scholarly journals Determining Diagnostic Criteria of Unexplained Recurrent Implantation Failure: A Retrospective Study of Two vs Three or More Implantation Failure

2021 ◽  
Vol 12 ◽  
Author(s):  
Yingying Sun ◽  
Yile Zhang ◽  
Xueshan Ma ◽  
Weitong Jia ◽  
Yingchun Su
Keyword(s):  
Pregnancy Rate ◽  
Diagnostic Criteria ◽  
Live Birth ◽  
Birth Rate ◽  
Negative Impact ◽  
Live Birth Rate ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Significant Difference ◽  
Definition Of

BackgroundThe definition of recurrent implantation failure (RIF) differs clinically, one of the most controversial diagnostic criteria is the number of failed treatment cycles. We tried to investigate whether the two implantation failure could be included in the diagnostic criteria of RIF.MethodsA retrospective analysis of the clinical data of patients (N=1518) aged under 40 years with two or more implantation failure, recruited from the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University from January 2016 to June 2019.ResultsAfter adjusting for confounding factors by using binary logistic regression, the results showed that partial general information and: distribution of associated factors were significant differences such as maternal age (aOR=1.054, P=0.001), type of cycle (aOR=2.040, P<0.001), stage of embryos development (aOR=0.287, P<0.001), number of embryos transferred (aOR=0.184, P<0.001), female factor (tubal pathology) (aOR=0.432, P=0.031) and male factor (aOR=1.734, P=0.002) between the groups with two and three or more unexplained implantation failure. And further explored whether these differential factors had a significant negative impact on pregnancy outcome, the results showed that: for patients who had three unexplained implantation failure, in the fourth cycle of ET, the live birth rate decreased significantly with age (aOR=0.921, P<0.001), and the live birth rate of blastocyst transfer was significantly higher than that of cleavage embryo transfer (aOR=1.826, P=0.007). At their first assisted pregnancy treatment after the diagnosis of RIF according to these two different definitions, there were no significant difference in the biochemical pregnancy rate, clinical pregnancy rate, ectopic pregnancy rate and abortion rate (P>0.05), but the live birth rate (35.64% vs 42.95%, P=0.004) was significantly different. According to the definition of ‘two or more failed treatment cycles’, the live birth rate of the first ET treatment after RIF diagnosis was significantly lower than that of patients according to the definition of ‘three or more failed treatment cycles’.ConclusionFor patients with unexplained recurrent implantation failure, two implantation failure cannot be included in the diagnostic criteria of RIF. This study supports the generally accepted definition of three or more failed treatment cycles for RIF.

scholarly journals Histological diagnostic criterion for chronic endometritis based on the clinical outcome.

2020 ◽  
Author(s):  
Kimiko Hirata ◽  
Fuminori Kimura ◽  
Akiko Nakamura ◽  
Jun Kitazawa ◽  
Aina Morimune ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
High Power ◽  
Birth Rate ◽  
Plasma Cells ◽  
Live Birth Rate ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Chronic Endometritis ◽  
Diagnostic Criterion

Abstract Background: Chronic endometritis is a slight inflammation of the endometrium that is histologically diagnosed mainly by the presence of plasma cells in the endometrial stroma. In many previous clinical studies, the clinical outcomes were compared between the group cured with antibiotics and the persistent group, and the subjects were patients with recurrent implantation failure. However, antibiotics cannot be administered without establishing diagnostic criteria in advance. It is also difficult to purely evaluate the effect of chronic endometritis on implantation when the control group is defined as patients with recurrent implantation failure without chronic endometritis, since the pregnancy rate in patients with recurrent implantation failure will be lower due to the presence of causes other than chronic endometritis for implantation failure. For these reasons, there appear to be no uniform criteria based on clinical outcomes that are accepted worldwide.Methods:A prospective observational study was conducted in a single university from June 2014 to September 2017. Patients who underwent single frozen-thawed blastocyst transfer with a hormone replacement cycle after histological examination for the presence of chronic endometritis were enrolled. Participants with recurrent implantation failure, recurrent pregnancy loss, and diseases suspected to cause implantation failure were excluded. Four criteria were used to define chronic endometritis according to the number of plasma cells in the same group of patients: 1 or more plasma cells, 2 or more, 3 or more, or 5 or more in 10 high-power fields. Pregnancy rates, live birth rates, and miscarriage rates of the Non-chronic endometritis and the chronic endometritis groups defined with each criterion were calculated.Results: The pregnancy rate and live birth rate of Non- chronic endometritis was highest and all P values for pregnancy rates, live birth rates, and miscarriage rates were smallest when the diagnostic criterion of chronic endometritis was defined as the presence of one or more plasma cells in 10 high-power fields. Conclusion: Chronic endometritis should be diagnosed as the presence of one or more plasma cells in 10 high-power fields. According to this diagnostic criterion, chronic endometritis adversely affected the pregnancy rate and the live birth rate.

