eSET subgroup (elective single-embryo transfer), which consisted of 50 main group patients and 46 controls. The groups did not differ in terms of age, infertility factors and infertility duration. The quality of transferred embryos was excellent or good in all main group patients (100%); in the control group, the quality of transferred embryos was excellent or good in 93.8% of cases (p = 0.037). Clinical pregnancies were achieved in 64.2% of women in the main group and in 60.2% of controls (p = 0.65). Delivery rates were 54% and 51.1% in the 5eSET and 5SET subgroups of the main group, respectively (p = 0.940). For the control group, delivery rates were 54.4% and 34.3% in the 5eSET and 5SET subgroups, respectively (p = 0.052, Fisher exact test). Elective single-embryo transfer (5eSET) and the use of TLM increased the chance of pregnancy 2.17-fold (p = 0.01).

P–209 Artificial collapse of human expanded blastocysts protects the quality of embryos during vitrification/warming procedure

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Karagianni ◽  
A Papatheodorou ◽  
N Christoforidis ◽  
A Chatziparasidou
Keyword(s):  
Laser Pulse ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Control Group ◽  
Reproductive Outcome ◽  
Blastocyst Quality ◽  
And Control

Abstract Study question Does artificial collapse of human blastocysts before vitrification affect the post warming quality of embryos and/or the reproductive outcome? Summary answer This study suggests that artificial collapse with laser pulse before vitrification significantly benefits blastocyst quality post-warming without improving reproductive outcome. What is known already The efficiency of vitrification of blastocysts can be influenced by various factors, such as the stage of the expansion and the quality of the embryos. Expanded blastocysts seem to be more sensitive and prone to cryo-injury during vitrification because of the large amount of blastocoelic fluid which may cause insufficient dehydration. Artificial collapse (AC) with micro-needles or with laser pulse can improve the vitrification procedure and protect the expanded blastocysts from cryoinjuries by reducing the fluid of the blastocoel. Study design, size, duration This prospective randomized study was performed at Embryolab Fertility Clinic, in Thessaloniki, Greece between July 2020 and November 2020 and included 94 ICSI treatments with no fresh embryo transfer. Patients with more than 4 blastocysts were randomized and allocated to the study (AC) group or control group. Randomization list was created by a computer-based program. The embryos were vitrified at the blastocyst stage and the best 1–2 embryos were transferred in a subsequent cycle. Participants/materials, setting, methods Patients were divided in two groups: AC group (n = 46) where 1 or 2 best expanded blastocysts were artificially collapsed by a laser pulse before vitrification and control group (n = 48) where the corresponding best expanded embryos remained untreated before vitrification. The embryos were graded according to Gardner’s criteria and vitrified using open system. Quality of embryos, pregnancy rate and clinical pregnancy rate from the first warming cycle were the parameters that were analyzed using z-test. Main results and the role of chance The analyzed embryos were in total 171, 85 in the AC group and 86 in the control group. The day 5 embryos in each group were 6.89 (±3.41) and 6.50 (±3.38) and the number of embryos per embryo transfer was 1.85 (±0.36) and 1.79 (±0.41) respectively. Cryoinjury was determined as the presence of degenerated cell in ICM or TE. In the AC group cryo-injury was significantly lower than in the control group [31.11% with at least 1 embryo per embryo transfer and 52.08% respectively (p = 0.0356), 6.67% with cryo-injury in both embryos and 14.58% respectively (p < 0.0001), 8.89% with cryo-injury in ICM and 10.42% respectively (p < 0.0001), 15.56% with cryo-injury in trophectoderm and 27.08% respectively (p < 0.0001), and 6.67% with cryo-injury in both ICM and trophectoderm and 12.50% respectively (p < 0.0001)]. Pregnancy rate (positive b-hcg) was not significantly different between the two groups (62.22% in AC group and 76.09% in control group, p = 0.1479), nor was the clinical pregnancy rate (52.38% and 60.87% in AC and control group respectively, p = 0.4208). Limitations, reasons for caution The number of cases included in this study was limited and the live birth rate was not yet available. More prospective randomized studies are needed in order to validate the benefit of artificial collapse before the vitrification procedure. Wider implications of the findings: Laser artificial Collapse does not compromise expanded blastocyst quality, on the contrary it seems to reduce the amount of cryoinjury observed post warming. Whether it can improve the reproductive outcome, remains to be examined in larger scale studies. Trial registration number Not applicable

The Influence of the Pelvic Floor Muscle Massage on Pregnancy Outcome in Patients Treated with Frozen-Thawed Embryo Transfer

