scholarly journals The Microbial Composition of Lower Genital Tract May Affect the Outcome of in vitro Fertilization-Embryo Transfer

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruiying Wang ◽  
Guojun Zhou ◽  
Lukanxuan Wu ◽  
Xin Huang ◽  
Yujing Li ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Genital Tract ◽  
Clinical Pregnancy ◽  
Vaginal Microbiota ◽  
Cervical Canal ◽  
Microbial Composition ◽  
Lower Genital Tract ◽  
Ivf Et

Objective: This work was conducted in order to study the effect of the lower genital tract (vaginal and cervical canal) microbiota on pregnancy outcomes of reproductive-aged women receiving embryo transfer.Study design: A total of 150 reproductive-aged patients who received the first fresh in vitro fertilization-embryo transfer (IVF-ET) were included in the study. Samples from the vagina and cervical site of each patient were collected separately using sterile swabs before ET. Genomic DNA was pyrosequenced for the V3–V4 regions of the 16S ribosomal RNA gene. Further bioinformatics analysis was performed using QIIME and R package. Pregnancy outcomes were followed and analyzed to compare differences in microbial composition.Results: The cervical microbiota had a higher Shannon index than the vaginal microbiota, and the microbial composition was different between the two sites. However, the Sorenson index between the two sites within the same individual was 0.370 (0.309–0.400). A total of 89 patients achieved clinical pregnancy after ET, while 61 failed. The Shannon indices and the microbial community of both vaginal and cervical microbiota between pregnant and non-pregnant groups were not significantly different. The relative abundance of Lactobacillus in the vagina and cervical canal did not differ between the two groups. Linear discriminant analysis, random forest analysis, and receiver-operating characteristic curve analysis showed that Bifidobacterium, Prevotella, and Lactobacillus iners in the vagina, as well as Solanum torvum, Fusobacterium, and Streptococcus in the cervix, may be negatively associated with clinical pregnancy after IVF.Conclusion: The cervical microbiota was more diverse than the vaginal microbiota, but because of anatomical continuity, there was a correlation between the two sites. The microbial composition of the vagina and cervical canal may influence the outcome of IVF-ET, but more samples are needed to verify this conclusion.

scholarly journals Association of the Cervical Microbiota With Pregnancy Outcome in a Subfertile Population Undergoing In Vitro Fertilization: A Case-Control Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Xinyao Hao ◽  
Pingping Li ◽  
Shanshan Wu ◽  
Jichun Tan
Keyword(s):  
Pregnancy Outcomes ◽  
Reproductive Tract ◽  
Case Control Study ◽  
Case Control ◽  
Clinical Pregnancy ◽  
Α Diversity ◽  
Significant Difference ◽  
Control Study ◽  
Ivf Et

The microorganisms of the reproductive tract have been implicated to affect in vitro fertilization (IVF) outcomes. However, studies on the reproductive tract microbiota of infertile women are limited and the correlation between cervical microbiota and IVF outcome remains elusive. This study aimed to characterize the cervical microbiota of IVF patients undergoing embryo transfer (ET) and assess associations between the cervical microbiota and pregnancy outcomes while exploring the underlying contributing factors. We launched a nested case-control study of 100 patients with two fresh or frozen-thawed cleavage embryos transferred per IVF cycle. Cervical swabs were collected on the day of ET and divided into four groups according to clinical pregnancy outcomes. Variable regions 3 and 4 (V3-V4) of the 16S rRNA gene were amplified and sequenced on the Illumina MiSeq platform. In fresh IVF-ET cycles, the clinical pregnancy group (FP, n = 25) demonstrated higher α diversity (P = 0.0078) than the non-pregnancy group (FN, n = 26). Analysis of similarity (ANOSIM) revealed a significant difference in β diversity between the two groups (R = 0.242, P = 0.001). In frozen-thawed ET cycles, though not significant, similar higher α diversity was found in the clinical pregnancy group (TP, n = 27) compared to the non-pregnancy group (TN, n = 22) and ANOSIM analysis showed a significant difference between the two groups (R = 0.062, P = 0.045). For patients in fresh IVF-ET groups, Lactobacillus, Akkermansia, Desulfovibrio, Atopobium, and Gardnerella showed differentially abundance between pregnant and non-pregnant women and they accounted for the largest share of all taxa investigated. Among them, Lactobacillus was negatively correlated with the other genera and positively correlated with serum estradiol levels. Logistic regression analysis suggested that the composition of the cervical microbiota on the day of ET was associated with the clinical pregnancy in fresh IVF-ET cycles (P = 0.030). Our results indicate that cervical microbiota composition has an impact on the outcome of assisted reproductive therapy.

