scholarly journals Effects of Early Cumulus Cell Removal on Treatment Outcomes in Patients Undergoing In Vitro Fertilization: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Pengcheng Kong ◽  
Mingru Yin ◽  
Chuanling Tang ◽  
Xiuxian Zhu ◽  
Orhan Bukulmez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Birth Rate ◽  
Cumulus Cell ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Preterm Birth Rate

BackgroundEarly cumulus cell removal combined with early rescue intracytoplasmic sperm injection (ICSI) has been widely practiced in many in vitro fertilization (IVF) centers in China in order to avoid total fertilization failure. However, uncertainty remains whether the pregnancy and neonatal outcomes are associated with early cumulus cell removal.ObjectivesTo investigate if early cumulus cell removal alone after 4 hours co-incubation of gametes (4 h group), has detrimental effect on the pregnancy and neonatal outcomes in patients undergoing IVF, through a comparison with conventional cumulus cell removal after 20 hours of insemination (20 h group).MethodsThis retrospective cohort study included 1784 patients who underwent their first fresh cleavage stage embryo transfer at the Centre for Assisted Reproduction of Shanghai First Maternity and Infant Hospital from June 2016 to December 2018 (4 h group, n=570; 20 h group, n=1214). A logistic regression analysis was performed to examine the independent association between early cumulus cell removal and pregnancy outcomes after adjustment for potential confounders. The neonatal outcomes between the two groups were compared.ResultsWhen compared with the 20 h group, the 4 h group had similar pregnancy outcomes, including rates for biochemical pregnancy, clinical pregnancy, ongoing pregnancy, miscarriage, ectopic pregnancy, multiple pregnancy, live birth. There were 1073 infants delivered after embryo transfer (4 h group, n=337; 20 h group, n=736). Outcomes in both groups were similar for both singleton and twin gestations, including preterm birth rate and very preterm birth rate, mean birth weight, mean gestational age, sex ratio at birth and rate of congenital birth defects. In addition, findings pertaining to singleton gestations were also similar in the two groups for Z-scores (gestational age- and sex-adjusted birth weight), rates of small for gestational age, very small for gestational age, large for gestational age and very large for gestational age infants.ConclusionsIn this study early cumulus cell removal alone was not associated with adverse pregnancy and neonatal outcomes. From this perspective, early cumulus cell removal to assess for a potential early rescue ICSI is therefore considered to be a safe option in patients undergoing IVF.

scholarly journals Effects of Early Cumulus Cell Removal on the Treatment Outcomes in Patients Undergoing in Vitro Fertilization: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Pengcheng Kong ◽  
Mingru Yin ◽  
Chuanling Tang ◽  
Xiuxian Zhu ◽  
Orhan Bukulmez ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Birth Rate ◽  
Cumulus Cell ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Vitro Fertilization

Abstract Background: Early cumulus cell removal combined with early rescue intracytoplasmic sperm injection (ICSI) has been widely practiced in many in vitro fertilization (IVF) centers in China in order to avoid total fertilization failure. This study aimed to investigate the effects of early cumulus cell removal alone after 4 h co-incubation of gametes (4 h group) on the pregnancy and neonatal outcomes as compared with the conventional cumulus cell removal after 20 h of insemination (20 h group) in patients undergoing IVF. Methods: This retrospective cohort study included 1784 patients who underwent their first fresh cleavage embryo transfer at the Centre for Assisted Reproduction of Shanghai First Maternity and Infant Hospital from June 2016 to December 2018 (4 h group, n=570; 20 h group, n=1214). There were 1073 infants delivered after the embryo transfer (4 h group, n=337; 20 h group, n=736). A logistic regression analysis was performed to examine the independent association between early cumulus cell removal and pregnancy outcomes after adjustment for the potential confounders. The neonatal outcomes between the two groups were compared.Result(s): The 4 h group had similar pregnancy outcomes, including biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, ectopic pregnancy rate, multiple pregnancy rate, live birth rate, when compared with the 20 h group. Both groups had comparable singleton and twin delivery rates (32.9% versus 33.5% and 13.2% versus 13.9%, respectively). There were 1073 infants delivered after the embryo transfer (4 h group, n=337; 20 h group, n=736). In both singleton and twin gestations, the preterm birth rate and very preterm birth rate, mean birth weight, mean gestational age, sex ratio at birth and rate of congenital birth defects in the 4 h group were similar to those in the 20 h group. In addition, Z-scores (gestational age- and sex-adjusted birthweight), the rates of small for gestational age, very small for gestational age, large for gestational age and very large for gestational age infants were also similar between the two groups in singleton gestations.Conclusion(s): Early cumulus cell removal alone was not associated with adverse pregnancy and neonatal outcomes in patients undergoing IVF. Thus, early cumulus cell removal to assess for a potential early rescue ICSI seems to be safe in terms of pregnancy and live birth outcomes.