scholarly journals The interaction of female age and active male smoking has negative influence on success rates of the in vitro fertilization treatments

2020 ◽  
Vol 23 (1) ◽  
pp. 57-62
Author(s):  
E Petanovska Kostova
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Birth Rate ◽  
Negative Impact ◽  
Live Birth Rate ◽  
Negative Influence ◽  
Binary Logistic Regression Analysis ◽  
Assisted Reproduction Technique ◽  
Ongoing Pregnancy Rate

AbstractThis study monitors the effect of male smoking and age of the woman on the success of the intracytoplasmic sperm injection (ICSI) fertilization process as part of the assisted reproduction technique (ART). A total of 703 couples in the in vitro fertilization (IVF) program were included. Binary logistic regression analysis was used to study the effect of male smoking on clinical pregnancy rate and live birth rate. The results from the study showed that interaction of male smoking and women’s age (>35 years) have significant negative impact on ongoing pregnancy rate and live birth rate.

scholarly journals Outcome of mock embryo transfer before the first IVF cycle: A randomized control trial

2020 ◽  
Author(s):  
Amol Borkar ◽  
Amit Shah ◽  
Anil Gudi ◽  
Roy Homburg
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Secondary Outcome ◽  
Significant Difference

Background: There is a lack of agreement among fertility specialists with regard to the routine use of mock embryo transfer (MET) before each in vitro fertilization (IVF) treatment cycle. While MET may be beneficial with previous difficult embryo transfer cases, its routine use before first IVF cycle has not been evaluated. Objective: To find out the effect of MET before the first IVF cycle on clinical pregnancy rate. Materials and Methods: This is a single-centre randomized controlled trial with a balanced randomization (1:1), carried out between November 2015 and October 2017, with 200 subjects at Homerton university hospital, London, randomized into either MET or control. The primary outcome was clinical pregnancy rate (detection of heart activity on the ultrasound scan), the secondary outcome measures were live birth rate, miscarriage and multiple pregnancy rates, difficult ETs, rate of blood or mucus on the catheter tip. Results: No significant differences were observed in the baseline or cycle characteristics between the two groups. The clinical pregnancy rate was similar between the MET and control groups based on both intension to treat and per protocol analyses (p = 0.98, p = 0.92, respectively). Additionally, no significant difference was seen in the live birth rate in both groups on intension to treat and per protocol analyses (p = 0.67, p = 0.47), respectively. Conclusion: Our study concludes that MET prior to first IVF cycle may not improve the success rate in young women without risk factors for a difficult embryo transfer. Key words: IVF, Mock embryo transfer, Pregnancy outcomes, Live birth.