scholarly journals Luaran Transfer Embrio Simpan Beku pada Pasien Endometriosis Pasca Operasi dan Non Endometriosis yang Menjalani IVF di Klinik Permata Hati RSUP Dr. Sardjito

2020 ◽  
Vol 7 (2) ◽  
pp. 108
Author(s):  
Rina Fatmawati ◽  
Shofwal Widad ◽  
Agung Dewanto
Keyword(s):  
In Vitro Fertilization ◽  
Success Rate ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Research Subjects ◽  
Vitro Fertilization ◽  
Biochemical Pregnancy

Background: Endometriosis is a chronic condition that is influenced by the hormone estrogen which affects women of childbearing age, and is associated with pelvic pain and infertility. In Vitro Fertilization (IVF) is currently the most efficient assisted reproductive technology and its high success rate is often done for infertility therapy in women associated with endometriosisObjective: The aim of this study is to determine whether postoperative endometriosis affected pregnancy outcomes in patients underwent frozen embryo transfer in IVF / ICSI programs.Method: This Research is done with a retrospective cohort design. The data was taken from medical records, research subjects who met the inclusion and exclusion criteria. The research data was collected, processed and analyzed using SPSS 23. Univariate, bivariate and multivariate data analysis was carried out to determine the effect between variablesResult: There were 458 research subjects in this study. Endometriosis patients were 119 subjects (26%). 57 subjects were categorized as minimum-mild endometriosis (47.9%) and moderate-severe subjects as many as 62 subjects (52.1%). The biochemical pregnancy rate (36.31%) and clinical pregnancy (29.4%) in patients with endometriosis was slightly higher than in non-endometriosis. But statistically it did not affect success rate of achieving biochemical (p = 0.428; RR 0.89; 95% CI: 0.71-1.24) and clinical pregnancy (p = 0.535; RR 0.883; 95% CI: 0.63- 1.22). The rate of miscarriage in postoperative endometriosis patients was higher than non-endometriosis patients (88.6% vs 80.7%) but was not statistically significant (p = 0.294; RR 1.69; 95% CI: 0.61-4.67) . Biochemical and clinical pregnancies were significantly affected by age, infertility, endometrial thickness, embryo age and embryo quality. The incidence of miscarriage was affected by the ovarian stimulation protocol.Conclusion: Endometriosis post operative statistically has no effect on pregnancy outcomes in the IVF / ICSI cycle with frozen embryo transfer compared with another cause of infertility .Keywords:Endometriosis, In Vitro Fertilization, Clinical pregnancy, biochemical pregnancy, miscarriage

scholarly journals Risk factors and pregnancy outcomes of heterotopic pregnancy secondary to in vitro fertilization-embryo transfer: A case series study

2020 ◽  
Author(s):  
Shaomi Zhu ◽  
Qinxiu Zhang ◽  
Linjiang Song
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Case Series ◽  
Tubal Infertility ◽  
Vitro Fertilization ◽  
Operative Duration ◽  
History Of ◽  
Ectopic Pregnancies ◽  
Ivf Et

Abstract Background: The early diagnosis and treatment of heterotopic pregnancy (HP) remain one of the biggest challenges in the field of gynecology. A coexisting intrauterine gestation makes the ectopic pregnancy in HP more difficult to diagnose. This case series analysis is designed to explore factors affecting the incidence of HP secondary to in vitro fertilization-embryo transfer (IVF-ET) and that affecting pregnancy outcomes after surgical treatment of HP.Methods: From the IVF registry system, the clinical data of 29 patients with HP and 92 with an intrauterine-only pregnancy (IUP) following embryo transfer from January 2009 to December 2017 were retrospectively analyzed.Results HP had a higher proportion of previous ectopic pregnancies, multiple abortion history ( ≧ 2 times) and tubal indication for IVF than IUP. In patients with HP, 31.03% had spontaneous abortion, 25.00% had preterm delivery and 58.62% resulted in a live birth. According to the results from logistic regression, history of multiple abortions (odds ratio (OR) 3.031, 95% confidence intervals (CI) 1.087-8.453; P=0.034), tubal infertility (OR 3.844, 95% CI 1.268-11.656; P=0.017), previous ectopic pregnancies (OR 2.303, 95% CI 0.625-8.490; P=0.021) and multiple embryo transfer ( OR 0.300, 95% CI 0.092-0.983; P=0.037) resulted in an elevated proportion of HP in IVF cycles. Incidence of HP was comparable between patients transferred with blastocyst and cleavage embryos. Shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube were associated with higher chance of survival in the coexistent intrauterine pregnancy after surgical treatment with HP.Conclusions:The early diagnosis of HP remains a challenge. Previous history of ectopic pregnancy, multiple abortions, tubal infertility and multiple embryo transfer may be considered as meaningful risk factors of subsequent HP following IVF-ET. In patients with HP treated by surgery, shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube means better reproductive prognosis.

