Comparison of Pregnancy and Neonatal Outcomes of Single Frozen Blastocyst Transfer Between Letrozole-Induction and HRT Cycles in Patients With Abnormal Ovulation

BackgroundThe use of frozen embryo transfer (FET) cycles has dramatically risen. The optimal endometrial preparation method for women undergoing FET is of utmost importance to provide the optimal chances of pregnancy. For patients with abnormal ovulation in particular, there have been few studies on FET protocols; notably, most of these studies focus only on the clinical pregnancy rate or live birth rate (LBR) and pay little attention to the regimen’s safety for offspring.MethodsIt was a retrospective cohort study. First FET cycle with a single blastocyst from whole embryo frozen IVF/ICSI at the Reproductive Center of Third Affiliated Hospital of Zhengzhou University between January 2016 and January 2020. The LBR was the primary outcome of interest. The secondary outcome measures were miscarriage rate and offspring safety, including preterm birth, low birthweight (LBW), small-for-gestational age (SGA), macrosomia and large-for-gestational age (LGA).ResultsIn total, 2782 FET cycles met the eligibility criteria for analysis. Additionally, there were 1178 singleton births from FET cycles. The clinical pregnancy rate was 58.4% in the L-FET group and 54.5% in the HRT group, with no statistical significance (P=.116). The miscarriage rate was higher in the HRT group than in the L-FET group (21.7% vs. 14.3%, P=.005). The LBR was significantly higher in the L-FET group than in the HRT group (49.6% vs. 41.7%, P=.001). Neonatal outcomes were similar between the two groups. After adjustments for confounding factors, the LBR was higher in the L-FET group (aOR 1.30, 95% CI 1.06-1.58). The rate of miscarriage was lower in the L-FET group (aOR 0.63, 95% CI 0.44-0.90).ConclusionFor patients with abnormal ovulation, the L-FET regimen has a higher LBR and lower miscarriage rate than HRT. The neonatal outcomes were similar between the two groups.

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Comparison of Pregnancy and Neonatal Outcomes of Single Frozen Blastocyst Transfer Between Letrozole-induction and HRT Cycles in Patients With Abnormal Ovulation

10.21203/rs.3.rs-204446/v1 ◽

2021 ◽

Author(s):

Junwei Zhang ◽

Zhen Li ◽

Lijun Sun ◽

Yichun Guan ◽

Mingze Du

Keyword(s):

Pregnancy Rate ◽

Gestational Age ◽

Low Birthweight ◽

Statistical Significance ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Neonatal Outcomes ◽

Large For Gestational Age ◽

Secondary Outcome ◽

Miscarriage Rate

Abstract Background: The use of frozen embryo transfer (FET) cycles has dramatically risen. The optimal endometrial preparation method for women undergoing FET is of utmost importance to provide the optimal chances of pregnancy. For patients with abnormal ovulation in particular, there have been few studies on FET protocols; notably, most of these studies focus only on the clinical pregnancy rate or live birth rate (LBR) and pay little attention to the regimen’s safety for offspring.Methods: It was a retrospective cohort study. First FET cycle with a single blastocyst from whole embryo frozen IVF/ICSI at the Reproductive Center of Third Affiliated Hospital of Zhengzhou University between January 2016 and January 2020. The LBR was the primary outcome of interest. The secondary outcome measures were miscarriage rate and offspring safety, including preterm birth, low birthweight (LBW), small-for-gestational age (SGA), macrosomia and large-for-gestational age (LGA).Results: In total, 2782 FET cycles met the eligibility criteria for analysis. Additionally, there were 1178 singleton births from FET cycles. The clinical pregnancy rate was 58.4% in the L-FET group and 54.5% in the HRT group, with no statistical significance (P=.116). The miscarriage rate was higher in the HRT group than in the L-FET group (21.7% vs. 14.3%, P=.005). The LBR was significantly higher in the L-FET group than in the HRT group (49.6% vs. 41.7%, P=.001). Neonatal outcomes were similar between the two groups. After adjustments for confounding factors, the LBR was higher in the L-FET group (aOR 1.30, 95% CI 1.06-1.58). The rate of miscarriage was lower in the L-FET group (aOR 0.63, 95% CI 0.44-0.90). Conclusion: For patients with abnormal ovulation, the L-FET regimen has a higher LBR and lower miscarriage rate than HRT. The neonatal outcomes were similar between the two groups.