The effectiveness of IVIG therapy in pregnancy and live birth rate of women with recurrent implantation failure (RIF): A systematic review and meta-analysis

2019 ◽  
Vol 134-135 ◽  
pp. 28-33 ◽  
Author(s):  
Samaneh Abdolmohammadi-Vahid ◽  
Fariba Pashazadeh ◽  
Zahra Pourmoghaddam ◽  
Leili Aghebati-Maleki ◽  
Sedigheh Abdollahi-Fard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Live Birth ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Ivig Therapy ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
In Pregnancy

scholarly journals GnRH agonist and hCG (dual trigger) versus hCG trigger for follicular maturation: a systematic review and meta-analysis of randomized trials

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kai-Lun Hu ◽  
Siwen Wang ◽  
Xiaohang Ye ◽  
Dan Zhang ◽  
Sarah Hunt
Keyword(s):  
Systematic Review ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Gnrh Agonist ◽  
Birth Rate ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Follicular Maturation ◽  
Hcg Trigger

Abstract Background Traditionally, final follicular maturation is triggered by a single bolus of human chorionic gonadotropin (hCG). This acts as a surrogate to the naturally occurring luteinizing hormone (LH) surge to induce luteinization of the granulosa cells, resumption of meiosis and final oocyte maturation. More recently, a bolus of gonadotropin-releasing hormone (GnRH) agonist in combination with hCG (dual trigger) has been suggested as an alternative regimen to achieve final follicular maturation. Methods This study was a systematic review and meta-analysis of randomized trials evaluating the effect of dual trigger versus hCG trigger for follicular maturation on pregnancy outcomes in women undergoing in vitro fertilization (IVF). The primary outcome was the live birth rate (LBR) per started cycle. Results A total of 1048 participants were included in the analysis, with 519 in the dual trigger group and 529 in the hCG trigger group. Dual trigger treatment was associated with a significantly higher LBR per started cycle compared with the hCG trigger treatment (risk ratio (RR) = 1.37 [1.07, 1.76], I2 = 0%, moderate evidence). There was a trend towards an increase in both ongoing pregnancy rate (RR = 1.34 [0.96, 1.89], I2 = 0%, low evidence) and implantation rate (RR = 1.31 [0.90, 1.91], I2 = 76%, low evidence) with dual trigger treatment compared with hCG trigger treatment. Dual trigger treatment was associated with a significant increase in clinical pregnancy rate (RR = 1.29 [1.10, 1.52], I2 = 13%, low evidence), number of oocytes collected (mean difference (MD) = 1.52 [0.59, 2.46), I2 = 53%, low evidence), number of mature oocytes collected (MD = 1.01 [0.43, 1.58], I2 = 18%, low evidence), number of fertilized oocytes (MD = 0.73 [0.16, 1.30], I2 = 7%, low evidence) and significantly more usable embryos (MD = 0.90 [0.42, 1.38], I2 = 0%, low evidence). Conclusion Dual trigger treatment with GnRH agonist and HCG is associated with an increased live birth rate compared with conventional hCG trigger. Trial registration CRD42020204452.

scholarly journals Comparison of IVF Outcomes between Minimal Stimulation and High-Dose Stimulation for Patients with Poor Ovarian Reserve

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tal Lazer ◽  
Shir Dar ◽  
Ekaterina Shlush ◽  
Basheer S. Al Kudmani ◽  
Kevin Quach ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Ovarian Reserve ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Poor Responders ◽  
High Dose ◽  
Poor Ovarian Reserve

We examined whether treatment with minimum-dose stimulation (MS) protocol enhances clinical pregnancy rates compared to high-dose stimulation (HS) protocol. A retrospective cohort study was performed comparing IVF and pregnancy outcomes between MS and HS gonadotropin-antagonist protocol for patients with poor ovarian reserve (POR). Inclusion criteria included patients with an anti-Müllerian hormone (AMH) ≤8 pmol/L and/or antral follicle count (AFC) ≤5 on days 2-3 of the cycle. Patients from 2008 exclusively had a HS protocol treatment, while patients in 2010 had treatment with a MS protocol exclusively. The MS protocol involved letrozole at 2.5 mg over 5 days, starting from day 2, overlapping with gonadotropins, starting from the third day of letrozole at 150 units daily. GnRH antagonist was introduced once one or more follicles reached 14 mm or larger. The HS group received gonadotropins (≥300 IU/day) throughout their antagonist cycle. Clinical pregnancy rate was significantly higher in the MS protocol compared to the HS protocol (P=0.007). Furthermore, the live birth rate was significantly higher in the MS group compare to the HS group (P=0.034). In conclusion, the MS IVF protocol is less expensive (lower gonadotropin dosage) and resulted in a higher clinical pregnancy rate and live birth rate than a HS protocol for poor responders.