scholarly journals Effect of embryo transfer depth on IVF/ICSI outcomes: A randomized clinical trial

2020 ◽  
Author(s):  
Robab Davar ◽  
Seyedeh Mahsa Poormoosavi ◽  
Fereshteh Mohseni ◽  
Sima Janati
Keyword(s):  
Assisted Reproductive Technology ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Uterine Cavity ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Group A ◽  
Group B

Background: Although there has been remarkable advancement in the field of assisted reproductive technology, implantation failure remains a significant issue in most infertile couples receiving these treatments. Embryo transfer is important in assisted reproductive technology and directly affects the implantation rates and pregnancy outcomes. Objective: To assess the effect of two different distance embryo transfer sites from fundal endometrial surface on the outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Materials and Methods: A total of 180 women who were candidate for IVF/ ICSI/ embryo transfer in Yazd Research and Clinical Center for Infertility were equally assigned to two groups based on the distance between the fundal endometrial surface and catheter tip to investigate implantation, chemical and clinical pregnancy (group A: 15 ± 5 mm and group B: 25 ± 5 mm, respectively). Results: The subjects in the group B showed significantly higher implantation rate, chemical and clinical pregnancy rate compared to the group A (p = 0.03, 0.01, 0.04, respectively). The rate of ongoing pregnancy and miscarriage indicated no significant differences between groups (p = 0.21, 0.27, respectively). Conclusion: In conclusion, our study showed that the depth of embryo replacement inside the uterine cavity at a distance of 25 ± 5 mm beneath fundal endometrial surface have better effects on the pregnancy outcomes of IVF/ICSI cycles and can be considered as an important factor to improve the success of IVF cycles. Key words: Embryo transfer, Endometrium, Pregnancy outcomes, IVF, ICSI.

scholarly journals Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

2020 ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Miliary Tuberculosis ◽  
Systemic Review ◽  
Vitro Fertilization ◽  
Pulmonary Tb ◽  
In Pregnancy ◽  
Ivf Et

Abstract BackgroundWhile miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.MethodsData of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, Medline, and EMBASE databases.ResultsOf 62,755 enrolled women, 7137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients complicated by TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.ConclusionsTB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. The coexistence of primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction is a risk factor for TB dissemination.

scholarly journals Transcutaneous electrical acupuncture point stimulation improves pregnancy outcomes in patients with recurrent implantation failure undergoing in vitro fertilisation and embryo transfer: a prospective, randomised trial

2019 ◽  
Vol 37 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Zhenhong Shuai ◽  
Xuemei Li ◽  
Xuelian Tang ◽  
Fang Lian ◽  
Zhengao Sun
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Clinical Pregnancy ◽  
In Vitro Fertilisation ◽  
Control Group ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Electrical Acupuncture

Objective: To evaluate the effect of transcutaneous electrical acupuncture stimulation (TEAS) on pregnancy outcomes in patients with recurrent implantation failure (RIF) undergoing in vitro fertilisation (IVF). Methods: A total of 122 women with RIF undergoing fresh embryo transfer cycle IVF were randomly allocated to a TEAS or mock TEAS (MTEAS) group. Gonadotrophin therapy using a long protocol was provided in both groups. TEAS consisted of 30 min of stimulation (9–25 mA, 2 Hz) at SP6, CV3, CV4 and Zigong from day 5 of the ovarian stimulation cycle once every other day until the day of embryo transfer. The patients in the control group received MTEAS. Implantation, clinical pregnancy and live birth rates were compared. Results: In the TEAS group, the implantation rate, clinical pregnancy rate and live birth rate (24.3%, 32.8% and 27.9%, respectively) were significantly higher than in the MTEAS group (12.1%, 16.4% and 13.1%, respectively). Conclusions: TEAS significantly improves the clinical outcomes of subsequent IVF cycles among women who have experienced RIF. Trial registration number: ChiCTR-TRC-14004730.

