scholarly journals Comparison of Clinical Pregnancy Rates and Affecting Factors Between Elderly and Young Infertile Females After Intra-Uterine Insemination: Benefited by ‘National Medical-aid Program for ART (assisted reproductive technology) in 2016

2020 ◽  
Vol 22 (3) ◽  
pp. 176-183
Author(s):  
Insun Jang ◽  
Dongyoung Kim ◽  
Jeong Sig Kim
2020 ◽  
Vol 13 (5) ◽  
pp. 189-196
Author(s):  
Charoenchai Chiamchanya ◽  
Kamthorn Pruksananonda

AbstractBackgroundWhile the assisted reproductive technology (ART) relieves the burden of infertility in many couples, it presents significant public health challenges due to the substantial risk for multiple birth delivery and preterm birth, which are associated with poor maternal and fetal health outcomes. For this reason, it is important to monitor the development and effectiveness of ART services in Thailand.ObjectiveTo analyze the trends of ART services in Thailand between 2008 and 2014.MethodsART clinics in Thailand are required to submit data to the Royal Thai College of Obstetricians and Gynecologists via the National Reporting System. The data from 2008 to 2014 were collected and analyzed.ResultsThe number of ART centers was increased from 35 to 47. The total fresh ART cycles were also increased from 3,723 to 6,516. The percentage values of intracytoplasmic sperm injection (ICSI), in vitro fertilization, gamete intrafallopian transfer, and zygote intrafallopian transfer cycles were changed from 77.87 to 95.59, 21.43 to 4.31, 0.21 to 0.09, and 0.45 to 0.05, respectively. The clinical pregnancy rates were 28.79–33.19, 22.84–51.34, 14.29–42.86, and 0.00–26.67, respectively. The clinical pregnancy rates in fresh vs. frozen-thawed cycles were 31.01–36.33 vs. 31.54–37.34 (P < 0.05). The clinical pregnancy rates in female age <35 vs. 35–39 vs. ≥40 years were 36.97–40.70 vs. 32.74–33.42 vs. 21.08–31.34, respectively (P < 0.001), and the percentage values of multifetal pregnancy rate were 18.75 vs. 13.30 and 13.69, respectively (P < 0.001). There were increasing preimplantation genetic screening (PGS) cycles, with the percentage of the clinical pregnancy rate (25.90–42.63, P < 0.05). The clinical pregnancy rates in medium-sized ART centers (100–300 cycles per year) vs. in small and large centers were 30.79–41.14 vs. 28.01–34.04 and 8.70–40.35, respectively (P < 0.001). Trends of increasing percentage of ART birth rate to total birth rate ratio were 0.24–0.34 (P < 0.05).ConclusionsThere were higher clinical pregnancy rates in frozen-thawed cycles. Higher multifetal pregnancy rate and clinical pregnancy rate were also found in younger females. There were increasing uses of ICSI and PGS. A trend toward increasing ART birth to total birth ratio was observed.


2020 ◽  
Vol 7 (1) ◽  
pp. 53-58
Author(s):  
I. V. Gorelova ◽  
J. A. Galkina ◽  
L. V. Kuznetsova ◽  
M. V. Rulev ◽  
I. E. Zazerskaya