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Evaluation of Pregnancy Outcomes at Advanced Maternal Age

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.587 ◽

2019 ◽

Vol 7 (12) ◽

pp. 1951-1956 ◽

Cited By ~ 1

Author(s):

Małgorzata Radoń-Pokracka ◽

Beata Adrianowicz ◽

Magdalena Płonka ◽

Paulina Danił ◽

Magdalena Nowak ◽

...

Keyword(s):

Caesarean Section ◽

Gestational Age ◽

Maternal Age ◽

Statistical Significance ◽

Advanced Maternal Age ◽

Neonatal Outcomes ◽

University Hospital ◽

Large For Gestational Age ◽

Predisposing Factor ◽

Over 40 Years

AIM: The study aimed to investigate the association between advanced maternal age (AMA) and the risk of adverse maternal, perinatal and neonatal outcomes about parity in singleton pregnancies.METHODS: We retrospectively analysed 950 women who gave birth in the Department of Obstetrics and Perinatology of the University Hospital in Kraków for six months (between 1st January and 30th June 2018). The patients were divided into 3 groups according to their age (30-34 years old, 35-39 years old and over 40 years old). Each of these groups was subsequently subdivided into 2 groups depending on parity (primiparae and multiparae). Maternal, perinatal and neonatal outcomes were compared between the groups and the subgroups.RESULTS: Comparison of the three age groups revealed that advanced maternal age might constitute a predisposing factor for preterm birth, caesarean section and large for gestational age (LGA). From these parameters, statistical significance was reached in case of greater risk of LGA (OR = 2.17), caesarean section (OR = 2.03) and elective C-section (OR = 1.84) in women over 40 years old when compared to the patients aged 30-34. Furthermore, AMA increases the risk of postpartum haemorrhage (OR = 6.43). Additionally, there is a negative correlation between maternal age and gestational age at delivery (R = -0.106, p < 0.05).CONCLUSIONS: Advanced maternal age can undoubtedly be associated with several adverse perinatal outcomes. At the same time, the risk of perinatal complications begins to increase after the age of 35 but becomes significant in women aged ≥ 40.

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INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

Reproductive Medicine ◽

10.37800/rm2021-2-7 ◽

2021 ◽

pp. 68-75

Author(s):

A.O. Polumiskova ◽

S.I. Tevkin ◽

T.M. Jussubaliyeva ◽

M.S. Shishimorova

Keyword(s):

Pregnancy Rate ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Miscarriage Rate ◽

Art Programs ◽

Group A ◽

The Difference ◽

Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

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P–231 Transnational oocyte donation program between Italy and Spain based on transport of vitrified oocytes: a five-years experience

Human Reproduction ◽

10.1093/humrep/deab130.230 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

A Volpes ◽

S Gullo ◽

M Modica ◽

P Scaglione ◽

A Marino ◽

...

Keyword(s):

Pregnancy Rate ◽

Ovarian Function ◽

Multiple Pregnancy ◽

Oocyte Donation ◽

Blastocyst Stage ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Egg Donation ◽