scholarly journals Maternal Hepatitis B Infection and Pregnancy Outcomes in the United States: A Population-Based Cohort Study

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Kristina L Bajema ◽  
Helen C Stankiewicz Karita ◽  
Mark W Tenforde ◽  
Stephen E Hawes ◽  
Renee Heffron
Keyword(s):  
United States ◽  
Cohort Study ◽  
Hepatitis B ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Placenta Previa ◽  
The United States ◽  
Population Based ◽  
Large For Gestational Age ◽  
Hepatitis B Infection

Abstract Background Hepatitis B virus (HBV) infection in pregnancy has been associated with risk of adverse maternal and infant outcomes in highly endemic settings, but this association is not well characterized in the United States. Methods We conducted a retrospective population-based cohort study in Washington State using linked birth certificate and hospital discharge records from 1992–2014. Among pregnant women with hepatitis B (n = 4391) and a hepatitis B–negative group (n = 22 410), we compared the risk of gestational diabetes, pre-eclampsia, eclampsia, placenta previa, preterm delivery, low birthweight, small for gestational age, and large for gestational age using multivariate logistic regression. Results Hepatitis B–infected pregnant women were more likely to be Asian (61% vs 8%, P < .001), foreign-born (76% vs 23%, P < .001), and older in age (77% vs 64% ≥26 years, P < .001). They were less commonly overweight or obese (33% vs 50%, P < .001). There was a lower risk of small for gestational age infants among HBV-infected women (adjusted RR [aRR], 0.79; 95% confidence interval [CI], 0.67–0.93). The risk of other adverse outcomes was not significantly different between hepatitis B–infected and –negative women (gestational diabetes: aRR, 1.11; 95% CI, 0.92–1.34; pre-eclampsia: aRR, 1.06; 95% CI, 0.82–1.35; eclampsia: aRR, 2.31; 95% CI, 0.90–5.91; placenta previa: aRR, 1.16; 95% CI, 0.35–3.84; preterm delivery: aRR, 1.15; 95% CI, 0.98–1.34; low birth weight: aRR, 1.08; 95% CI, 0.90–1.29; large for gestational age: aRR, 1.01; 95% CI, 0.82–1.24). Conclusions In a low-burden setting in the United States, hepatitis B infection was not associated with adverse pregnancy outcomes.

scholarly journals the PREGNANCY OUTCOMES DO INFLUENCE BY EXTREMES OF BODY MASS INDEX

2021 ◽  
Vol 71 (2) ◽  
pp. 690-93
Author(s):  
Lubna Razzak ◽  
Ramna Devi ◽  
Sana Tariq ◽  
Anchal Seetlani ◽  
Sara Jamshed
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Body Mass ◽  
Gestational Age ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Maternal Outcomes

Objective: To investigate whether extreme of body mass index (BMI) is associated with pregnancy outcomes. Study Design: Retrospective cohort study. Place and Duration of Study: Hamdard University Hospital, Karachi, Pakistan, from Feb 2019 to Jan 2020. Methodology: We conducted a retrospective cohort study of 1000 women delivered in between February 2019 to January 2020. BMI is categorized into four groups according to the Asian-Pacific cutoff points as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), and obese (>25 kg/m2). Maternal outcomes measured were pre-eclampsia, gestational diabetes, delivery by cesarean section, instrumental delivery, anemia, postpartum hemorrhage and fetal outcome included small for gestational age and large for gestational age. Logistic regression model was used to adjust the confounder. Maternal outcomes were evaluated with relative risks and 95% confidence intervals. Results: In results, 13%, 54%, 22%, 9% and 2% were underweight, normal body mass index, overweight, obese and morbidly obese categories respectively. The gestational diabetes, pre-eclampsia, labour induction, frequency of cesarean section, postpartum hemorrhage increased linearly with increasing body mass index and expressed as adjusted odds ratio (95% confidence interval) respectively: 10.0 (95% CI 3.5, 28.7), 5.3 (95% CI 2.0, 14.1), 2.7 (95% CI 1.1, 6.8), 4.9 (95% CI 2.8–8.8), 2.5 (95% CI 0.31– 20.6). The anemia and small for gestational age were found in underweight group with adjusted odd ratio2.47 (95% CI 1.6– 3.6), 4.6 (95% CI 2.6, 8.1) respectively........

Sign in / Sign up

Export Citation Format

Share Document