Background. Data on the effect of the number of received oocytes on the outcomes of assisted reproductive technology (ART) programs are contradictory. The frequency of obtaining a small number of cells ranges from 5.6 to 35.1 %. Identifying women who have chances of getting pregnant, despite this situation, is important for drawing up an adequate treatment plan.Objective of this study is to assess the pregnancy rate depending on the number of retrieved oocytes in ART cycles with ovarian stimulation, which ended with the transfer of embryos, as well as determining the characteristics of patients with a reduced response, in whom the pregnancy occurred.Design and methods. The study included 526 women who were treated for infertility in the department of ART of the Almazov National Medical Research Centre in 2017. Patients were divided into three groups depending on the number of oocytes retrieved: less than 5, from 5 to 9 and 10 or more. Group 1 (number of oocytes less than 5) included 126 women, group 2 (from 5 to 9) — 223 women and group 3 (number of oocytes 10 and more) — 177 patients. The average age of the patients was 33.37 years (from 22 to 48 years).Results. The frequency of obtaining a positive blood test and clinical pregnancy rate were comparable in groups 2 and 3 (53.81 % and 49.72 %, respectively) and significantly lower in group 1 (41.27 %, p > 0.05). Clinical pregnancy in group 1 occurred in 34.13 % of cases, which was significantly different from the indicators of group 2 + 3, where the gestational egg visualized in 47.5 % of cases (p < 0.05). In a group of women with a small number of oocytes, the most important predictors of pregnancy were obtaining 2 or more oocytes, and anti-mullerian hormone (AMH) level above 1 ng / L.Conclusion. The number of oocytes is an important predictor of pregnancy rate. The chances of becoming pregnant in women with a small number of oocytes depend on the level of AMH and the number of oocytes obtained.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Klaus F. Bühler ◽  
Robert Fischer ◽  
Patrice Verpillat ◽  
Arthur Allignol ◽  
Sandra Guedes ◽  
...  

Abstract Background This study compared the effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa; GONAL-f®) with urinary highly purified human menopausal gonadotropin (hMG HP; Menogon HP®), during assisted reproductive technology (ART) treatments in Germany. Methods Data were collected from 71 German fertility centres between 01 January 2007 and 31 December 2012, for women undergoing a first stimulation cycle of ART treatment with r-hFSH-alfa or hMG HP. Primary outcomes were live birth, ongoing pregnancy and clinical pregnancy, based on cumulative data (fresh and frozen-thawed embryo transfers), analysed per patient (pP), per complete cycle (pCC) and per first complete cycle (pFC). Secondary outcomes were pregnancy loss (analysed per clinical pregnancy), cancelled cycles (analysed pCC), total drug usage per oocyte retrieved and time-to-live birth (TTLB; per calendar week and per cycle). Results Twenty-eight thousand six hundred forty-one women initiated a first treatment cycle (r-hFSH-alfa: 17,725 [61.9%]; hMG HP: 10,916 [38.1%]). After adjustment for confounding variables, treatment with r-hFSH-alfa versus hMG HP was associated with a significantly higher probability of live birth (hazard ratio [HR]-pP [95% confidence interval (CI)]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; relative risk [RR]-pFC [95% CI]: 1.09 [1.05, 1.15], ongoing pregnancy (HR-pP [95% CI]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; RR-pFC [95% CI]: 1.10 [1.05, 1.15]) and clinical pregnancy (HR-pP [95% CI]: 1.10 [1.05, 1.14]; HR-pCC [95% CI]: 1.14 [1.10, 1.19]; RR-pFC [95% CI]: 1.10 [1.06, 1.14]). Women treated with r-hFSH-alfa versus hMG HP had no statistically significant difference in pregnancy loss (HR [95% CI]: 1.07 [0.98, 1.17], were less likely to have a cycle cancellation (HR [95% CI]: 0.91 [0.84, 0.99]) and had no statistically significant difference in TTLB when measured in weeks (HR [95% CI]: 1.02 [0.97, 1.07]; p = 0.548); however, r-hFSH-alfa was associated with a significantly shorter TTLB when measured in cycles versus hMG HP (HR [95% CI]: 1.07 [1.02, 1.13]; p = 0.003). There was an average of 47% less drug used per oocyte retrieved with r-hFSH-alfa versus hMG HP. Conclusions This large (> 28,000 women), real-world study demonstrated significantly higher rates of cumulative live birth, cumulative ongoing pregnancy and cumulative clinical pregnancy with r-hFSH-alfa versus hMG HP.


2008 ◽  
Vol 90 ◽  
pp. S349 ◽  
Author(s):  
E.M. Kolibianakis ◽  
K. Loutradi ◽  
C.A. Venetis ◽  
E.G. Papanikolaou ◽  
T.B. Tarlatzi ◽  
...  

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