Cleavage Stage ◽

Miscarriage Rate

Abstract Study question What is the clinical efficacy of an oocyte donation program based on the transportation of vitrified oocytes between two countries? Summary answer The transnational oocyte donation program is efficient, safe and comparable to other strategies (transport of frozen sperm and embryos). What is known already Egg donation represents a valid treatment strategy for women who have exhausted their ovarian function and it has considerably increased in the last years. In Italy, egg donation is allowed after the judgment of the Constitutional Court n. 162 in 2014 but no reimbursement for the donors is provided. For this reason, the number of voluntary donors is irrelevant. Therefore, the great majority of egg donation cycles is carried out by using imported cryopreserved oocytes from foreign countries. However, recent evidence has questioned the overall efficacy of this strategy in comparison with the shipment of frozen sperm and vitrified embryos. Study design, size, duration A retrospective cohort study was conducted between July 2015-December 2020 at two private IVF clinics. 264 couples were treated (mean maternal age: 43.1± 4.6 years, range: 26–51; mean donor age: 24 ±3 years, range: 20–33) with vitrified oocytes shipped from a single Spanish egg bank (IMER, Valencia) to the receiving reproductive clinic in Italy (ANDROS Clinic, Palermo). All the oocytes for each batch were thawed. Participants/materials, setting, methods The primary outcome of this study was the cumulative clinical pregnancy rate (CPR) among the completed cycles for each batch of oocytes. Those cycles in which a clinical pregnancy was obtained, or all embryos derived by a single batch of oocytes had been transferred or no embryo was produced were defined as completed. In addition to main analyses, sensitivity analysis was performed to examine how the number of inseminated oocytes may affect CPR. Main results and the role of chance 2,367 oocytes in 355 batches were sent from Spain to Italy. 2,209 oocytes in 334 batches for 264 patients were thawed with a survival rate of 82.4% (1,821/2,209). The mean number of oocytes received per patient was 6.6 ± 1.0. The fertilization rate was 72.1% (1,312/1,821). 499 embryos were transferred (38.0%), 335 at the cleavage stage (67.1%) and 164 at the blastocyst stage (32.9%); 197 supernumerary embryos were vitrified (15.0%), 18 at the cleavage stage (9.1%) and 179 at the blastocyst stage (90.9%). 616 embryos were not viable (47.0%). No more than two embryos were transferred for each embryo transfer (ET). The completed cycles were 307 out of 334 (91.9%). The CPR per completed cycles was 46.6% (143/307) and 54.2% per patient (143/264). Clinical pregnancy rate per fresh ET in completed cycles with supernumerary cryopreserved embryos was significantly higher compared with that of the completed cycles without surplus embryos (56/101 versus 68/193, p = 0.001). Logistic regression revealed that the number of inseminated oocytes was positively associated with CPR in a significant manner (B = 0.220, p = 0.007; OR = 1.25, 95%CI=1.06–1.47). The multiple pregnancy rate was 15.4% (1 triplet and 21 twin pregnancies). The miscarriage rate was 22.4% (32/143). Limitations, reasons for caution The retrospective design of the study needs to be confirmed in larger and multicenter prospective studies comparing the strategy of vitrified donated oocytes and fresh ET with the policy of fresh donated oocyte and frozen/thawed ET. Wider implications of the findings: The transnational oocyte donation program with vitrified oocytes is associated with good success rates. The number of inseminated oocytes represents a crucial factor for increasing the CPR, improving the embryo selection for fresh ET and giving more chances of pregnancy with the transfer of surplus vitrified embryos. Trial registration number Not applicable

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Dydrogesterone is Superior as Luteal Phase Support in selected Previously Failed In-Vitro Fertilisation and Embryo Transfer Patients

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.05.01.08 ◽

2021 ◽

Vol 5 (1) ◽

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Birth Rate ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

P Value ◽

Miscarriage Rate ◽

Secretory Endometrium ◽

Micronized Progesterone

Different forms of exogenous progesterone have been seen to play a very important role in endometrial maturity. Implantation failure appears to be a significant factor in Assisted reproductive technique (ART) procedures. Even a mature endometrium becomes non-receptive, preventing implantation or rejection of implanted embryo in early months of pregnancy. Hence natural micronized progesterone (NMP) and dydrogesterone have been used since decades to improve endometrial maturity and receptivity. The aim of this study was to investigate causes of failed implantation inspite of uneventful Grade I embryo transfer in ART procedure and the role of natural micronized progesterone (NMP) and dydrogesterone for endometrial maturation. 80 women aged range between 25-40 yr old who visited Department of Reproductive Medicine at Calcutta Fertility Mission, over a period of 24 months (January 2017 to December 2019), satisfying the inclusion criteria, were enrolled in this retrospective observational study. Endometrial aspirate histopathology was done during the secretory phase. They were treated with natural micronized progesterone (NMP) or oral dydrogesterone and results of endometrial changes, clinical pregnancy rate, live birth rate and miscarriage rate were statistically analysed. 26.25% and 29.6% of women were seen to have mid-secretory changes of the endometrium after being treated with NMP in one cycle and dydrogesterone in the subsequent cycle, respectively. 62.71% of women had shown early-secretory changes with dydrogesterone which was statistically significant compared to those treated with NMP (p value=0.006).8.5% of these women showed persistent non-secretory endometrium with either of these medications. The Clinical Pregnancy Rate (CPR) was 38.1% and 47% in the group of patients who were treated with NMP and dydrogesterone respectively. Though pregnancy rate was slightly higher in dydrogesterone group, it was not statistically significant (p value = 0.578). 28.5% and 41% women had live births and 9.5% and 5.8% of them had miscarriage in NMP and dydrogesterone group, respectively, though our data appears to be statistically not significant (p value –0.415) (p value – 0.679). In our study 26.25% women had mid-secretory endometrium after treatment with NMP. 29.6% and 62.71% of these women who had non-secretory or early secretory endometrial changes on treatment with intravaginal NMP, showed endometrial mid-secretory and early-secretory changes respectively, on treatment with dydrogesterone, which implies that oral dydrogesterone is superior to NMP when administered for endometrial maturation in selected patients. Clinical pregnancy rate, live birth rate or miscarriage rate were similar with either NMP or dydrogesterone.