scholarly journals Effect of Intrauterine Instillation of Granulocyte Colony-stimulating Factor on Endometrial Thickness and Clinical Pregnancy Rate in Women undergoing in vitro Fertilization Cycles: An Observational Cohort Study

2014 ◽  
Vol 5 (3) ◽  
pp. 100-106 ◽  
Author(s):  
Jatin Shah ◽  
Aparna Gangadharan
Keyword(s):  
Single Dose ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Clinical Pregnancy ◽  
Granulocyte Colony Stimulating Factor ◽  
Thin Endometrium ◽  
History Of ◽  
Ivf Et

ABSTRACT Introduction In spite of significant advances in the field of reproductive medicine, repeated implantation failure (RIF) is a challenging and extremely disappointing problem. The success of in vitro fertilization and embryo transfer (IVF-ET) cycles depends mainly on uterine receptivity and embryo quality. Successful evaluation of endometrial receptivity conducive to embryo implantation continues to be a challenge in assisted reproductive technology (ART). Several researcher groups have reported the successful use of granulocyte-colony stimulating factor (G-CSF) during IVF cycles in terms of achieving higher clinical pregnancy rates on account of increased endometrial thickness. Women who fail to achieve adequate endometrial thickness despite conventional treatment with high dose estrogen or those with a history of repeated implantation failures in spite of normal endometrial thickness often do not achieve pregnancy and resort to gestational surrogacy. A new therapeutic approach to achieve successful pregnancy in such patients would be very desirable. Study objectives To assess the efficacy of a single dose of intrauterine G-CSF on endometrial thickness, implantation and clinical pregnancy rates in women who either had a thin endometrium after estrogen priming (< 8 mm) or a history of repeated implantation failures at IVF, undergoing embryo transfer after 10 days of priming with oral estradiol and vaginal slidenafil. Materials and methods Two hundred and thirty-one women (between 24 and 46 years of age) undergoing IVF-ET were recruited for the study. All cases were prospectively studied at the Mumbai Fertility Clinic and IVF Center (a subdivision of Kamala Polyclinic and Nursing Home) over a period of 6 months from January to June 2014, after their written informed consent. Subgroup I consisted of 117 patients who had a persistently thin endometrium (< 8 mm) in spite of high dose oral estradiol valerate and vaginal sildenafil priming. Subgroup II consisted of 114 patients who had a history of repeated (two or more) implantation failures (RIF) at IVF-ET cycles despite adequate endometrium (≥8 mm). All were infused with a single dose of G-CSF (300 mcg) in the uterine cavity after 10 days of priming with oral estradiol valerate and vaginal sildenafil citrate. Endometrial thickness was reassessed 4 days after G-CSF instillation. This was followed by administration of intramuscular progesterone in oil (100 mg) daily with embryo transfer on day 5 of progesterone for all patients. All embryo transfers for patients undergoing oocyte donation or embryo donation were done at the 4-cell stage on day 2. All Frozen embryo transfers (FET) of vitrified embryos were at 8 cell stage. Estimation of serum beta hCG was at 14 days post-embryo transfer for all patients. Successful implantation and net clinical pregnancy rate was confirmed based on appearance of gestational sac on sonogram after 10 days and observation of fetal cardiac activity after 20 days of positive β-hCG results. Results Out of total 231 patients recruited in the study, 95% patients from subgroup I (n = 111) and 94% patients from subgroup II (n = 107) showed mean increase in endometrial thickness by at least 2.5 mm within 4 days of G-CSF single dose instillation. A total of 218 patients from both subgroups underwent S. β-hCG estimation 14 days post IVF-ET. Out of 103 β-hCG positive patients, 83 showed net clinical pregnancy (fetal cardiac activity present) giving a net pregnancy rate of 38.07% for the whole study group with 37% in the subgroup with thin endometrium (< 8 mm) and 39.25% in the subgroup with adequate (≥8 mm) endometrium with history of two or more failed implantation at previous IVF-ET cycles. There were no adverse events for the whole study population. Conclusion There can be a strong possibility with a single dose of 300 mcg intrauterine infusion of G-CSF to achieve significant increase in the endometrial thickness with higher successful pregnancy rate among infertile women under- going IVF-ET cycles with a history of a persistently thin endometrium or repeated implantation failures (rather difficult to treat patients). G-CSF could be a valuable tool to consider before advising the option of surrogacy. In the absence of a control group, our conclusions warrant conduct of further studies. How to cite this article Shah J, Gangadharan A, Shah V. Effect of Intrauterine Instillation of Granulocyte Colony-stimulating Factor on Endometrial Thickness and Clinical Pregnancy Rate in Women undergoing in vitro Fertilization Cycles: An Observational Cohort Study. Int J Infertil Fetal Med 2014;5(3):100-106.