2021 ◽  
Vol 7 (5) ◽  
pp. 1842-1852
Author(s):  
Longying Shen ◽  
Chang Liu
Keyword(s):  
Pelvic Floor ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Pelvic Floor Muscle ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Observation Group ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Objective: To research the influence of the pelvic floor muscle massage on pregnancy outcome of patients treated with frozen-thawed embryo transfer (FET). Methods: We choose 120 patients who will have the frozen-thawed embryo transfer after it is unfreezed, and they are departed into two groups averagely, 60 of observation group and 60 of control group. Both groups start taking estradiol valerate twice a day on the third day of the menstrual cycle, 3mg one time. 14 days later, all patients need to inject progesterone except taking estradiol valerate. The observation group: Starting the pelvic floor muscle massage from the end of menstruation till the day of injecting progesterone, 15-20 minutes, 50 HZ, the acupoints are huiyin and baliao. The contrast group doesn't have any other therapeutic measures. We will transfer the high-quality embryo on the suitable day. We contrast the basic conditions, the embryo, the endometrial thickness and types of uterine endometrium. To analyze the endometrial blood type, PI, RI, S/D, biochemical pregnancy rate, clinical pregnancy rate and early abortion rate. Results: There are no statistical result in transferring conditions, the endometrial thickness and types of uterine endometrium. After the treatment, we find that: 1. in the observation group, after the treatment of pelvic floor muscle massage ,the endometrial blood of the menstrual 17th day compared with the menstrual 9th day, type I decreases clearly, type If and B increase evidently(p<0.05);2. in the observation group after the treatment of pelvic floor muscle massage, we get that the indexes RI, PI and S/D of the menstrual 17th day compared with the menstrual 9th day , reduced remarkably(p<0.05);3 the observation group of patients after treatment, the menstrual 17th day endometrial blood flow decreased significantly than control group in blood flow I type, type If + B increased significantly,(p < 0.05) ;4. The observation group of patients after treatment, PI, RI and S/D of the menstrual 17th days was lower than control group significantly (P < 0.0S);S. in the observation group of patients after treatment ,the endometrial thickness compared with the control group was no statistically different (p>0.05), but the endometrial thickness of the observation group was higher than the control group;6.the implantation rate and clinical pregnancy rate are higher in the observation group than those in the control group. Conclusion: The pelvic floor muscle massage improves the endometrial thickness and endometrial blood conditions, so as to increase the clinical pregnancy rate of patients with frozen-thawed embryo transfer (FET).

P–791 Comparison of the live birth rate after single embryo transfer in fresh versus frozen cycle: no evidence to support routine freeze-all strategy

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Toikkanen ◽  
A Terho ◽  
S Pelkonen ◽  
H Martikainen
Keyword(s):  
Treatment Outcome ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Single Embryo Transfer ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Natural Cycle ◽  
Luteal Support

Abstract Study question Is the treatment outcome compromised after superovulation for fresh IVF/ICSI in comparison to frozen cycle with spontaneous ovulation and luteal support with progesterone? Summary answer Live birth rate (LBR) is dependent on embryo quality both in the fresh and frozen cycles with no sign of harmful effect of the superovulation. What is known already Freeze-all strategy has been advocated in recent years based on the assumption that luteal phase after superovulation is not optimal for embryo implantation. The effects of variable hormonal treatments, given in association with ART, on the endometrium, are still largely unknown. Therefore, more data is needed in order to optimize the treatment policies. Study design, size, duration This is an observational retrospective single-center cohort study. Data were collected from Oulu University Hospital’s ART-database including a total of 5647 single embryo transfer cycles from years 1995–2020. Patients stimulated with long agonist protocol for IVF/ICSI and day 2–3 transfer were included. Frozen embryo transfer was performed in a natural cycle with an ovulation test used for timing of transfer. Luteal support with progesterone was given for two weeks in all cycles. Participants/materials, setting, methods There were 3053 IVF/ICSI fresh cycles (2237 top and 816 N-top) and 2594 frozen cycles (806 top and 1788 N-top). The main outcome measure was LBR compared between fresh and frozen cycles when either a top or a N-top embryo was transferred. As a secondary outcome, clinical pregnancy rate was investigated. Data on the age and body mass index (BMI) of the patients was available. Student’s T-test was used to compare continuous variables. Main results and the role of chance The groups did not differ regarding the age and BMI of the patients. After the transfer of a top quality embryo the clinical pregnancy rate (35.4 vs. 30.8%; p &lt; 0.05) and LBR (29.4 vs. 25.5%; p not significant) was slightly higher in the fresh cycle. After the transfer of a N-top quality embryo the clinical pregnancy rate (19.9 vs. 19.4%) and LBR (15.9 vs. 15.4%) were similar both in the fresh and frozen cycles. Limitations, reasons for caution This study only represents cleavage stage embryo transfers, and all FETs were performed in a natural cycle. In a retrospective study there may also be residual confounding that could not be excluded. Wider implications of the findings: This study provides further evidence that treatment outcome regarding LBR is not affected by superovulation therapy. Hence, the use of freeze-all strategy is warranted only in cases with a risk of ovarian hyperstimulation syndrome. Trial registration number Not applicable