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The Impact of the Time Interval Between Cycles on Pregnancy Outcome of Intrauterine Insemination

10.21203/rs.3.rs-936649/v1 ◽

2021 ◽

Author(s):

shuai zhang ◽

minglian zhou ◽

Hanhan Tang ◽

Huijuan Guan ◽

Huaiyun Tang

Keyword(s):

Pregnancy Rate ◽

Birth Rate ◽

Statistical Significance ◽

Live Birth Rate ◽

Abortion Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Continuous Group ◽

Delayed Group ◽

Number Of Treatment

Abstract Objective: The objective of this study was to estimate whether the time interval between two intrauterine inseminations (IUI) treatments needs to be extended by one menstrual cycle or more, and whether this will have an impact on the clinical pregnancy rate (CPR).Study Design: Retrospective cohort study.Study site: The study site was the reproductive medicine center of a teaching hospital.Patient(s): The subjects were women and their husbands who received two or more intrauterine insemination in our reproductive medicine center due to mild infertility in the period from January 2014 to December 2020. Patients were divided into 2 groups according to the number of days between the last menstrual day(LMD)and the previous IUI operation day(POD), continuous group (the time from the LMD to POD ≤ 34 days) and delayed group (the time from the LMD to POD ≥ 35 days). If the previous cycle was a pregnancy or abortion cycle, the next cycle immediately adjacent to it was defined as a new cycle, and the days between the two cycles were not included in the study.Intervention(s):No intervention.Main Outcome Measure(s): A total of 1491 cycles were finally included in the study.990 cycles followed by the second IUI cycle after the previous failure,501 cycles at least one menstrual cycle was separated between two IUI treatments. The primary outcome measure was clinical pregnancy rate (CPR), with secondary outcomes including abortion rate and live birth rate. Differences in clinical pregnancy rate (CPR)、abortion rate and live birth rate were compared between the two groups.Result: No significant differences with regard to baseline demographic and the number of treatment cycles, the duration of infertility, the type of infertility, the mode of treatment, and the cause of infertility were observed between the two groups.There were no statistical differences between the delayed group vs continuous group regarding the clinical pregnancy rate(15.0% vs 13.7%), live birth rate(78.7% vs 74.3%), and abortion rate(17.3% vs 18.4%)（P＞0.05）.The above factors were included for binary logistic regression analysis. The observed difference in clinical pregnancy rate between the groups was not statistically significant after adjustment(OR = 1.101,95%CI 0.807-1.499, P=0.546）.The all cycles were divided into four groups based on female age. results showed that when the female's age was ≤ 25 years old, the pregnancy rate in the continuous group was 16.5%, which was significantly higher than that in the delayed group by 5.8% (difference 0.107, 95% CI 0.016-0.198, P = 0.055), approached, but did not reach, statistical significance. When the female was 30-35 years old, the pregnancy rate in the delayed group was 19.4%, which was significantly higher than 10.9% in the continuous group (difference 0.085, 95% CI 0.016-0.154, P = 0.011). The difference between the two groups was statistically significant. The all cycles were divided into three groups based on years of infertility. Our results show that when the number of years of infertility was≤2 years, the clinical pregnancy rate was 20.7% in the delayed group and 12.5% in the continuous group (difference 0.107, 95% CI 0.150-0.014, P = 0.013), statistical significance was maintained. Based on the number of treatment cycles, it is divided into 2 cycles, 3 cycles, and≥4 cycles. The results showed that when≥4 cycles, the pregnancy rate in the continuous group were 19.4%, which was significantly higher than 6.1% in the delayed group (difference 0.133, 95% CI 0.246-0.020, P = 0.038). Statistical significance was maintained at P < 0.05.Conclusions: Overall, prolonging the interval between two IUI did not significantly improve pregnancy outcomes. Yet, for different age stages, duration of infertility, and the number of treatment cycles, we suggest that more flexible treatment strategies can be tried to improve the clinical pregnancy rate.