scholarly journals Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: a report of seven cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Miliary Tuberculosis ◽  
Vitro Fertilization ◽  
Peking University ◽  
In Pregnancy ◽  
Ivf Et

Abstract Background While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET. Methods Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 and December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. Results Out of 62,755 infertile women enrolled, 7137 (11.4 %) showed signs of prior pulmonary TB on chest X-ray (CXR). Among the 15,136 women (mean age: 33.2 ± 5.0 years) who successfully achieved clinical pregnancy, seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Conclusions TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Signs of prior TB on CXR may be risk factors for TB reactivation during pregnancy.

scholarly journals Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy

2020 ◽  
Vol 11 ◽  
Author(s):  
Xing Yu Sun ◽  
Yun Zhu Lan ◽  
Shuang Liu ◽  
Xiao Ping Long ◽  
Xi Guang Mao ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Antral Follicle ◽  
Clinical Pregnancy ◽  
Multivariate Logistic Regression Model ◽  
Vitro Fertilization ◽  
Factors Affecting ◽  
Infertile Women ◽  
Ivf Et

ObjectivesTo retrospectively analyze the correlation between anti-Müllerian hormone (AMH) and the number of oocytes obtained by controlled ovarian hyperstimulation (COH) in women of different ages and explore the factors affecting in vitro fertilization and embryo transfer (IVF-ET) in clinical pregnancy of infertile women to provide evidence for infertile women to choose assisted reproduction strategies.MethodsInfertile women who received IVF-ET or intracytoplasmic sperm injection and embryo transfer (ICSI-ET) treatment in the reproductive center of XX hospital between October 2018 and September 2019 were included. Patient data on medical records, age, body mass index (BMI), years of infertility, basic follicle-stimulating hormone (FSH), basic luteinizing hormone (LH), basic estradiol (E2), anti-Müllerian hormone level (AMH), antral follicle count (AFC), gonadotropins (Gn) medication days, Gn dosage, endometrial thickness on transplantation day, the number of retrieved oocytes, the number of mature oocytes obtained, the number of embryos transferred, clinical pregnancy status, etc., were collected.ResultsA total of 314 patients were enrolled in this study, with an average age of 31.0 ± 4.5 years. The infertility period ranged from 0–21 years. The AMH level showed a downward trend with increasing age. Overall, the AMH level of women of all ages was positively correlated with the number of retrieved oocytes (r = 0.335, p &lt; 0.001). The AMH level of women between 22 and 28 years old was positively correlated with the number of retrieved oocytes (r = 0.164, p &lt; 0.061) but it was not statistically significant. Similarly, the AMH level of women aged 29–35 and 36–43 was positively correlated with the number of retrieved oocytes (r = 0.356, p &lt; 0.001; r = 0.461, p &lt; 0.001). The average age of the pregnant group (30.6 ± 4.4 years) was lower than that of the non-pregnant group (32.2 ± 4.6 years) (p &lt; 0.001). The number of oocytes obtained (9.8 ± 4.5) and the number of embryos transferred (1.9 ± 0.4) in the pregnant group was significantly higher than that in the non-pregnant group (9.2 ± 4.5; 1.7 ± 0.5); the difference was statistically significant. The multivariate logistic regression model showed that age (OR = 0.574 95% CI: 0.350–0.940), AMH (OR = 1.430 95% CI: 1.130–1.820) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030–1.790) were factors affecting clinical pregnancy.ConclusionWe found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women was positively correlated with AMH. Moreover, the number of oocytes and embryo transferred in the pregnant group was significantly higher than those in the non-pregnant group. Furthermore, age, AMH and the number of oocytes affected the clinical pregnancy.

scholarly journals Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: A report of seven cases and systematic review

2020 ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Miliary Tuberculosis ◽  
Vitro Fertilization ◽  
Pulmonary Tb ◽  
In Pregnancy ◽  
Ivf Et

Abstract Background: While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.Methods: Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, MEDLINE, EMBASE, and Chinese Wanfang databases.Results: Of 62,755 enrolled women, 7,137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.Conclusions: TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Physicians should not only enhance awareness about miliary TB, but also consider the occurrence of this form of TB, particularly in patients presenting with unknown fever as well as those in whom risk factors for TB reactivation such as primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction coexist.

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