P–392 Clinical outcomes of endometrium receptivity analysis(ERA) testing in patients with repeated IVF failures

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
W J Yang ◽  
F Lu ◽  
L Che. yu ◽  
Y. Y Hsuan ◽  
C Chin. Hung ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Implantation Failure ◽  
Single Center ◽  
Implantation Window ◽  
Ivf Failure ◽  
Endometrium Receptivity

Abstract Study question Is ERA testing different between RIF patients with control group? Summary answer In RIF patients, there were more chances of non-receptive endometrium. ERA testing may be helpful for the patients with repeated IVF failure. What is known already: The endometrium receptivity analysis testing might have the ability to detect the implantation window. In repeat implantation failure patients, detecting of precisely implantation window may have some benefits. Study design, size, duration This was a single-center retrospective observational study. Two hundred and forty-nine patients who underwent ERA testing following frozen-thawed embryo transfer in our center were including in this study between January 2019 and May 2020. Participants/materials, setting, methods 181 patients having unexplained repeated IVF failure (RIF group, at least tow implantation failure) and 68 patients having no experience with embryo transfer (Control group) who underwent ERA testing were including in this study. Both of Patients having a receptive (R) ERA and having a non-receptive (NR) ERA underwent a personalized embryo transfer (pET) on ERA. ERA results and clinical outcomes compared between RIF group and control group were analyzed by Chi-square test. Main results and the role of chance The proportion of R/NR results were 33:35 for the RIF group and 118:63 for the Control group, demonstrating the displacement of the window of implantation in patients with RIF. Our results revealed an endometrial factor in 51% RIF patients, which was significantly greater than the Control group 34.8% (P = 0.02). Among the patients with NR ERA result, there are not significantly difference in clinical pregnancy rate in the RIF group compared with control group (57.1%. vs. 61.9%). The clinical pregnancy rate of the patients with receptive ERA result also is comparable in both group (70.3% vs. 66.7%). Limitations, reasons for caution This is a retrospective, single center study with limited case number. There were may some bias with ERA testing errors. Wider implications of the findings: In RIF patients, there were more chances of non-receptive endometrium. ERA testing may be helpful for the patients with repeated IVF failure. Larger randomized studies are required to validate these results. Trial registration number 18MMHISO70e

P–287 Uterine adenomyosis does not affect perinatal outcomes in ART treatments

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Trinchant ◽  
M Cruz ◽  
A Requena
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Perinatal Outcomes ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Ovum Donation ◽  
Uterine Adenomyosis