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Twice vitrification-warming procedures has no effect on frozen-thawed embryo transfer outcomes

10.21203/rs.3.rs-1059310/v1 ◽

2021 ◽

Author(s):

xiaoyue Shen ◽

Min Ding ◽

Yuan Yan ◽

Shanshan Wang ◽

jianjun Zhou ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Live Birth ◽

Birth Rate ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Miscarriage Rate ◽

Frozen Thawed Embryo Transfer ◽

Thawed Embryo Transfer

Abstract Background To evaluate the frozen-thawed embryo transfer (FET) outcomes of repeated cryopreservation by vitrification of blastocysts derived from vitrified-warmed day3 embryos in patients who experienced implantation failure previously. Methods We retrospect the files of patients who underwent single frozen-thawed blastocyst transfer cycles in our reproductive medical center from January 2013 to December 2019. 127 patients transfer of vitrified-warmed blastocysts derived from vitrified-warmed day3 embryos were defined as twice-cryopreserved group. 1567 patients who transfer blastocysts that had experienced once vitrified-warmed were used as once-cryopreserved group. None of them was pregnant at the previous FET. The outcomes were compared between two groups after a 1:1 propensity score matching (PSM). Results The clinical pregnancy rate was 52.76%, live birth rate was 43.31% in twice-cryopreserved group. After PSM,108 pairs of patients were generated for comparison. The clinical pregnancy rate, live birth rate or miscarriage rate was not significantly different between two groups. Logistic regression analysis indicated that double vitrification-warming procedures did not affect FET outcomes in terms of clinical pregnancy rate (OR 0.83, 95%CI 0.47-1.42), live birth rate (OR 0.93, 95%CI 0.54-1.59), miscarriage rate (OR 0.72 95%CI 0.28-1.85). Furthermore, the pregnancy complications rate, gestational age or neonatal abnormalities rate between two groups was also comparable, while twice vitrification-warming procedures might increase the macrosomia rate (19.6% vs. 6.3%, P = 0.05). Conclusion Transfer of double vitrified-warmed embryo at cleavage stage and subsequent blastocyst stage did not affect live birth rate and neonatal abnormalities rate, but there was a tendency to increase macrosomia rate, which needs further investigation.

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P–612 Transdermal testosterone vs. Placebo (lubricant gel) pre-treatment in improving IVF outcomes in diminished ovarian reserve patients (POSEIDON group 3 and 4): a randomised controlled trial

Human Reproduction ◽

10.1093/humrep/deab130.611 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

K D Nayar ◽

S Gupta ◽

R Bhattacharya ◽

P Mehra ◽

J Mishra ◽

...

Keyword(s):

Pregnancy Rate ◽

Controlled Trial ◽

Implantation Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Miscarriage Rate ◽

Ongoing Pregnancy Rate ◽

Testosterone Gel ◽

Group 3 ◽

Pre Treatment

Abstract Study question To compare the efficacy of transdermal testosterone with placebo (lubricant gel) in improving IVF outcomes using GnRH antagonist protocol in POSEIDON group 3 and 4 patients. Summary answer Patients receiving pre-treatment with testosterone gel had higher mean number of oocytes retrieved and grade A embryos as compared to the patients receiving lubricant gel. What is known already Diminished ovarian reserve (DOR) is associated with suboptimal ovarian response, higher cycle cancellation rate and lower clinical pregnancy rate following IVF cycles. Various treatment regimens have been devised for management of such patients and use of adjuvants in the form of oral or transdermal androgen is one of them. Androgens improves follicular response to gonadotropin stimulation as well as increase FSH receptor expression in granulosa cells, in turn leading to better oocyte yield and pregnancy rate. Aim was to compare the effect of transdermal testosterone gel with placebo gel on ART outcome in DOR patients (POSEIDON Group 3 and 4). Study design, size, duration A prospective, randomised controlled trial was carried out from 1st September 2019 to 31st October 2020 at a tertiary infertility centre in India. 50 patients fulfilling the criteria of Group 3 and Group 4 of POSEIDON classification were included in the study. Patients with endocrine disorders (thyroid, prolactin), endometrioma, history of surgery on the ovaries, sensitivity to testosterone gel, male factor infertility and deranged liver and renal function tests were excluded. Participants/materials, setting, methods Enrolled patients were randomised into two groups of 25 patients each, one group was pretreated (TTG group) with transdermal testosterone gel, 12.5 mg/day from day 6th of previous cycle to day 2nd of stimulation cycle while patients in other group took lubricant gel for the same duration before stimulation with GnRH antagonist fixed protocol followed by fresh Day 3 transfer. Main results and the role of chance The baseline characteristics of the two groups were comparable. The primary outcome measures were the number of oocytes retrieved and number of grade A embryos formed (according to Istanbul consensus). The secondary outcome measures were implantation rate, clinical pregnancy rate, miscarriage rate and ongoing pregnancy rate. The mean number of oocytes retrieved in TTG group was 5±1.02 which was significantly higher than placebo group–3.5±1.2, (p < 0.001). The mean number of Grade A embryos were also significantly higher (4.78±0.54 vs 3.00±0.23, p < 0.001) in TTG group. The TTG group had higher implantation rate (28% vs 20%, p = 0.49), clinical pregnancy rate (32% vs 18%, p = 0.41), ongoing pregnancy rate (32% vs 16%, p = 0.38) and lower miscarriage rate (0% vs 20%, p = 0.38), however, these differences were not statistically significant. Limitations, reasons for caution The study was done at a single centre with small sample size, replication with more subjects and in different centers is needed. Wider implications of the findings: Pre-treatment with testosterone gel in DOR patients improves ovarian response to stimulation and results in higher number of oocytes retrieved and good quality embryos resulting in improved clinical pregnancy rates. Transdermal testosterone is advantageous because of better bioavailability, easy application, patient friendly and less adverse effects. Trial registration number MCDH/2019/54