The Deferred Embryo Transfer Strategy Seems Not to be a Good Option After Repeated IVF/ICSI Cycle Failures

2018 ◽  
Vol 26 (9) ◽  
pp. 1210-1217 ◽  
Author(s):  
Mathilde Bourdon ◽  
Pietro Santulli ◽  
Yulian Chen ◽  
Catherine Patrat ◽  
Khaled Pocate-Cheriet ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Embryo Transfer ◽  
Live Birth ◽  
Birth Rate ◽  
Previous History ◽  
Multivariate Logistic Regression Analysis ◽  
Live Birth Rate ◽  
Multivariate Logistic Regression ◽  
Icsi Cycle ◽  
Significant Difference

Objective: The aim of this study was to assess whether a deferred frozen–thawed embryo transfer (Def-ET) offers any benefits compared to a fresh ET strategy in women who have had 2 or more consecutive in vitro fertilization (IVF)/intracytoplasmic injection (ICSI) cycle failures. Design: An observational cohort study in a tertiary referral care center including 416 cycles from women with a previous history of 2 or more consecutive IVF/ICSI failures cycles. Both Def-ET and fresh ET strategies were compared using univariate and multivariate logistic regression models. The main outcome measured was the cumulative live birth rate (CLBR). Results: A total of 416 cycles were included in the analysis: 197 in the fresh ET group and 219 in the Def-ET group. The CLBR was not significantly different between the fresh and Def-ET groups (58/197 [29.4%] and 57/219 [26.0%], respectively, P = .437). In addition, after the first ET, there was no significant difference in the live birth rate between the fresh ET and Def-ET groups (50/197 [25.4%] vs 44/219 [20.1%], respectively). Multivariate logistic regression analysis indicated that compared to the fresh strategy, the Def-ET strategy was not associated with a higher probability of live birth. Conclusions: In cases with 2 or more consecutive prior IVF/ICSI cycle failures, a Def-ET strategy did not result in better ART outcomes than a fresh ET strategy.

scholarly journals Pregnancy Outcomes Following the First Frozen Blastocyst Transfer Among Women Aged Less Than 35 Years Old: A Retrospective Cohort Study

2021 ◽  
pp. 1-7
Author(s):  
Le Hoang ◽  
Le Duc Thang ◽  
Nguyen Thi Lien Huong ◽  
Nguyen Minh Thuy ◽  
Vu Thi Mai Anh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Live Birth ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Multiple Pregnancy ◽  
Live Birth Rate ◽  
Group 2 ◽  
Group 1

Background: Many guidelines have been issued regarding the number of embryos to be transferred after in vitro fertilization (IVF), but patients and clinicians may be reluctant to accept or offer a single embryo transfer due to the expected lower chance of pregnancy or live birth. This study was aimed to provide additional information on cycle outcome according to the number and quality of thawed transferred blastocysts. Methods:A retrospective cohort study was designed to collect the data of 505 patients who performed the first frozen blastocysts transfer at Tam Anh General Hospital from June 2018 to September 2019. One good-quality embryo was transferred for 121 patients (Group 1), two good for 214 patients (Group 2), one good and one poor for 112 patients (Group 3), one good and two poor for 25 patients (Group 4), and one or two poor for 33 patients (Group 5). Results:The pregnancy rate was 71.9%, 74.8%, 69.4%, 84.0%, and 39.4% in Group 1–5, respectively. The multiple pregnancy rate was 36.9%, 16.9%, and 32.0% in Groups 2–4, respectively, higher than Group 1 (4.9%). The live birth rate was 55.6%, 50.9%, and 60.0% in Group 2–4, respectively, but not significantly different from the Group 1 (47.9%). Conclusions:Transferring an additional good or poor embryo, along with a good embryo, does not increase the live birth rate while the incidence of multiple pregnancies rises significantly.

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