Abstract Study question Is adenomyosis associated with worse clinical and perinatal outcomes in ovum donation cycles? Summary answer Adenomyosis was associated with reduced live birth rate per embryo transfer but not with increased risk of miscarriage or worse perinatal outcomes than controls. What is known already The effect of adenomyosis on IVF/ICSI outcomes are controversial as studies addressing this issue are limited in number and heterogeneous. Conclusions withdrawn from previous works differ regarding the prospective or retrospective design of the study. Two different metanalysis conducted showed that adenomyosis reduced implantation and clinical pregnancy rate and increased miscarriage risk. However, current data regarding perinatal outcomes of assisted reproduction techniques cycles in patients diagnosed with uterine adenomyosis is scarce. Study design, size, duration A retrospective cohort study in which 3307 patients undergoing ovum donation cycles were included. Patients who underwent single embryo transfer (SET) between years 2018 and 2019 were included and divided into two groups: adenomyosis (n = 179) and controls (n = 3218). Participants/materials, setting, methods Inclusion criteria consisted of patients in an oocyte donation program who had fresh SET on day 5 blastocyst stage development. Patients diagnosed with miomas and/or severe endometriosis and those who had undergone previous uterine surgical interventions were excluded from the study. Cases consisted of patients with a history of either focal or diffuse adenomyosis diagnosed via transvaginal ultrasonography (TVUS). Main results and the role of chance Clinical pregnancy rate per embryo transfer was 82/179 (45.8%) in those women diagnosed with adenomyosis versus 1869/3218 (59.8%) in control group (OR = 0.57 95% CI. 0.41–0.78, p &lt; 0.001). Miscarriage rate was similar in the two study groups and differences found were not statistically significant, being 15/82 (18.3%) for adenomyosis and 309/1869 (16.5%) for control group. A lower live birth rate per embryo transfer was observed in women diagnosed with adenomyosis versus control, being 68/179 (38%) and 1560/3128 (49.9%) respectively (OR = 0.615 95% CI 0.44–0.85, p = 0.002). There were no statistically significant differences between childbirth delivery methods (vaginal versus caesarean section). Furthermore, means of gestational age at the time of delivery, newborn size and weight and incidences of low birth weight, preterm birth and admission in neonate intensive care unit (NICU) did not differ between the two groups. In addition, IVF and perinatal outcomes were similar in patients with diffuse adenomyosis compared to focal adenomyosis. Limitations, reasons for caution This is an observational study and thus possible confounders cannot be completely excluded. Diagnostic of adenomyosis is complex and, despite imaging via TVUS is both sensitive and specific, different criteria may be combined in order to fully assess the diagnostic. Wider implications of the findings: Published literature has described how adenomyosis negatively impacts clinical outcomes in ART cycles; however, data regarding perinatal results is scarce. This study is of interest as it provides a first insight for clinicians showing that adenomyosis affects clinical but not perinatal outcomes in ovum donation cycle. Trial registration number Not applicable

scholarly journals Effect of Human Chorionic Gonadotropin Injection Before Frozen Embryo Transfer on Pregnancy Outcomes in Endometriosis-Associated Infertility

2020 ◽  
Vol 7 ◽  
Author(s):  
Yanbo Du ◽  
Lei Yan ◽  
Mei Sun ◽  
Yan Sheng ◽  
Xiufang Li ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Abortion Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Control Group

Purpose: The aim of this study was to investigate the effect of human chorionic gonadotropin (hCG) in hormone replacement (HT) regime for frozen thawed embryo transfer in women with endometriosis (EM).Methods: We performed a retrospective, database-search, cohort study and included data on EM patients who underwent frozen embryo transfer (FET) between January 1, 2009 and August 31, 2018. According to the protocols for FET cycle, the patients were divided into two groups: control group (n = 296) and hCG group (n = 355). Clinical pregnancy rate, live birth rate, early abortion rate, late abortion rate, and ectopic pregnancy rate were compared between the two groups.Results: There was a significant increase in clinical pregnancy rate in the hCG group (57.7 vs. 49%, p = 0.027) compared with the control group. The live birth rate in the hCG group (45.6 vs. 38.5%, p = 0.080) was also elevated, but this difference was not statistically significant.Conclusion: hCG administration in HT regime for FET increases the pregnancy rate in women with EM.

scholarly journals Effect of intrauterine injection of human chorionic gonadotropin before frozen–thawed embryo transfer on pregnancy outcomes in women with endometriosis

2019 ◽  
Vol 47 (7) ◽  
pp. 2873-2880 ◽  
Author(s):  
Zhihui Xu ◽  
Wenming Chen ◽  
Chune Chen ◽  
Yikang Xiao ◽  
Xia Chen
Keyword(s):  
Birth Weight ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Clinical Pregnancy ◽  
Control Group ◽  
Neonatal Birth Weight ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Objective To investigate the effect of human chorionic gonadotropin (hCG) intrauterine injection before frozen–thawed embryo transfer (FET) in women with endometriosis. Methods This retrospective cohort study included 45 women with endometriosis who underwent hCG intrauterine injection before FET; each woman was matched with three patients with endometriosis who did not receive hCG intrauterine injection (controls). Data on pregnancy and prenatal outcomes were extracted from medical records and compared. Results Patients in the hCG intrauterine injection group had significantly higher rates of pregnancy and clinical pregnancy (64.4% and 57.8%, respectively) than controls (47.4% and 39.3%, respectively). Neonatal birth weight for both singletons and twins was significantly higher in the hCG group (3486 ± 458 g and 2710 ± 437 g, respectively) than in the control group (3195 ± 401 g and 2419 ± 370 g, respectively). Conclusion Pregnancy rate, clinical pregnancy rate, and birth weight were improved in women with endometriosis who underwent intrauterine hCG injection compared with those who did not receive hCG before FET.

scholarly journals IVF and ICSI outcomes of female patients with X chromosome mosaicism: A 5-year retrospective cohort study

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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