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Effect of Endometrium Thickness on Clinical Outcomes in Luteal Phase Short-Acting GnRH-a Long Protocol and GnRH-Ant Protocol

Frontiers in Endocrinology ◽

10.3389/fendo.2021.578783 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jie Zhang ◽

Yi-Fei Sun ◽

Yue-Ming Xu ◽

Bao-jun Shi ◽

Yan Han ◽

...

Keyword(s):

Pregnancy Rate ◽

Clinical Outcomes ◽

Live Birth ◽

Birth Rate ◽

Endometrial Thickness ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Miscarriage Rate ◽

Long Protocol

ObjectiveTo investigate the factors that influence luteal phase short-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol and GnRH-antagonist (GnRH-ant) protocol on pregnancy outcome and quantify the influence. About the statistical analysis, it is not correct for the number of gravidities.MethodsInfertile patients (n = 4,631) with fresh in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and embryo transfer were divided into GnRH-a long protocol (n =3,104) and GnRH-ant (n =1,527) protocol groups and subgroups G1 (EMT ≤7mm), G2 (7 mm <EMT ≤10 mm), and G3 (EMT >10 mm) according to EMT on the trigger day. The data were analyzed.ResultsThe GnRH-ant and the GnRH-a long protocols had comparable clinical outcomes in the clinical pregnancy, live birth, and miscarriage rate after propensity score matching. In the medium endometrial thickness of 7–10 mm, the clinical pregnancy rate (61.81 vs 55.58%, P < 0.05) and miscarriage rate (19.43 vs 12.83%, P < 0.05) of the GnRH-ant regime were significantly higher than those of the GnRH-a regime. The EMT threshold for clinical pregnancy rate in the GnRH-ant group was 12 mm, with the maximal clinical pregnancy rate of less than 75% and the maximal live birth rate of 70%. In the GnRH-a long protocol, the optimal range of EMT was >10 mm for the clinical pregnancy rate and >9.5 mm for the live birth rate for favorable clinical outcomes, and the clinical pregnancy and live birth rates increased linearly with increase of EMT. In the GnRH-ant protocol, the EMT thresholds were 9–6 mm for the clinical pregnancy rate and 9.5–15.5 mm for the live birth rate.ConclusionsThe GnRH-ant protocol has better clinical pregnancy outcomes when the endometrial thickness is in the medium thickness range of 7–10 mm. The optimal threshold interval for better clinical pregnancy outcomes of the GnRH-ant protocol is significantly narrower than that of the GnRH-a protocol. When the endometrial thickness exceeds 12 mm, the clinical pregnancy rate and live birth rate of the GnRH-ant protocol show a significant downward trend, probably indicating some negative effects of GnRH-ant on the endometrial receptivity to cause a decrease of the clinical pregnancy rate and live birth rate if the endometrial thickness exceeds 12 mm.

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

10.21203/rs.3.rs-27374/v1 ◽

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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